Session One. Naturopathic Philosophy, Principles and Practice.

Transcription

1 Session One Naturopathic Philosophy, Principles and Practice

2 ... have patience with everything unresolved in your heart and [ ] try to love the questions themselves as if they were locked rooms or books written in a very foreign language. Don't search for the answers, which could not be given to you now, because you would not be able to live them. And the point is to live everything. Live the questions now. Perhaps then, someday far in the future, you will gradually, without even noticing it, live your way into the answer. ~ Rainer Maria Rilke, Letters to a Young Poet, 1903 Endeavour College of Natural Health 2

3 Assessment Workbook One due end Week 6 (20%) Workbook Two due end Week 12 (20%) Quiz held in Week 9 (20%) Final Exam held in Exam Week (40%) Endeavour College of Natural Health 3

4 Session Overview o Conceptual, philosophical and ideological underpinnings of naturopathy o Importance and relevance of philosophy and clinical theory in practice o Introduction to the framework of the semester Endeavour College of Natural Health 4

5 Naturopathic Philosophy o Naturopathy, as a generally used term, began with the teachings and concepts of Benedict Lust. o It is both a way of life and a concept of healing that employs various natural means of treating. (Cody, 2006, p.41) Endeavour College of Natural Health 5

6 Whole Medical System o whole considers all aspects of an individual, their health, disease & illness (body, mind, emotions, spirit) o medicine - science & practice of diagnosis, treatment & prevention of illness & disease o system an organised approach based on a theory of practice/ philosophy o Examples: Naturopathy, Traditional Chinese Medicine, Ayurveda Endeavour College of Natural Health 6

7 Whole Medical System Complete systems of theory and practice that have evolved independently over time in different cultures and apart from conventional medicine or Western medicine (NCCAM 2013) Endeavour College of Natural Health 7

8 History of Naturopathy o The word Naturopathy is a Latin-Greek hybrid which can be defined as being close to or benefiting from nature (Mitchell, 1998) o The basic philosophy of naturopathy is that there is an inherent healing power in nature (Lust, 1919) Endeavour College of Natural Health 8

9 History of Naturopathy o The profession of naturopathy and its name originated in the late 19th century (Drs John and Sophia Scheel homeopathy and water cure practitioners) o In 1902 Lust purchased the term naturopathy to describe the eclectic compilation of doctrines of natural healing that he envisioned to be the future of natural medicine (Pizzorno, 2006, p.41) Endeavour College of Natural Health 9

10 Benedict Lust o o Lust cured by Kneipp cure (In Woerishofen, ). o He immigrated to America to proselytize his principles of the Kneipp Water-Cure (Micozzi, 2006, p.223)

11 Influences of Thought o Water cure - Vincent Preissnitz (hydrotherapy, ) influenced Father Sebastian Kneipp (Kneipp/water cure, ) o Nature cure - created by Dr Arnold Rickli ( ), F.E. Bilz ( ), made popular in USA by Henry Lindlahr ( ) Endeavour College of Natural Health 11

12 Vincent Priessnitz o o Austrian Farmer o Father of Hydrotherapy and Nature Cure Arrested for practicing medicine without license o Treated 40,000 people o Cold water applications - wet sheet pack o Simple diet, exercise, fresh air, and maintaining circulation Endeavour College of Natural Health 12

13 Father Sebastian Kneipp o o Bavarian Dominican priest o Five Pillars of Care Water Plants Exercise Nutrition - whole grains, fruits & vegetables with limited meat Balance / Spirituality o My Water Cure Endeavour College of Natural Health 13

14 Influences of Thought o Natural hygienist movement - Sylvester Graham ( ) and John Harvey Kellogg ( ) o Homeopathy - Samuel Hahnemann ( ), Constantine Hering (Law of cure, ), Edward Bach (Flower essences, ) o Autotoxicity - John H. Tilden ( ), Elie Metchnikoff ( ) Endeavour College of Natural Health 14

15 Naturopathic Philosophies o Vitalism (vital force) describes the intelligence that animates each and every person and it refers to forces beyond the physical self that govern life, health and healing. Vitalism postulates that there is a self-organising principle within all life (some say within all matter). The vital force is an invisible power which is discernible only from its effects. (Kaptchuk, 2001) Endeavour College of Natural Health 15

16 Naturopathic Philosophies o Holism means all, entire or total. It is based on the realisation that the whole is greater than the sum of the parts. Holism is based on the understanding that all entities and systems in the universe exist as a unified whole. The parts of the whole are dynamically interdependent and interrelated. The whole is greater than the sum of its parts and cannot be comprehended through an isolated examination of its constituent parts. Holism asserts that the parts must be discussed as an integrated whole in order to be fully understood. (Barrett et al. 2003) Endeavour College of Natural Health 16

17 Principles and Theories o Six principles First, Do No Harm (primum non nocere) Healing Power of Nature (vis medicatrix naturae) Treat the Cause (tolle causam) Treat The Whole Person (tolle totum) Doctor as Teacher (docere) Prevention (preventare) o Three theories Humoral Theory Emunctory Theory Therapeutic Order Endeavour College of Natural Health 17

18 Definition Naturopathy is a distinct method of healing, underpinned by a philosophical perspective which recognises that all living forms possess a self-regulatory, inherent ability for selfhealing. This inherent ability, or Vital Force, operates in an intelligent, orderly fashion. Naturopathic approaches to health care are aimed at supporting and enhancing the body s own ability to heal itself. Expressions of health and disease are considered reflections of the dynamic interchange between the physical, mental, social, environmental and spiritual landscape of the individual. (cont) Endeavour College of Natural Health 18

19 Definition Naturopathy is both an art and a science, drawing upon several lines of evidence, which range from qualitative, quantitative, cultural and traditional. Naturopathic practice integrates a number of modalities, principally nutrition, herbal medicine and tactile therapy. These modalities are applied on the basis of specific principles, and within the context of a healing environment which endeavours to empower the individual, motivate and educate them in order to restore, maintain and optimise wellbeing. Definition developed by the Naturopathy & Nutrition Forum, 2000 and subsequently adopted as the definition for Naturopathy for the National Training Package 2002 Endeavour College of Natural Health 19

20 Definition o Naturopathic medicine is a distinct method of primary health care an art, science, philosophy and practice of diagnosis, treatment, and prevention of illness. Naturopathic physicians seek to restore and maintain optimum health in their patients by emphasizing nature's inherent self-healing process, the vis medicatrix naturae. This is accomplished through education and the rational use of natural therapeutics (Snider & Zeff, 1989) Endeavour College of Natural Health 20

21 Other Definitions One of the many dictionary definitions: o A system of therapeutics based on natural foods, light, warmth, massage, fresh air, regular exercise, and the avoidance of medications. Advocates believe that illness can be healed by the natural processes of the body (Mosby's, 2009) Endeavour College of Natural Health 21

22 It s not what we use to treat, it s how and why we treat the way we do Endeavour College of Natural Health 22

23 Common Australian Naturopathic Modalities o Nutritional/dietary counseling and teaching o Lifestyle modification counseling o Nutritional medicine o Herbal medicine o Homoeopathy o Flower essences o Soft tissue manipulation Endeavour College of Natural Health 23

24 Scope of Practice o Legal: Privacy and confidentiality, client access to records, informed consent by the client, duty of care, negligence, WHS (Work Health & Safety) and infection control their application and relevance to clinical practice o Ethics: Standards of behaviour subscribed to by joining a professional association o Morals: Personal standards of acceptable behaviour Endeavour College of Natural Health 24

25 What physicians think medicine is profoundly shapes what they do, how they behave in doing it, and the reasons they use to justify that behaviour whether conscious of it or not, every physician has an answer to what he thinks medicine is, with real consequences for all whom he attends the outcome is hardly trivial It dictates, after all, how we approach patients, how we make clinical judgments. (Pellegrino, 1979) Endeavour College of Natural Health 25

26 Health Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. (Preamble to the Constitution of the World Health Organization) Normal and harmonious vibration of the elements and forces composing the human entity on the physical, mental, moral and spiritual planes of being, in conformity with the constructive principle of nature applied to individual life. Health is determined by many factors. (Lindlahr, 1913) Endeavour College of Natural Health 26

27 Health In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence (Hahnemann, 1849) Endeavour College of Natural Health 27

28 Health 1. The reference class is a natural class of organisms of uniform functional design; specifically, an age group of a sex of a species. 2. A normal function of a part or process within members of the reference class is a statistically typical contribution to their individual survival and reproduction. 3. Health in a member of the reference class is normal functional ability; the readiness of each part to perform all its normal functions on typical occasions with at least typical efficiency. (Boorse, 1977) Endeavour College of Natural Health 28

29 Disease Abnormal or inharmonious vibration of the elements and forces composing the human entity on one or more planes of being, in conformity with the destructive principle in nature applied to individual life. (Lindlahr, 1913) Endeavour College of Natural Health 29

30 Disease o "Biomedical disease is demonstrable pathophysiology or pathochemistry and is diagnosed by the demonstration of pathologic features.(it is) a matter of physics and chemistry (Jennings, 1986) o Disease is a state of the human organism that actually or potentially disadvantages a person for survival, reproduction or full enjoyment of life (characteristic for age) other than by sole reason of social circumstance or by temporary and reversible environmental change (Emson, 1987) Endeavour College of Natural Health 30

31 Illness o Subjectively experienced phenomena are "illnesses (Jennings, 1986) o An individual s experience of ill health; the effects of the signs and symptoms on the individual s experience of life. Endeavour College of Natural Health 31

32 Healing o Heal (verb) Cause (a wound, injury, or person) to become sound or healthy again (Oxford Dictionaries, 2017) o Psychological field: A process in the service of the evolution of the whole personality towards ever greater and more complex wholeness (Egnew, 2005) o Nursing field: The process of bringing together aspects of one s self, body-mind-spirit, at deeper levels of inner knowing, leading toward integration and balance with each aspect having equal importance and value (Egnew, 2005) Endeavour College of Natural Health 32

33 Cure o (noun) A curative medicine or agent, able to sure disease. From Latin curare. a substance or treatment that cures a disease or condition. o (verb) Relieve (a person or animal) of the symptoms of a disease or condition. Eliminate (a disease or condition) with medical treatment. o The unqualified use of the word cure could breach section 133 (National Law) unless there is acceptable evidence that a health service cures a condition. Endeavour College of Natural Health 33

34 Legal issues with use of Cure o TGA advertising code 2015 Any representation regarding abortifacient action; or any representation regarding the treatment, cure or prevention of the following diseases: Neoplastic, Sexually Transmitted Diseases (STD), HIV AIDS and/or HCV; or Mental illness o ACCC - False or misleading statements o Code of Conduct for Unregistered Practitioner Health care workers not to make claims to cure certain serious illnesses 1) A health care worker must not claim or represent that he or she is qualified, able or willing to cure cancer or other terminal illnesses. 2) A health care worker who claims to be able to treat or alleviate the symptoms of cancer or other terminal illnesses must be able to substantiate such claims. Endeavour College of Natural Health 34

35 Standard Model of Diagnosis and Treatment of Disease 1. Diseases exist as discrete entities 2. Disease entities can be identified 3. Disease entities can be eliminated through treatment 4. Evidence-based application of drugs or surgery constitutes appropriate and effective treatment Adapted from Zeff J.L., 1997; Zeff, Snider, Myers, 2006 Endeavour College of Natural Health 35

36 Traditional Naturopathic Model for Restoration of Health 1. Universe is ordered, intelligent, wise, and benign 2. Health is a constant and natural state of being 3. Ill health is an adaptive response to disturbance in organism 4. Removal of disturbing factors will result in potential return of normal health 5. Intervention should involve least force necessary to stimulate self-healing mechanisms Adapted from Zeff J.L., 1997; Zeff, Snider, Myers, 2006 Endeavour College of Natural Health 36

37 What defines a naturopathic approach to disease and illness? Endeavour College of Natural Health 37

38 Role of Philosophy and Clinical Theory in Practice o Philosophy allows for examination of held beliefs and encourages logical argument to encourage analysis and clarity of concepts o Principles and theories provide structure for the eclectic nature of the profession o Philosophical concepts of health, healing and disease distinguish naturopaths from other therapeutic systems o Brings awareness to the lens through which all patients are viewed to guide diagnosis and treatment Endeavour College of Natural Health 38

39 Ways of Knowing o Sense perception o Emotion o Reason o Imagination o Faith o Intuition Endeavour College of Natural Health 39

40 Evidence-Based Medicine Evidence-Based Medicine A systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values. (Sackett et al, 2000) Endeavour College of Natural Health 40

41 The EBM Model Clinical Expertise Patient Values Best Evidence Personal Peers Clinical Reasoning Societal Cultural Spiritual Research Peers Empirical Treatment Plan Endeavour College of Natural Health 41

42 Evidence-Informed Practice Appears to provide more flexibility regarding the nature of the evidence and its use, i.e., it implies that many different levels of evidence and types of evidence (described above) are needed and used to support decisions in clinical practice (Woodbury & Kuhnke, 2014). Endeavour College of Natural Health 42

43 Ending Quote for the Day Knowing how to think empowers you far beyond those who know only what to think. ~ Neil DeGrasse Tyson Endeavour College of Natural Health 43

44 References Barrett B, Marchand L, Scheder J, Plane MB, Maberry R, Appelbaum D, et al. Themes of Holism, Empowerment, Access, and Legitimacy Define Complementary, Alternative, and Integrative Medicine in Relation to Conventional Biomedicine. The Journal of Alternative and Complementary Medicine. 2003;9(6): Boorse, C. (1977). Health as a theoretical concept. Philosophy Science 44, Cody, G. (2006). The history of naturopathic medicine, part 1: The emergence of an American school of healing. In Pizzorno, J.R. & Murray, M. T. (Eds.), Textbook of natural medicine (3 rd ed. Vol 1. pp.41 65). Missouri, St. Louise: Churchill Livingstone Elsevier. Lust, B. (1919). Universal naturopathic encyclopaedia directory and buyers guide. Volume I. New York: Self Published. Di Stefano, V. (2006). Holism and complementary medicine. Sydney: Allen & Unwin. Ebell, M. (2017). Evidence-based practice overview. Retrieved from Egnew, T. R. (2005). The meaning of healing: Transcending suffering. Annals of Family Medicine, 3(3), Emson, H. (1987). Health, disease and illness: matters for definition. CMAJ, Vol. 136, April 15. Hahnemann, S. Dudgeon, R.E. (1849). Organon of Medicine (5th German ed.). London: Headland. Jennings, D. (1986). The confusion between disease and illness in clinical medicine. CMAJ. Oct 15; 135(8): Endeavour College of Natural Health 44

45 References Kaptchuk, T. (2001). History of vitalism. In: M. Micozzi (Ed.), Fundamentals of complementary and alternative medicine (2nd ed., pp ). Philadelphia, PA: Churchill Livingstone. Lindlahr, H. (2010). Nature cure. Miami, FL: Hardpress Publishing. Mertz, M. (2007). Complementary and alternative medicine: The challenges of ethical justification. Medicine, Health Care and Philosophy, 10(3), Mitchell, S. (1998). Naturopathy. Understanding the healing power of nature. Great Britain: Element Books Ltd. Pellegrino, E. (1979). Medicine, science, art: an old controversy revisited. Man and Medicine. 4.1: Pizzorno, J.E. & Murray, M.T. (2006). Textbook of natural medicine. St. Louise, Missouri: Churchill Livingston Elsevier. Pizzorno, J.R. (1996). Natural Medicine in Micozzi M.S. (eds), Fundamentals of complementary and alternative medicine. New York: Churchill Livingstone Elsevier. Sackett. D,L, Strauss. S,E, Richardson. W,S, et al. (2000) Evidence-based medicine: how to practice and teach EBM. London: Churchill-Livingstone Snider, P & Zeff, J. (1989). House of Delegates Position Paper. Definition of Naturopathic Medicine. American Association of Naturopathic Physicians Naturopathic%20Medicine.pdf Micozzi M Fundamentals of Complementary and Integrative Medicine 3 rd Edition. Elsevier Missouri Endeavour College of Natural Health 45

46 References NCCAM, Complementary, Alternative, or Integrative Health: What s In a Name? 2013; health/whatiscam?nav=gsa Woodbury, G. & Kuhnke, J. (2014). Evidence-based practice vs. evidence-informed practice: What's the difference? Wound Care Canada. Vol 12, No 1, Spring Retrieved from Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April Warburton, N. (2013). Philosophy, the basics, (5 th ed.). Oxon: Routledge. Endeavour College of Natural Health 46

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