Cover Stories: Why New Age Medicine Is Catching On

  • You have a backache. (Who doesn't?) Your spouse says go to the doctor, but you don't really have a doctor. The local hospital has a walk-in clinic, but that means waiting, X rays, blood tests, waiting again -- this time in a backless paper dress -- only to be handed a bunch of insurance forms and a prescription for pills that make you logy. Your back still hurts, so you're referred to a fancy specialist. More X rays. More insurance forms. More waiting in a backless paper gown, followed by talk of disk surgery from a doctor who looks as if his back hurts. It sounds awful, and next comes the final insult, the letter from your insurance company: "See rejection code."

    Then your friend at work says his wife had acupuncture for her tennis elbow, and it worked. Or he knows a chiropractor who does wonders with sore backs. Or your sister-in-law comes back from the health-food store with the name of a woman who does shiatsu. "Is that the raw fish or the seaweed?" you ask, laughing very carefully so as not to jiggle your back.

    Or let's say your problems are larger and darker. You have inoperable cancer. You are depressed and frightened. You ask your oncologist whether you should stop smoking or change your diet. He shrugs and looks glum. "If you want to," he says, "but at this point it probably doesn't matter."

    So, you wonder, if the doctor has written you off, where on earth can you turn?

    If you are like millions of other Americans, you may find yourself at the doorstep of a homeopathic doctor or a "guided imagery" therapist or a chiropractor or any of the other innumerable practitioners of "alternative medicine." Some of these alternatives, like acupuncture or shiatsu massage, are rooted in ancient Asian healing traditions. Others, like crystal healing and bioenergetics, were born in the New Age (i.e., rooted in the ether over California). Many alternative therapies assume that mind and body are subtly interlocked and influence each other powerfully. In terms of credibility, they run the gamut from the generally accepted -- acupuncture for pain relief; to the plausible -- inhaling eucalyptus to open the sinuses (aromatherapy); to the frankly bizarre -- having the middle of your right foot manipulated to improve your liver function (reflexology).

    Although a number of alternative techniques are widely accepted in Europe, American physicians generally take a skeptical view. But that hasn't stopped the treatments from gaining popularity. A TIME/CNN poll by Yankelovich Clancy Shulman found that about 30% of people questioned have tried some form of unconventional therapy, half of them within the past year.

    The growth of alternative medicine, now a $27 billion-a-year industry, is more than just an American flirtation with exotic New Age thinking. It reflects a gnawing dissatisfaction with conventional, or "allopathic," medicine. For all its brilliant achievements -- the polio vaccine, penicillin, transplant surgery -- conventional medicine, many folks feel, has some serious weak spots, not the least of which is the endless waiting in paper gowns for doctors who view you as a sore back, an inoperable tumor or a cardiac case rather than a person. "The problem with modern medicine is that it is only pathology oriented, and practitioners don't take the time to communicate with their patients," says Dr. Stephan Rechtschaffen, an M.D. who uses a preventive approach to healing at the Omega Institute for Holistic Studies, which he co-founded, in Rhinebeck, N.Y. "People are fed up with the old answers. They are beginning to realize that illness does not just drop out of the sky and hit them over the head. Health is an ongoing process."

    Conventional medicine has always put its emphasis on crisis intervention, and that is where it is most successful. It is what you want when they haul you in from a car wreck, or your Achilles tendon has snapped on the tennis court, or you've got a tumor in your lung. Standard medicine is about doing battle with a disease, bringing up the big guns of surgery and drugs to search out and destroy the miniature monsters that make people sick: bacteria, viruses, cancer cells, auto-antibodies and other biological evils. If your baby daughter has a 105 degrees fever, she needs big-gun medical attention, not brown rice and meditation.

    What physicians are far less successful at is telling you how to stay healthy or what to do about the multitude of ailments that do not strike as a sudden crisis but sneak up and refuse to go away. Into this basket fall most of the diseases related to aging and life-style -- arthritis, osteoporosis, lower-back pain, high blood pressure, coronary-artery disease and ulcers. Medicine's prescription for these chronic diseases often tends to be of the same pill-and-scalpel variety that works so well for acute disease. But who wants to be chronically zonked on medication or have his arteries Roto- Rootered every few years? "Doctors are trained to use drugs and surgery," says internist Dean Ornish of the University of California at San Francisco, who pioneered research into the use of diet, exercise and meditation to reverse heart disease. "To paraphrase Abraham Maslow, if all you're trained to use is a hammer, the whole world looks like a nail."

    Sure, doctors know that diet and exercise matter and that stress takes a toll. But medical schools provide little instruction in these matters. Doctors tend to downplay interactions of mind and body. The patient's state of mind doesn't matter to bacteria, conventional medical thinking goes, so whether the < patient is optimistic or anxiety ridden is of little practical concern. In any case, doctors are often too rushed to find out. Ornish recalls his first day of internship at Boston's Massachusetts General Hospital. The head resident told him, "Now, this guy's just had his heart attack, and he's going to want to talk. Just take his pulse and move on; we've got 48 others to see."

    This approach doesn't sit well with the nation's big new crop of medical consumers and chief dabblers in alternative therapies: the baby-boom generation, which is just beginning to show the wear and tear of middle age. "Most people see a doctor for all of 10 minutes and walk out with a bunch of prescriptions, but the baby boomers want more from doctors," says Dr. Deepak Chopra, a Massachusetts physician whose hot-selling book, Quantum Healing, promotes Ayurvedic medicine, a 4,000-year-old healing tradition from India.

    As a group, the boomers have always had something of an authority problem (think sit-ins, sexual revolution). With health care as with everything else, they want to be involved in the decision making. They want lots of attention. They want to take charge. And having made a cult of personal health -- racking up miles on the StairMaster, eschewing red meat, fretting over pesticides on their vegetables -- they feel eminently qualified to do so. For many boomers, that translates into health care a la carte. They'll see the medical doc for appendicitis and check in for tune-ups and TLC with the chiropractor, and if they don't get results, fine, they'll move on to a deep- tissue-massage therapist. A little Windham Hill music never hurt anyone.

    "I want to assume a partnership with my doctor," says a fortysomething college professor from Buffalo attending a "wellness week" at the Omega Institute. "When I had breast cancer 17 years ago, I was very passive and gave the doctors all the authority," she says ruefully. Now, having invested $550 for five days of lectures, meditation, yoga classes and wholesome food, she says, "It's wonderful to have something you can do yourself to get better. That," she adds, reaching for the buzz word of the '90s, "is empowerment."

    But you needn't register at a wellness retreat to find your way into the lush, enchanted forest of New Age and alternative therapies. Indeed, to get there a traveler needn't stray far from the path of conventional medicine. A handful of alternative techniques have found gradual acceptance among M.D.s. / And some physicians are even referring their patients for unconventional treatment. Among the more accepted remedies:

    ACUPUNCTURE. Alternative here, traditional in China, where it has been practiced for more than 2,000 years. Acupuncturists use hair-thin needles, gentle finger pressure (acupressure) or, in a modern variant, electrodes to stimulate designated points along the body through which healthful qi (pronounced chee) energy is said to flow. The various points are believed to be connected to specific organs and body functions. A point near the wrist, for example, is associated with respiration.

    In the U.S. the technique was virtually unknown outside Chinese neighborhoods until New York Times journalist James Reston needed an emergency appendectomy while on assignment in China in 1971. Reston reported that an acupuncturist's needles effectively blocked his pain following the operation. Now 21 states license acupuncturists, and many insurance companies will cover the treatments. In 24 states, however, only physicians may perform the technique. Acupuncture seems to be most effective in relieving arthritis and chronic pain. It even works on animals. In addition, studies show it is useful in easing the misery of smokers, alcoholics and other addicts trying to kick their habit.

    Among the technique's fans is top fashion photographer Francesco Scavullo, who was battling crippling arthritis before he sought the ministrations of Dr. Ling Sun Chu in New York City. "Before Dr. Chu, I lived on cortisone, Motrin, Advil and other pills that are bad for the liver," says Scavullo. Instead of "ending up in a wheelchair," he enthuses, "I was skiing and jumping horses." But beware acupuncturists -- or any healers -- who promise too much. "It's not a cure-all," says Chu, 83, who is also an M.D. Preferably acupuncture should be used in conjunction with Western medicine.

    BIOFEEDBACK. For mechanistic Westerners, this is the mystical in gadget form. By looking at dials on a machine that measures skin temperature (stress cools, relaxation warms) or electrodermal response (similar to an electrocardiogram), the patient, wired with sensors, learns to control what is usually involuntary: circulation to the extremities, tension in the jaw, heartbeat rates and even pupil size (for advanced students). "If you studied yoga for years, you might be able to get the same effect," says Dr. Elliot Wineburg, assistant professor of psychiatry at Mount Sinai School of Medicine in Manhattan.

    For ordinary folks, biofeedback can be a useful tool in treating dozens of ailments, from asthma to epilepsy, chronic pain to drug addiction. It is perhaps the single most effective treatment for Raynaud's disease, a condition mainly afflicting women, in which the fingers turn white, cold and painful when they are exposed to cold. A series of biofeedback sessions trains sufferers to improve circulation in their hands. Many insurers now cover biofeedback, and even some old-line hospitals offer the therapy.

    HYPNOSIS. The original hocus-pocus has moved off the magician's stage and into the doctor's office. According to the American Society of Clinical Hypnosis, 15,000 health professionals now practice the technique. While not a cure, making healthy suggestions to hypnotized patients, studies show, can help them heal faster, give up smoking and other bad habits, and feel less pain -- long after a session ends. One remarkable study showed that burn patients heal faster, with less pain and fewer complications, if they are put in a trance shortly after they are injured.

    Exactly how it works remains mystifying. Doctors guide patients into a hypnotic state by having them focus on a particular mental image, a soothing voice or an object (yup, a swinging watch on a chain will do the trick). Once the patient is there, habitual patterns of thought are temporarily suspended. One theory is that the limbic system -- the brain region linked to emotion and involuntary responses like blood pressure -- is stimulated under hypnosis and rendered capable of reacting to external suggestions. An estimated 1 in 10 people, however, is not suggestible.

    GUIDED IMAGERY. Relaxed in a near trance, patients are "guided" by a therapist or tape recording to visualize their condition mentally and to wish it away. Introduced in the 1970s to help athletes and musicians perform better, the method has won increasing acceptance among some doctors as a way to battle chronic pain, tumors and persistent infections. Patients are advised to study in detail how their immune system is responding to a particular ailment and then, with cues from a therapist, to imagine the antibodies and white blood cells zapping the foe.

    The technique is also thought to aid in recovery by reducing stress. Patients are urged to picture themselves in a soothing environment, like a beach at night with waves lapping softly. "The idea is to use any or all of the senses to quiet the mind," says Dr. Carl Simonton of the Simonton Cancer Center in Pacific Palisades, Calif. One study found that guided imagery before minor surgery helped patients recover faster and with less pain. Cancer patients using the technique also showed a heightened immune response, although whether that improved their survival odds remains uncertain.

    CHIROPRACTIC. Although most doctors still wince when you mention chiropractors, some fairly rigorous studies have shown their manipulations of the spine to be effective in relieving lower-back pain. Orthopedic surgeons have even been known to refer patients to back crackers, and some 30 U.S. hospitals have chiropractors on staff. Because almost every nerve in the body runs through the spinal cord, chiropractors maintain that they can treat all manner of ills by "adjusting" the vertebrae. However, beyond the lower back, there is no proof -- aside from reams of anecdotal testimony -- that the method works.

    A pilgrim in the forest of alternative cures can wander a long, strange way. Once you've set foot there -- if only to see a state-licensed acupuncturist upon your doctor's recommendation -- you may find yourself lost in the wild thicket on the fringe. Alternative medicine is a subculture. Its disparate practitioners know one another, attend the same holistic seminars, frequent the same bookshops. The acupuncturist will suggest that you see a shiatsu person he knows on the other side of town. The shiatsu masseuse will encourage you to buy certain herbs. Before you know it, you've suspended disbelief and are having your foot rubbed by a reflexologist -- a practitioner of a therapy, popular among the Amish, that maintains that your body's control panels are your feet. (The liver's special rheostat is in the middle of the right foot; the gallbladder's is nearby.)

    Or perhaps you'll find yourself in an herbalist's lair, a shop like the one run by Ron Teeguarden in Venice, Calif., crammed full of respectable-looking people seeking Astragalus, said by the Chinese to strengthen the immune system, or the prized Reishi mushroom, purported to help counter the effects of chemotherapy. Teeguarden, 44, who spent years in Asia studying herbalism, offers private counseling for $35 a session to clients who include John McEnroe and Lisa Bonet. And while you're in the neighborhood of California, you may even wander over to one of several Ayurvedic centers, where therapists ! will pour warm sesame oil over your body to release toxins and blocked energy.

    Many therapists are cross-fertilizers, picking up bits of different disciplines. Greer Jonas does reflexology with some aromatherapy thrown in; she is also licensed for Swedish massage. Jonas works in her clean, well- lighted apartment on Manhattan's Upper West Side. Hanging crystals tinkle before an open window. Brown and blue bottles of lavender, rosemary and rose essence exude their fragrances. Lavender relaxes the client, Jonas advises. Rosemary "breaks up fibrous tissue" when massaged into a woman's breasts. "The body holds a lot of memories," she says. "You touch an area, and sometimes the person starts to cry." Jonas says she tries to clear troubled "pathways" and offer comfort, but "it's a little tricky to say that massage or reflexology is actually going to cure anything."

    Reflexologists claim that the therapy dates back to at least 2330 B.C. and is depicted in a wall painting in an Egyptian tomb. It's a familiar theme. Egyptology figures in the credentials of a number of alternative remedies, as do claims that the British royal family are loyal patients. (The royals are said to be particularly fond of homeopathy, a system that treats diseases by administering tiny doses of the substances that might normally cause the same symptoms as the ailment.) "We're not just another New Age fairy tale" is also much heard. So says Marcel Lavabre, president of the 200-member American Aromatherapy Association, based in Pasadena, Calif. Lavabre admits that "for an infection, essential oils wouldn't be as strong as an antibiotic, but they wouldn't have side effects." A mixture of thyme and lavender with rosemary is used in France to heal wounds, he adds.

    A skeptic accustomed to conventional medicine quickly misplaces all familiar landmarks when trying to assess the possible medical value of such treatments. Surely the notion that your entire body can be treated via the feet stretches credence to the breaking point -- especially when you consider that chiropractors say the same thing about the spine, while iridologists (yes, another specialty) say the eyes are the windows to your inner health. Why, there are even acupuncturists who claim you can treat virtually any spot in the body by poking needles at various points around the ear.

    In general, the explanations given by practitioners cannot be squared with the Western science of physiology. Indeed, the mumbo-jumbo accounts are enough & to turn a believing patient skeptical. Chiropractors speak of subtle misalignments or "subluxations" of the spine, but other doctors usually cannot detect them. Acupuncture concerns itself with 12 pulses and 12 organs -- six solid, or yin, and six hollow, or yang -- connected to fingers and toes by channels through which energy flows.

    Energy is a big theme in alternative healing, but it has no real equivalent in conventional medicine (except for the fact that all living things generate weak electromagnetic fields). "Unseen, unmeasurable energy has been observed by many cultures throughout history," says William Anderson, an acupuncturist in Chicago. "In India they call it prana. In the Soviet Union, bioplasm. Some call it life force."

    Critics, and that includes most conventional doctors, say the chief danger of alternative medicine -- aside from wasting money -- is that the patients get so carried away with unconventional cures that they dismiss regular medicine entirely. "The nightmare," says University of Chicago neurologist Clifford Saper, "is seeing someone who has a spinal-cord tumor who's been going to a chiropractor for years instead of to a doctor. You want to throw your hands up and say, 'If only I'd seen him earlier I could have helped him that much more.' " Doctors also warn about the risks of unregulated medicine, which is subject to both quackery and fads. A poorly trained massage therapist can do a good deal of damage. And some of the food supplements purveyed by health-food stores in recent years proved so harmful that they had to be pulled off the market.

    William Jarvis, public-health professor at Loma Linda University in Southern California, condemns virtually all alternative medicine. The founder of the National Council Against Health Fraud, he rejects macrobiotics as "not only unproven but a bizarre and dangerous diet for sick people." Aromatherapy is "crazy," he says. "If you are going to claim that something is safe and effective for human disease, you need to have proof."

    Some medical research is attempting to translate the workings of alternative medicine into something doctors can comprehend. Research has shown, for instance, that an acupuncturist's needles stimulate nerve cells to release endorphins, powerful opiate-like substances that relieve pain. Homeopathic remedies have been found effective for influenza, headache and allergies in numerous medical studies conducted in Europe. Meanwhile, herbs used in Chinese and Indian medicine have been shown to contain some of the same active ingredients found in conventional drugs.

    More research of this kind could go a long way toward sorting out the usefulness of alternative medicine. But as heart disease researcher Dean Ornish knows from experience, funding for such research is extremely difficult to come by. Despite impeccable credentials from Harvard and Baylor University, Ornish was at first unable to get grants from the government or the American Heart Association for his work using diet and relaxation to treat cardiac patients. "They said it was impossible to reverse heart disease. They said you need to use drugs, because you can't motivate people to change their ways over a long time." Ornish eventually turned to real estate barons and oil moguls for funding. "Medical training is funded by drug companies," he observes. "So are medical journals and scientific meetings." And pharmaceutical companies have little to gain from alternative approaches.

    But even when researchers can find no scientific basis for an alternative treatment, it still may be effective. This is the famed placebo (Latin for "I will please") effect. To most laymen and most conventional doctors, placebo means "fake" -- phony medicine doled out to please a whiny patient or fed to the control group in a scientific experiment. If the medicine being tested does no better than the placebo, then it's worthless, because the placebo does nothing at all.

    Or does it? Belief can't be measured in milligrams, but trust in a faith healer -- or in an M.D. with his powerful prescription pad -- sometimes actually heals. Antibiotics can kill bacterial infections but not viruses, yet if a patient does not know this, tetracycline may "cure" a viral sore throat. Give medical students a stimulant when they think they're getting a sedative (so goes a story told by the late author Norman Cousins), and they feel sleepy. Curse a believing tribesman (if you are a credible shaman), and he dies. Cheerlead tirelessly to encourage cancer patients to be optimistic and to support one another (if you are cancer surgeon Bernie Siegel, author of Love, Medicine and Miracles), and the patients may have a better survival rate.

    There's more to placebo than one might think. "People have an incredible ability to respond to suggestion," says neurologist Saper, who has investigated links between the brain and the immune system. "It's well documented that pain is very suggestible, and even complaints based on pathology improve when people think they are getting better. In fact, that's how most medicine was practiced up until the 20th century."

    Saper confirms that lowering a patient's stress level, with relaxation techniques or simply encouraging trust in the doctor, can be healing. Research suggests that stress triggers the release of chemical messengers from the brain that suppress the immune system; relaxation would therefore revive the immune response. Call it a placebo effect if you will, but giving patients emotional support, making them laugh -- as advocated by Cousins -- and bolstering their sense that they can influence their own well-being (yes, empowerment) can also be potent medicine.

    In a series of studies with nursing-home residents, Harvard psychologist Ellen Langer showed that elderly people live longer and have fewer health complaints if they are encouraged to make decisions for themselves. Ornish, who stunned fellow physicians by showing -- with angiograms, no less -- that life-style changes can open up clogged arteries, is persuaded that meditation and group support were important to his patients' progress. "I see in almost every heart patient a sense of isolation, of not having or being enough," says Ornish. "I've become increasingly convinced that we are dealing here with emotional and spiritual dimensions."

    A growing number of doctors around the country have become more open to alternative approaches, looking particularly at the way that body, mind and life-style interact. Andrew Weil, a Harvard-trained M.D. and author of The Natural Mind, practices this sort of "holistic" medicine in Tucson.

    Weil's patients tend to be well educated and a bit disillusioned with conventional doctors. Weil usually starts off with a long and wide-ranging intake interview, trying to get a complete picture of a patient's life. He points out to a middle-aged migraine sufferer that both his headaches and his heavy coffee drinking started in college. He suggests eliminating all caffeine ("It's powerfully addictive; wait for a three-day weekend, because you'll have withdrawal symptoms") and taking an herbal remedy called feverfew. For a man suffering from ulcers, he explores sources of stress -- a job relocation, an impending divorce -- and suggests sessions with a hypnotherapist "to see if there are unresolved issues." He sometimes refers patients to an acupuncturist, and even a few to a Native American shaman, though he draws the line at crystal therapy. Weil also knows when to send a patient with chest pains to the hospital for emergency surgery.

    At Canyon Ranch, a glossy health spa on the outskirts of Tucson that specializes in alternative techniques, a gifted physical therapist named Karma Kientzler watches a patient, Susan Pinkus, operate an exercise machine. Chemotherapy for ovarian cancer had left Pinkus with severe nerve damage in her hands and feet; she had poor balance and almost no sense of control over her extremities. Kientzler's mind-and-body system, which she calls "emotion and motion," has brought Pinkus back to near normal. A few days ago, she was able to ride a horse on a trail. "You have given me back my dignity," she tells Kientzler.

    Of course, Pinkus might have recovered without help. That's always possible. Still, she provides one more reason to view alternative medicine with fewer snickers and a couple more nods. And while we're nodding, better do something about that migraine. Cut out the coffee, take the herb feverfew twice a day. If that doesn't work, there's always the old Chinese gent uptown with the needles.


    CREDIT: TIME Graphics by Steve Hart


    Some therapies have more credibility than others. Those that are more mainstream appear toward the bottom of each list; those at the fringe are positioned out on the limbs.






    CREDIT: From a telephone poll of 500 American adults taken for TIME/CNN on Oct. 23 by Yankelovich Clancy Shulman. Sampling error is plus or minus 4.5%. "Not sures" omitted.

    CAPTION: Have you ever sought medical help from:




    Homeopathic doctor

    Faith healer

    Would you ever consider seeking medical help from an alternative doctor if conventional medicine failed to help you?

    Would you go back to an alternative doctor?