Conventional medicine, including surgery and the use of synthetic drugs, has been around for only a relatively short period of time.  Conventional medical interventions are often what we receive when we go to the doctor or the hospital, and there are certainly times when the advances in modern conventional medicine are something to appreciate.  For instance, when we are seriously injured, we’re very relieved to arrive at a modern emergency room equipped with the latest technology.  However, conventional medicine tends to be more invasive, more expensive, and less focused on prevention or illness and wellness (Lemley, 2014).  Many people seek alternative, more natural, or less invasive approaches to illness and injury, with more focus on wellness and prevention.

In 1993, one study found that one in three Americans had sought out and used some type of alternative therapy (Kam, 2014).  This trend has just increased over the past decade.  According to the American Hospital Association, the number of hospitals that offer some kind of complementary medicine approaches has more than doubled.  Almost one-quarter of hospitals said they planned to add complementary therapies in the future.  Some of these include chiropractic biofeedback, and nutritional counseling.  More and more insurance companies are also beginning to cover complementary therapies (Kam, 2014).  When talking about integrative medicine, it’s important not to confuse it with integrated medicine, which is becoming more prevalent.

Integrative Medicine or Integrated Medicine?

While integrative medicine is a holistic, collaborative approach that includes alternative and complementary approaches to healthcare, integrated healthcare has to do with how and where healthcare services are provided.  For example, many behavioral healthcare providers and physical health providers are working more closely with each other, sharing information, and even sharing the same office.  This makes healthcare services more accessible, and improves the ability of healthcare providers to communicate with each other.  The hope is that with this increased collaboration, the quality of care will improve and costs will go down.  For example, it’s less likely that two physicians (e.g. primary care doctor and psychiatrist) will order the same lab tests, if they are in regular contact with each other. Additionally, it’s hard for practitioners to be all things to all patients, so integrating their practice with other specialist practitioners makes sense.

Understanding Integrative Medicine

In recent years, the healthcare system seems to be more willing to recognize the potential benefits of alternative and complementary interventions, and incorporate some of these practices into modern healthcare.  Alternative medicine and interventions may include practices outside of, or instead of, conventional medicine.  These interventions may be closer to nature and emphasize the mind-body connection.  Complementary medicine refers to a combination of conventional and alternative interventions, and may be more common than true alternative medicine in the modern healthcare system.  An example of complementary medicine would be the use of acupuncture or meditation to help manage the side effects of chemotherapy.  (Complementary, Alternative, or Integrative Health, 2014).  Some complementary/alternative approaches to wellness include:

• Acupuncture
• Massage therapy
• Meditation  (e.g. mindfulness meditation or transcendental meditation)
• Movement therapies (e.g. Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration)
• Relaxation techniques (e.g. breathing exercises, guided imagery, and progressive muscle relaxation, biofeedback)
• Spinal manipulation/chiropractic
• Tai chi and qi gong (practices from traditional Chinese medicine)
• Yoga
• Healing touch
• Hypnotherapy
• Guided imagery
• Natural supplements/ diet-based interventions

Guided imagery and massage can help people with chronic pain, while ginger root may help those with nausea due to medication side effects (Complementary, 2014).  More and more often, these interventions are being combined with conventional approaches to improve outcomes, and offer patients more alternatives to support their health and wellness. 

Principles of Integrative Medicine

Healing with alternative medicine or complementary medicine takes a whole person approach.  The relationship between the medical professional and the patient is of utmost importance and all aspects of the patient’s health and lifestyle are important.  Integrative medicine utilizes all types of appropriate interventions that may help the patient—conventional or alternative.  Some guiding principles of integrative medicine, according to Dr. Andrew Weil, include:

• A collaborative partnership between the patient and the healthcare professional in the healing process
• Appropriate use of conventional and alternative methods to facilitate the body's innate healing response
• Consideration of all of the factors that influence health, wellness and disease (mind, body, spirit and community)
• A philosophy that doesn’t reject conventional medicine nor accept alternative therapies uncritically
• Recognition that good medicine should be based in good science and open to new ideas and new research
• Use of natural, effective, and less-invasive interventions, whenever possible
• Increased focus on and promotion of health, wellness and prevention of disease, in addition to the treatment of illness and disease.
• Training of healthcare providers to be models of health and healing, committed to the process of self-exploration and self-development (Lemley, 2014)

Additionally, it’s important for all healthcare providers to be trained in integrative medicine.  Medical schools are beginning to add courses on more nontraditional interventions and therapies. For examples, at the University of California at San Francisco, medical students can supplement their study of infectious disease and immunology with classes like, “Herbs and Dietary Supplements” or “Massage and Meditation”.  They can even participate in exchange student opportunities that enable them to study Traditional Chinese Medicine.  As integrative medicine continues become more accepted and practiced, it will not be uncommon to meet physicians who are also able to provide acupuncture, or nurses who provide massage therapy (Kam, 2014).

Treating the Whole Person: The Body-Mind Connections

Integrative medicine is about treating the whole person, utilizing conventional medicine and complementary medicine to help people heal and feel better.  It’s a more holistic approach may appreciate how body systems and the mind and body are connected, and how they affect each other.  The person is treated, and not just the disease.   One important component of integrative medicine is the emphasis on the collaborative relationship between the patient and the healthcare provider. More and more, medical students are now being trained to think about the whole person—body, mind, and spirit—when approaching treatment. Physical health is connected to psychological health, which is connected to spiritual health.  

The mind-body connection is more appreciated and valued that it has been, in part because science is demonstrating those connections.  For example, researchers are finding connections between the brain and the immune system, convincing even the skeptics that the connection between the mind and the body is very real (Kam, 2014).  Another example of the mind-body connection that is easy for most of us to relate to is the connection between the emotional state of stress or anxiety and our body.   When we are under constant or reoccurring stress, our body starts to suffer right along with our mind.  We can start to experience tense muscles, headaches, body aches, stomach problems, and even high blood pressure.  The experience of stress makes your body feel like it’s under attack, or about to be attacked at any moment.  Our body releases hormones that increase the hear-rate and blood pressure, initiating the flight or fight response (Mind-Body Wellness, 2013).  Now, this is a normal and healthy state to be in—if we are being chased by a mountain lion, but it’s not a state we want to be in every day!  

 A close and reciprocal relationship also exists between our heart and brain.  We used to believe that our emotions were created and lived in our brains, but now know that emotions live in our brain, and our heart, literally.   Researchers from the Institute of HeartMath have found that emotions are as much about the heart as they are the brain.  The heart is constantly communicating with the brain, and is linked to our emotions, and can sense how we feel. Our emotions can change the signals the brain sends to the heart, and our heart, in turn, send signals to our brains.  When we experience emotions like anger, anxiety, frustration, or insecurity, our heart rhythms become more irregular.  This can impact our ability to think clearly.  Studies have found that the risk of developing heart disease is higher for people who experience a lot of these emotions (Does Your Heart Sense, 2006).   On the other hand, emotions like appreciation, compassion, caring, and love cause the heart to produce a different type of rhythm, a more harmonious rhythm. These rhythms create balance in the nervous system and cardiovascular efficiency. Feeling appreciative seems to be especially beneficial to our hearts.  So, in addition to exercising and eating good food, we can focus on our emotional health and reducing stress as ways to keep our hearts healthy and strong.

 Another fascinating example of the connection between the mind and the body is the very close connection between our brain and the bacteria in our “gut”.   Researchers have discovered that the bacteria in our gut not only affect the gut, but also the brain.  These bacteria can influence neural development, brain chemistry, behavior, emotions, pain perception, and even how we respond to stress.  Altering the balance of “good” and “bad” bacteria in the gut can alter brain chemistry, leading animals to be bolder or more anxious.  Many studies have shown that even mild stress can alter the bacteria balance in the gut, making us more susceptible to disease (Carpenter, 2012).  So sayings like, “trust your gut”, butterflies in your stomach”, or “he has a nervous stomach”, may have more basis in science that we thought. 

Integrative Self-Care

As we come to practice and value integrative approaches to the treatment of disease, it makes sense to also use take an integrative approach to our health and wellness.  Too often in our society, we live in our heads, losing touch with our bodies and spirits. We eat fast food on the run, cheat ourselves on sleep, and sit in offices with fluorescent lights all day.  How can we get back to supporting and caring for our whole selves? Try these steps:

• Breathe deeply: This helps you to relax throughout the day
• Eat Chocolate (just a little): Chocolate can stimulate feel-good chemicals in the brain
• Get enough sleep:  Lack of sleep can wreak havoc on your body, causing you to feel jumpy, irritable, and disoriented.
• Get Outside:  Lack of natural sunlight can cause you to feel lethargic, and even depressed.
• Get some exercise:  This can decrease anxiety depression, and stress.  A little is better than none.
• Eat some fat:  Cutting out all fat is not a good idea. Try eating good fats to keep your memory at its best and your mood on an even keel
• Eat breakfast!  Eat a balance of carbohydrates, protein and fats to get you going.
• Ditch cigarettes: Get help if you’re having trouble kicking the habit.
• Balance work and life:  Try not to just be your work.
• Have a social support system:  Social support can make you happy, reduce stress and make you healthier.

Understanding and appreciating all of the mind-body connections, and taking good care of ourselves—body, mind and, spirit-- can help us develop better integrative treatment approaches that consider and value the whole person.

_________________________________________________________________________________________________________________________________

Carpenter, S. (2012). That gut feeling. Retrieved September 3, 2014, from http://www.apa.org/monitor/2012/09/gut-feeling.aspx

Complementary, alternative, or integrative health: What's in a name? (2014). Retrieved September 3, 2014, from http://nccam.nih.gov/health/whatiscam

Does your heart sense your emotional state? (2006, January 26). Retrieved September 3, 2014, from http://www.today.com/id/11023208/ns/today-today_health/t/does-your-heart-sense-your-emotional-state/#.VA5JAWN27yU

Kam, K. (2014). What is integrative medicine? Retrieved September 3, 2014, from http://www.webmd.com/a-to-z-guides/features/alternative-medicine-integrative-medicine

Lemley, B. (2014). What is integrative medicine? Retrieved September 3, 2014, from http://www.drweil.com/drw/u/ART02054/Andrew-Weil-Integrative-Medicine.html

Mind-body wellness-topic overview. (2013, May 21). Retrieved September 3, 2014, from http://www.webmd.com/mental-health/tc/mental-health-problems-and-mind-body-wellness-overview

Noe, C. (2014). 50 Mind, body, spirit mistakes (even smart women make). Retrieved September 3, 2014, from http://www.fitnessmagazine.com/health/spirit/your-best-you/mind-body-spirit-mistakes-women-make/