A complex systems science perspective for whole systems of complementary and alternative medicine research.
Whole systems complementary and alternative medicine (WS-CAM) approaches share a basic worldview that embraces interconnectedness; emergent, non-linear outcomes to treatment that include both local and global changes in the human condition; a contextual view of human beings that are inseparable from and responsive to their environments; and interventions that are complex, synergistic, and interdependent. These fundamental beliefs and principles run counter to the assumptions of reductionism and conventional biomedical research methods that presuppose unidimensional simple causes and thus dismantle and individually test various interventions that comprise only single aspects of the WSCAM system. This paper will demonstrate the superior fit and practical advantages of using complex adaptive systems (CAS) and related modeling approaches to develop the scientific basis for WS-CAM. Furthermore, the details of these CAS models will be used to provide working hypotheses to explain clinical phenomena such as (a) persistence of changes for weeks to months between treatments and/or after cessation of treatment, (b) nonlocal and whole systems changes resulting from therapy, (c) Hering's law, and (d) healing crises. Finally, complex systems science will be used to offer an alternative perspective on cause, beyond the simple reductionism of mainstream mechanistic ontology and more parsimonious than the historical vitalism of WS-CAM. Rather, complex systems science provides a scientifically rigorous, yet essentially holistic ontological perspective with which to conceptualize and empirically explore the development of disease and illness experiences, as well as experiences of healing and wellness.
College of Nursing, The University of Arizona, Tucson, AZ 85724-21203, USA. mkoithan@nursing.arizona.edu
Mary
M
Koithan
Iris R
IR
Bell
Kathryn
K
Niemeyer
David
D
Pincus
D035843:Biomedical Research; D000529:Complementary Therapies / Q000379:methods*; D003299:Cooperative Behavior; D006694:Holistic Health; D006801:Humans; D055809:Illness Behavior; D033183:Interdisciplinary Communication; D010686:Philosophy, Medical; D012586:Science / Q000379:methods*; D013598:Systems Theory; D014799:Vitalism