We’ve all seen the terms: alternative, integrative, mind-body. So what do they actually mean? As someone who has studied medicine using the expressive arts, psychology, neuroscience and integrative medicine, I know it can be confusing. In this post, I’ll explain the differences between each approach and when they should be used.
Conventional vs. Complementary & Alternative: Mainstream Western medicine practices are called conventional practices [1]. This encompasses standard of care treatments like medication and medical procedures. Most of us are familiar with conventional medicine, as it is the most popular form of medicine practiced in American hospitals and clinics. Conventional medicine is considered the gold standard for emergency situations. If a patient was in an accident or was having a heart attack, conventional medicine would be the way to go. Conventional medicine can, and often is, used for non-emergency health situations like the treatment of a chronic illness. While conventional medicine can be safe and successful for such patients, more and more people are turning to CAM therapies to receive additional support [1]. CAM, an acronym meaning complementary and alternative, encompasses therapies that fall outside of medical convention. If the therapy is used in place of conventional medicine, for example replacing medication with herbs, it is called alternative [1]. If the therapy is used simultaneously with conventional medicine, for example using herbs or vitamins in addition to medication, it is called complementary [1].
According to the National Center for Complementary and Integrative Health (NCCIH), more than 30% of adults and 12% of children use CAM therapies [1]. While some of these therapies are not scientifically validated, many are. Lavender aromatherapy has been shown to reduce heart rate, blood pressure and serum cortisol significantly, suggesting activation of the parasympathetic nervous system (relaxation response) [2-4]. Based on such results, Lavender is considered to have anxiolytic (anti-anxiety) properties. Mindfulness meditation reduces symptoms of pain, depression and anxiety and is generally considered an effective way to improve psychological well-being [5-10].
Both of these practices, aromatherapy and mindfulness meditation, fall under the umbrella of CAM therapies. However, they fall into two distinct subgroups: natural products and mind-body practices [1]. Aromatherapy is considered a natural product, along with herbs, vitamins, minerals and probiotics [1]. 17.7% of Americans use some sort of natural product for their health [11]. When taking a natural product, it is important to speak with your Medical Doctor about safety issues and possible interactions with your medications. Mindfulness meditation is a mind-body practice. During mind-body practices, patients attend to and sometimes change thought or emotional patterns to influence physical health. For example, when practicing mindfulness meditation patients are instructed to notice emotional states and thought patterns that arise without judgment or reactivity. This practice has been shown to increase immune functioning and decrease the stress-hormone cortisol [12, 13]. In addition to meditation, other popular mind-body therapies include relaxation techniques (deep breathing, guided imagery and progressive relaxation), massage and yoga [11]. Mind-body practices are especially powerful for patients with complex medical issues, such as chronic or mental health conditions, because they support the emotional and cognitive aspects of health in addition to the physical.
Integrative and Holistic Medicine: Integrative Medicine combines conventional and CAM therapies to promote health and wellness [1]. It isn’t strictly based on Western or Eastern philosophies, but is a blend of both. Integrative Medicine uses scientifically validated practices to optimize impact. While such practices can be used for symptom reduction, they are also used to prevent future health issues. This preventative focus is a key philosophy of Integrative Medicine; rather than treating symptoms of a disease when they arise, Integrative practitioners focus on optimizing wellness by engaging in health practices before symptoms arise. Of course, if you already have a medical condition you can work with an Integrative practitioner to reduce your existing symptoms. Integrative practitioners often adopt a holistic approach, using CAM practices to support the patient emotionally and mentally as well as physically.
References
[1] National Center for Complementary and Integrative Health (NCCIH). September, 24, 2017. Complementary, Alternative, or Integrative Health: What’s In a Name?Retrieved from https://nccih.nih.gov/health/integrative-health
[2] Chien LW, Cheng SL, Liu CF. The effect of lavender aromatherapy on autonomic nervous system in midlife women with insomnia. J Evid Based Complementary Altern Med 2011;2012:1-8.
[3] Nagai M, Wada M, Usui N, Tanaka A, Hasebe, Y. Pleasant odors attenuate the blood pressure increase during rhythmic handgrip in humans. Neuro Lett 2000;289:227-229.
[4] Shiina Y, Funabashi N, Lee K, Toyada T, Sekine T, Honjo S, Komuro I. Relaxation effects of lavender aromatherapy improve coronary flow velocity reserve in healthy men evaluated by transthoracic Doppler echocardiography. Int J Cardiol 2008;128:193-197.
[5] Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med 2008;31:23–33.
[6] Chan RR, Larson JL. Meditation interventions for chronic disease populations: a systematic review. J Holist Nurs 2015;33:351–65.
[7] Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, Worthington JJ, Pollack MH, Simon NM. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatr2013;74:786–92.
[8] Meize-Grochowski R, Shuster G, Boursaw B, DuVal M, Murray-Krezan C,Schrader R, Smith BW, Herman CJ, Prasad A. Mindfulness meditation in older adults with postherapetic neuralgia: a randomized controlled pilot study. Geriatr Nurs 2015;36:154–60.
[9] Michaelsen A, Kunz N, Jeitler M, Brunnhuber S, Meier L, Ludtke R, Bussing A, Kessler C. Effectiveness of focused meditation for patients with chronic low back pain – a randomized controlled clinical trial. Complement Ther Med 2016;26:79–84.
[10] Zhang J, Liu X, Xie X, Zhao D, Shan M, Zhang X, Kong X, Cui H. Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial. Explore 2015;11:180–5.
[11] National Center for Complementary and Integrative Health (NCCIH). September, 24, 2017. Use of Complementary Health Approaches in the U.S.: National Health Interview Survey (NHIS) Retrieved from https://nccih.nih.gov/research/statistics/NHIS/2012
[12] Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli SF, Urbanowski F, Harrington A, Bonus K, Sheridan JF. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med 2003;65:564-570.
[13] Matousek RH, Dobkin PL, Pruessner J. Cortisol as a marker for improvement in mindfulness-based stress reduction. Complementary Ther Clin Prac 2010;16:13-19.
