In the fall of 2012, UCLA Center for East-West Medicine Researcher Sonya Pritzker, Ph.D., L.Ac. taught the upper-division special topics course, Anthro 157: Perspectives on Complementary, Alternative, and Integrative Medicine.
In This Article:
- Final Examination
- Mock Proposal for Long-Term Anthropological Research
- Discussion of Advantages and Disadvantages to Clinical Research (Randomized Control Trials) in CAM/IM
- Analysis of Socio-Economic Context of CAM/IM in the U.S.
- Examination of the Major Cultural Forces Impacting the Rising Popularity of CAM/IM in the U.S.
- Discussion of the Role of Language in the Development of CAM/IM in the U.S.
- Instructor Reflections and Student Feedback
In the fall of 2012, the UCLA Department of Anthropology invited UCLA Center for East-West Medicine Researcher, Sonya Pritzker, Ph.D., L.Ac., to teach the upper-division special topics course, Perspectives on Complementary, Alternative, and Integrative Medicine, for the second consecutive year. In Fall quarter of 2012, there were 78 enrolled students, consisting mostly of junior and senior level anthropology majors, but also including several other majors such as psychology, sociology, microbiology, and Chicano/Chicana studies. Although the course was designed specifically for anthropology majors, it was also geared to pre-med students interested in complementary and alternative medicine (CAM) and integrative medicine (IM).
Generally speaking, the course offered students a broad understanding of CAM/IM in the U.S. and beyond, with a specific focus on the social, cultural, economic, and political forces shaping the way multiple forms of CAM/IM, including but not limited to Chinese medicine, Ayurveda, massage, yoga, and naturopathy. Questions the course addressed included:
- What does it mean to look at any medical system with an anthropological gaze?
- What are the cultural elements involved in the rising popularity of CAM/IM in the US in the last several decades?
- In what ways can anthropology supplement the biomedical research model for examining CAM/IM modalities?
- How do Americans communicate differently with their CAM/IM practitioners versus their biomedical physicians?
- What are some of the different ways that we can profitably define IM and utilize this definition to transform the way we understand medicine?
- What are the tools that CAM/IM has to offer for underserved populations?
- What is the role of CAM/IM in healthcare reform, and more generally, in addressing the healthcare crisis?
In addition to addressing these questions through lectures, readings, and class discussion, the course included weekly guest lectures from scholars and practitioners at UCLA who are researching and practicing CAM/IM in various forms.
Readings included selections from the texts, Toward an Integrative Medicine: Merging Alternative Therapies with Biomedicine (Baer 2004), The Anthropology of Alternative Medicine (Ross 2011), and Complementary and Alternative Medicine: Bodies, Therapies, Senses (Barcan 2011), as well as many original anthropological articles and reports of clinical research in CAM/IM.
Assignments included reading responses that were submitted twice weekly. Students were asked to include their personal responses, as well as one to three or more analytical, theoretical, or cross-article questions pertaining to the days reading. These questions provided discussion points addressed during each lecture, and made for lively discussions about the ethics of integration, the ways in which CAM and IM practitioners work to establish legitimacy in a biomedically dominated society, issues related to healthcare reform, the role of belief in healing, and research methods for investigating CAM/IM, among other topics.
During the quarter, each student was also required to conduct a field visit to a CAM context. For this purpose, they could make a visit to an alternative or integrative practitioner, a yoga class, or conduct an observation or interview with a CAM/IM researcher. They were instructed to write up anthropological field-notes about their experience. Many of the students thus visited a practitioner of Chinese medicine, sought care from a massage or Reiki practitioner, or attended a yoga class, most of them for the first time. Their field-notes provided many provocative observations in these settings, including comments about the ways in which different practitioners integrated ideas from biomedicine into their practice; the ways in which practitioners spoke to their patients about a range of concerns beyond the usual “medical” issues; the ways in which clinic spaces were designed; and the ways in which practitioners dressed (e.g., whether they wore a white coat or dressed casually). One student conducted an online ethnography of CAM/IM skeptics, and another wrote a report on CAM/IM in the media, focusing especially on one popular TV series, Private Practice, that includes an integrative clinic.
The final exam for the course consisted of four essays. Students were given five prompts and asked to write two to three pages on four of their choice.
One prompt asked them to create a mock proposal to do more long-term anthropological research on their fieldwork topic, or another CAM/IM related topic. Several outstanding proposals were created in this context, including a multi-year study examining the utilization of traditional ritual healing and biomedicine by members of a particular Navajo tribe; a study examining the use of CAM/IM in relation to alienation from biomedicine by lesbian-identified women in Los Angeles; a year-long study of CAM and IM at transformational music, arts, and healing festivals in the U.S.; and an investigation into hybridity in American Reiki practices.
Another question prompted discussion of the advantages and disadvantages to conducting clinical research (randomized controlled trials) in CAM/IM, and asked “how might anthropological, qualitative methods contribute to stronger studies?” Students responded with a nuanced understanding of the limitations of RCTs to capture the effectiveness of CAM and IM modalities for treating complex conditions, including quality of life.
Discussing the socio-economic context of CAM/IM in the U.S., including some of the barriers to providing CAM/IM services to underserved populations, was also another option on this list of topics for the final examination. The prompt also required students to address how we might overcome these barriers and what benefits might result from successfully addressing these challenges. Here, the students had several innovative ideas for educating underserved populations in CAM/IM, providing free low-cost CAM/IM care in both clinics and homes, and working with Medicare and Medicaid to ensure more coverage of CAM/IM modalities so that more individuals have access to care.
Another question inquired into the major cultural forces influencing the rising popularity of CAM/IM in the U.S., the major social and cultural challenges to integration, and what might be envisioned for the future of CAM/IM. In this context, the students demonstrated a grasp of the historical development of CAM/IM in the U.S., including the influence of various back-to-nature groups, New Age movements, and a growing dissatisfaction with biomedicine. Most strikingly, almost all of the students who chose to answer this question expressed the hope and desire for CAM to be fully integrated with biomedicine in the future. As many of the students began the course with a good deal of skepticism about CAM, this response was particularly inspiring.
The final exam question asked the students to discuss the role of language in the development of CAM/IM in the U.S., and while many of the students talked about the suggested topics of translation, socialization, and doctor-patient communication, others provided an in-depth examination of the terms used to name CAM/IM, and the importance of language in the healing process.
When Professor Pritzker was asked to provide her reflections on the course, she shared her perspective that “Overall, the 2012 course was extremely successful.” Additionally, she further elaborated that the course discussions were greatly enhanced by the thoughtful questions that students consistently generated in their reading responses. When guest speakers came to class, the students were well prepared and eager to learn more about each scholar or clinicians’ areas of expertise. Most of the students integrated their knowledge fluidly on the final exam, and demonstrated a great deal of original thought and nuanced appreciation of the culture of CAM.
Many of the course evaluations were extremely positive, with students saying, for example:
- “Out of all my classes I have taken at UCLA, this has got to be by far my favorite one….I loved the fact that I learned something new and different every lecture about the different methods and approaches used for alternative medicine.”
- “The class was amazing, and I am walking away from it with an enormous amount of new knowledge.”
- “A strength of the course is that it is inherently valuable. Everything that I learned in the course is something that I paid close attention to because the content of the information is something that I will use in my daily life to improve my overall health and the health of my loved ones. It opened my eyes to new health practices and made me more open minded.”
- “ I feel like I have gained a new understanding of our current healthcare system and learned how to care for myself in a new way. I only hope that students in currently studying medicine are able to take this course.”
- “I really enjoyed everything I've learned and experienced as a result of this class, and will look forward to seeing how alternative medicine can help improve how we view and utilize medicine in the future.”
- “I had little to no interest in CAM/IM before taking this course, but after the first class session I was hooked and have found myself doing additional research on topics we learned in class purely for my own intellectual pursuits.”
However, there were also several critical evaluations of the course. Most prominently, several students complained that the instruction left little room for students to voice perspectives that challenged CAM/IM. They felt that there was room for improvement in creating a more objective, open discussion of the subject matter, something that Professor Pritzker is taking to heart for the next session. In creating a culture of integration, it is of utmost importance that all voices be heard and considered.