James S. Gordon, MD was an invited speaker at the AAPB to talk about Mind-Body Medicine and the Future of Health Care. Dr. Gordon is the Founder and Director of the Center for Mind-Body Medicine in Washington, DC (www.cmbm.org) and is a Clinical Professor in the Departments of Psychiatry and Family Medicine at the Georgetown University School of Medicine. He made the obvious point that mind-body medicine should be at the heart of what we do, particularly for the increasingly common chronic conditions; and that the drug/surgery mainline medicine approach should be reserved for the more critical, acute medical issues. He referred to this as the “Self-Care” Model, consisting of a combination of complementary and alternative medicine approaches and psychosocial interventions. Of course he was preaching to the choir, and along the way he was very supportive of the role biofeedback could play in this endeavor of changing the medical model. Nevertheless, I felt that his view of biofeedback was the traditional, more limited one (read relaxation training), and he was probably unacquainted with the inroads that we have made through neurofeedback in addressing even classical medical and psychiatric categories.

Gordon referred to the often-quoted study in The New England Journal of Medicine that showed some 42% of Americans were already using complementary and alternative medicine (CAM) in that timeframe (1997). In certain cases, the penetration is much greater. Some 69% of cancer victims resort to CAM, and similar numbers apply to HIV and chronic pain patients. So CAM is not just tending the worried well.

Why should this be happening now? We are seeing increases in chronic illness, and not just because the population is getting older. Problems are developing at earlier ages, although the evidence is mainly observational, with the notable exception of Type II diabetes. There seems to be an explosion of people developing illnesses earlier; Gordon even mentioned ADD in this connection (although matters are more obvious with the more severe behavioral disorders such as childhood Bipolar Disorder and the autistic spectrum–SO).

A second factor appears to be growing difficulties in relationship between patients, doctors, and other health professionals. The perceptions regarding such difficulties go both ways. An AMA study of dissatisfaction among physicians found some 36% to say that they would not go to medical school if they had it to do over again. Over 50% said that they would tell their children not to go into medicine. If that is the case, then surely the motivations for remaining involved become increasingly monetary as time goes on.

A third factor is new information becoming available about ancient healing. Chinese herbalism, for example, is supported by many studies. Perhaps more importantly, patients have a similar worldview as the alternative practitioner. This is more conducive to the formation of a healing partnership. Compliance with standard medical prescriptions for care is at the level of 40-50% by self-report, and is actually at the level of <20% when independently verified. Clearly we must move from concepts of compliance to that of collaboration. Research [by our own Pat Norris) has shown that those studies in which the therapist was engaged with the patients show better results regardless of the modality. Another aspect is group work, which tends to happen in the context of delivery of alternative modalities. “We are just at the beginning of understanding the power of group support,” says Gordon, along with a strong recommendation that biofeedback practitioners consider adopting group work. In fact, Gordon suggests the use of group support as a container even for major interventions. Finally, there is the matter of money. It is clear that we can’t keep going with the health care system that we have. The funding will simply not be available. Dr. Gordon integrates relaxation therapies, hypnosis, meditation, acupuncture, nutrition, herbalism, musculoskeletal manipulation, dance, yoga and physical exercise into his own practice of medicine and psychiatry. He has recently authored the book Manifesto for a New Medicine: Your Guide to Healing Partnerships and the Wise Use of Alternative Therapies (Perseus Books). He has also served on the White House Commission on CAM Policy. (See the www.WHCCAMP.hhs.org website.) In fact, the White House report has not yet been printed and distributed. Dr. Gordon urges us to request the White House to release the report. Such requests should be addressed to Secretary Tommy Thompson at the Department of Health and Human Services. In fact, Gordon suggests that a Coordinating Office for Integrative Medicine and CAM be established within HHS. Public pressure is the obvious way to get this done. After all, both OAM and NCCAM were created as a result of public demand. Specifically, there should be a shift in research to look at integrative care, and public money should be made available for those very things that cannot be patented, such as natural herbal products and unpatentable procedures. This will not happen through the entities that exist in government today. Nuggets “Alternative health is what docs over thirty did not learn in medical school.” “We have to teach people to take care of themselves….” “Kiss your doctor good bye----” “If you are doing research…. You should be protected from censure….” “Every health professional should be deeply schooled in self-awareness, self-care, nutrition, exercise, and stress management……” “We have to get back to the basics of being a healer….” ---James S. Gordon, MD

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