‘The Anthropology of Alternative Medicine’ by Anamaria Iosif Ross (Berg, 2012)
The Anthropology of Alternative Medicine by Anamaria Iosif Ross is marketed as ‘invaluable to undergraduates and graduate students in anthropology, psychology, and health-related professions such as nursing, physical and occupational therapy, and biomedicine’ (forth cover). Given the increasing prominence of complementary & alternative medicine (CAM) in healthcare research, a textbook geared towards introducing novice learners to this field of study is welcomed.
The scope of this slim volume is ambitiously broad, ‘a concise yet wide-ranging exploration of non-biomedical healing’, with the core empirical discussions focused on the author’s fieldwork on Reiki in her country of birth, Romania. Between the introduction and conclusion are three chapters, each representing distinct concepts within alternative practices: substance, energy and information flow (e.g. helminthic therapy); spirit, consciousness and trance (e.g. shamanism); body, movement and the senses (e.g. Reiki and aromatherapy). Each chapter closes with a short list of suggested discussion questions, essay titles and suggested readings and films.
At times, reading the book felt akin to being the child grasped tightly in hand by the adult who walks quickly, eyes ahead, aware they have a large area to cover so takes long strides, sudden shortcuts and drops one off at a final unknown destination. There were momentary pauses, and beautifully written prose in areas, where the author was clearly well versed, such as her fieldwork. In other sections, the tightly woven prose hops, skims and jumps between topics with little warning. Ross, aware of the potential effect of her writing style, warns the reader early on ‘every subtopic or example addressed in the book arguably would deserve chapter or a book of its own, which may at times disappoint a seasoned reader or frustrate the avid novice […] it will at times seem haphazard or even unjust in its selections, and peculiar in its emphases, whetting the appetite for more local details, touching too briefly on worthy topics, omitting some influential scholars’ (pp.10-11).
As a result, how each reader responds to the text will depend upon their research training, experience and preferred/taught reading style. However, rather than a standalone introductory textbook for novice learners, this slim volume appears more suitable as a supplementary textbook for experienced lecturers and researchers perhaps paired with books, such as Alternative medicine?: A History by Roberta Bivin (2007) or Body Matters: A Phenomenology Of Sickness, Disease, and Illness by James and Kevin Ehro (2010).
The introductory chapter (alternative medicine in the 21st Century) begins ‘[a]lternative medicine is ideally suited to anthropological examination, being represented as the elusive and challenging other of modern capitalist biomedicine’ (p.1). Ross rejects the label CAM as a biomedical construction, preferring the term alternative medicine although she warns the reader that the term is complex and will be ‘used cautiously and interrogated often’ stating that ‘what is deemed alternative at a particular time and place is often a mainstream practice in another time and place’ (p.5). The chapter presents readers with a whistle-stop tour of key concepts intended to prepare the reader for the remainder of the book, that include: biomedicine’s focus on creating a ‘normal’ functioning material body without the absence of disease, the difference between the terms curing (biomedicine) and healing (alternative medicine) and the role of patient agency in healing. A discussion on the return of helminthes in western medicine (e.g. hookworms in intestinal treatments) offers a useful case study for students in understanding key differences between alternative and western medicine. Although, the broad description of the book’s dominant themes left me uncertain about the key points that the author wanted to make in the remaining chapters, except that she was seeking to be ‘adventurous as well as concise and open-ended’ in her writing (p.11).
The second chapter (substance, energy and information flow) introduces the concept of flow in alternative medicine that ‘[…] is a fundamental aspect of the natural world, the ultimate essence of life itself, a testimony to the dynamically complex nature of reality, and the basis of relationship. Everything that gives life and nourishes life must flow: rainwater, rivers, blood, semen, breast milk, nutrients, digestion, conversation, trade goods, and of course the underlying quality of everything in the universe’ (p.41).
Over 39 pages of tightly written prose, Ross moves from the importance of balance and equilibrium in classical and indigenous medicine to the flow of information (rumours) and the dark-side of knowledge that fuelled the financial crisis; then onto the duality of water and contamination that underpins homeopathy. She takes us briefly into the world of energy, life-force and the powers of the Sun then onto nourishment and healing, the American health food movement in the early twentieth century and the rising trend of alternative consumption movements in the development world. On page 69, she introduces her fieldwork, slows her pace, and takes the reader into the field of dowsing, energy and information; and (finally) I begin to understand why (though only just) she offers the reader the previous glut of information.
The third chapter (Spirit, Consciousness and Trance) introduces the role of spirit(s) and consciousness in health and healing. Ross draws on a diversity of examples, including the practice of hesychast prayer in Romania and the power of silence. She introduces the novice learner to anthropological concepts of (Shamanic) consciousness and symbolic healing through the work of ethnographers who both study and (unusually) engage in their chosen practice. One example being Susan Greenwood, an anthropologist and magician. Ross concludes this chapter with an introduction to classical concepts in anthropology on ritual healing and religious pilgrimage; and although throughout the book she frames all examples of western medicine as the ‘other’ to alternative medicine, I am reminded of John Welch’s paper: Ritual in Western Medicine and Its Role in Placebo Healing (2003).
Chapter 4 (Body, movement and the senses) draws predominantly on Thomas Csordas’ writings on embodiment (1990) and Margaret Locke and Nancy Scheper-Hughes concept of the mindful body (1987). Ross outlines the anthropology of sensations, moving beyond the historical dominance of the visual, and draws on a schemata of 11 senses outlined by Hinton, Howes, and Kirmayer (see p.123). Focusing in detail on smell, taste, touch, rhythm and dance, she discusses the prominence of the senses in therapies across cultures. She brings these concepts together through a discussion of earlier fieldwork in the late 1980s during the fall of the deposed Romanian dictator, Ceaușescu. At this point, Ross’ writing transforms into ‘thick description’, common to ethnographers, that is engaging, thoughtful and in contrast to the rest of the book, that is at times frenetic in pace. While reading this chapter, I became aware that the text reads (intended or not) as an extended opinion piece with bold statements, interwoven with thoughtful reflective prose drawn from her fieldwork. For this chapter onwards, I am no longer thrown by blanket unreferenced statements of ‘fact’, such as ‘covered head to toe with sunscreen, they are going against a biologically evolved need for sunlight’ (p.54). Ross concludes this chapter by challenging, and rejecting, the use of the current term ‘alternative medicine’ and instead proposes the concept of ‘polythetic medicine’, to understand the diverse aspects of alternative medicine, based upon a classification by the anthropologist Rodney Needham (see p.151). For me, this chapter is the most rigorously written, and the final section, while woefully short, is arguably the main teaching ‘hook’ for a diverse range of students, and an interesting discussion framework for the field of ‘alternative medicine.’ Notably, the proposition to adopt the term ‘polythetic medicine’ instead of alternative medicine deserves a separate chapter, with an extended discussion, rather than tucked away in the final section of the penultimate chapter.
In her concluding chapter, (looking into the Future of Alternative medicine), Ross closes the book as she begins by remaining reluctant to offer any static or bounded description of the nature of alternative practices; as she writes ‘just as this book’s chapter divisions do not represent permeable categories of healing traditions, “alternative” healing approaches and practices criss-cross cognitive and experiential domains of contemporary life, blurring dominant notions and understandings of persons, relationships and experiences’ (p.157).
The book is a tour de force of ‘facts’ interwoven with narratives on diverse traditions and therapies within the field of alternative medicine. However, as the author warned me, at times I found the book both disappointing and frustrating, in part as when reviewing a book I look to understand the author’s intended purpose, structure and key messages so that I review the book the author wrote not the one I wanted them to write. At the close of the introduction, the author writes ‘the book calls the reader on a winding journey to examine diverse models and manifestation of health illness and healing in diverse contexts, where the local and global cross paths, moving back and forth between the universal and the highly specific’ (p.37).
I would recommend, ‘sit back and go with the flow’ and this slim volume will generate new thoughts and topics for discussion, regardless of your discipline or experience.
Reviewed by Dr Fionagh Thomson, a methodologist with an interest in how to create the space and time with participants to think through and describe their everyday lives: focusing on what people do rather than what they think they do. She works with video, camera, paper and conversation. Her current research interests include: different representations of the ‘body’ in medical spaces, the extension of our senses through tools/technologies in meaning-making, hermeneutics (Gadamer, Ricoeur & Ihde) and the challenges of accessing everyday embodied experiences not easily represented through pen or voice.
Correspondence to Dr Fionagh Thomson
References
Aho, J. A., & Aho, K. (2008). Body matters: A phenomenology of sickness, disease, and illness. Lexington Books.
Bivins, R. (2007) Alternative medicine?: a history. Oxford University Press.
Csordas, T. (1990) Embodiment as a paradigm for Anthropology. Ethos, 18:5-47
Scheper-Hughes, N. & Lock, M. (1987) The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology. Medical Anthropology Quarterly. (1): 6-41.
Welch, J. S. (2003) Ritual in western medicine and its role in placebo healing. Journal of Religion and Health. 42 (1): 21–33.