Negotiating the Holistic Turn - the Domestication of Alternative Medicine

Bibliographic Data

ID2265760
AuthorsRichard Bilson (Manchester Metropolitan University), Geraldine Lee‐treweek (Manchester Metropolitan University)
Year2006
Volume28
Issue3
Pages381-384
Publication date2006-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/j.1467-9566.2006.00497e.x
OpenAlexW2129436972
LanguageEN
Citations received7

Fadlon, J. Negotiating the Holistic Turn - the Domestication of Alternative Medicine . New York : State University of New York , 2005 . £34.50 (hbk) 157pp . ISBN 0-7914-6315-X Baer, H. Toward an Integrative Medicine - Merging Alternative Therapies with Biomedicine . California : Altamira Press , 2004 . $27.95 (pbk) 224pp . ISBN 0-7591-0302-X The field of the sociology of complementary and alternative medicine (CAM) can be viewed as the poor cousin of the sociology of health and illness. Whilst public and medical interest in this area continues to grow, both in the UK and in most Western societies, there is a paucity of texts that tackle this ever-increasing field of treatment and consumption. Publishers often pigeonhole anything with alternative/complementary medicine in the title as nursing or healthcare related only. Moreover, once published, such texts often find themselves (mis)placed in ‘new age’ or mind, body spirit catalogues and book shop sections - never to be found by mainstream sociologists, who may, if they did find them, be pleasantly surprised. Both these texts must be commended for making it to publication and for helping to develop this emerging area. They also contribute sparkling insight into the integration of CAM in the USA (Baer) and the methods by which CAM has become familiar and accepted in Israeli society (Fadlon). Specifically, they both address issues around CAM modalities working alongside, or in close proximity to, orthodox healthcare approaches but they do so by using different theoretical frameworks. Fadlon's text focuses upon the process through which foreign holistic practice is made familiar (a process she terms ‘domestication’). Although the work is set within the Israeli context the process she discusses can be identified in a number of Western countries. Fadlon describes her work as ethnographic and she uses both qualitative and quantitative data in her book. The scope of the work is very broad with in-depth discussion of clinics that use what she terms non-conventional medicine (NCM), case studies of patients, description of institutions of learning in NCM and excerpts from newspapers and other documents. A brief historical discussion is provided in the book's introduction, along with clarification of NCM's legal status in Israel. Chapter 1 outlines the approach and conceptual framework of the book. Fadlon notes that her main concern is with the issues of ‘acculturation and assimilation’, the former term implying that previously autonomous cultural traditions, over time and during their contact with one another, will often lead to far-reaching changes in either or both systems. Fadlon argues assimilation occurs when a minority group gradually becomes part of conventional society. Both these processes she sees as part of the more general concept of domestication, in which alien, or at least generally unknown, holistic practice is made familiar in a society. Chapter 2 provides a detailed historical, legal and cultural account of the Israeli context of this work and raises some methodological considerations. Chapter 3 ethnographically walks the reader through a practising NCM clinic, which is noted as being part of a large general (conventional) hospital and that uses a range of NCM modalities such as acupuncture and reflexology. In doing this Fadlon provides a very in-depth rich insight into both the physical and symbolic settings in which domestication occurs in Israel. The way the clinic looks, operates, interacts with the general hospital, along with a description of the staff, how they approach patients as well as their attitudes to medicine and NCM, are all scrutinised here. Chapter 4 focuses upon the patients of NCM and their attitudes. Here, the patients’ willingness to pick and mix, using either conventional or non-conventional medicine as it suits them is focused upon. However, the qualitative ethnographic findings presented indicate that NCM in Israeli society is preferably consumed under the supervision of conventional medicine. Chapter 5 outlines how NCM ideas are filtered through to the general public in Israel by the media. Using excerpts from newspaper articles, Fadlon demonstrates that domestication is occurring, as although there are stories in the media that attack NCM, there is an even balance of other stories that celebrate it. In the last chapter, Fadlon's ethnographic approach is applied to the places where NCM qualifications are attained and the content of the NCM courses that are available. Interestingly, evidence of medical orthodoxy is shown to permeate these institutions: biomedical paraphernalia adorns the rooms alongside, for example, ancient Oriental decor; and conventional science and biomedicine are important components of the curriculum as much as are alternative healing techniques. Baer's text takes a different approach from Fadlon's. Rather than focusing upon the processes that make CAM familiar in society, his work provides an overview of patterns of integration of various CAM in the USA. The subtitle, Merging Alternative Therapies with Biomedicine provides a clue as to the approach taken by the text. The work identifies and discusses the processes by which alternative forms of healing move towards being constructed by biomedicine as complementary. It also highlights the new approach of integrative medicine, in which biomedical and complementary approaches are used together, either in hospital or clinic settings, or are combined when treating individual cases of illness or disease. Whilst the text outlines the processes of change in the area of ‘other’ forms of healing it does not neglect the importance of consumption and individual charismatic personalities within this process. In this way the book provides a broad brushstroke approach to the development of CAM, but at the same time focuses in on particular insightful cases, people and events that illuminate key points. The introduction provides a comprehensive overview of healing taxonomies. It is very striking from Baer's discussion that the issue of how to define ‘other’ healing practices is still contentious and difficult to pin down. The US context, which is the main focus of this text, is a particularly complicated setting for trying to define or organise healing because of the diversity of the population and therapeutics available. Because of ethnic and religious variety, the US has a multitude of indigenous and imported folk healing practices and influences on health provision and, as a result, there is enormous choice for the user/consumer of services. In Chapter 1, Baer outlines the public growth in interest in holistic health and new-age health beliefs. Insightfully, he notes the diverse influences on the holistic health movement, including counter-cultural influences from the late 1960s and 1970s, the human potential movement and environmental social movements. This is a really interesting approach as many discussions fail to identify the diverse components and proponents of holism. One important area Baer does miss out here is the holistic movement within orthodox medicine. We are thinking here of the pioneering work of individuals within the hospice movement and palliative/terminal nursing care. But that criticism aside, Baer does broaden the debate on the development of holism and CAM in a way that no other writer has. Chapter 2 moves on to outline ‘semi-legitimation’ of chiropractic, naturopathy, oriental medicine/acupuncture and homoeopathy. Here, Baer engages the reader in the history of the push towards professionalisation in these modalities. The high level of historical and policy detail in this section is fascinating. Chapter 3 examines what Baer defines as partly professionalised groups and their struggle to find a niche in the holistic health market place. Interestingly, he identifies not only conflicts between other healing and biomedicine but those that occur within and between other healing forms themselves. In Chapter 4, Baer tackles the relatively recent move towards redefining ‘other’ forms of healing as complementary and alternative medicine (CAM). His discussion focuses upon the impact of key medical and nursing organisations, such as the American Holistic Nurses Association, along with the influence of individual conventional practitioners in establishing CAM as an acceptable area of medical interest. In doing this the chapter outlines the medical networks that began the process of mainstreaming key CAM ideas. In Chapter 5, Baer turns his attention to key spokespeople of the holistic health movement, selecting Deepak Chopra and Andrew Weil for special attention, along with the responses their approaches have drawn from orthodox biomedical colleagues and the public. This in many ways is perhaps the most innovative section of the book. Chapter 6 examines the role of governmental and corporate organisations in the proliferation of CAM integrations. Again, this is an innovative part of the book, as it outlines the way that CAM-use as a money-saving device is increasingly advocated in the US by groups such as insurance schemes. Chapter 7 examines the possibilities for CAM and outlines the obstacles that still stand in the way of integrative approaches. Such obstacles include the power and authority of biomedicine, the anger and critiques of so-called fraud busters (many of whom are medically trained) and the threat posed by the growing demand from mainstream medicine for evidence of CAM efficacy. Baer paints a picture of an uncertain future in which integrative approaches in the USA, whilst popular with the public, still have their enemies in regular medicine and beyond. Baer's work is broad in scope but manages to provide a fascinating account of the history, contemporary situation and potential future of integrative approaches in the USA. Skilfully written, he manages to include some interesting accounts of the personalities and power play that takes place around holistic forms of healing. A definite ripping read for all sociologists of health and illness, Baer's work steps beyond being solely about CAM by providing an account of change in new and emerging professional health groups. Both these pieces of work present wonderful accounts of ‘other’ forms of healing in their particular societies and both have much to offer academics interested in health and wellbeing, social change and knowledge and power. Whilst Fadlon's work is not fully successful in distinguishing her concept of domestication, it provides rich ethnographic insight into how non-conventional healing forms operate in Israel. Indeed, it is a shame she did not focus more upon the culturally specific issues raised by her settings as this aspect of the work was absorbing. Fadlon's style is somewhat bitty though and the chapters often appear to work as separate units in the text. This stylistic point aside, it is difficult to put the book down due to its compelling topic. Baer's work has more broad appeal perhaps than Fadlon's due to his focus upon professional projects and strategies in healthcare more generally. In essence though, both works are well worth the read as together, although different in many ways, they complement each other in terms of their detail and contemporary approaches

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