For Europe, the CAMbrella Project recently defined CAM as follows: “CAM, as utilised by European citizens, represents a variety of different medical systems and therapies based on the knowledge, skills and practices derived from theories, philosophies and experiences used to maintain and improve health, as well as to prevent, diagnose, relieve or treat physical and mental illnesses. CAM therapies are mainly used outside conventional health care, but in many countries some therapies are being adopted or adapted by conventional health care”.
A number of key elements are characteristic of the CAM approach to healing. They include for example:
Most Complementary and Alternative Medicine practices are based on a holistic, or ‘whole person’ approach, i.e. how the physical, mental, emotional, and spiritual elements of an individual are interconnected to maintain or regain wellness and health. Holistic approaches focus on the whole individual person rather than just on the illness or a diseased part of the body. They fully involve the patient in the diagnosis and management of his/her illness. Many aspects of a patient’s life may affect a health problem and understanding the ‘whole individual environment’ helps to develop a successful treatment plan. The aim of holistic therapy is to restore harmony of body, mind and spirit.
Homeostasis, as currently defined, is a self-regulating process by which biological systems maintain stability while adjusting to changing conditions. This concept explains how an organism can maintain more or less constant internal conditions that allow it to survive in the face of a changing and often hostile external environment. When confronted with physiological and mental/emotional stress, a healthy organism is able to mount a protective response, to reduce the potential for harm, and restore an (adapted) equilibrium. If this coping strategy is not successful, illness may result.
This perspective on health and disease is a central tenet of the CAM approach and has lately gained acclaim in a proposal in a mainstream medical journal (Britsh Medical Journal) for a new definition of health as ‘The ability to adapt and self manage in the face of social, physical, and emotional challenges.’ Rather than health being defined solely as the absence of disease, this dynamic definition focuses on resilience or the capacity to cope which maintains and restores a person’s integrity, equilibrium, and sense of wellbeing.
Human beings are considered as whole, adaptable living systems whose innate constitutional vitality and resistance to disease can be stimulated, supported and strengthened to maintain or regain health. CAM therapies are mainly directed towards reinforcing the resilience, resistance and immune status of the individual concerned thereby reducing the susceptibility to illness and disease as well as addressing any already existing disease process. As such CAM approaches are not limited to simply addressing certain diseases but are universally applicable to patients suffering from all kinds of diseases. Such treatment is in many cases complementary to conventional intervention that is more disease focused.
CAM therapies vary to suit individual needs instead of being used to treat specific diseases regardless of the individual who is suffering; the focus is on treating the person rather than the condition. Taking account of the patient's constitutional nature and social context as well as the individual response to any affliction enables the doctor/practitioner to adjust and individualise the treatment strategy throughout a course of treatment for optimum effect. A more individualised approach has lately also been acknowledged in mainstream medicine and has become known as ‘personalised medicine’, which however more narrowly refers to molecular biologic specifications in individuals rather than to a response to individual patient needs as is understood in the concept of person-centred medicine.
Salutogenesis is a term coined by Aaron Antonovsky, a US professor of medical sociology. The term describes an approach focusing on factors that support human health and wellbeing, rather than on factors that cause disease. More specifically, the "salutogenic model" is concerned with the relationship between health, stress, and coping. Salutogenesis explores the reasons why some people stay healthy in the face of hazardous influences whilst others, faced with similar pathogenic factors or other difficulties fall ill. Thus the ultimate objective of health promotion is to highlight and facilitate the prerequisites for a healthy life. There seems to be only a limited attempt to apply this approach within biomedical practice but it is central to the CAM perspective.
A positive functioning partnership between the patient and the healthcare professional engages of the patient’s innate healing capacity and provides motivation to make healthy lifestyle changes. Such a positive therapeutic relationship should not be dismissed as a ‘placebo effect’ or a ‘good bedside manner’. In their encounter with CAM providers, citizens particularly value the following:
- Empathetic communication in consultations with more time available than in biomedical encounters
- Involvement in their own care through e.g. decision-making about their treatment options and the provision of self-help strategies
- Whole person approach and person-centred healthcare
- Explanatory frameworks within which to explore health and illness, which are frequently congruent with citizens’ own ideas about health and illness.
Patients report a high satisfaction rating from this kind of encounter.
Staying healthy and preventing disease requires the development of personal responsibility and involvement. The concept of self-care requires a conscious focus on and understanding of one’s physical, mental and emotional state and the ability to take corrective action when necessary. Helping patients to develop sufficient levels of self-awareness and the know-how required to change unhealthy patterns of behaviour to improve their health is remarkably empowering for the patient. In the first instance this will enable a person to self-correct a relatively minor health problem. If the condition is more serious it may be necessary to consult a healthcare professional who can work with the patient to take the steps required to recovery. In this way, the patient is not a passive participant; the patient and healthcare professional cooperate as partners.