SYLLABUS. Teaching Assitant: "Daniel Albaugh" Class Time: 11:20 AM - 2:00 PM Wednesday

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1 SYLLABUS Course: Alternative Medicine Department: Psychology Course #: PSYC Professor: Deborah Norris, Ph.D. Scientist in Residence and Adjunct Professor Department of Psychology American University Washington, D.C Phone: Teaching Assitant: "Daniel Albaugh" Class Time: 11:20 AM - 2:00 PM Wednesday Course Overview The purpose of this course on Alternative Medicine is to explore complementary and alternative healing practices. Throughout human culture, one group has given a name to the Others. In this case CAM is a name given to healing practices that are not yet a part of Allopathic medicine, or that are outside the realm of drug therapy and surgery. Our study will be conducted in the context of a scientific review of recent evidence-based biomedical research on effectiveness and mechanism of action for various therapeutic modalities. The course will thus include a review of scientific method as it is applied in medicine. According to the N.I.H. National Center for Complementary and Alternative Medicine (NCCAM), a body of data is emerging from NCCAM's investments in research that is informing public policy and helping guide practices." This data will be reviewed and evaluated for scientific validity, utility and merit. Many of the alternative or holistic medical concepts are rooted in thousands of years of practice in other cultures. Now these ancient healing practices are being incorporated into mainstream modern medicine. According to a survey conducted by NCCAM in 2002, 75% of Americans have used CAM therapies at some time in their lives (NCCAM Newsletter, Summer, 2004, v.xi, No.3). The FY 2006 appropriation for NCCAM is $122,692,000. In 1997, people in the U.S. spent $27 billion in out-of-pocket expenses for alternative medicine. And now most insurance companies cover CAM therapies for specific treatments. Clearly, Americans are using complementary and alternative medicine. But many questions remain, such as, What therapies are they using? For what health problems and concerns? Are these therapies effective, and if so, what is their mechanism of action? This course will address these questions in the context of the science of health, healing and optimal well-being. The materials for study will be based on a survey of the evidence-based biomedical research literature, towards the goal of advancing scientific knowledge. Clearly an obstacle in integrating CAM therapies into current biomedical practices has

2 been the difference in the language and culture of the CAM practitioners. This course will also consider a biomedical interpretation of CAM therapies, based on an understanding and analysis of the CAM cultures from which they arise. Ultimately such an historical perspective may offer students and future researchers a broader base for advancing science. In this course we will build upon foundation courses which have established the concept of biological, psychological or chemical science disciplines, and continue to learn the language of today's state-of-the-art modern allopathic medical science. We will review how medical science works, through explicit examination of the historical development and current status of scientific methods, concepts and principles. We will explore these basic concepts of scientific reasoning and discovery as they are applied to research in modern biology and medicine. We will consider allopathic biomedical concepts from the perspective of the evolution of ancient healing practices, and visa versa. Students will learn about the evolution of medicine by comparing the historical development of ancient healing practices with the current status of modern medical scientific methods. By surveying scientific biomedical literature, students will learn how medical research applies scientific method by successive experimentation to replicate data, control variables, explain error and build explanatory models for understanding the mechanism of action of alternative and complementary healing strategies. For historical perspective, we will consider how this scientific process differs from or is similar to the ancient processes through which complementary and alternative therapeutic systems developed. The course will explore the wide range of CAM therapeutic systems, as well as the languages of these systems, including acupuncture, TCM, Ayerveda, chiropractic, bioenergy, meditation, homeopathy, nutrition and herbalism, and more. Students will gain writing experience through the progressive stages of preparing a term paper addressing how CAM therapies may be used or integrated into a treatment program for specific diseases, and the validity and precautions involved in these applications. Students in this class will review the literature that is beginning to show us how to understand holistic medical practices in today s language of science. Student outlines will be reviewed and students will be given feedback on their research and writing before preparing a final term paper. For experience in public speaking, term papers will be discussed in class, and as fuel for further debate. As students learn the language of science as well as that of many and varied ancient healers, we may in the process come to a new place in our understanding of our culture s medical practices. We may also expand beyond our knowledge of the biochemistry of our bodies, as we incorporate other energetic phenomena which may be involved in the healing potential of the human body. We will explore concepts such as energy pathways, biofeedback, electromagnetic sensory processes and other mysteries of healing. Ultimately, the question is how to use the perspective of today s biomedical sciences to evaluate the utility of complementary and alternative practices. It is possible that studying the frontiers of holistic medicine will contribute to the direction of medicine specifically and science in general. The goal is that the understanding gained in this class will create better consumers, health care providers, and scientists.

3 Philosophy The philosophy underlying this course is that the use of complementary and alternative medical (CAM) therapies has made a firm impact on the standard of medical care in this country, due to a grass-roots movement and consumer demand. As a result, important developments are occurring in scientific research on healing, in medical school curricula, and in the standard of care in the medical fields. Research in CAM therapies is being driven by the need for evidencebased biomedical research to identify the mechanism of action of CAM therapies. As such a large number of people are using CAM therapies, academic programs are now educating clinicians, scientists and consumers alike on the pros and cons of alternative therapies, as well as the precautions of integrating CAM and traditional therapies. Preparation of medical providers and consumers will rely on the ability to scientifically evaluate the biological, physical, chemical and behavioral effects and mechanisms of action of CAM therapies. Therefore this course provides students with an understanding of the field of complementary and alternative medicine, the range of therapeutic modalities available, their indications and contraindications, the evolution of the healing arts, and the current scientific investigation of the mechanism of action and reliability of effect of CAM therapies. Short Course Description This introduction to complementary and alternative medicine reviews the wide variety of CAM therapies that are in use, including acupuncture, chiropractic, herbal medicine, homeopathic medicine, energy medicine, behavioral medicine and others. The course critically examines the scientific validity and practice of alternative therapies, and reviews the state of the science in understanding the biological basis for their action. Known and potential adverse reactions will be reviewed. Placebo and nocebo effects will be considered. We will look closely at the state of the art of research into CAM therapies. This course includes an overview of the general biological, physiological, and neurochemical basis of CAM therapies, as well as a survey of the basic physical, biochemical and behavioral effects of CAM therapies. Understanding the underlying mechanisms of action is a priority in the scientific study of CAM therapies. Most complementary or alternative healing practices have a long history of use, and a rationale for effectiveness based on the cultural practices and beliefs in which they evolved. Therefore, in this course students gain an understanding of the theories and traditional concepts of CAM therapies. Course Objectives The objective of this course is to prepare students to be informed consumers, practitioners or scientific researchers in the state of the art and science of integrative medicine. Scientific Methodology "Through observation and analysis of the physical and biological world, scientists discern basic principles that explain natural phenomena and unravel many mysteries. Whether chemist, biologist, physicist or experimental psychologist, scientists rely on theory and experimentation to test and refine understanding of our bodies, our complex environment, and the universe." In this course, we will thoroughly and critically examine research regarding the use, effectiveness and mechanism of action of specific complementary and alternative medical practices. We will review the design, application and outcome of clinical trials studying the utility and effects of

4 these therapies on our bodies. Summary of Course Content: The major issues to be covered in Alternative Medicine are: - Review of recognized complementary and alternative medical therapies - History of cultural and social role of CAM therapies - CAM therapy effects and application to disease/healing: use and precautions - Mechanisms of healing actions, psychoneuroimmunology - Current research in biomedical studies of CAM therapies - Application of CAM therapies in today's society - Integration of CAM therapies into U.S. medical culture. Course Goals: A scientific examination of an integrative medical approach. This course will introduce an array of medical approaches, their viability in treating a host of disorders, the current state of research on them, and revisions occurring in the U.S. health care policy. Taking into account a variety of perspectives, a new framework for understanding healing and our health will be considered. Topics to be covered: Introductory concepts: What is CAM? Perspectives on definitions. Central tenets: Homeostasis The Duh factor. Depathologizing the body. Self-Empowerment? Optimal well-being? Relationship of healer and spiritual leader; healing and spirituality Concepts of healing: The immune system Psychoneuroimmunology Scientific Method Overview of approaches to be covered - categories of alternative therapies Physical, body-based approaches Behavioral/emotional/mental approaches Spiritual approaches Eastern medicine (meridian approaches) Ayerveda Bioenergy approaches Other frameworks: Structural, Biochemical, Lifestyle management, etc.

5 Alternatives: Physical, body-based approaches: Lifestyle habits Stress management Exercise Diet & Nutrition Stress Management Spirituality Diagnostic tools: Overt symptoms: condition of hair, nails, skin, tongue, eyes Trace mineral (hair) analysis Detailed information on health, emotional & life history Diet & Nutrition: Macrobiotic Diet The Zone Diet, (Barry Sears, protein and veggies with little or no grains - ancestral basis: eating grains is evolutionarily recent... only 12,000 years ago with the invention of settled agriculture) South Beach Diet Zone Diet Low-Carb (Atkins) Macrobiotic Cave Man Raw foods (Ann Wigmore & the Hippocrates Institute: raw foods, importance of enzymes) Gary Null s Ultimate Anti-Aging Program (benefits of juicing; possibility of reversing key biomarkers for age) Eat Right for your (Blood) Type (ancestral reasons for recommended diet: O blood type = carnivore; A-blood type = vegetarian; B in-between) Role of Nutrition in Health Vitamins, Minerals, Fats, Enzymes, etc. Nutritional therapies (chelation, DHEA, glandular, hormone, ascorbic acid) Cleansing programs (colon, blood, fasting, enemas... ) Plant-based Remedies Herbal medicine & supplements (herbs, teas, capsules, tinctures, etc.) Plant spirit medicine of Native American Indians (Eliot Cowan) Homeopathy (Samuel Hahnemann, Key Laws: Law of Similars ( like cures like ) and Law of Infinitesimal Dilution.) Non-traditional Mechanical Approaches Osteopathy / Cranio-sacral / Chiropractic / Kinesiology Neuro-muscular system and its role in diagnosis and treatment; importance of the meninges and the cerebral-spinal fluid Massage Therapies Alexander Technique, Feldenkrais - proper use of the body Light, Color or Sound (Music) Therapies

6 Behavioral/Emotional/Mental Approaches Psychotherapy Meditation Neuro-linguistic programming Biofeedback Cellular memory & neuro-cellular therapies (Caroline Myss: Your biology is your biography) Guided Imagery Hypnotherapy Spiritual Approaches New research studies on the effectiveness of prayer Role of spirituality in other cultures Shamanism Voodoo

7 Eastern Medicines Traditional Chinese Medicine: methods for assessing health Meridian-based physiology: origins & principles Meridian-based treatments: Acupuncture / Acupressure / Jin Shin Jyutsu Reflexology / Iridology (diagnostic) / Five-element Ayurveda (3 doshas: vata, pitta and kapha) Yoga Tai Chi Qi Gong Bioenergy Approaches Bioenergy physiology Our energy bodies - auric, etheric, etc. Chakras (Barbara Ann Brennan; Caroline Myss) Reiki Magnet & electromagnetic field therapies Pranic Healing Bioenergy healers Teaching Methodology This is a seminar class of limited size to allow maximum opportunity for each student to participate in class discussion, interaction and questions. As an upper level graduate class, students are expected to prepare course material in advance of class and arrive prepared to discuss this material, including asking questions and answering questions. I will present lecture material as appropriate. Students are also expected to bring learning material to the class time. Readings Readings are based on current scientific literature. Readings include information available from texts, scientific journals, internet websites and handouts. Some of the reading assignments are available in the Blackboard Course Documents Files for this course. Texts: Alternative Medicine: The Definitive Guide (2nd Edition) by Burton Goldberg, John W. Anderson, Larry Trivieri " Energy Medicine: The Scientific Basis, James L. Oschman,Candace Pert. Fasting and Eating for Health: A Medical Doctor's Program for Conquering Disease, Forward by Neal D. Barnard, by Joel Fuhrman See Class Schedule for online readings. Academic Integrity Policy Cheating of any form will be immediately reported to the Dean of the College of Arts and Sciences. Please be familiar with the Academic Integrity Code, The American University.

8 GRADING CRITERIA Class Participation: Students will be marked for class attendance, preparedness for class, participation and contribution to discussion, and for submission of class notes. Class notes should be posted to Blackboard Discussion Section for this class, and must be submitted by Friday following class, unless otherwise noted, (e.g. class notes for 1/14 are due by 1/16). Class notes are due on the following dates: 1/16, 1/23, 1/30, 2/6, 2/13, 2/20, 2/27, 3/20, 3/27, 4/3, 4/10, 4/17. Full class participation in all areas will account for 25% of your final grade. Papers and Presentations: There is one required paper, which will culminate in a class presentation/discussion. The topic of this paper will be the disease, illness or symptom of your choosing. Your topic selection should be submitted in class by Wednesday, January 21, 2009 for full credit. Outlines are due on February 4, 2009, and should include references for full credit. The content of the paper will describe three therapeutic modalities for evaluating the etiology, course of illness and treatment of one disease of your choosing. From the perspective of each of these three therapeutic modalities, your paper should include a full description of the possible etiologies of this disease. For example, acupuncture might consider the cause of illness being an imbalance in ones wood ; whereas meditation might find sources of fear; whereas allopathic medicine might diagnose kidney disease; and Ayerveda would detect excess pitta. These are basically four different languages for referring to the same problem. Your paper should include a full evaluation, interpretation and description of the illness based on each of three therapeutic modalities. The paper should further evaluate the therapeutic approach for each of three therapies, outlining the treatment program in detail. The paper should also include a justification for each of these three approaches, as well as possible interactions, precautions, contraindications, side effects, and potential therapeutic outcome. The paper should thoroughly describe the mechanism of action for each of the three therapies, justifying the use of each approach. Describe the literature that supports the basis for this therapy and site all relevant reference material. This paper is worth 20 % of your grade, and the class presentation is worth 5%. Exams: There are two exams. Exams must be taken at the date and time scheduled, unless student provides documentation of a health or family emergency. Each Exam is worth 25% of the final grade. Class attendance, preparation, participation, class notes: 25 points Total Paper and Presentation 25 points Total (20/5) Exams: 25 Points Each (50 Total) Entire Course: 100 points Total Final Grade: Based on the cumulative score, grades will be determined on a scale of 0 to 100 as follows: A=93-100, A- =90-92, B+=87-89, B=83-86, B-=80-82, C+=77-79, C=73-76, C-=70-72, D=60-

9 69, F=0-59.

10 SCHEDULE OF CLASSES January 14 Topic: Introductions- To Course; to each other, to subject matter, etc. Alternative, Complementary, Integrative, Holistic Medicine Defined, versus Allopathy. Healing, Psychoneuroimmunology Online Readings due: pgs 4-16; January 21 PAPER TOPIC SELECTIONS DUE Topic: Healing, The Immune System, Psychoneuroimmunology, Stress. Depathologizing the Body. Scientific Method in Medical Practice. Online Readings due: Pgs ; January 28 Topic: Historical traditions: Traditional Chinese Medicine, Five-element, Meridian, Yin-Yang, Acupuncture, etc. Ayurvedic Medicine. American Indian Medicine. Religion in Medical Practice, Prayer Online Readings: pgs 41-42; 86-93; ; February 4 OUTLINES DUE Topic: Lifestyle Factors, Meditation, Biofeedback, Hypnosis, Guided Imagery, Breathwork, Guided Relaxation, Self-awareness Training, etc. Placebos, Nocebos, Vodoo. Online Readings: Pgs ; February 11 or 18: One of these classes is cancelled, one is not dates t.b.d. (read) Topic: Energy Medicine, Bioenergetic Healing, Reiki, Reconnective Healing. Discussion of Energy Medicine: The Scientific Basis, James L. Oschman. Online Readings:

11 Pgs ; ; February 25 Topic: Exercise, Yoga, Pilates, Alexander technique, Feldenkrais, Chiropractic, Massage, Physical Therapy Online Readings: Pgs ; 37-38; March 4 EXAM March 18 Topic: Diets, Nutrition, Fasting, Supplements, Herbal Medicine, Naturopathy, Chelation Therapy, Environmental Illnesses, Gulf War Illnesses Online Readings: pgs , ; March 25 Topic: The Future of Mind/Body/Spirit Medicine Discussion of Fasting and Eating for Health: A Medical Doctor's Program for Conquering Disease, Joel Fuhrman. April 1 April 8 April 15 April 22 PAPERS DUE Class Presentations (Practical application of alternative therapies to specific diseases). Class Presentations (Practical application of alternative therapies to specific diseases). Class Presentations (Practical application of alternative therapies to specific diseases). EXAM