People may choose to be treated by spiritual massage healing alone or in conjunction with secular medical treatment. Spiritual massage healing may be an alternative to medical treatment just as medical treatment may be an alternative to spiritual massage healing. When spiritual massage healing is the only treatment a person is receiving, it is not complementary because it is not adjunctive or supplemental to any other treatment. But there is another important aspect of spiritual massage healing which has to be considered. The terms alternative and complementary  have been applied to secular massage therapy, but are not applicable to spiritual massage healing the same way because of the separtion of church and state.

Until recently, medicine paid little attention to  spiritual healing, and secular massage therapy has ignored the spiritual nature of bodywork. That is precisely why the Church for Spiritual Healing and Health, the Spiritual Massage Healing Ministry, the Journal of Spiritual Bodywork, and the Spiritual Massage Ministry Newsletter were established.1,2 They satisfy the needs of those who are interested in the spiritual nature of bodywork, as distinct from secular massage.

Massage therapy is defined by state massage laws and by the American Massage Therapy Association as a secular symptom-directed, medically-oriented therapy.3 This is obviously not spiritual healing. Secular massage therapy is concerned only with symptoms of medical problems associated with the body, not spiritual matters involving the soul.2 Because of the constitutional separation of church and state, the state can regulate secular massage therapy whether it is alternative or complementary.  But it cannot regulate spiritual massage healing whether it is alternative or complementary.

Spiritual massage healing is a legally unique kind of healing which is very different from secular massage therapy.3 As we shall see, the state cannot even define spiritual healing. If it cannot define spiritual healing, how can it regulate it? The state must have clear-cut definitions of everything it regulates. Otherwise, it will attempt to regulate something that is subject to legal challenge because it is ambiguous; it may be defined in different ways. This is precisely why state massage laws define what they mean by "massage" and "massage therapy."

The term massage in spiritual massage healing has a very different meaning than it has in massage therapy.  In spiritual massage healing, massage is used only because some movements that the spiritual massage healer does may superficially resemble what people generally call massage.2 However, spiritual massage healing and secular massage therapy are very different in philosophy, training and practice.2,3 The basis of spiritual massage healing and other forms of spiritual healing is "In God we trust." The basis of medicine is "In science we trust." The basis of secular symptom-directed, medically-oriented massage therapy is "In state massage laws and the National Certification Examination we trust."

Spiritual massage healing is a form of prayer because it is religious worship.2 It is also a form of prayer because it is the laying on of hands, and the laying on of hands is a form of prayer. According to William A. McGarey, Director of the Edgar Cayce Foundation Medical Research Division, "The cultivation of spiritual insights is the activity that goes on unconsciously as one prays or as one meditates. Prayer need not be of the silent or the verbal type. It may be an action, such as the laying on of hands, the process that passes energy on to another individual, which brings about some degree of healing."2 The state cannot dictate how one may pray because prayer is a form of worship and the state cannot dictate how one may and may not worship.

Spiritual massage healing is a form of religious healing that is performed during a religious ceremony.1,2 The religious ceremony is what both the spiritual massage healer and her client engage in jointly to facilitate the spiritual healing. In secular massage therapy, the massage therapist does it all. The client simply lies on the table and passively lets it happen.

The Pennsylvania State Board of Medicine, which regulates the practice of secular healing arts, specifically excludes "healing by spiritual means or prayer" from its jurisdiction3 because of the constitutional separation of church and state. For the same reason, the Board also does not define "healing by spiritual means." Because the State Board of Medicine does not regulate "healing by spiritual means or prayer," how can the Commonwealth of Pennsylvania regulate spiritual massage healing which is "healing by [both] spiritual means and prayer"?

How one does spiritual massage healing, including spiritual healing, and how one prays and worships are defined by one's religion, philosophy, and conscience,2 not by law. The Commonwealth of Pennsylvania cannot define religion and church.3 Therefore how can the Commonwealth define what is and what is not religious worship,  and how an individual may or may not worship her or his God - unless the practice of that worship causes injury to others?

It is interesting that the Pennsylvania State Board of Medicine, which regulates surgery as a medical practice, does not restrict the surgical practice of circumcision to licensed doctors when circumcision is done as part of a religious ceremony.3

Spiritual massage healing is legally different from secular massage therapy.3 It is a form of religious worship for both the practitioner and the client because both of them are seeking healing help from God.2,3  The practice of spiritual massage healing, like other forms of "healing by spiritual means and prayer," is protected by the separation of church and state.

Specifically, what does alternative … medical therapies in the previous paragraph mean? Doctors may examine, diagnose, and provide a patient with information, but not necessarily treat that patient. Examination, diagnosis, and advice are medical procedures, but not medical therapies because they are not medical treatment.

The meaning of alternative  is restricted to medical therapies in the penultimate paragraph. However, the term alternative  in the National Institutes of Health (NIH) Office of Alternative Medicine5 obviously means alternative to medical treatment. Because alternative health care modalities are not all medical, it is incorrect to categorize them all as alternative medicine. (I shall say more about this later.) An alternative modality may not be medical treatment although, as pointed out in Part 1, medical treatment may be an alternative health care modality.

Restricting all alternative health care modalities to the category of alternative medicine also makes no sense from the point of view of state laws that regulate the practice of medicine. These laws obviously do not apply, for example, to chiropractic and massage which are regulated by their own their state laws. If something is not conventional medical treatment, calling it alternative medicine does not, ipso facto,  make it medicine.  In some cases, the term alternative medicine is therefore an oxymoron. It makes no sense.

The term alternative medical therapies4 is also ambiguous because therapies  include medical as well as non-medical (i.e., alternative) modalities. The term therapy  may also refer to treatment of conditions involving the soul, independently of the body.2 The terms alternative health care  and alternative health care modalities  are more appropriate than alternative medicine  and alternative medical therapies.

"Let there be light."

To understand the differences between the terms alternative  and complementary  requires that we differentiate between definitions of treatments  and the treatments  themselves. Definitions of treatments exist independently of patients who receive the treatments. But treatments do not exist independently of patients who receive them. Treatments may differ from their definitions when doctors use the treatments for purposes for which they are not ordinarily prescribed; i.e., defined. We therefore cannot decide whether medicine or some other health care modality is alternative or complementary without knowing what treatment(s) each individual patient is receiving, when, and under what conditions.

It is therefore not a matter of simply adopting one or the other of the two terms - alternative or complementary - for general use a priori or in vacuo;  that is, independently of each particular treatment situation to which one or the other term may apply.  Neither term can replace the other because they may have different meanings under different circumstances.

To understand the differences between the terms alternative  and complementary  also requires that we identify different roles doctors play. Doctors may provide patients (a) with medical treatment without providing them with medical information, (b) with medical information without providing them with medical treatment, and (c) with both medical information and medical treatment. Information per se is not medical treatment.

When the same doctor treats patients with alternative health care modalities, alone or in conjunction with medical treatment, alternative  and/or complementary  is not an issue. It becomes an issue when people pay providers of alternative health care, who are not physicians, billions of dollars.6 Doctors become concrned because they are not getting that money.

This article focuses on clarifying the terms alternative and complementary  as they are used to describe the relationship between medicine and alternative health care modalities. However, even within alternative health care itself, independently of medicine, the terms are also applicable. For example, Swedish massage is a useful complementary modality for chiropractic treatment. Doctors are much less concerned about what these terms mean in professions other than medicine because much less money is involved..  

The fact that many patients use doctors only as a source of medical information is recognized by the cardiologist Dr. Bruno Cortis. He described "exceptional heart patients who kept the reins of health care in their own hands. They wanted their doctors to serve as advisors and consultants, not as authorities. They resented it if their doctors attempted to run the show. They insisted on making the final decisions themselves." Some of these patients "made use of alternative and experimental methods of which their doctors knew very little. In short, they insisted on doing things their own way… Many of these patients confounded their doctors by getting well when they were supposed to get worse. They thrived when they were supposed to weaken. They lived when they were supposed to die."7 In these cases, doctors served only as "advisors and consultants."

These considerations clearly reveal that treatment with alternative modalities may be complementary to or completely independent of medical treatment. It is impossible for alternative modalities to be complementary to medical treatment when people are not receiving any medical treatment. Conversely, medical services may be complementary to alternative health care. This occurs when doctors only monitor or provide information to patients who are being treated only by alternative health care practitioners.

However,  many people don't want doctors even as "advisors and consultants." This is reality, and medicine knows it because "one in three U.S. patients routinely uses alternative therapies, and seven in ten users do not discuss the practices with their primary physicians."4  That is one reason why The Department of Continuing Education at the Harvard Medical School and the Department of Medicine at the Beth Israel Hospital are jointly presenting the course Alternative Medicine: Implications for Clinical Practice  in Boston on March 27 - 29, 1996.4

Two different solar models for health care

Doctors tend to place themselves in a central position of health care providers, like the sun in our solar system, with alternative modalities rotating around them like planets around the sun. I call this model heliocentric. It seems to fit the view of Joseph J. Jacobs, M.D., former director of the National Institutes of Health (NIH) Office of Alternative Medicine. For him, "the term alternative medicine  is a misnomer." "It's not an alternative to conventional treatments. It's supplemental,"5 which is another way of saying complementary.  For this reason, some individuals want the  Office of Alternative Medicine to be renamed the Office of Complementary Health Care.

This proposed change raises the question - complementary to what? The assumption by doctors that all alternative health care is or should be complementary to their medicine is, as has been shown, a denial of present-day reality. Many people who are being treated by practitioners of alternative modalities reject medical care. For them, medical treatment is unacceptable. The alternative treatment these individuals get is truly alternative health care because it is an alternative to medicine. It is not complementary to medical treatment because they are not getting any medical treatment. A heliocentric model of health care that is more realistic than the one described above has the patient, not the doctor, in the center of the health care system, with medicine and alternative health care modalities, all equally and independently  available, rotating around each patient who decides which one(s) he wants. 

Dr. Jacobs is correct in concluding that the term alternative medicine  is a misnomer.  But he is wrong in implying that alternative health care is "not an alternative to conventional treatments. It's supplemental."5 That's only one side of the coin. Alternative health care may be supplemental to conventional medical treatment, just as conventional medical treatment may be supplemental to alternative health care.

To summarize, alternative modalities are not always supplemental to conventional medicine. They cannot be supplemental to medical treatments when people are treated only by alternative modalities. They are also not associated with conventional medical treatment when patients use doctors (a) only to monitor their progress and (b) only to provide information by answering questions while they are on alternative modalities. Under these circumstances, doctors provide only information, not medical treatment.

Doctors' limited view of reality

"In light of evidence that one in three U.S. patients routinely uses alternative therapies, and seven in ten users of alternative therapy do not discuss these practices with their primary physicians, there is a need for professional education and improved patient-provider communication in this area."4 This alleged need reflects doctors' limited view of reality. The greatest need is for doctors to understand that alternative health care is now mainstream, and why more and more people are using less and less medical treatment.

The medical establishment has unsuccessfully tried to suppress homeopathy, naturopathy, and chiropractic because they are economic competitors. If the medical establishment tries to do that with present-day  alternative health care modalities, it will clearly reveal its economic motive.6 That will lower the credibility of medicine which many people already look on as a business and industry whose primary objective is profit.

What's wrong with conventional medicine?

One reason why so many people have given up on conventional medicine is that too many doctors are death-oriented or negative in other ways. This was pointed out by Andrew Weil, M.D., who considers "voodoo death" as the ultimate example of a negative placebo effect." These curses, which Weil calls "a kind of medical 'hexing'", are doctors' comments to their patients, such as:

"They said I would just have to live with it." 

"They said there was nothing more they could do for me." 

"They said I'd be dead in six months." 

"They told me it would only get worse."

Fortunately, Weil found that he could break these medical hexes by administering humor. "When I can get patients to laugh," he wrote,  I feel that the curses are dispelled."8

People have also given up on convention medicine  because they do not want what Weil calls "antimedicine" which "in essence is counteractive and suppressive." Antimedicine consists of "antispasmodics and antihypertensives, antianxiety agents and antidepressants, antihistamines, antirhythmics, antitussives, antipyretics, and anti-inflammatories, as well as beta-blockers and H2-receptor antagonists."

People want medicine which has a health-oriented philosophy instead of a "disease focus." With respect to this, Weil directs attention to "our National Institutes of Health. Really," he writes, "they are National Institutes of Disease: The National Cancer Institute, The National Institute of Allergy and Infectious Disease, the National Institute of Arthritis and Skin Diseases, The National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and so on. Where is the National Institute of Health and Healing?"8

Finally, the practice of medicine has become impersonal to the extent that many describe it as a dehumanized assembly line where the bottom line is profit for doctors, hospitals, the pharmaceutical industry, and insurance companies.6 To avoid this, many people seek alternative health care, because it is personal, humane, non-interventive, has less adverse side effects, and is effective. Moreover, they personally pay billions of dollars annually for  alternative health care because their health insurance usually does not cover the fees of primary health care providers who are not doctors.

Doctors too often heliocentrically assume that they are or should be the only ones who provide primary health care, and that alternative modalities, with which people choose to be treated, should be complementary to conventional medical care; that is, under the direct or indirect control of doctors. This would, of course, enable them to get fees sometimes for little if any service.

Health care would cost much less if alternative health care providers were paid directly by insurance companies. However, the medical establishment is opposed to this for obvious reasons.

References

1. Schatz, A. Why the Church for Spiritual Healing and Health was established. Spiritual Massage Ministry Newsletter. 1(4): 1-3, 1995.

2. Schatz, A. The Church for Spiritual Healing and Health. Spiritual massage healing. Journal of Spiritual Bodywork. 1(1):1-53, 1995.

3. Schatz, A. Massage therapy and spiritual message healing are legally different modalities. Spiritual Massage Ministry Newsletter. 1(10):1-2, 1995.

4. Alternative Medicine: Implications for Clinical Practice. A course sponsored by the Harvard University Department of Continuing Education and the Department of Medicine, Beth Israel Hospital. Boston, MA. March 27-29, 1996

5. Time for new head, new approach at OAM. Jour. Amer. Med. Assoc. 272:1806-1810, 1994.

6. Schatz, A. and Carlson. K. We need a new kind of national health care. More of the same won't work.  Journal of Well Being. 9(4):19-27, 1994.

7. Cortis, B. Heart & Soul. A Psychological and Spiritual Guide to Preventing and Healing Heart Disease. Villard Books. New York. 1995.

8. Weil, A. Spontaneous Healing. How to Discover and Enhance Your Body's Natural Ability to Maintain and Heal Itself. Alfred A. Knopf. New York. 1995.

House of Humor. Gabrovo, Bulgaria

We who are about to laugh salute you.

Albert Schatz

The title of this article is a quote from Reinhold Niebuhr.1  The article is a sequence to "Holy Laughter. The serious humor of Albert Schatz who believes 'A laugh a day keeps insanity away.'"2

Two books that intrigued Albert Schatz with respect to humor are The Individual and His Religion, which points out that humor provides us with a fresh perspective in life,3 and  Laughter Helps the Heart and Soul.4 Albert believes humor is an integral part of our joi de vivre,  because it contributes to good health. "You can't laugh and cry at the same time," he says, "and you can't laugh and be depressed at the same time." Albert has what he considers a fairly reliable test for a sense of humor: "I say something funny. If you laugh, you have a sense of humor. How much you laugh indicates how much of a sense of humor you have."5

He tells people who don't think he's funny, "Try my humor on for size. If it fits, wear it, and let it help you enjoy life. If it doesn't fit, figure out what you learned by trying it on. Either way, you benefit." When someone told him, "There is a method to your madness and a madness to your method." he replied, "That's your problem, not mine."5

Albert is not satisfied  with René Descartes' dictum, "I  think, therefore I am." because "I am."  means only that "I exist. " For Albert, merely existing is not enough. People have a right to live fully and fully enjoy life. This is essentially what "life, liberty, and  the pursuit of happiness" in the Declaration of Independence means to him. But people need good health to enjoy "life, liberty, and the pursuit of happiness." Humor helps them attain, regain, and maintain good health.5

Albert therefore goes beyond Descartes when he proclaims  "I laugh, therefore I live."  and "I live, therefore I laugh."  He also says, "A laugh a day keeps insanity away." But, although humor is important, it is also important and sometimes even necessary to cry because crying, too, can contribute to our health."5

The healing value of humor is finding increasing support among therapists. For example, F. Farrelly and J. Brandsma write, "If the client is not laughing during at least part of the provocative therapy encounter, the therapist is not doing provocative therapy and what he is doing may at times turn out to be destructive. Humor plays a central, crucial, key role in provocative therapy; it is encouraged and necessary, not just a tangential adjunct to the 'real work."6

Norman Cousins concluded that laughter was a major factor in his ability to heal himself from what was considered an incurable collagenous disease.7,8 A report in Sweden confirmed Cousins' belief that laughter contributes to healing.9 That report concluded that "A humor therapy program can improve the quality of life for patients with chronic problems. Laughter has an immediate symptom-relieving effect for these patients." Laughter is also a form of exercise10 that is beneficial for the internal organs,11 in the aging process,12 and in counteracting stress.13

Cousins devoted a whole chapter to The Laughter Connection  in his book Head First. The Biology of Hope.14  This chapter begins with the following two quotations.

The most acutely suffering animal on earth invented laughter.-  Friedrich Nietzsche

There ain't much fun in medicine, but there's a heck of a lot of medicine in fun. - Josh Billings

The chapter ends with a list of books, audio cassettes, and video cassettes that are available to patients in the Comprehensive Cancer Center at Duke University. Cousins says that this collection is, "so far as I know, the most far-reaching of its kind."

References

1. McWilliams, P., and John-Roger. You Can't Afford the Luxury of a Negative Thought. A Book for People with Any Life-Threatening Illness - Including Life. p. 458. Prelude Press. Los Angeles, CA. 1989.

2. Brewster, M. Holy laughter. The serious humor of Albert Schatz who believes "A laugh a day keeps insanity away. Spiritual Massage Ministry Newsletter. 1(3):3-4, 1995.

3. Allport, G. The Individual and His Religion. Macmillan. New York. 1950.

4. Leighty, J.M. Laughter Helps the Heart and Soul. The Houston Chronicle. June 9, 1987.3. Carlson, K. We who are about to laugh salute you. Holistic Massage Newsletter. 1(1): 1,  1987.

5. Carlson, K. "We who are about to laugh salute you." (A. Schatz) Holistic Massage Newsletter. 1(1):1. August 2, 1987.

6.  Farrelly, F., & Brandsma, J. Provocative Therapy. Meta Publications Cupertino, CA. 1974.)

7. Cousins, N. Anatomy of an illness.  New England Journal of Medicine. 295:1458-1463, 1976.8. Cousins, N. Anatomy of an Illness. Reflections on Healing and Regeneration. W.W. Norton & Co. New York. 1979.

9. Ljungdahl, L. Laugh if this is a joke.  Journal of the American Medical Association. 261: 558, 1989.

10. Fry, Jr. W.F. In the Health Briefing Section.  Insight. May 25, 1987.

11. Walsh, J.J. Laughter and Health. D. Appleton and Company. New York. 1928.

12. Fry, Jr. W. Humor, Physiology, and the Aging Process.  pp. 81-98 in: Humor and Aging. edited by L. Nehemow, K.A. McCluskey-Fawcett, and  P.M.McGhee. Academic Press. Orlando. 1968.

13. Martin, R.A., and Lefcourt, H.M. Sense of humor as a moderator of the relation between stressors and moods. Journal of Personality and Social Psychology. 45:1313-1324. 1983.

"The objective of this course [was] to explore the relationship between spirituality and healing in medicine and to give perspectives from … the  major … world religions. The physiological, neurological, and psychological effects of healing resulting from spirituality also [were]  discussed… Research" has "established that people experience increased spirituality as a result of eliciting [a certain physiological] state regardless of whether or not they use a religious focus.

Spirituality [is] expressed as experiencing the presence of a power, a force, an energy, or what [is] perceived of a God and this presence [is] close to the person. Furthermore, spirituality [is] associated with fewer medical symptoms.

The reports presented include:

Hindu and Buddhist Spiritual Healing Practices

Neurobiological Mechanisms Related to the Placebo Effect.