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Intentionality in Alternative Medicine

by Ruth-Inge Heinze, PhD(more info)

listed in alternative medicine, originally published in issue 14 - August 1996

Representatives of Western medicine consider ethnomedicine (i.e., alternative medicine) to be anecdotal and unproven which gives the words ‘anecdotal’ and ‘unproven’ a new meaning. The Asian medical systems I have worked with for decades have been practised successfully for over two thousand years. They went through a much longer period of trial and error than Western medical systems and they do admit their limitations. The question is ‘what distinguishes Asian medical systems from Western medical models?’

Chinese base their practices on the Pen T’sao (Book on Herbs), written by the mythical Shen Nung. The Pen T’sao used today, was composed during the Ming Dynasty (1368-1644 A.D.). The Nei Ching (Book on Internal Diseases), ascribed to the Yellow Emperor (Huang-ti), was codified in the first century A.D. In their diagnosis, Chinese physicians use the ‘Five Elements’ or the so-called ‘Mother and Son Law.’ Each of the five elements are connected to body organs, i.e.,

WOOD:            Liver, Gall Bladder
FIRE:               Heart, Small Intestine
EARTH:          Spleen, Stomach
METAL:          Lung, Large Intestine
WATER:         Kidney, Bladder.

Translated into treatment procedures, this means:

WATER (kidney, bladder) nourishes WOOD (liver, gall bladder);
WOOD (liver, gall bladder) nourishes FIRE (heart, small intestine);
FIRE (heart, small intestine) nourishes EARTH (spleen, stomach);
EARTH (spleen, stomach) nourishes METAL (lung, large intestine);
METAL (lung, large intestine) nourishes WATER (kidney, bladder).
WATER (kidney, bladder) destroys FIRE (heart, small intestine);
FIRE (heart, small intestine) destroys METAL (lung, large intestine);
METAL (lung, large intestine) destroys WOOD (liver, gall bladder);
WOOD (liver, gall bladder) destroys EARTH (spleen, stomach);
EARTH ( spleen, stomach) destroys WATER (kidney, bladder).

Each diagnosis also evaluates age, sex, the temporary position of ch’i (life force which daily circulates twice through the body along twelve meridians and numerous smaller ones), and the conditions of the six humors-hot/cold, wet/dry, and heavy/light. In other words, Chinese physicians do not treat diseased organs because their condition is considered to be too late for beginning treatment. Organs which nourish the diseased organ are fed, the destructive influences of other organs are modified, and those organs (see above) through which the ch’i will flow next are un-blocked. In sum, the goal is to restore balance between Yin and Yang.

In traditional China, physicians were only paid as long as they kept their patients healthy. Many physical and emotional problems can, indeed, be taken care of (i.e., balanced) before a crisis situation develops. It is important to realize that Chinese systems emphasize preventive medicine.

The classical Greek system, also over two thousand years old, speaks of the balance of four humors: damp/hot (blood), damp/cold (yellow bile), dry/hot (black bile) and dry/cold (phlegm). Present-day practitioners still take the oath of Hippocrates, the great Greek physician who lived 460-377 B.C. The books of Luman al-Hakim, e.g., inform about the Arabic system which is similar to the Greek.

The Ayurvedic system in India knows of the balance between three humors: kapha (phlegm), pitta (bile) and vayu (wind). The knowledge of the Atharva Veda as the Susruta and the Caraka Samhita, both codified during the first century A.D., has also been practised much earlier (Heinze, 1988:136). Furthermore, books kept in Buddhist monasteries in Thailand refer to Jivaka, the physician of the Buddha who, according to legend was sent by his teacher into the jungle to find out which herbs could be used for healing. After several years, Jivaka returned and pronounced that all herbs could be used when applied wisely (Heinze, 1988:136).

In Singapore today, Western and Chinese medical practitioners are both publicly recognized and cooperate, e.g., patients with high blood pressure are taught meditation and receive acupuncture at General Hospital. Malaysia also has included folk practitioners into the Malaysian medical system already in the seventies, with the result that the workload of Western educated physicians (who are not available in sufficient numbers) was markedly reduced. One explanation is that folk practitioners are especially successful in treating psychosomatic illnesses (Heinze, 1988:132-133).

My interest in ethnomedicine goes back to my childhood in Germany where, aside from Western trained physicians, a wide range of different health practitioners were available. In other words, preventive medicine was taught and, most of all, alternative health practitioners and Western trained doctors knew their limitations and treated each other with respect, without getting into a competitive stance.

I seriously question the attitude with which Western medical professionals approach the issue of health and healing. When asked the simple question ‘What is health?’ most will define health negatively, i.e., as the absence of dis-ease. The etymological relationship of the words ‘heal’ and ‘whole’ has been examined already in the past but even ‘wholeness’ is difficult to define when most Westerners don’t know what is lacking.

The latest trend stresses the importance of ‘intentionality.’ Aren’t all physicians and health practitioners supposed to have the intention to assist in issues of health and well-being? Intentionality seems to be part of the Hippocratic Oath they have taken. So there should not be any need to stress intentionality on the part of the practitioner. My point is that nobody has sufficiently investigated yet, whether patients actually have the intention to be healed and, most of all, whether they have been positively supported and involved in the healing process.

Physicians as well as health practitioners agree that healing is not possible when patients are not cooperating. Many of our contemporaries have the unconscious tendency to sabotage their own healing and well-being. The reasons for such attitude can be manifold. There may be sado-masochistic tendencies but mainly there will be the need for attention and some patients draw satisfaction out of exploiting the sympathy of others. This is certainly valid for a large number of psychosomatic cases.

Important to note is that patients in Western medical systems are not allowed to participate in the process of getting well. In cases of genetic or chronic disease, patients can learn how to monitor their deficiencies and should not be scared into negative thought processes. During research on the relationship between patients and healers (see also, Kleinman, 1980, and Torrey, 1986), I found, indeed, cases of negative programming by physicians. When the expected course of an ailment is spelled out, it is no wonder when patients accept the suggestions and develop the expected symptoms. More and more documentation is piling up that patients who were diagnosed with a fatal illness but refused to accept the verdict of being incurable, not only survived longer than predicted, but, in some cases, even went into complete remission and could be considered cured against the predictions of licensed physicians (Kuebler-Ross in Elliott, 1995:35).

No physician can, with any integrity, predict the exact course of any illness because the factors contributing to a dis-ease are much too complex. A state of imbalance (dis-ease) will, for example, develop as the result of (1) hypo- or hyperfunctions of body organs, (2) unstable emotional states, (3) unstable social relationships, (4) geo-magnetical and atmospheric influences (e.g., sun flares), etc., in sum, the present state of the patient as well as the health practitioner vary considerably over time. Asian practitioners (including shamans) are never so unprofessional as to promise success; they create, however, a space where the unexpected can happen.

I propose that the first step toward healing should be the active involvement of the patient, as well as his/her friends and relatives, in the healing process. How can we stimulate the intentionality of clients? Some research has been conducted on the use of hypno-therapy, self-hypnosis, imagery (Achtenberg, 1985), music (Campbell, 1991), breathing, and movement exercises, (Heinze, 1995) i.e., anything which (1) provides the experience that proves change is possible, (2) offers satisfaction, (3) reconfirms life, and (4) generates positive feelings, i.e., stimulates the patients own self-healing powers. A large range of exercises can, therefore, be taught to improve health and transform consciousness with the goal of providing conceptual frameworks to experience the subtle infrastructure of our body.

The format of this review does not permit me to bring up my own experiences in support of this view but I am ready to share them with anyone on a personal basis.

The main task of health practitioners in Asia, which includes shamans and mediums, is to shift a patient’s attention, out of an illness pattern into a condition where changes become possible (Heinze 1988, 1991). Almost all of the over one hundred practitio- ners I worked with shared, furthermore, one particular clinical characteristic: they were skilled at responding quickly to intra- and interpersonal crises (see also, Kleinman, 1980:233-234). Kleinmam observed three stages in healing rituals. First, the sickness is labelled with an appropriate and sanctioned cultural category. The label is ritually manipulated (culturally transformed). Finally a new label (cured, well) is applied and sanctioned as a meaningful symbolic form that may be independent of behavioral or social change (1980:372).

Chinese medicines have fewer side effects than Western medicines. Western medicine works much quicker, but it only removes symptoms, it does not, like Chinese medicine, remove the underlying cause. . . . Chinese medicine may not help you sometimes but it won’t hurt you. Western medicine may remove your symptoms or illness, but sometimes the treatment is worse than the illness (1980:87).

Most of the clients I interviewed during my thirty-five years of research had first seen Western trained physicians but had met difficulties in communication. They found most modern doctors to be too impersonal and businesslike, giving patients very little information about the actual situation, charging high fees, and prescribing expensive medicines. Patients were especially apprehensive about modern miracle drugs where unpleasant side-effects were discovered after treatment. . . . it was felt that modern doctors seem to know only of two alternatives: drugs or operations. . . . They treat. . . the symptoms not the cause of illness.

On the other hand, clients received immediate personal attention and empathy from [folk practitioners]. Charges, if any, are low. . . . Patients are not isolated in hospitals. . . separated from relatives and friends who cooperate in the healing process (see also, Miller 1979:179, note 20).

Clients as well as practitioners do not confuse modern medical treatment with traditional medicine. They do not believe one can substitute for the other. [Furthermore,] ‘. . . healing ceremonies are highly charged emotionally’ (Frankl 1961:66). They are no intellectual processes. Environmental or bodily stresses and feelings of estrangement and isolation fade away. . . . Faith is generated. The belief that, when approached correctly, forces greater than man will intervene is an important factor (Heinze, 1988:130-131).

Health is a matter of choice. Not only of the physician and health practitioner but also of the patient. Health can be balanced and maintained before any dis-ease has the chance to develop. We can become aware of habits which undermine our health so that we can replace them with habits which reinforce our well-being. Everybody can learn to awaken his or her body’s inherent wisdom. The quality of intentionality of all individuals involved in the healing process is essential. Any communication whether from physician to client or from client to physician should be positive. Even when complete healing is physically not possible, a positive maintenance program can be discussed realistically. Positive intentions of all involved can improve otherwise hopeless situations.


Achtenberg, Jean. Imagery in Healing, Shamanism and Modern Medicine. Boston, MA: Shambala, 1985
Campbell, Don. Music: Physician for Times to Come. Wheaton, IL: Quest Books, 1991
Elliott, William. Tying Rocks to Clouds, Meetings and Conversations with wise and Spiritual People. New York: Doubleday, Image Books, 1995
Frank, J. D. Persuasion and Healing: A Comparative Study of Psychotherapy. Baltimore, MD: The Johns Hopkins Press. 1961
Heinze, Ruth-Inge. Trance and Healing in Southeast Asia Today. Bangkok/ Berkeley: White Lotus/Independent Scholars of Asia, Inc., 1988
Kleinman, Arthur. Patients and Healers in the Context of Culture, an Exploration of the Borderland Between Anthropology, Medicine and Psychiatry. Berkeley/Los Angeles, CA: University of California Press, 1980
Miller, Casper J., S. J. Faith Healers in the Himalayas. Kathmandu, Nepal: Tribhuvan University Press, 1979
Torrey, E. F. Witchdoctors and Psychiatrists: The Common Root of Psychotherapy and its Future. New York: Harper and Row, 1986.


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About Ruth-Inge Heinze, PhD

Ruth-Inge Heinze (PhD, Research Associate, Centre for Southeast Asian Studies, University of California, Berkeley) conducted research and has worked in the field of ethnomedicine in Asia, Europe, and the United States for over thirty-six years. In addition to licenses in Reiki I and II, she also holds an Acupuncture license from a Singapore clinic and a license in Chinese Herbal Medicine from the Taoist Academy in San Francisco.

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