The Healing Gods Complementary and Alternative Medicine in Christian America - PDFCOFFEE.COM (2024)

The Healing Gods

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The Healing Gods Complementary and Alternative Medicine in Christian America

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CANDY GUNTHER BROWN

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3 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016

© Oxford University Press 2013 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data Brown, Candy Gunther. The healing gods : complementary and alternative medicine in christian America / Candy Gunther Brown. pages cm Includes bibliographical references and index. ISBN 978–0–19–998578–4 (cloth : alk. paper) 1. Alternative medicine—United States. 2. Alternative medicine—Religious aspects—Christianity. 3. Mind and body therapies—United States. I. Title. R733.B884 2013 610—dc23 201205001

9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper

For Josh, Katrina, and Sarah

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Contents

Acknowledgments

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Abbreviations

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Introduction: Why Is Complementary and Alternative Medicine (CAM) Supposed to Work?

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1. Is CAM Religious?

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2. Yoga: I Bow to the God within You

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3. Is CAM Christian?

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4. I Love My Chiropractor!

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5. Does CAM Work, and Is It Safe?

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6. Acupuncture: Reclaiming Ancient Wisdom

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7. How Did CAM Become Mainstream?

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8. Energy Medicine: How Her Karma Ran Over His Dogma

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Conclusion: Why Does It Matter If CAM Is Religious (and Not Christian)—Even If It Works? Notes

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Bibliography

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Index

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Acknowledgments

Acknowledging debts for a project such as this is always a pleasant duty. This book was funded by the Flame of Love Project through the John Templeton Foundation, University of Akron, and Institute for Research on Unlimited Love; and Indiana University, through a Lilly Endowment New Frontiers in the Arts and Humanities grant, Outstanding Junior Faculty award, and New Frontiers traveling fellowship. The conclusions do not necessarily represent views of funding agencies. Since this book is an outgrowth of my previous Global Pentecostal and Charismatic Healing, edited (Oxford University Press, 2011), and Testing Prayer: Science and Healing (Harvard University Press, 2012), I remain indebted to all those who facilitated these companion projects. By permission, chapter four expands on “Chiropractic and Christianity: The Power of Pain to Adjust Cultural Alignments,” Church History 79:1 (2010): 1-38. This book does not intend to provide medical or legal advice. I benefited from outstanding research assistants: Kate Netzler Burch, Sarah Dees, Erin Garvey, Dana Logan. I learned from student papers by Elisa Boruvka, Yi Cai, Sarah Carleton, Brittany Carlton, Alison Dolezal, Nathan Frankel, Danielle Gadberry, Diane Grise, Chere’ Denise Hunter, David Klein, Claire Kruschke, Marcus Lamaster, Kaitlyn Lennox, Michael Metroka, Ethan Oates, Sarah Peters, Jessica Rivers, Emily Sullivan, Blake Vanderbosch, Rebecca Vasko. The manuscript improved through comments from colleagues Heather Blair, Heather Curtis, Constance Furey, David Haberman, Michael Ing, Andrea Jain, Sylvester Johnson, Robert Johnston, Craig Keener, Mathew Lee, Nancy Levene, Rebecca Manring, Patrick Michelson, Richard Miller, Richard Nance, Margaret Poloma, Stephen Selka, Lisa Sideris, Aaron Stalnaker; and students and friends Rachel Coleman, Dawnetta Cooper, Travis Cooper, Chris Hampson, Amanda Koch, Emilee Larson, Andrew Monteith, Molly Scripture. I am grateful for legal guidance from Daniel Conkle, J.D., Sarah Hughes, J.D., Jody Madeira, J.D., Ph.D., Aviva Orenstein, J.D., Winnifred Sulivan, J.D., Ph.D. I appreciate the medical expertise of Kenneth Cornetta,

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M.D., Thomas Hwang, M.D., Martin Moore-Ede., M.D., Ph.D., Stephen Mory, M.D., David Zaritsky, M.D. Many thanks to Cynthia Read and excellent staff and anonymous readers for Oxford University Press. I thank my husband, Josh, and daughters, Katrina and Sarah, for sharpening my arguments and loving and entertaining me.

Abbreviations

ACA ACS AHNA AHRQ AMA AME ANA AYA CAM CCA CDSR CEU CMAN FDA FTC ICA JAMA MBSR MMA NACM NANDA NCCAM NCI NIH OAM PHS POCA

American Chiropractic Association American Cancer Society American Holistic Nurses Association Agency for Healthcare and Research Quality American Medical Association Association for Mindfulness in Education American Nurses Association American Yoga Association complementary and alternative medicine Christian Chiropractors Association Cochrane Database of Systematic Reviews continuing education unit Christian Martial Arts Network Food and Drug Administration Federal Trade Commission International Chiropractors’ Association Journal of the American Medical Association Mindfulness-Based Stress Reduction mixed martial arts National Association for Chiropractic Medicine North American Nursing Diagnosis Association National Center for Complementary and Alternative Medicine National Cancer Institute National Institutes of Health Office of Alternative Medicine Public Health Service People’s Organization of Community Acupuncture

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RCT TCM TM WCA WHO

Abbreviations

randomized controlled trial Traditional Chinese Medicine Transcendental Meditation World Chiropractic Alliance World Health Organization

The Healing Gods

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Introduction Why is Complementary and Alternative Medicine (CAM) Supposed to Work?

if you are like most Americans, you or someone you care about has probably tried complementary and alternative medicine (CAM). Maybe you sought relief from back pain by visiting a chiropractor, treated the common cold with an over-the-counter homeopathic remedy, or coped with workplace stress by practicing yoga. The choice of CAM made sense as an inexpensive, natural investment in your health that promised a reprieve from suffering or enhanced wellness for body, mind, and spirit. You may have wondered whether CAM would work and whether it was worth your time and money. But your healthcare provider or Internet advice pointed to scientific evidence, so you gave it a try. You probably did not ask why CAM is supposed to work. To ask this simple question—and to insist on getting more than superficial answers—is to open a fascinating window onto how CAM may influence not only your health but also your religion. This book explains how and why CAM entered the American cultural mainstream, most remarkably finding a niche among evangelical and other theologically conservative Christians, although much of CAM is religious but not distinctively Christian and lacks scientific evidence of efficacy and safety. Most CAM advertisements stress natural, scientifically validated health benefits. But whether or not they tell you this, many CAM providers make religious or spiritual assumptions about why CAM works, assumptions inspired by selective interpretations of multifaceted religious traditions such as Hinduism, Buddhism, and Taoism (Daoism) that developed in Asia or metaphysical spirituality that grew up in Europe and North America.1 Popular interest in CAM has never been greater than it is today. Surveys show that 38 percent of Americans use CAM, and almost everyone has a

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relative or a close friend who is a CAM user. Perhaps 80 percent of Americans have tried CAM at least once. Use of CAM is not in itself a new development. Surveys conducted in 1924 and 1990 both reported that 34 percent of Americans used CAM that year. But the perceived boundary between conventional and alternative medicine appears to be loosening. In 1990, Americans made 425 million visits to CAM practitioners, compared with 388 million visits to conventional medical doctors. In 1997, 32 percent of patients had during the previous year consulted both an M.D. and a CAM provider for the same condition, compared with 1990, when only 20 percent combined visits to both provider types.2 The recent integration of CAM into the mainstream health-care market and conservative Christian subculture is an extraordinary development. Before the 1960s, most of the practices considered in this book—yoga, chiropractic, acupuncture, Reiki, Therapeutic Touch, meditation, martial arts, homeopathy, and anticancer regimens—if encountered at all, were generally dismissed as medically and religiously questionable. Conventional medical doctors disparaged CAM as quackery, and Christian clergy denounced CAM as idolatry because it seemed tainted by “Eastern” religions or “New Age” spirituality. Today, CAM fills growing niches in Walmarts, YMCAs, public schools, hospitals, business corporations, and Christian churches. Medical doctors are reassessing CAM as cutting-edge, “integrative” medicine. Evangelical Christians are reclassifying CAM as religiously neutral “science”—indeed, as better than biomedicine, because it is more “natural” and free of the atheistic bent of medical materialism. By the twenty-first century, CAM had moved from the peripheries to the center of culturally accepted health-care practices. This book poses a pivotal question: What causes practices that most Americans once classified as illegitimate for medical and religious reasons to be redefined as legitimate routes to physical and spiritual wellness? My basic answer is that CAM promoters strategically marketed products to consumers poised by suboptimal health to embrace effective, spiritually wholesome therapies. Once-suspect health practices became mainstream as practitioners recategorized them as nonreligious (though generically spiritual) health-care, fitness, or scientific techniques—congruent with popular understandings of quantum physics and neuroscience—rather than as religious rituals. This development is noteworthy because certain CAM claims are similar to religious claims, but CAM gained cultural legitimacy because many people interpret it as science instead of religion. Examining this process of cultural redefinition illumines how Americans navigate the relationship between the “religious” and the “secular.” This leads to broad questions, such as: What is

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religion? What is science? How are scientific vocabularies and methods used in cultural, religious, and legal debates, and how do religious and commercial motives shape understandings of science? What happens when people transpose religious/secular categories? Ultimately, what difference does it make if CAM is understood to be science but functions like religion? My agenda is to tell the intriguing and sometimes astonishing story of the mainstreaming of CAM in America. A significant aspect of this story is that CAM is a charged issue that evokes powerful emotional responses from supporters and critics. Many people have unmet health needs that occasion physical and emotional suffering, experiences exacerbated by uncertainty, fear, repeated attempts and failures to find help from medical or religious sources, and implicit or explicit judgments from others that one is thinking about or pursuing health the wrong way. Although certain readers may have strongly positive or negative emotional reactions to the content of this book, I do not intend to make normative claims about what Christians or other Americans should believe or practice. I do, however, voice concerns about the processes and contexts through which CAM’s mainstreaming has occurred, because these mechanisms can hinder people’s agency to make the health-care and religious decisions they want to make and intensify rather than alleviate human suffering. I hope to provide insight into the complex cultural, ethical, and legal issues involved as Americans navigate the health-care market.

What Is CAM? Common definitions of CAM encompass any healing practice not “included in mainstream health care in the United States,” because it “lacks or has only limited experimental and clinical study” indicating medical value. Many therapies labeled as “alternative,” “complementary,” “integrative,” or “holistic” share more than a lack of conventional medical validation. Conventional medicine, or biomedicine, constructs human bodies as biological organisms and employs material treatments to cure individual diseases, while also, at least as an ideal, attending to patients’ mental, emotional, and social-cultural needs. By contrast with the materialistic premises of biomedicine, holistic (from the Greek holos, or “whole”) worldviews presume that health entails much more than absence of disease and that humans—as complex interrelationships of mind-body-spirit—possess vast self-recuperative potential. Concepts of humans as inseparable units of soul, spirit, and flesh (Hebrew nephesh, ruach, basar) can be found in ancient religious and philosophical traditions, including Judaism and Christianity, but the term holistic was coined by the South African philosopher Jan Smuts in 1926 and popularized by the

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holistic health-care movement of the 1970s. Holism, as the term is often used today, presupposes that all reality is essentially one (monism), and matter and energy, physical and nonphysical entities, exist in a continuum and constantly affect each other.3 Holistic ideas permeate American culture. It has become commonplace to speak of health for body, mind, and spirit—so commonplace that one may not notice the significance of the last term in this trinity. Use of the term spirit, as with spiritual and spirituality, implies that living beings have an “immaterial aspect” that is “radically nonmaterial.” Such an idea may lead into metaphysical—beyond physical—concepts of “correspondence” between mind and spirit (or communication across natural and spiritual realms), psychic intuition, clairvoyance, and use of nonmaterial energy to change the material world.4 A central assumption unifying diverse CAM practices is the existence— and possibility of redirecting—universal life force or vital energy. This “energy” is variously termed qi (pronounced “chee”), ki, prana, animal magnetism, vital force, biofields, or Innate Intelligence, concepts that may sound familiar to those introduced to “the Force” by Star Wars. Blockages or imbalances in the flow of vital energy from the universe through the human body presumably cause disease, often written as “dis-ease,” or lack of ease. Holistic healing may involve opening blockages or redirecting flows of energy through the body’s energy channels (nadis or meridians, joined at chakras), rebalancing opposing energy principles (yin and yang), or restoring harmonious equilibrium between human bodies and a divine principle that indwells the cosmos and flows through all things. Techniques include physical touch of the body or redirection of energy fields beyond the body using one’s hands or instruments such as needles, or ingestion or external application of substances intended to restore energy balance. Some practices combine handling energy fields with invocation of aid from personal deities or spirits and rituals to protect against maleficent spirits or dangerous energies. Other practices take for granted the existence of vital energy but can be employed without reference to energetic principles.5 The term energy has positive connotations. People feel well when they’re “energetic” or “energized”; “energy drinks” appear in impulse-buy sections of grocery stores; “energy” evokes images of a valuable resource that does useful work and increases human comfort. Energy is an expansive concept, broad enough to appeal generally while allowing room for divergent, even contradictory interpretations. The same word refers to measurable wavelengths and frequencies of electricity, light, sound, and magnetism and to invisible forces undetectable by conventional scientific instruments. The flexibility of the energy label obscures a fundamental difference between biomedical and

Introduction

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holistic concepts. Vital energy is more than a physical force. It is alive and life-giving, intelligent, and goal-directed, beneficently promoting homeostasis or balance. Vital energy is “subtle,” meaning that it cannot be proven to exist. People claim to know it is real through intuitive perception or observation of apparent effects. While performing healing rituals, people report physical sensations such as warmth, tingling, or vibrations akin to “electricity.”6 Electricity is a compelling modern metaphor that bridges physical and spiritual notions of energy. Electricity is an invisible force that can be felt, does work, and can be detected and measured using modern technology, but electricity was no less “real” before scientists discovered instruments to measure it. People sometimes reason that if they sense something comparable to electricity, then—even though this energy cannot be detected or measured by technology—it, too, is a real, natural, though invisible, force. The National Center for Complementary and Alternative Medicine (NCCAM) differentiates “veritable” energy fields, those that can be measured, from “putative” energy fields, those that “have yet to be measured.” Implicitly, if scientific instrumentation becomes sufficiently sophisticated, it may become possible to measure, and establish the existence of, putative energy.7 Those interested in finding evidence of vital energy experiment with novel technologies. Energy-detection devices include a superconducting quantum interference device (SQUID), a gas-discharge visualization device (GDV), a scintillation counter to quantify “tiny flashes of light” generated by “gamma rays,” and Kirlian photography (named after Russian inventors Semyon and Valentina Kirlian). Kirlian photography, for instance, is a technique of “high-voltage photography” that purportedly captures changes in the “electrodynamic field” that permeates and surrounds objects following energy treatments. Critics object that apparent variations in “aura” can be accounted for by mundane physical factors, such as variable moisture levels of objects photographed, pressure exerted on films, and exposure length; any moist or conductive object appears to have an aura when touching a photographic plate connected to a high-voltage source of electricity, but the aura disappears when photographs are taken in a vacuum, since no ionized gas is present. Surveying the state of research on putative energy, the NCCAM concludes that “neither the external energy fields nor their therapeutic effects have been demonstrated convincingly by any biophysical means” to exist.8 In the absence of evidence that putative energy exists, supporters imply that all energy, whether or not its existence can be verified, is essentially similar. Holistic-healing publicist Kay Koontz suggests that “the idea of using energy to diagnose and heal isn’t completely foreign to Western medicine. After all, electrocardiograms and electroencephalograms have long been used to record

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the electrical energy of the heart and brain, respectively.” If medical doctors can use one form of energy, Koontz reasons, why not integrate other forms into medical treatment? James Oschman, who advertises his scientific credential of a Ph.D. in biological sciences from the University of Pittsburgh (but who left academia before receiving tenure), asserts that all “healing energy, whether produced by a medical device or projected from the human body, is energy of a particular frequency or set of frequencies that stimulates the repair of one or more tissues.” Fernan Poulin, the producer of a “Chakra Meditation CD,” defines all energy as “vibrational frequencies that travel on filaments of ether and are directed by focus and intent.” Poulin implies the biomedical reality of subtle energy by hinting at its involvement in biological processes of the central and peripheral nervous systems, since cerebrospinal fluid and electrolytes conduct electricity over the nerves. Borrowing terminology from physics and chemistry, Poulin claims that “prana (a light particle attached to an oxygen molecule) fuels the energy fields by the way we breathe. . . . The vibrations that constitute thoughts and emotions enter the body via energy centers called the chakras. These seven centers are located along the spinal cord where there is an increase in volume of nerve ganglia and plexus plus endocrine glands.” In Poulin’s account, distinctions between veritable and putative energy disappear.9 Using contemporary scientific language to market metaphysics as a superior form of medicine is nothing new; it dates back at least to the fourteenthcentury Renaissance. Today’s privileged vocabularies—quantum physics and neuroscience—lend plausibility to claims that CAM is frontier science. The “new physics” allegedly provides an “explanatory model” for energy healing by demonstrating the equivalence of matter and energy or that reality consists entirely of energy. A guide to Christian Reiki stresses that “physics has clearly proven that the entire universe is composed of energy and physical matter is a concentration of energy.” Actually, the m in Einstein’s famous equation E = mc2 refers to mass, which physicists distinguish from matter, and there is disagreement among physicists about the sense in which mass and energy can be viewed as equivalent. Physicists do not have in mind “subtle” energy. A textbook on The Theory and Practice of Therapeutic Touch (2001) asserts that “this new physics believes that energy and mass are the same thing, every living thing in the universe is a pattern of moving energy and that all living beings are interconnected to all other living things and interacting with them all the time.” The authors reason that because humans have mass, they must also have energy; energy is always in motion interacting with other energy; therefore, and here is the logical leap, humans can affect the subtle energy fields of other humans. Distant healing through nonlocal (and nonphysical)

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“intentions” invokes the idea that subatomic particles affect one another at a distance. The premise that an observer affects the outcomes of experiments bolsters the inference that human consciousness directs energy and even creates matter. The concept that everything in the universe is connected seems to support the interchangeability of matter and consciousness. Such claims reflect imprecise applications of physics to nonphysical concepts of energy in a manner that resonates with popular understandings of science.10 Nonscientists have similarly become fascinated by recent research in neuroscience investigating the physiological basis of religious experiences. Functional magnetic resonance imaging (fMRI) tracks changes in the brain produced by prayer and meditation. The Dalai Lama invited neuroscientists to study effects of Buddhist meditation on brain structure and function. Sympathetically reporting on this research, Amit Sood, M.D., associate professor of medicine at the Mayo Clinic, calls attention to a “startling and exciting discovery—the mind can change the brain. Software can indeed transform the hardware. Training our mind using mind-body approaches can soothe the limbic areas of the brain such as the amygdala, and engage areas of the brain such as the prefrontal cortex, whose activity enhances resilience and happiness, and trains executive functions.” Exponents of CAM interpret such findings as evidence of a mind-body-spirit continuum and of the inadequacy of materialistic brain models.11

Who Uses CAM, and Why? Although newly integrated within the biomedical mainstream, CAM usage in America is anything but new. The basic story is that holistic and biomedical healing have coexisted all along, but their relationship changed in three stages: first, consolidation of a medical mainstream against which to define CAM; second, differentiation of CAM from the mainstream; third, reintegration of CAM within the mainstream. This narrative is not wholly linear. There were two waves of popular interest in metaphysical healing, in the mid-nineteenth and mid-twentieth centuries. Both waves reflected widespread disillusionment with dominant medical and religious models and offered means of coping with losses incurred in national wars, during which modern scientific technologies brought death rather than healing, raising questions about the value of scientific “progress.” Medical and religious healing intermingled from the start in colonial America. European colonists brought with them a mix of empirically derived medical knowledge and folk healing then associated with “witchcraft,” “astrology,” and the “occult.” Europeans consulted Native American and African folk healers,

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perceiving them as possessing not only natural knowledge but also special access to supernatural power. Christian clergy warned parishioners to beware religious contamination but did little to inspire hope of healing from the Christian God.12 The sixteenth-century Protestant Reformation and the eighteenth-century Enlightenment discouraged—but did not quench—“superstitious” expectations of nonmaterial healing. One of the most influential reformers, John Calvin (1509–1564), developed the doctrine of “cessationism” to argue (against Catholic miracle claims) that miracles had ceased with the biblical era because they were no longer needed to confirm the gospel. God might still heal in response to prayer, but such healing was not miraculous, and most healing should be expected through medical means. Clergy influenced by Calvin taught that God sends sickness to prosper the souls of his children, so the proper response is passive resignation. Notably, however, a fifth of Puritan church-membership candidates described their conversions as fulfilling healing vows. Regardless of clerical teachings, people experiencing physical and emotional suffering sought healing wherever they thought they might find it, whether from European doctors, Christian prayer, or recourse to non-Christian healers. By discouraging expectant prayers for healing, Calvinist clergy pushed colonists to seek healing resources beyond Christianity.13 Promoters of Enlightenment science denigrated recourse to the supernatural to explain or cure disease, yet metaphysical healing did not disappear with the rise of modern medicine. Colonists attempted to use their growing understanding of natural law to wield material and nonmaterial forces to heal. Medical textbooks recommended astrologically proper herbal preparations and spiritually premised Native American recipes.14 Before the late eighteenth century, there was no uncontested “conventional” medical system against which to define “alternatives.” Rival practitioners and medical sects competed for clients. Benjamin Rush (1745–1813), a signatory of the Declaration of Independence and a religious Universalist, has been credited with founding the first conventional medical system in America. The “heroic” medicine advanced by Rush made the patient the hero, enduring invasive “therapies”—such as bloodletting, intestinal purging (using calomel, a mercury derivative), sweating, and blistering—to “deplete” the body of excess substances. The heyday of heroic medicine coincided with unsettling social developments, including industrialization, urbanization, communications and transportation revolutions, and deployment of new technologies in warfare to kill more efficiently.15 Popular dissatisfaction with Calvinist theology, heroic therapeutics, and the social costs of modernization had by the post-Civil War era fed the growth of “nature cures,” such as mesmerism, homeopathy, spiritualism, vegetarianism,

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mind cures, osteopathy, chiropractic, and Christian Science. Health reformers decried the corrupting influences of sedentary, indoor lifestyles and unnatural food and drink produced by “artificial civilization” and distributed by the market revolution, a world populated by anonymous, untrustworthy manufacturers and tainted by invisible poisons. Sylvester Graham (1794–1851), a Presbyterian minister best remembered for the graham cracker (which today bears little resemblance to the whole-grain, unsweetened original), warned that commercial bread made from processed white flour symbolized the nutritional and moral bankruptcy of modernity. Graham’s interest in “natural” foods, such as freshly baked, homemade, whole-wheat bread, arose primarily not from chemical properties but from a view that natural foods preserve “vital energy” needed for both spiritual and physical sustenance. The label of “natural” accumulated more-than-physical valences that persist today, as vaguely spiritual, better than “artificial” or “materialistic,” harking back to an Edenic era uncorrupted by the Fall to sin and sickness. More Christians also prayed for divine healing, paving the way for the early-twentieth-century rise of Pentecostalism.16 The prestige of conventional medicine improved during the second half of the nineteenth century. Forming the American Medical Association (AMA) in 1847, regular physicians sought to obligate patients to obey their authority and avoid practitioners the regulars considered “quacks.” Americans enjoyed better health, in part through medical discoveries related to anesthesia and the germ theory of disease, public-health measures for sewage disposal and water purification, and building modern hospitals. In a landmark judicial ruling, Dent v. West Virginia (1889), the Supreme Court upheld the authority of a state medical examining board to prohibit an inadequately trained irregular physician from practicing, solidifying the ascendancy of regular medicine. The publication and widespread adoption of William Osler’s medical textbook, Principles and Practice of Medicine (1892), brought consistency to conventional diagnostics.17 By the twentieth century, biomedical science had matured, and the materialistic paradigm of scientific naturalism predominated. Thomas Huxley coined the phrase scientific naturalism in 1892 to describe an empirical approach to gathering knowledge about the material world that rejected supernatural explanations; although scientific naturalism can simply denote empirical methodology, Huxley had in mind a broader, philosophical commitment to materialism that a growing number of regular doctors—in the wake of Charles Darwin’s publication of The Origin of Species (1859)—found appealing. The AMA’s membership rolls and cultural influence increased following its reorganization in 1901. In 1910, Abraham Flexner published a report on medical

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education that endorsed restructuring medicine as a modern “profession.” Individualized clinical approaches declined in favor of standardized diagnosis, instrumentation, therapies, and a “clinical gaze” that perceived human bodies as biological organisms that function in predictable ways. Medical authority increased with the introduction of sulfa drugs in the 1930s, antibiotics in the 1940s, and “wonder drugs” in the 1950s. By the mid-twentieth century, scientific medicine had become the most influential profession in America.18 As the medical profession became a more unified and culturally powerful force, it also became a clearer target against which those dissatisfied with the status quo reacted. Holistic healing persisted but outside the consolidating mainstream. As of 1930, 25 percent of American healers were “irregulars,” many of whom were self-styled “doctors” who lacked in-depth medical training in any school of practice and who disseminated metaphysical ideas of “spirit” at odds with medical materialism and dominant strains of Christian theology. Alternative healers survived the regulatory assaults of medical and religious authorities by forming alliances with oppositional political cultures. Whole-foods and dietary-supplement movements became popular in the 1950s. The political pull of alternative healing increased dramatically with the rise of the “counterculture” of the 1960s and the holistic health-care movement of the 1970s.19 The quest of post-World War II Americans for deeper spirituality created hunger for a “counterculture.” As the Vietnam war aggravated building frustrations, people expressed dissatisfaction with American “institutions,” including religious institutions. Some looked for revitalization within the Christian tradition by participating in ecumenical—Protestant and Catholic—Charismatic renewal and “Jesus people” movements of the 1960s and 1970s, which (like the earlier Pentecostal movement) rejected cessationism for renewed expectation of miraculous healing. Others looked outside the bounds of Christianity for fresh spiritual resources. The Immigration Act of 1965, an outgrowth of the civil rights movement, removed restrictions based on national origins, leading, for instance, to a dramatic increase in immigration from Asia. Many immigrants were Christians, but some introduced new neighbors and coworkers to traditions such as Zen Buddhism and Transcendental Meditation (TM). Some Americans learned meditation in the counterculture and later joined the Jesus people movement, bringing new meditation practices with them.20 The Catholic church’s Second Vatican Council (1962–1965) introduced sweeping changes in church doctrines and practices. Vatican II accepted Protestants as “separated brethren” and authorized Charismatic renewal. A Declaration on the Relation of the Church to Non-Christian Religions (1965) affirmed that the church “rejects nothing of what is true and holy” in other

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religions. Vatican II pushed some Catholics toward religious practices from other traditions. The Irish Jesuit Robert Kennedy recounts in Zen Spirit, Christian Spirit (1995) that Vatican II “swept away my old religious certitudes,” making Zen—which Kennedy encountered on mission in Japan—attractive as a new source of “insight and discernment” that “would not be blown away again by authority or by changing theological fashion.” Post-Vatican II Catholics were more likely than their predecessors to practice CAM. Reacting against this trend, Cardinal Joseph Ratzinger (later Pope Benedict XVI) issued a letter to Catholic bishops in 1989, warning that efforts to pray with the body through Zen, TM, or yoga can “degenerate into a cult of the body and can lead surreptitiously to considering all bodily sensations as spiritual experiences.” In 2003, the Vatican issued A Christian Reflection on the “New Age,” which indicts CAM practices, including meditation, biofeedback, yoga, acupuncture, herbal medicine, Therapeutic Touch, polarity massage, psychic and crystal healing, nutritional therapies, homeopathy, and chiropractic. The United States Conference of Catholic Bishops’ Committee on Doctrine singled out Reiki in 2009 guidelines, expressing concerns about Buddhist roots and warning that attempts to “Christianize Reiki by adding a prayer to Christ” do “not affect the essential nature of Reiki.” Despite such cautionary statements, many post-Vatican II Catholics—who were on the whole increasingly prone to dissent from Church teachings—explored CAM.21 Alongside changes in American religious life, the holistic health-care movement cultivated interest in consumer choice and “natural” remedies. By the 1970s, patients were more aware of drug side effects and frustrated by rising costs and limited accessibility of conventional medical treatment, depersonalization of care resulting from medical specialization, and the “presumptive expertise” of physicians who interpreted every illness within a biochemical construct of disease. One acupuncture consumer, whom we will call Maureen, recalls that she began treatment after prescription drugs failed to alleviate headaches. Maureen’s favorite aspect of acupuncture is that she no longer needs pills “full of chemicals”—and expensive.22 National health-care spending tripled from $41 billion to $140 billion annually between 1965 and 1975, with out-of-pocket expenses doubling. In 2009, Americans spent $2.83 trillion, not including $363 million out of pocket— a 26-percent increase from 2005. In 2012, the average family of four could expect $5,091 in out-of-pocket health-care expenses for the year. Partly as a cost-saving measure, the U.S. government extended support to CAM research. In 1991, Congress established within the National Institutes of Health (NIH) an Office of Alternative Medicine (OAM), with a budget of $2 million. In 1998, Congress upgraded the OAM to a National Center for Complementary and

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Alternative Medicine. The NCCAM budget grew from $49 million in 1999 to $128 million in 2013. Funding for CAM research from all NIH programs rose from $116 million in 1999 to $300 million in 2009.23 Growing recognition of the limits of biomedicine opened space for alternatives within, instead of as rivals against, the medical mainstream. Practices denounced as “medical cults” in the 1960s became “alternatives” in the 1980s, achieved the status of “complementary” medicine by the 1990s, and shone as “integrative” medicine in the 2000s. Remarkably, the AMA—for decades the most strident opponent of irregular medicine—led the way in this cultural revolution but not at first voluntarily. As late as 1963, the AMA’s Committee on Quackery was formed with the mandate “to contain and eliminate chiropractic.” The AMA lost a landmark court case, Wilk v. American Medical Association (1990), which forbade the AMA to discriminate against chiropractors or other “unscientific” practitioners. Symbolically, the AMA devoted a special issue of its official journal in 1998 to reporting results of clinical trials of seven unconventional therapies, four of which (chiropractic, acupuncture, yoga, and herbs) found positive effects.24 The qualified acceptance of integrative medicine helped conventional doctors to domesticate potentially subversive practices within the biomedical paradigm. Doctors worry that many CAM users—more than two-thirds of Americans older than fifty, according to a 2007 national survey—do not tell their doctors. When physicians speak positively about holistic therapies or make referrals, patients are more likely to admit to using CAM, which makes it easier for doctors to watch for potentially dangerous interactions.25 Endorsement of CAM by some medical professionals goes beyond grudging tolerance. An American Psychological Association summary of Complementary and Alternative Therapies Research (2009) is frankly promotional: “Certain CAM therapies seem to hold tremendous promise for clients with psychological and medical conditions, not only helping them resolve symptoms but also restoring their general health and emotional well-being. . . . My hope is that the research that has been done and reviewed in this volume will motivate clinicians to consider CAM therapies for their clients.” The idea that clinicians should consider CAM would have seemed highly unusual, if not perverse, in the 1950s. By the 2000s, times had changed.26 The range of commonly practiced CAM options widened, and the popularity of once “exotic”-sounding therapies grew—but not because of mounting scientific evidence. In 2007, the most commonly used therapies were nonvitamin, nonmineral natural products (18 percent of Americans), deep breathing (13 percent), meditation (9 percent), chiropractic or osteopathic manipulation (9 percent), massage (8 percent), and yoga (6 percent). Smaller contingents used special diets (4 percent), homeopathy (2 percent), acupuncture (1 percent),

Introduction

13

t’ai chi or qigong (1 percent), energy healing or Reiki (.5 percent), naturopathy (0.3 percent), biofeedback (0.2 percent), or Ayurveda (0.1 percent). Between 2002 and 2007, the prevalence of acupuncture, deep breathing, massage, meditation, naturopathy, and yoga increased significantly. These surges are noteworthy because only 25 percent of systematic medical reviews concluded that these CAM practices were effective for the conditions for which they were used. In other words, the popularity of these once-marginal therapies grew largely independently of scientific validation.27 There are important variations to the story of who uses CAM for what reasons. Studies suggest that CAM users are most often white women, ages thirty-five to fifty-five, who are better educated and have higher incomes than the general population. Rocky Mountain residents are two to three times more likely than South Atlantic residents to use CAM. Certain alternatives, such as chiropractic, are favored in rural, educationally and economically disadvantaged areas where there is popular suspicion of medical professionals. As many as 80 percent of conventionally treated cancer patients use CAM. The most common reason given for CAM use is pain (38 percent). This is unsurprising given studies indicating that a majority of Americans “live with chronic or recurrent pain.” People in pain may try multiple therapeutic approaches—including medically prescribed drugs, prayer, chiropractic, massage, homeopathy, and yoga—although few people report that any of these remedies work “very well.” One survey found that 47 percent of CAM users are not treating any particular problem; they want to maintain health, give themselves a luxurious “treat,” or pursue a holistic lifestyle.28 People who employ one holistic method are likely to use other CAM approaches. This is because of philosophical similarities and because holistic healing is practiced in the context of relational and institutional networks. Practitioners of various therapies know one another, refer patients to one another, attend the same seminars, and shop in the same health-food stores and bookstores. Experimenting with any one CAM approach can provide a gateway to holistic worldviews. Yet just because CAM practitioners are attracted to a common pool of activities, that does not mean that every activity with a CAM following is inherently metaphysical; not everyone who buys herbal supplements or eats a vegetarian diet is a closet metaphysician.29

Christian America’s Other Gods A striking illustration of CAM’s newly mainstream status is that it has gained a foothold in the evangelical Christian subculture. According to a 2008 national survey, 76 percent of Americans self-identify as Christians, and

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34 percent specify that they are “Born Again or Evangelical Christians.” In a 2007 national survey, 36 percent of respondents identified as Pentecostal or Charismatic. Terms for describing Christian identity derive from the New Testament. The Greek euaggellion and the Anglo-Saxon godspel, or “good news,” refer to preaching a message of salvation from sin and death through Jesus Christ. When asked how to attain salvation, Jesus replied that one must be born again through the Holy Spirit. Jesus’s disciples reputedly received the Holy Spirit on Pentecost, a Jewish holiday fifty days after Passover, shortly after Jesus’s crucifixion. Early Christian writers, such as the apostle Paul, used the Greek charisma to refer to gifts of the Holy Spirit, such as healing, miracles, prophecy, and speaking in unknown tongues. Self-described evangelicals are a diverse group expressing a range of theological, political, and social convictions; despite media portrayals, not all evangelicals support the Religious Right. Certain evangelicals pursue Charismatic gifts, whereas others staunchly defend cessationism. Some readers may be surprised that 18 percent of self-identified born-again/evangelicals are Catholic. Many African-American Christians share theological convictions with evangelicals but reject the label because of the historical relationship between many evangelicals and slavery. Nevertheless, evangelical self-identity can be correlated with certain theological beliefs: that God provided a way for forgiveness through the life, death, and resurrection of Jesus; that the Bible is the inspired word of God; that Christianity involves conversion to Christ; and that Christians should encourage non-Christians to become Christians.30 This book is about the eclectic healing practices of Americans. I single out evangelical and other theologically conservative Christians as a case study—although other cultural or religious groups could have been selected instead—because evangelicals provide a barometer for the mainstreaming of once-marginal cultural practices. Evangelicals have been described as “culturally adaptive biblical experientialists,” who seek a transformative presence in culture while maintaining biblical standards of purity for themselves. These are Christians who appropriate non-Christian resources from their surrounding culture to evangelize outsiders and edify believers and also use the Bible as a safeguard against cultural contamination. Since the mid-twentieth century, evangelicals have been particularly concerned to guard against “Eastern” religions and the “New Age.” Yet evangelicals accepted CAM despite its ties to non-Christian religions and metaphysical spirituality.31 Evangelicals tend to be highly attuned to perceived threats to theological orthodoxy, which is why many of them back public campaigns to reclaim the heritage of a “Christian America.” The Religious Right angers progressive America by its crusades against the allegedly national “sins” of abortion,

Introduction

15

same-sex marriage, and religious relativism, while calling for a return to a golden age when America was once a Christian nation. Despite such rallying cries, America was not founded by orthodox Christians who set out to base government on Christian principles. Neither the Declaration of Independence nor the Constitution mentions the Bible or Christianity. Most of America’s founding fathers, including George Washington, Thomas Jefferson, and Benjamin Franklin, were Deists who denied that God revealed himself in the Bible and rejected Jesus’s virgin birth, miracles, atoning death, and resurrection. Many of the founders were also Freemasons. Masonic ritual not only draws on Christianity but also contains references to other deities, including the Canaanite god Baal and the Egyptian god Osiris. When Christian leaders call for a return to America’s founding principles, they forget the enslavement of African-Americans and the disenfranchisement of blacks and women.32 The Christian America narrative veils one of the most prominent themes in the Hebrew Bible. In the biblical narratives of God’s relationship with his chosen people Israel, prophets chastise God’s people for repeatedly turning aside from undivided worship of Yahweh to seek help from gods of surrounding nations or through “divination,” defined as manipulation of spiritual forces to control the physical world. God even—shockingly, to modern sensibilities—commanded the Israelites to kill Canaan’s indigenous inhabitants lest the Israelites be lured into worshipping their Baals and Asherahs, which promised fertility, health, and protection. Moses reputedly warned the Israelites as they entered the promised land that “the LORD your God will cut off before you the nations you are about to invade and dispossess. But when you have driven them out and settled in their land, and after they have been destroyed before you, be careful not to be ensnared by inquiring about their gods, saying, ‘How do these nations serve their gods? We will do the same.’ You must not worship the LORD your God in their way.” Yet the Israelites “embraced other gods,” suffered judgment, in desperation sought Yahweh, and, once the crisis had passed, returned to following other gods. Community members responded hostilely to prophets such as Jeremiah who denounced religious pluralism because their neighbors’ gods seemed effective. The Israelites did not want to stop burning incense and pouring out drink offerings to the Queen of Heaven, because when they sought help from multiple spiritual sources, they had “plenty of food and were well off and suffered no harm.”33 Deploying the narrative of America’s Christian origins against the idolatry of the “other” eclipses ironies of Christians’ own therapeutic and spiritual explorations. The narrative casts modern Christians as successors to biblical characters. In the hermeneutic tradition of typology, seventeenth-century

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Puritans became the New Israel, and the New World became the New Canaan. God made room for the Puritans by removing America’s idolatrous indigenous inhabitants, through disease and warfare, as God fought his chosen people’s enemies and cleared the continent to establish America’s manifest destiny. America would be a city upon a hill that all of Europe could see so that they would have a chance to repent of national sins that courted divine judgment. Today, the narrative warns, America is itself in danger of national judgment because of a politically powerful liberal agenda represented by President Barack Obama that supposedly promotes abortion, the idolatry of Molech; same-sex marriage, the idolatry of Sodom; Islam, the idolatry of Ishmael; and the New Age, the idolatry of Egypt and Canaan. The enemies endangering God’s blessing on America are said to be those in the liberal fold. All the while unacknowledged is Christian America’s invocation of “gods” of health.34 The myth of a Christian America makes opaque the enemies within. There is a disjunction between seventeenth-century “jeremiads,” Puritan sermons modeled after those of the prophet Jeremiah to lament the present generation’s declension from the faith of the fathers, and prophetic denunciations of today that envision conservative Christians as an embattled remnant standing firm against liberal assaults. Modern prophets lament the declension of the other rather than the self. Evangelical sermons warn against making money, work, television, or material goods into “idols,” since there are presumably no real idols in evangelical America. No one puts up altars to Baal or erects Asherah poles in backyards these days. Evangelicals would worry about burning incense in a Hindu or Buddhist temple, but these are still viewed as foreign, minority religions on the outskirts and safely disconnected from mainstream Christian America. The idea that America is “God’s nation,” represented by “God Bless America” and “In God We Trust,” solidifies the common though empirically unsupported view that Christianity is American and other religious and spiritual beliefs are un-American. Regardless of whether one thinks evangelicals should be more or less affirming of religious pluralism, it is ironic when the same Americans who publicly display themselves as pillars in a Christian nation pursue health practices that embody divided allegiances.35

Who Needs to Know? This book is for CAM consumers, health-care providers, policy makers, judicial interpreters, and professional scholars. All of these groups need to know not just whether CAM works but also why it is supposed to work, because CAM bears on both health and religion.

Introduction

17

A pattern that emerges in the following chapters is that those exploring CAM—often because they are still suffering despite seeking help from conventional doctors or churches—begin by restricting participation to “purely physical” practices or substituting Christian for metaphysical meanings. But the processes and contexts of CAM’s mainstreaming constrain consumer agency. This book presents evidence that certain CAM promoters engage in self-censorship, fraud, deception, or manipulation, misrepresenting or delaying introducing metaphysical concepts until after novices have been attracted by physical benefits. As practice deepens, participants experience subtle coercion to incorporate a broader range of meanings, resulting in unintended shifts in beliefs. Imbalances in knowledge and power between CAM providers and clients particularly impede the autonomous decision making of vulnerable groups, such as children, the elderly, and the seriously ill. Many consumers do resist coercive pressures and contest presented interpretations of CAM by ascribing their own meanings. Yet participation in relatively mainstream CAM practices increases comfort with vitalistic premises, providing entry to practices that individuals once regarded skeptically. Because this progression occurs gradually, participants—even those who at the outset reject metaphysics—may slip into metaphysical worldviews without making informed decisions. Twenty-first-century Americans are not unique in their propensity to mix and match therapeutic options from diverse philosophical and religious frameworks or simultaneously to hold incommensurate beliefs that serve different practical functions. When people need healing or desire better bodies and more peaceful minds, it is unsurprising that they look around for help. The impulse to draw eclectically on medical and religious resources to pursue health can be found in all eras and people groups. Indeed, many Americans celebrate pluralism. There is nothing remarkable about combinative practices, except when exhibited by adherents of monotheistic religions that strictly prohibit seeking help from “other gods.”36 Although evangelicals are in principle committed to shunning religious eclecticism, they can be just as eclectic as anyone else when healing is at stake. When people, evangelical Christians included, need healing or want better health, the urgent—and legitimate—question of which health-care choice works best overshadows theoretical concerns about why therapies work. If Christians experience cognitive dissonance, desire for benefits prompts them to rationalize, rather than change, therapeutic choices. In what scholars term “lived” religion, people select, negotiate, and create from available options as they confront life’s complexities. It is, nevertheless, paradoxical when groups that strenuously eschew theological pluralism embrace therapeutic pluralism,

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when doing so leads them to engage in the very theological combinativeness they so assiduously sought to avoid.37 Noting the general tendency of people to negotiate their own logical inconsistencies does not clarify what it is about a particular cultural context that makes people willing to combine certain contradictory impulses but not others. A primary goal of this book is explanation rather than judgment. Numerous books about CAM have been published in recent years. Many books seek either to promote or to condemn holistic healing. My perspective is rather that of a cultural and religious historian and interpreter puzzling with the incongruities, overlaps, and contradictions that make culture an interesting object of study. I stumbled on this project while working on a previous book for which I interviewed pentecostals about their divine-healing practices, during the course of which informants surprised me by volunteering information about their love for CAM. Intrigued, I spent nine years combing vast pro- and antiCAM literatures—books, scholarly journals, popular newspaper articles, Web sites, and audiovisual resources; clinical studies, medical review articles, and theories of informed consent and biomedical ethics; constitutional jurisprudence; and sociological and ethnographic research. I observed CAM practices, distributed surveys, interviewed dozens of CAM participants and critics, and supervised research assistants as they observed and interviewed dozens more. Working on a topic for which new sources appear almost daily feels like trying to shoot a moving target. It is inevitable that this book will leave out relevant sources published too late for my consideration. It is equally impossible to cite even the majority of relevant sources without alienating length-conscious publishers and readers; references are restricted to short-form notes and a pruned-down bibliography.38 Rather than render a verdict about whether particular CAM practices are intrinsically good or bad, this book reveals unsuspected implications of unreflective therapeutic eclecticism for health, religion, and democracy. At stake are informed decision making in the health-care market and boundaries between religion and government in a pluralistic society. Holistic health care raises ethical and legal questions of informed consent, protection of vulnerable populations, and religious establishment—affecting values of personal autonomy, self-determination, religious equality, and religious voluntarism—at the heart of biomedical ethics, tort law, and constitutional law. On an individual level, health-care consumers need to understand not only medical risks and benefits but also factors bearing on long-term goals and values, including religious commitments. Health-care providers have a responsibility to inform patients if those providers have reason to believe that using CAM may influence

Introduction

19

patients to make different religious choices from those they would make otherwise. Patients are responsible for investigating options, because for choices to be free, they must be made with understanding. On a societal level, CAM’s mainstreaming presents challenges to those accountable for safeguarding consumer rights and religious disestablishment. Health-care educators, policy makers, and courts need to understand the premises upon which CAM is based to determine how or where CAM sponsorship is suitable.

Overview Chapter 1—“Is CAM Religious?”—argues that “religion” should be defined broadly enough to encompass both spiritually premised bodily practices and theological creeds. The chapter illustrates how certain CAM providers take inspiration from metaphysical spirituality fashioned in Europe and North America and manifold religious traditions, such as Taoism, Buddhism, and Hinduism, forged in Asia, and it explains why practitioners downplay CAM’s religious aspects in favor of efficacy and nonsectarian spirituality. Chapter 2—“Yoga: I Bow to the God within You”—takes yoga as a case study to develop the claim that CAM is religious. The chapter demonstrates that although practitioners describe yoga as secular exercise and universal spirituality, doing yoga encourages adoption of religious meanings. Because many Christians define religion in terms of intellectual creeds rather than bodily rituals, they do not recognize yoga as religious and are unduly optimistic about the ease of refashioning yoga from “Hindu” to “Christian” simply by relabeling it as such. This raises the more general question of whether CAM and Christian worldviews converge. Chapter 3—“Is CAM Christian?”—shows how CAM worldviews differ in significant respects from worldviews historically held by many theologically conservative Christians. Yet the reasoning processes used by evangelicals have led increasing numbers of them to CAM. Evangelicals characteristically guard against theological contamination while appropriating non-Christian resources for Christian purposes. They classify practices either as legitimate, religiously neutral science or as illicit “New Age” spirituality or “Eastern” religion based on whether the “roots” and “fruits” are good. Paradoxically, fear of contamination from investigating Eastern religions and the New Age made evangelicals more likely to engage in practices premised in non-Christian worldviews without realizing it, leading to unintended theological shifts. Chapter 4—“I Love My Chiropractor!”—takes as a case study Christian defenses of chiropractic. Despite rationalizations motivated by unmet needs for effective pain relief, chiropractic philosophy is premised on metaphysical

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spirituality. Chiropractic became mainstream as publicists employed vocabularies that reconstituted a philosophical alternative to Christianity as scientific, spiritual, and Christian, while continuing to frame chiropractic as metaphysics for sympathetic audiences. Evangelical patients who worried about theological orthodoxy yet wanted pain relief reclassified chiropractic from an illegitimate, New Age spiritual practice to a legitimate, scientific complement to medicine and prayer for divine healing. Crucial to chiropractic’s acceptance among Christians as religiously neutral science is its apparent efficacy. This leads to the larger question of whether there is scientific evidence that chiropractic— along with other forms of CAM—is effective and safe. Chapter 5—“Does CAM Work, and Is It Safe?”—argues that most CAM practices lack scientific evidence of efficacy and safety, but CAM has become mainstream despite, rather than because of, the scientific evidence. This is because CAM promoters used scientific-sounding language, published a growing volume of relatively poor-quality studies, and made claims that exceed the evidence, strategies that conventional doctors also sometimes use to promote their own services. Consumers want to believe that CAM is scientifically validated because they need healing, and conventional medicine too often fails to cure and entails serious side effects. The chapter distinguishes among varieties of CAM for which there is more or less scientific support and indicates how research favoring the efficacy of certain therapies classed as CAM implies the efficacy of all of CAM, whether or not there are plausible physical mechanisms or demonstrable effects. Chapter 6—“Acupuncture: Reclaiming Ancient Wisdom”—contends that Americans embraced acupuncture because they perceive it as an ancient, scientifically backed supplement to modern medicine. There is more medical evidence buttressing acupuncture than there is for many CAM approaches, but the evidence is weaker than many people suppose. Boosters succeeded in bringing acupuncture into the American health-care system—and securing approval from Christians—by using ancientness to imply efficacy, substituting medical for Taoist explanations of why acupuncture works, and downplaying specific mechanisms in favor of clinical studies reporting benefits. Nevertheless, systematic reviews of the medical evidence do not warrant the conclusion that acupuncture is effective or invariably safe. Acupuncture’s mainstreaming did not depend primarily on scientific validation, and this suggests the broader question of what other factors account for CAM’s mainstreaming. Chapter 7—“How Did CAM Become Mainstream?”—explains how CAM has been integrated into secular and Christian health-and-wellness markets even though it is religious, not particularly Christian, and lacks scientific

Introduction

21

evidence of efficacy and safety. There is both demand for CAM and ample supply. Many people who need healing have failed to find help from conventional doctors or Christian churches. As health-care consumers looked for choices that offer more than biomedicine alone, CAM providers marketed products and services as nonreligious, though spiritual commodities backed by scientific research. Readily available in secular settings and targeted to multiple cultural subgroups, CAM offers something for everyone. Chapter 8—“Energy Medicine: How Her Karma Ran Over His Dogma”— uses case studies of Reiki, Therapeutic Touch, and Healing Touch to illuminate processes by which CAM enters medical and Christian mainstreams. Energy healers draw on Buddhist, Hindu, and Western metaphysical traditions in treatment and training. Yet practitioners depict energy medicine as scientific and spiritual but not religious to win audiences of hospital administrators and patients in pain. Predominantly female practitioners disempowered by maledominated medical and Christian professions hide their metaphysics to gain access to mainstream medicine. This leads to a final question of the significance of mainstreaming processes. The book’s conclusion asks, “Why Does It Matter If CAM Is Religious (and Not Christian)—Even If It Works?” I argue that focusing on whether CAM works obscures religious assumptions about why CAM should work. There are important ethical and legal implications for individuals and society that merit consideration by CAM consumers, health-care providers, policy makers, and courts. The problem identified is not the mainstreaming of CAM per se but rather the processes involved and the contexts of CAM sponsorship. Certain CAM providers conceal CAM’s religious dimensions—resorting to self-censorship, fraud, deception, or manipulation—to avoid offending clients or to induce religious transformations. Consumers, understandably preoccupied by pragmatic goals of relieving pain or improving health, engage in CAM without investigating religious premises. If certain consumers knew more about CAM, they might not consent to participate. Yet the act of participating can influence consumers to modify beliefs, leading to unpremeditated religious reorientations. These processes compromise personal autonomy and self-determination and impede the informed decision making necessary for healthy operation of American economic and political systems. Misrepresenting CAM to enhance palatability violates patient rights. Government endorsement of CAM—through public schools and direct funding—disrespects religious equality and religious voluntarism and may de facto result in unconstitutional establishment of religion.

1

Is CAM Religious?

during an average week, Americans of every religious background may take a class in yoga or t’ai chi at the gym, get a chiropractic adjustment or an acupuncture treatment at a medical office, practice mindfulness meditation in the workplace, relax with shiatsu massage at a mall spa, eat a diet that balances yin and yang, and then return to church, mosque, or synagogue on the weekend, not noticing, or at least not discomfited, that they have been practicing religion all week long (see figure 1.1). This chapter contends that much of CAM is religious, but few people recognize it as such, or if they do, practitioners downplay religion in favor of efficacy and nonsectarian spirituality. The term religion should be defined broadly enough to encompass religious traditions that emphasize bodily practices above intellectual creeds and “spirituality” untethered to discrete religious traditions. Particular CAM practices reflect selective interpretations of metaphysical spirituality constructed in Europe and North America and/or complex religious traditions formed in Asia, including Taoism, Buddhism, and Hinduism.

What Is Religion? This book offers a relatively broad definition of religion as including not only theistic beliefs but also bodily practices perceived as connecting individuals with suprahuman energies, beings, or transcendent realities or as inducing heightened spiritual awareness or virtues. Such a definition does not sharply distinguish between religion and spirituality, both of which make metaphysical assumptions about the nature of reality. This broad definition can be justified by the diversity of human experience and the need to account for the variety of ways in which people set apart that which seems sacred from the profane.1

Is CAM Religious?

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figure 1.1 Yoga, t’ai chi, and healing spa next door to Edward Jones Investments in an urban strip mall, 2011. (Photograph by author)

Protestant dominance in America bred narrow definitions of religion, with Christianity as the standard against which everything else is measured. Protestantism is centrally concerned with language. Sixteenth-century reformers emphasized the primacy of the Word of God, revealed in the Bible, and of faith in the gospel message. René Descartes (1596–1650) advanced a dualistic model of the material world as distinct from “mind” or “spirit.” Protestants defined material bodies and bodily practices as less intrinsically religious than correct doctrines. Protestants do consider certain practices sacred, but what one believes or says during the practice confers meaning: “This is my body given for you; do this in remembrance of me” in communion; “I baptize you in the name of the Father, Son, and Holy Spirit”; “I now pronounce you man and wife.” Catholics have a higher, sacramental view of religious practices as physical means that communicate supernatural grace. Perhaps for this reason, the Catholic church has criticized CAM as religious, while Protestants coded CAM as nonreligious science, exercise, or nutrition.2 Labeling a practice “non-Christian” does not make the practice nonreligious. Word-oriented Protestants tend to read their textual bias onto other religions, placing more emphasis on “sacred texts” of other traditions than many (particularly nonelite, often illiterate) participants place on them. By Protestant

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reasoning, religions that do not emphasize doctrines, creeds, church services, or worship of a single deity may not seem to be religions at all. Protestants have been prone to misunderstand embodied traditions in which practice is itself an essential expression of religious devotion, while doctrines may play a relatively minor role. For many Hindus and Buddhists, for instance, religious significance may come directly in the doing, rather than secondarily in believing or saying something while performing bodily or mental practices. This is because many people understand knowledge of the divine to be experiential, rather than merely intellectual. If body and spirit are not separable categories but aspects of each other, then bodily practices can be both spiritual and physical. From such a perspective, it would make little sense to isolate bodily practices from spiritual purposes.3 Labeling a practice “spiritual” does not make the practice nonreligious. When many people in the United States think of religion, they think first of Christianity. They may also think of guilt-inducing proscriptions on behavior and requirements that adherents regularly attend church, intellectually assent to doctrines or recite creeds, and legalistically follow rules that seem applicable only to a culturally circumscribed group. Many Americans (including many Christians) want to distance themselves from this kind of religion. The term spirituality, by contrast, denotes an individual’s private seeking after sacred meaning untethered to public adherence to traditional religious institutions, doctrines, creeds, or rituals. In lived experience, religion and spirituality often intermingle. According to public-opinion polls in the 2000s, most Americans self-identify as both spiritual and religious. In one survey, a mere 10 percent of Americans said they were spiritual but not religious, and 17 percent described themselves as religious but not spiritual; 57 percent identified with both labels. More important, both religion and spirituality fulfill many of the same functions, for instance, affirming a person’s place in the cosmos and offering a sense of purpose, meaning, and hope.4 Certain CAM promoters find it advantageous to present CAM as spiritual instead of religious. This allows boosters to court audiences of evangelicals and adherents of other (or no) religions. The basic strategy involves claiming that “ancient” CAM practices predate the rise of specific religions, identifying CAM with universal spirituality, and denying that it conflicts with any religion. Declaring that practices are spiritual but not religious does not, as if by fiat, necessarily remove religious meanings. Neither does asserting that practices are “universal” and thus suitable for people of any or no religion automatically resolve potential tensions. Labeling a practice “science” does not make the practice nonreligious. Americans who envision science and religion as nonoverlapping magisteria

Is CAM Religious?

25

may not grasp the intertwining of the two in certain comprehensive worldviews. In traditional Chinese culture, there was no separate word for religion because religious and medical concepts of health worked together, with religion providing a theory and empiricism contributing a method for obtaining knowledge. One of the earliest-known texts on herbalism is the Chinese Pen Ts’ao, “The Great Herbal” (c. 2700 b.c.e.). The presumed author, Shen Nung, is a mythical figure revered as “father of medicine” and “god of agriculture.” He reputedly used empirical methods to create a pharmacopoeia by tasting and classifying 365 herbs into a “superior” or nontoxic group, a “medium” or “slightly toxic” group, and an “inferior” or poisonous, group. But this taxonomy was guided by metaphysical assumptions, for instance, that herbs are potent because they correspond to organs in a mysterious way or drive harmful spirits away.5 Non-Christian religious practices have been marketed as science to offset American fears of religious contamination. The introduction of Zen Buddhist meditation to America provides an apt example. Soyen Shaku (or Shaku Soen; 1860–1919), credited as the first Zen missionary to America, traveled from Japan to the World Parliament of Religions at the Chicago World’s Fair of 1893. As backdrop to this convocation, Charles Darwin’s Origin of Species (1859) provoked new questions about the relationship between science and religion just as Americans were becoming aware of diverse religious traditions, such as those that came to be called Hinduism and Buddhism. As the historian Richard King has observed, Westerners were prone to ask, “How scientific is Buddhism?” and Asian Buddhists used the opportunity to frame Buddhism as compatible with science and thus superior to Christianity. Western enthusiasts and Asian modernizers downplayed seemingly “idolatrous,” “superstitious” beliefs, focusing on techniques such as zazen, a form of sitting meditation practiced with eyes cast down and lightly focused, sometimes facing a blank wall, while learning to “think nonthinking” or exhibit “no-mind” (mu-shin) on a moment-to-moment basis.6 Soyen recognized late-nineteenth-century Americans’ enthusiasm for science and their search for universal spirituality and common ground among religions, adapting Zen accordingly. Using the language of “natural law” and “moral law,” Soyen claimed that the Buddha’s teachings “are in exact agreement with the doctrines of modern science” in accessing ultimate reality. Soyen’s student D. T. Suzuki (1870–1966) published twenty English-language books that selectively rendered the essence of Zen spirituality as pure experience and unmediated encounter with reality, thereby severing Zen from Buddhism or any specific religion. This interpretation helped subsequent popularizers—such as Ruben Habito (a former Jesuit

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priest) and founding teacher at the Maria Kannon Zen Center in Dallas, Texas—to “assure everyone concerned that Zen does not threaten a healthy faith in the ultimate as expressed in the Christian tradition,” since Zen is “an invitation to a direct experience, and the only thing that is required is a willingness to engage in that journey of self-discovery.” Such selective characterizations of Zen as congruent with science and shared spirituality widened Zen’s appeal.7 By the late twentieth century, Zen had become a mainstay of popular culture, particularly among white, middle-class, highly educated Americans. Book titles beginning with the phrase Zen and the Art of append a countless variety of objects, such as Golf, Motorcycle Maintenance, Information Security, Pottery, Stand-up Comedy, Murder, Vampires, Cooking, Gardening, Running, Fly Tying, Sharemarket Investment, Crossword Puzzles, Falling in Love, Poker, Knitting, Raising Chickens—the list seems endless.8 Despite frequent disavowals that CAM is religious, attested benefits of CAM resemble benefits commonly attributed to religion. The Mayo Clinic is reputedly one of the best medical centers in the world; it has also taken a lead in promoting CAM—for more-than-medical reasons. The Mayo Clinic Book of Alternative Medicine (2010) identifies the “best integrative therapies.” This guide awards a “shining green light” to safe and effective “mind-body” practices, including meditation, t’ai chi, yoga, progressive muscle relaxation, and guided imagery. The explicit reason is that such practices provide a “guide to a higher purpose. These practices are thus not an end in themselves.” The goal is cultivating “values of peace, forgiveness, compassion, selflessness, integrity and love” that will “unfold the deeper, kinder person that is within all of us” and “transform you into an embodiment of wisdom and love.” Mind-body medicine frees the mind from the “prejudices” of “excessive negative thoughts and the related state of mindlessness. The hope is to bring your attention to the splendor of the present moment in a state of acceptance that empowers you to engage in meaningful action.” Mindfulness restores appreciation of the “beautiful world” and cultivates “a higher meaning to life, gratitude and interconnectedness.” References to such concepts as higher purpose, meaning, and values such as love and compassion blur distinctions between medicine and religion. Indeed, the book advises patients, “if you are exploring organized religion, remember to consider a variety of different faith traditions.” Sold as a guide to alternative medicine, the text dispenses a religious prescription.9 Certain CAM practices may fulfill similar functions to religion. The Japanese term karate-do is translated as the “way of the empty hand,” with do referring to a path of spiritual self-development shaped by Zen Buddhist and Taoist concepts. Karate is believed to have developed on the island of Okinawa

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around the fourteenth century, as residents combined wushu, or martial disciplines, learned from neighboring China with peasant self-defense techniques, later adding Japanese martial techniques, bujutsu, governed by the code of bushido, or “way of the warrior,” an ethical guide. Karate is today practiced within the social environment of the dojo, or practice hall. The traditional garment, or gi, worn by karateka, or practitioners, is white, because in Japanese culture, this color symbolizes death, emptiness, purity, absence of ego, and single-minded commitment. Karateka recite ethical codes, execute stylized techniques in the context of hierarchical social relations, and end sessions seated formally, eyes closed, performing zazen. In the assessment of John Donahue, a scholar who has trained in four karate dojos over seven years, desire for self-defense skills or physical fitness may at first attract American students, but the “more complex” goals of karate are “spiritual.” The “mystical, quasi-magical dimension” of karate is never far from its appeal. Donahue considers karate to be like religious ritual in that it provides a “highly structured and symbolic activity that facilitates the focus of psychic and physical energy to create a flow experience.” Karate “possesses an aura of morality, although it requires no specific adherence to creed or rules of human behavior outside of the microcosmic social universe of the training hall.” Karate offers ritually and ethically satisfying experiences without negative associations of religious creeds and rules.10 All of the above examples notwithstanding, labeling a practice “CAM” does not make the practice religious. There is diversity among and within CAM approaches, which may have no one founder or founding moment or tradition but multiple schools, each of which has changed over time. Although many CAM practices have long been closely tied to Hindu, Buddhist, and Taoist cultures, what we think of today as Hinduism, Buddhism, and Taoism were not always so neatly defined. Scholars sometimes use the metaphor of a mountain to describe the relationship among the major Chinese religious traditions, or the three “peaks” of Taoism, Confucianism, and Buddhism. Although some people tried to keep the peaks separate, most remained at the base of the mountain and drew freely from any or all traditions. Even today, these multidimensional traditions encompass great capacity for selection and combination.11 Some practices commonly included under the CAM umbrella may not have any ties to religion. For instance, a distinction may be drawn between biomedical use of herbs solely for chemical properties and herbalism, which implies a vitalistic view of herbs as possessing spiritual qualities. Certain Chinese herbs, such as ginger for motion sickness, have been incorporated into the biomedical armamentarium based on clinical demonstration of safety

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and efficacy. One-fourth of modern prescription drugs derive from plants. In herbalism, by contrast, plants with healing attributes may be identified as deities or homes for spirits or as possessing personality and temperament. Herbalists may seek a spiritual relationship with plants from which they harvest herbs by asking the plant’s permission, extracting spiritual energy from the sun or moon by gathering herbs at a particular time of day or month, or invoking help from spirits of the deceased. Herbs can be envisioned as absorbing negative vibrational energy or emitting vibrations and fragrances that please the spiritual world and thus be used in teas or baths, worn as an amulet, or shaped into a broom to sweep away harmful spirits. As herbalist Rosemary Gladstar describes her diagnostic procedure: “I pray and let the spirit of the herbs guide me.” Many herbalists believe that unless people perform rituals properly, herbs are ineffective.12 As with herbs, consumption of vegetarian and vegan (eliminating dairy and eggs along with meat) diets may or may not be metaphysically premised. Hindu writer Shamsunder Khandavalli argues that plants “contain greater amounts of the life giving vital energies,” whereas animal foods “contain volatile deceased PRANA and violent psychic impressions embedded in them due to the extreme pain and torture endured during killing,” differences that can allegedly “be seen through Kirlian photography.” Ethical veganism has been associated with Jainist and Buddhist concepts of compassion. By contrast, the term whole-food, plant-based diet came into vogue in the 2000s to denote strictly dietary veganism, based on evidence that diets of whole grains, vegetables, fruits, and legumes may prevent or reverse diseases.13 Given the potential—but not the necessity—for CAM to be religious, it is important to ask which CAM therapies have been shaped by particular religious traditions and in what ways. Rather than provide a comprehensive answer to this question, the remainder of this chapter considers examples that illustrate points of connection between certain understandings of CAM and selective interpretations of metaphysical spirituality, Taoism, Buddhism, or Hinduism.

Western Metaphysics The concept of vital energy has a lengthy, multifaceted history in the Western world. Sources include European alchemical, astrological, and Hermetic traditions associated with Paracelsus (1493–1541), Athanasius Kircher (1602–1680), Franz Anton Mesmer (the developer of mesmerism; 1734–1815), and the Jewish Kabbalah and their notions of “life force” and correspondence between natural and supernatural orders of reality. Charles Poyen introduced mesmerism,

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also known as animal magnetism, in the United States in 1836; the practice presupposes that humans possess a magnetic field that can be used to heal disease by attracting the good or evil that endows all matter. Hypothesizing that “magnetic ether” flows through the solar system into the human nervous apparatus, mesmerists—like osteopaths, chiropractors, and spiritualists—used hand gestures or “passes” to remove “obstructions” in the flow of “spirit” or “vital fluid” and restore “harmony” between human bodies and the cosmos.14

Osteopathy: Medicine with Something Extra A native of Virginia, Andrew Taylor Still (1828–1917) began as a “magnetic healer,” or mesmerist, and in 1874, he introduced osteopathy, from the Greek osteon, or “bone,” as an improved method for removing obstructions to the flow of “vital energy” by physically manipulating the body. Compared with chiropractic (developed twenty years later and based on similar principles), osteopathy more quickly shed its sectarian reputation because of the more genteel social origins of early osteopaths and because osteopaths more readily incorporated biomedical reasoning and methods. When Congress established Medicare in 1965, it covered osteopathy but not chiropractic. According to the NCCAM, the designation “conventional” medicine encompasses that which is “practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathic medicine) degrees.” Doctors with both degrees complete similar coursework, are eligible for the same residencies, and practice in the same hospitals. Today, most people consider osteopathy to be nearly indistinguishable from biomedicine.15 Osteopathy can, however, still be distinguished by its holistic orientation. Articles published in the Journal of the American Osteopathic Association in the 1990s and 2000s identify the first tenet of “modern osteopathic philosophy” as a conviction that “the person is a unit of mind, body, and spirit” and that “health includes the health of a patient’s spirit.” The official Osteopathic Medical College Information Book (2008) prints a testimonial by a student who “fell in love with the DO philosophy. . . . I found the concept of treating the mind, body, and spirit quite attractive.” Osteopathic physician Joey Shulman stated in 2007 that “osteopaths believe that the body is a self-regulating and self-healing organism, and when interference is removed [ for instance, through manual therapies], the body will return to its normal state of health and wellness.” Doctor of osteopathy and New York Times best-selling author Joseph Mercola attests that “DOs bring something extra to the practice of medicine,” a “‘whole person’ approach.” Mercola uses a “Meridian Tapping

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Technique,” a kind of “psychological acupressure,” by “tapping on special acupuncture meridians with your fingertips while tuning into a specific problem, using positive affirmations,” along with chiropractic and homeopathy, because all of these practices share basic assumptions about the nature of reality.16

Homeopathy: Dynamizing Spiritlike Power Samuel Hahnemann (1755–1843) invented homeopathy (from the Greek for “similar” and “suffering”) in Germany in the early 1800s, and the practice arrived in the United States in 1825, soon developing into the largest medical sect of nineteenth-century America. Tradition has it that Hahnemann, a conventionally trained village doctor, conducted experiments to improve on standard medical practices. He administered to himself cinchona tree bark, a standard treatment for malaria, and found that it produced malaria-like symptoms. This led him to formulate the “law of similars,” which states that substances that produce in healthy persons symptoms similar to those of a disease can treat that disease. Upon testing other substances on healthy individuals, in “provings,” some substances exhibited toxic effects. To mitigate side effects, Hahnemann diluted the substances and found that they were even more effective in treating disease than when used at full strength. From this observation, he derived the “law of infinitesimals,” which states that the strongest medicines are those with the smallest dose. Hahnemann published his new medical system as the Organon of the Rational Art of Healing (1810). He disdainfully coined the label allopathic medicine from the Greek roots for “other than the disease” to imply that most medicine violates the healing laws of nature by polluting human bodies with large quantities of poison unrelated to the cause of disease, while neglecting remedies provided by nature.17 Despite Hahnemann’s empirical methods, homeopathic theory presupposes vitalism. The Organon, called the Bible of homeopathy even today, overflows with references to a “spiritual vital force.” In healthy individuals, this “dynamistic, immaterial, vital energy, animating the material part of the human body, reigns absolutely.” Since disease results from a disturbance in “vital energy by dynamistic influence,” healing requires restoration of balance “by a spirit-like (dynamic) process.” Since matter is not “something inanimate,” homeopathy works to “potentize” or “dynamize” the “spiritlike medicinal power” latent in material substances so that it is “excited and enabled to act spiritually upon the vital forces.” This is done through “trituration,” grinding insoluble solids to mix them with inert substances, or “succussion,” vigorously shaking and repeatedly hitting liquid dilutions

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against an object. Assuming that dynamizations conserve and transmit spiritual energy, Hahnemann believed that remedies were effective even if they were so dilute that the final solution did not contain any of the original substance.18 Homeopathic medicines are often highly dilute. Hahnemann created the centesimal or C scale to dilute substances by a factor of one hundred between succussions. Modern practitioners also use a decimal or X scale to denote dilution by a factor of ten. Over-the-counter remedies are typically available in potencies from 6X to 30X and C, but homeopaths prescribe potencies from 100C to 50,000C (sometimes up to 1,000,000C). At a potency of 12C or 24X, there is a one-in-100,000 chance that a pill will contain one molecule of the original substance. A 30C dilution—the potency recommended by Hahnemann for most purposes—yields a ratio of 10–60 substance to solvent. Critics estimate that at this dilution, a patient would have to consume 1041 pills (which adds up to a billion times the earth’s mass) or drink 1034 gallons of a liquid medicine (10 billion times the earth’s volume) to be assured of consuming one molecule of the active ingredient. A 200C dilution, used for the flu remedy Oscillococcinum (derived from duck liver and heart, and sales of which exceeded $681 million in 2011), yields a ratio of 10–400; skeptics calculate that 10320 additional universes of matter would be required for there to be one molecule in the final substance. Hahnemann, who died in 1843, would not have been aware of such facts. It was not until 1865 that scientists first calculated Avogadro’s number (the ratio of constituent particles to amount of a substance). But by Hahnemann’s (and many modern homeopaths’) reckoning, such calculations would in any case have been beside the point. This is because homeopathic remedies were developed not for their chemical but for their vital properties.19 Hahnemann’s medical theories bore the imprint of his eclectic religious beliefs. Although a member of Germany’s Protestant Lutheran church, he was a self-described Deist and a Freemason (Lodge of St. Andrew of the Three Lotuses), and he took Confucius as his model. Many of Hahnemann’s nineteenth-century followers were intellectual elites, including conventionally trained physicians, who combined homeopathy with other spiritually premised religious and healing systems such as Transcendentalism, mesmerism, and Swedenborgianism. The Swedish mystic Emanuel Swedenborg (1688–1772) believed he was divinely commissioned to reform Christianity by refuting traditional Christian doctrines such as the trinity and demonstrating that the last judgment and second coming of Christ had already occurred, based on visionary experiences in which he conversed with angels, demons, and spirits from other planets. Homeopathy’s first American popularizer, Hans

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Burch Gram—who translated and published Hahnemann’s Characteristics of Homeopathy in America in 1825—was a physician, a Swedenborgian, and a Freemason. The influential Post-Graduate School of Homeopathics, established by Swedenborgian James Tyler Kent in Philadelphia in 1890, taught that the human “aura . . . occupies a very important place in homeopathic studies” and advised homeopaths to see “with the eyes of the spirit.” A century later, in 1989, a homeopathic school administrator told an interviewer that “in Homeopathy you are definitely into the spiritual realm. It is very easy to make a religion of it. . . . Nearly all the doctors attending the faculty are involved in some sort of spiritual practice such as anthroposophy [use of intuition to access the spiritual world] or transcendental meditation.” To many practitioners, homeopathy has seemed congruent with diverse metaphysical approaches.20 Today the homeopathic toolbox can include intuition, clairvoyance, astrology, electroacupuncture, applied kinesiology (muscle-response testing, premised on a correspondence between muscle strength and qi meridians), iridology (interpreting the iris as a microcosm of the energetic body), or dowsing with a pendulum (a rod-shaped device with weights that swing to read energy patterns). Some twenty-first-century homeopaths speak of “higher realms of the spirit world,” “magnetically charging” substances with “spiritual energy,” putting the “essence or ‘prana’ of virtually anything into a bottle,” and receiving “divine messages and guidance from the Holy Spirit.” Tess, a homeopathic healer in Cambridge, Massachusetts, explains that her remedies release “patterns of energy that are stuck” and repair “energy leakages.” Homeopaths make medicines out of such unlikely substances as dog’s ear wax, dental plaque, vomit, tears from a weeping young girl, polyurethane, Braille paper, mercury, Stonehenge, arsenic, New York City, live scorpions, blood from an AIDS patient, and cancerous tumors. Some homeopathic remedies are not material but “imponderables” such as moonlight (luna), computer-terminal rays, wind (ventus), the north pole of a magnet (magnetis polus arcticus), and a vacuum (i.e., empty space). Homeopaths may skip the step of diluting any substance, instead placing plain water in the center of a geometric figure or writing down the name and potency of an intended medicine. One homeopath administered “Electricitas 200C” to a car with problems in the engine’s electrical system, by writing the prescription on a sheet of paper and placing it near the engine; the remedy was credited with enabling the car to complete a cross-country trip. Some practitioners treat at a distance by placing remedies next to a photograph or a hair sample or sending intentions over the telephone or via Internet chat rooms. Such practices reflect an assumption that remedies operate on a spiritual, rather than a merely chemical, level.21

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Naturopathy: Reliance on the Cosmic Forces Naturopathy, or “nature disease,” a term coined in 1895 by John Scheel and popularized by the reputed father of American naturopathy, Benedict Lust (1872–1945), is a philosophy of healing premised on vitalism. Lust described his system as “absolute reliance upon the cosmic forces of man’s nature.” A 2010 guide to Clinical Naturopathy affirms that “a fundamental belief of naturopathy is that ill health begins with a loss of vitality. . . . Vitalism is the belief that living beings depend on the action of a special energy or force. . . . The vital force is non-material. . . . It is the guiding force . . . different from all the other forces recognised by physics and chemistry.” Dr. Matthews, a licensed naturopathic physician who has been practicing for twenty-five years, articulates his goal as strengthening the “vital force” within each patient. Matthews defines vital force as something “spiritual,” which admittedly cannot be “quantified” except by its apparent effects on the body’s “structure/anatomy,” “function/ physiology,” and “behavior/psychology.” Although using biomedical terms such as anatomy, physiology, and psychology, Matthews equates vital force with prana, qi, and the Holy Spirit. Despite the persistence of vitalism in modern naturopathy, it has gained recognition as a field of medicine and as of 2013, was licensed by sixteen states, the District of Columbia, two U.S. territories, and five Canadian provinces. As defined by the Association of Accredited Naturopathic Medical Colleges in 2011, “naturopathic medicine celebrates the healing power of nature. . . . Above all, it honors the body’s innate wisdom to heal.” Naturopathic doctors oppose the use of “toxic” drugs, vaccination, radiation, and surgery, preferring holistic modalities such as homeopathy, acupuncture, massage, and aromatherapy.22 Methods selected by naturopaths, such as aromatherapy, share vitalistic perspectives. According to the Complete Aromatherapy Handbook (1990), inhaling or absorbing essential plant oils through the skin mobilizes the “body’s own self-healing powers” as “essential” oils connect users with the essence, or spirit, of the plants. Aromatherapy for the Soul (1999) avers that essential oils “have their own vibrations that connect with the frequencies in the human energy field causing effects in the physical, emotional, and spiritual body.” This is because “all plants have souls and spirits that guard and protect the species . . . depending on the sacredness of the purpose the plant is put to.” Thus, “healing takes place when a person connects into the plant spirit, becoming the plant and understanding its personality. Using spirit as the method of transference, the plants’ energy or healing properties are transmitted to the person.” By such reasoning, “pure” essential oils are the most powerful, because they transfer the strongest vibrations of spiritual energy.23

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Anticancer Diets: Nourishing the Life Force Energetically A central premise of aromatherapy, that plants transfer vital energy, undergirds several popular nutritional approaches to cancer. A German-Jewish physician, Max Gerson (1881–1959), borrowed from Paracelsus and European folk medicine to conclude that organic vegetable and fruit juices, uncorrupted by artificial chemical contaminants, nourish the life force. The Gerson therapy prescribes the consumption of one eight-ounce glass of freshly squeezed, organic juice (green, carrot, apple, and orange) each hour, for a total of thirteen glasses—the equivalent of twenty pounds of produce—per day. Gerson added other vegetarian foods and supplements, including large quantities of raw calf-liver extract, until evidence linked consumption of raw liver to infection and death (raw liver is still used in some clinics). Another hallmark of the Gerson therapy is the use of organic coffee enemas, which purportedly rid the liver of toxins. To avoid U.S. regulations, the Gerson Institute established clinics outside the United States, most famously in Tijuana, Mexico; as of 2006, Tijuana’s Hospital La Gloria charged $1,700 per week, with a recommended stay of eight weeks. Gerson Institute staff claim a cure rate of 50 to 90 percent for most cancers. In The Gerson Therapy: The Amazing Nutritional Program for Cancer and Other Degenerative Diseases (2001), Gerson’s daughter, Charlotte, urges that juices must be consumed immediately to transfer the “plant ‘vital force,’ ‘qi,’ or ‘prana’ present in the juices when freshly made,” which “promotes healing at the energetic or psychic level rather than at the cellular or biochemical level.” Variations on the Gerson therapy abound, such as the Kelley program, the Hallelujah Diet, the Breuss Cancer Cure, and the Budwig (or “flaxseed oil/cottage cheese”) protocol. The developers of various proprietary formulas, such as Protocel (a.k.a. Entelev/Cantron/CanCell), Iscador (mistletoe), and Essiac/Flor Essence, also employed vitalistic reasoning. For instance, Protocel uses special “vibrational frequencies” to alter “energy fields,” thereby reducing cell “voltage levels.”24 Raw foods and wheatgrass diets similarly begin with vitalistic assumptions. Options: The Alternative Cancer Therapy Book (1992) describes raw, organic foods as “living energy transferred to the body” and warns that “the vital energy locked in foods is weakened or destroyed by cooking, canning, and even, to some degree, freezing.” The developer of wheatgrass therapy, Ann Wigmore (1909–1994), considered chlorophyll “the life blood of the planet.” If chlorophyll is cooked, the “sacred” 7-to-4 acid-alkaline balance is “killed,” deactivating the enzymes. (Conventional scientists discount the idea that enzymes are alive or that enzymatic activity benefits the eater versus the organism that produced the enzymes.) It is interesting to follow Wigmore’s reasoning from the Bible’s story that Babylonian King Nebuchadnezzar recovered from insanity

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after seven years of eating grass. The biblical account specifies in Daniel 4 that God sentenced Nebuchadnezzar to eat grass like a wild animal because of his sin of arrogance and that he recovered after repenting. Wigmore instead credited the grass for its curative properties. Wigmore also advocated healing through astrology, acupuncture, reflexology, hydrotherapy, and color therapy.25

Taoism Taoism (or Daoism) emerged in China several thousand years ago and developed into diverse forms alongside other philosophical and religious traditions, including Confucianism and Buddhism. Depending on the stream of Taoism considered, the Tao, or “Way,” has been variously described as a “guiding force” or “universal intelligence,” an “unbroken wholeness,” the “neutral essence of all life,” as “pre-existent to being and form” and “dependent on nothing,” as “nothingness” and “everything,” and as that which is “neither good nor evil, but just is.” The term qi (or ch’i) is often translated as “vital energy” or “vital breath” and used to designate a subtle force or substance thought to exist within the physiological processes of the human body and everything else in the world. There are different kinds of qi, organized according to eight principles, or opposing and interdependent aspects, that must be balanced: cold-heat, interior-exterior, excess-deficiency, and yin-yang (sometimes described as male-female, day-night, heaven-earth, dry-wet, motionrest). There are also five phases or elements of qi: fire, earth, metal, water, and wood. In the human body, qi presumably moves along meridians, or channels, that crisscross the body to connect yin organs with paired yang organs. The heart stores the “mind/spirit.” The spleen helps the stomach to convert food to qi and to raise qi/yang to the head. The lungs govern qi, the kidneys store “congenital essence” qi, and the liver ensures the free flow of qi. The “triple burner” is not a self-contained organ but a functional energy system responsible for producing and circulating nourishing and protective qi to regulate other organs. Traditional Chinese Medicine (TCM, which includes acupuncture and herbalism), qigong (cultivating qi through physical and mental training for health and longevity), and wushu (martial disciplines) unblock the flow of qi to restore balance and harmony with the Tao.26

T’ai Chi Ch’üan: Supreme Ultimate Boxing Wushu is commonly translated as “martial arts.” Whereas hard/external styles (including karate, judo, kickboxing, and kempo) emphasize physical movements, soft/internal styles (for instance, t’ai chi and aikido) are

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called “meditation in motion,” because they focus on internal energy flows of qi between yin and yang states. T’ai Chi Ch’üan (or Taijiquan), simplified as t’ai chi, can be translated as “Supreme Ultimate Boxing.” The “Supreme Ultimate” refers to the Tao. Tradition has it that the Taoist culture hero Chang San-feng created t’ai chi between the tenth and the seventeenth centuries and that Chen Wang-ting (1597–1664) further developed t’ai chi out of Taoist philosophy, TCM, and martial techniques. The original t’ai chi form is thought to consist of thirteen postures, which correspond to the eight trigrams (mystical sequences of broken and unbroken lines) of the I Ching (a foundational text for Taoism and other Chinese religious traditions) and five qi phases of Chinese alchemy. Controlled breathing and movements, such as hitting, lifting, and throwing, represent the dynamic state of yin and yang separating, while remaining static indicates combination, resulting in circulation and balance of yin and yang. Similar assumptions undergird other martial arts and such practices as moxibustion (burning herbs at acupoints), polarity therapy, and shiatsu massage. After the Communist revolution of 1949, Mao Tse-tung disseminated the idea that Chen Wang-ting originated t’ai chi, as this served the government’s strategy of downplaying Taoist influences on Chinese history. Cheng Man-ch’ing (1901–1975) promoted t’ai chi in the United States, where it gained popularity as a form of exercise gentle enough for the elderly. In 2007, 2.3 million Americans, or 1 percent of the population, had practiced t’ai chi in the past year.27

The Macrobiotic Way of Life George Ohsawa (born in Japan as Yukikazu Sakurazawa; 1892–1966) introduced many Europeans and Americans to macrobiotic eating (from macro for “great” or “long,” and bios for “life”) with his book, Zen Macrobiotics: The Art of Rejuvenation and Longevity (1965). Ohsawa’s diet consisted of ten increasingly restrictive stages, until one consumed only water and brown rice, selected for the nearly ideal yin-yang balance. One of Ohsawa’s students, Michio Kushi (1926– ), popularized a more moderate (and nutritionally adequate) version of the diet by publishing The Cancer Prevention Diet (1984). Kushi begins with the premise that “our body is constantly being composed of, and sustained by, Ki (also known as Chi) energy . . . running through the meridians. That stream is going toward the inside where it creates energy centers known as chakras . . . our spiritual and mental body.” Macrobiotics expresses the “principles governing the flow of energy and the attraction of opposites [which] are known traditionally in the East as yin and yang, the primary forces of heaven and earth that create, sustain, and animate all things.” According to

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macrobiotic philosophy, some cancers are yin, and others are yang. Yin cancers may be treated by eating yang foods, including cooked vegetables, fruit, and fish. Yang cancers may be opposed by yin foods, such as raw vegetables. Because yin-yang balance is relative, the same diet is not for everyone. Healers may base prescriptions on “pulse diagnosis,” “ancestral diagnosis,” “astrological diagnosis,” or “aura and vibrational diagnosis.” Macrobiotics emphasizes correct eating, because food is “the central factor over which human beings have the most control.” But, according to Kushi, macrobiotics is more than a diet; the “macrobiotic philosophy offers a unifying principle to understand the order of the universe as a whole.” Macrobiotics is a “way of life encompassing all dimensions of living.” Although for decades Kushi opposed conventional cancer treatments as incompatible with macrobiotic philosophy, in 2004, he had a cancerous tumor surgically removed from his colon, after losing his daughter and his wife to cancer, although all three Kushis had been long-term macrobiotic adherents.28

Buddhism Similar to Taoism, Buddhism is a complex set of religious traditions that began in India and developed in China over the course of millennia. The “four noble truths” are fundamental principles of Buddhism, namely, that life is suffering, suffering originates in attachment, suffering can be ended, and there is a path to the cessation of suffering. The “eightfold path” attributed to Siddhartha Gautama (c. fifth century b.c.e.) involves releasing objects of attachment, including the very “idea of a ‘self’ which is a delusion, because there is no abiding self . . . and we are merely a part of the ceaseless becoming of the universe.” The cultivation of mental and physical disciplines (right view, right intention, right speech, right action, right livelihood, right effort, right mindfulness, and right concentration) frees the mind from the stress of fluctuations occasioned by moving toward desires and away from dislikes or focusing on past mistakes and future worries. Extinguishing attachments removes the cause of suffering and prepares the mind and body for enlightenment, realization of Buddhahood, or nirvana, the release from reincarnation’s cycle of life and death.29

Mindfulness Meditation: Now Is the Only Time You Have The term mindfulness refers to the seventh aspect of the eightfold path of Buddhism. Mindfulness is one of a number of Buddhist approaches to meditation, such as visualizing oneself conforming to the image of a Buddha,

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exhibiting “no mind,” or repeating a mantra, the Sanskrit term for a special kind of word with power to create spiritual transformation. Mindfulness cultivates moment-to-moment awareness of what one is doing and can be practiced while sitting, walking, lying down, or going about daily activities.30 In Christian contexts, the term meditation is a synonym for thoughtful reading, reflection, and personal application of scripture. The Bible promises blessings to one “whose delight is in the law of the LORD, and who meditates on his law day and night.” Medieval Christian monastics practiced Lectio Divina, Latin for “divine reading,” or contemplation of God’s Word. Christian mystics such as John of the Cross, Teresa of Avila, Madame Guyon, and Fénelon used contemplative prayer to seek consciousness of God’s presence. Modern evangelical prayer books encourage meditating on the Bible. Debbie Williams advises in Pray with Purpose (2006): “Look up and meditate on the verses referenced in each chapter. . . . Meditating and ‘chewing’ on God’s Word helps you digest and absorb what you’ve read.” Christians who have this definition of meditation in mind may assume that mindfulness meditation is essentially similar.31 The most influential promoter of mindfulness in America is Jon KabatZinn (1944– ), a European-American professor of medicine and founding director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical Center. Kabat-Zinn used his medical credentials and university affiliation to make Buddhist meditation acceptable to non-Buddhists by downplaying religious and spiritual language in favor of simple techniques. He wrote the bestselling Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness (1990), with the explicit goal of making the “path of mindfulness accessible to mainstream Americans so that it would not feel Buddhist or mystical so much as sensible.” Meditation is, according to KabatZinn’s best-seller Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life (1994), “simply about being yourself and knowing something about who that is.” Meditation is “really about paying attention,” and since paying attention is “something that everybody does, at least occasionally, meditation is not as foreign or irrelevant to our life experience as we might once have thought.” Mindfulness is “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” Because a focus on the present moment seems ordinary, mindfulness appears “acceptable and accessible” to most Americans.32 Kabat-Zinn describes mindfulness as the “heart of Buddhist meditation.” He insists, however, that “you don’t have to be a Buddhist to practice it,” since “its essence is universal.” The technique “stands on its own” when extricated

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from its Buddhist context and can be practiced by anyone as a “way of looking deeply into oneself in the spirit of self-inquiry and self-understanding.” Moreover, “mindfulness has little to do with religion, except in the most fundamental meaning of the word, as an attempt to appreciate the deep mystery of being alive and to acknowledge being vitally connected to all that exists.” Kabat-Zinn argues directly that “mindfulness will not conflict with any beliefs or traditions—religious or for that matter scientific—nor is it trying to sell you anything, especially not a new belief system or ideology.” By avoiding “the word ‘spiritual’ altogether,” Kabat-Zinn introduced mindfulness-based programs in hospitals, prisons, public schools, businesses, and professional sports. In 2013, the Center for Mindfulness directory listed 889 such programs.33 The flagship model for teaching meditation in secular settings is KabatZinn’s eight-week Mindfulness-Based Stress Reduction (MBSR) program. Kabat-Zinn bills the “stress clinic” as helping patients develop “strengths that they already have and come to do something for themselves to improve their own health and well-being.” The program consists of three components. In sitting meditation, participants direct their attention to their breath, physical sensations, thoughts, and emotions. The body scan is a guided meditation during which participants systematically shift their attention from one area of the body to another. The third component is “mindful hatha yoga.” Whether sitting, lying down, or performing asanas, participants cultivate “moment-tomoment awareness” and assume the “stance of an impartial witness to your own experience.” Such nonjudgmental awareness purportedly relieves stress and enhances patients’ ability to cope with their circumstances. Although ostensibly distinct from religion or spirituality, the MBSR program reflects metaphysical assumptions about the nature of reality. Kabat-Zinn admits that “it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions.” An emphasis on moment-to-moment awareness stems from the assumption that “our lives unfold only in moments” rather than leading toward life beyond the present world. With this premise, Kabat-Zinn urges audiences to “remember, now is the only time you have for anything.”34 Although MBSR largely detaches meditation from Buddhism, the content of other meditation programs designed for secular health-care settings is overtly Buddhist. An Indo-Tibetan Program in Contemplative Self-Healing piloted by Dr. Joseph Loizzo and colleagues with breast-cancer patients at New York Presbyterian Hospital-Weill Cornell begins in week one with the skill of mindfulness meditation, by presenting illness and stress as “opportunities for self-healing” and teaching the “four noble truth framework of self-healing.” Mindfulness breaks the “link between addictive craving and obsessive clinging”

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by acting on an “extremely subtle” level of consciousness to produce “transcendent insight.” By week ten, patients learn not to view death as “final annihilation or judgment.” Week eleven counsels against viewing human behavior as “predetermined by God.” Week twelve adds that peace results from acceptance of “what is, without illusions or violence,” rather than stemming from the “grace of God, acceptance of others or God.” Week thirteen challenges “extreme views of the self or person as a name for the brain or as powerless creatures of a jealous God.” Week sixteen denies that love and compassion are “solely a matter of divine grace or duty” by depicting these virtues as “natural muscles.” As patients progress through the course, the content becomes progressively more direct in advocating Buddhist truths as superior to Christian doctrines.35 Retail bookstores make mindfulness and other meditation approaches available to both the healthy and the sick in bulging inspiration and self-help sections. Ben & Jerry of ice cream fame wrote an introduction for David Harp and Nina Smiley’s Three Minute Meditator, in its fifth edition in 2007. The text teaches that each person is “part of a collective consciousness which includes all that has ever existed.” The techniques of visualization, relaxation, compassion, and “don’t know” lead even casual meditators to “enlightenment.”36

Hinduism Some people trace the roots of Hinduism back to the Indus Valley of the Indian subcontinent several thousand years ago. We know almost nothing about the region’s early religious practices. But as traditions developed over time, there was considerable overlap among philosophies and practices now identified as Hindu, Buddhist, or Jain. It is only very recently that people applied the terms Hindu or Hinduism to themselves. Eighth-century c.e. Arab traders first used these terms as geographical and cultural designations; nineteenth-century Westerners used the terms to impose order on newly encountered religious traditions that had a long history in South Asia. The oldest literature, which nearly all schools of what is now called Hinduism take as their source and view as the revealed words of the divine, is the large body of orally transmitted texts known collectively as the Vedas (or “knowledge”), the earliest of which may date as far back as 1500 b.c.e. In the post-Vedic Brahmanical tradition, the all-pervading divine existence or reality behind everything in the universe is Brahman, another aspect of which is Atman, or “universal spirit.” One influential school of Hindu philosophy, Advaita Vedanta, focuses on the nonduality of Self (Atman) and the Whole (Brahman) and teaches paths for realizing one’s union with the divine. By contrast, Vedanta devotional schools seek various sorts of relationship with the divine.37

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Transcendental Meditation: The McDonald’s of the Meditation Business Maharishi Mahesh Yogi (c. 1918–2008) popularized the practice of Transcendental Meditation (TM) in 1960s America, when he became guru to the Beatles and attracted other celebrities such as actress Shirley MacLaine and football hero Joe Namath. Television personality Merv Griffin introduced the Maharishi (meaning “Great Sage”) to Americans with talk shows in 1975 and 1977. In 1975, Time magazine pictured the Maharishi on its cover and described TM as “the turn-on of the ’70s—a drugless high that even the narc squad might enjoy.” Estimates of the number of TM practitioners during the movement’s heyday range from 600,000 to 5 million.38 A goal of TM is realizing one’s unity with the divine. The Maharishi taught that “on the level of the Transcendental Consciousness we are Divine already.” But “although we are 100 percent Divine, consciously we do not know that we are Divine.” Invoking the Christian strain of American culture with a twist, the Maharishi taught that since “Christ said, ‘Be still and know that I am God,’” the meditator should “be still and know that you are God and when you know that you are God you will begin to live Godhood, and living Godhood there is no reason to suffer.” As of 2013, the official TM Web site presents TM as leading to “higher states of consciousness.” Whereas yoga may use breathing or postures to reach a meditative state, TM exercises only the mind. The basic TM practice, inspired by Advaita Vedanta, involves repetition of a mantra for twenty minutes, morning and evening, while sitting comfortably with eyes closed. By contrast with ascetic traditions, the Maharishi taught, it is possible to add meditation to a normal lifestyle, which should be characterized by happiness and, indeed, bliss. For this reason, best-selling author Adam Smith calls TM “the McDonald’s of the meditation business.”39 Like McDonald’s, TM has gained a massive following using a shrewd business model. Free introductory lectures, often held on university campuses, recruit participants. Once prospective students are intrigued, instructors offer an opportunity to take a fee-based course and receive a personalized mantra. (Disaffected former practitioners charge that instructors repeatedly assign the same mantras, which invoke the names of Hindu deities. For instance, aing is a sound, or seed syllable, associated with the goddess Saraswati.) Advanced TM classes promised to teach “yogic flying,” or levitating in the lotus position, and time travel. By the 1980s, the Maharishi had used TM revenues to establish Maharishi International University of Management in Fairfield, Iowa, and hundreds of TM centers (called Peace Palaces) across the United States and in other countries. By the time of his death in 2008, the Maharishi had

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built a business empire (including an Ayurvedic medicine company) that had amassed him a personal fortune in excess of $1 billion, plus several billion dollars in corporate holdings.40

Biofeedback: The Mystical in Gadget Form Psychologists who wanted to emulate the ability of expert yogis to control involuntary bodily functions developed biofeedback in the 1960s. Biofeedback applies modern medical devices, such as electroencephalograph (EEG) and electromyograph (EMG), to give patients immediate feedback on progress in achieving relaxed mental states and changing physiological functioning. Electrodes and electronic lights and sounds, alongside clinical studies reporting efficacy, make biofeedback appear to be the epitome of modern science.41 Although it uses high technology, biofeedback’s developers envisioned the practice in spiritual terms. As a Time magazine article described biofeedback in 1991, “for mechanistic Westerners, this is the mystical in gadget form.” Pioneering researchers Elmer and Alyce Green framed their studies of yogis in India as explorations of subtle energies related to higher forms of consciousness in the film Biofeedback: The Yoga of the West (1974) and the book Beyond Biofeedback (1977). The Greens were founding members of the International Society for the Study of Subtle Energies and Energy Medicine, the Association of Transpersonal Psychology, and the Association for Applied Psychophysiology and Biofeedback and on the advisory board of the Universal Awakening, “A Meta-movement that Supports the Development of Greater Harmony, Creativity, and Fulfillment.” In a 1999 article, Elmer Green called alpha-theta brain-wave training “instrumental Vipassana” (Buddhist insight meditation) that enables practitioners to access planetary consciousness. In the film Bioenergy: A Healing Art (1992), Green claimed to measure the energy field surrounding a healer who uses Tibetan meditation. In The Ozawkie Book of the Dead: Alzheimer’s Isn’t What You Think It Is (2001), Green interpreted Alzheimer’s as a spiritual transition toward a higher plane of existence. Near the end of his career, Green revealed that his vision of using science to demonstrate subtle energies began at age three, when he was visited by a “High Entity” or “Teacher,” “a glowing figure in regal robes,” who guided his subsequent research.42 Other biofeedback founders shared the Greens’ spiritual vision of consciousness transformation. In 1980, Barbara Brown, first president of the Biofeedback Research Society, explained the technique as mobilizing the “universal, innate ability of the unconscious mind to control and regulate all

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physical processes.” Well-known holistic medicine professor Kenneth Pelletier similarly observed that biofeedback produces a “profound transformation of human consciousness.” This transformation is explicitly spiritual. According to Donald Moss, president of the Association for Applied Psychophysiology and Biofeedback, writing in 2002, “biofeedback teaches inner quieting. In the stillness many individuals find emotional release and many discover the presence of spirit.” Moss clarifies what he means by “spirit”: “Biofeedback in this sense becomes a practical form of Taoism, a gentle seeking of harmony in the body and in one’s world.” Moss continues, “neurofeedback may induce states of consciousness conducive to spiritual awakening and personal transformation.” Patients who use the common “alpha/theta protocol,” according to Moss, “experience a spiritual transformation as part of the treatment process . . . the spiritual experience of being one with God.” For such practitioners, biofeedback techniques bring scientific technology into the service of spiritual transformation.43

Conclusion Although CAM practitioners have distanced CAM from “religion” by describing it as nonreligious, spiritual, and scientific, CAM fits a broad definition of religion. Holistic healing shares traits with religion, and specific interpretations of CAM express aspects of Western metaphysical spirituality or religious traditions such as Taoism, Buddhism, or Hinduism. Using generically spiritual language to describe CAM does not, in itself, make CAM spiritual rather than religious. Neither does borrowing vocabulary from scientists make CAM scientific instead of religious. The argument that CAM is spiritual but not religious—when used to reassure Christians and other monotheists that they can practice CAM without committing apostasy—makes opaque a basic disjuncture between certain CAM worldviews and historic Christian theological traditions. Although CAM and Christian perspectives are both in one sense “holistic,” in that they envision material and spiritual realms as interconnected, CAM also tends to be monistic; creator and creation, or divine consciousness and nature, are of essentially the same substance. Sickness results when energy becomes blocked or imbalanced; healing practices restore harmony between individuals and the universe by unblocking and rebalancing energy. From a monistic perspective, combining elements from multiple religious and spiritual traditions and including diverse beliefs and practices are enriching. By contrast, Christian worldviews have historically been dualistic, in the sense of emphasizing the otherness of a creator God from whom the created order

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became alienated through sin, defined as disobedience to a personal God; sickness is one consequence of sin’s entrance into the world. (The term dualism occasions confusion because it can also function as an antipode to holism, by endorsing an idea, from Greco-Roman philosophy, that body is separate from, and inferior to, spirit.) In the sense in which I am using dualism, many Christians believe that redemption and reconciliation between individuals and the divine is only possible through the atoning death and resurrection of the sinless Jesus Christ, as believers appropriate grace by repentance and faith. Many Christians consider single-minded devotion to the Christian God and exclusion of other traditions essential to religious purity. The merger of CAM and Christian worldviews—and integration within a biomedical mainstream predicated on scientific naturalism (which often reflects a materialistic and monistic worldview)—is a remarkable cultural development that invites explanation.44 In a multicultural world, it is common for people to learn practices from other religious traditions and to reimagine the meanings of these practices. The same set of bodily actions may be perceived by one participant as a religious ritual with spiritual significance, whereas someone else views those actions as a physical routine. We should not impose on people meanings they would not themselves ascribe to their actions. The following chapters demonstrate that the meanings participants ultimately ascribe to their practices are often not the meanings they consciously chose. This is because participating in bodily practices can change the meanings that people assign to their practices, sometimes in subtle ways not immediately recognized by participants. Activities that start off as nonreligious health promotion or Christian devotion may take on new religious valences. Evangelicals may be least on their guard against practices they would normally seek to avoid when those practices are recoded as nonreligious. Offering a critique of the complicity between today’s Christians and “global market culture,” the Harvard theologian Harvey Cox warns that “our problem as Christians today is that although we oppose idolatry in general terms, it is often difficult to notice the most obvious and invasive forms of idolatry, maybe because they do not announce themselves as ‘religious.’ We are faced with a formidable theological task. We need to uncover and unmask the service of false gods, even—indeed especially—when they mask themselves in secular disguises.” What constitutes a “false god” is debatable, but Cox astutely points out that people’s specific, apparently nonreligious, actions can belie general statements of belief. Chapter 2 explores this theme through a case study of yoga.45

2

Yoga I Bow to the God within You

brooke boon began attending “secular” yoga classes because she “just wanted to get into shape!” Yet her teachers “routinely encouraged their students to ‘look within’ to find their divinity. They whispered promptings for us to seek enlightenment through oneness with the universe.” After converting to Christianity, Boon felt uneasy about the spiritual dimensions of yoga but did not want to give up the physically and spiritually satisfying practice. Her solution—which both resolved a personal religious crisis and proved a commercial success—was to establish the “Holy Yoga” program in 2003 as a Christian alternative. Boon, who lives in Phoenix, Arizona, gained an international following by publishing a book, Holy Yoga: Exercise for the Christian Body and Soul—marketed to Christian consumers by Time Warner’s Faith Words in 2007—and by selling related DVDs, and certifying more than 475 Holy Yoga instructors in ten countries on three continents.1 Boon distinguishes her brand of yoga from “traditional Eastern yoga” by contrasting the purpose of “becoming one with God” with “becoming surrendered to God, devoted to Him, and united with Him in purpose.” Interpreting yoga as more than physical exercise, Boon insists that yoga’s “Eastern” religious roots are “irrelevant because in Holy Yoga, our entire intent and focus are completely on Jesus Christ.” Boon affirms concepts found in some South Asian religious yoga traditions: that there is a universal “vibrational frequency” with the sound “Aum” or “Om” (she avoids teaching students to chant the syllables “to dissipate fear concerning their usage in relation to worship”), and humans are “energetic beings” whose vitality accumulates at “chakras.” Boon Christianizes such concepts by describing them as aspects of “God’s truth in creation.” Boon’s yoga classes look a lot like other modern postural yoga classes, using similar poses, breath control, and meditation practices, but

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replacing Hindu references with Christian language and music, Bible meditations, and frequent allusions to Jesus.2 Boon is one of a growing group of Christian yoga marketers who exemplify a pattern in the mainstreaming of yoga in America. Yoga is contested in today’s cultural climate, because many Americans desire the physical and spiritual benefits that they associate with yoga yet feel wary of “Eastern” religion. Attracting a handful of U.S. adherents as early as the nineteenth century, yoga’s meteoric rise in popularity can be dated to the mid-twentieth century. Promoters won an American clientele by denying that yoga is religious and presenting yoga as science, exercise, philosophy, nonsectarian spirituality, commodity, and Christian devotional discipline. Since few Americans investigated yoga theory for themselves, most accepted selective descriptions as factual. Today many consumers think of yoga as having vaguely “Eastern” or “Hindu” origins but do yoga as physical and spiritual exercise, not because they want to practice Hinduism. Few Americans interpret “health-club” yoga as religion, because its emphasis on bodily practices instead of intellectual creeds differs from Word-oriented, Protestant understandings of religion. Yet, as this chapter argues, it is difficult to sever yoga’s physical from its religious aspects. Efforts to secularize or Christianize yoga often result in superficial relabeling rather than creation of fundamentally distinctive practices.

Yoga in South Asian Religious Culture When most Americans today think of yoga, they first think of postures, or asanas, that make the body fit and flexible. Yet prior to the 1920s, asanas played at most a subordinate role in most yoga practice. The history of yoga in South Asia and globally is more complicated and interesting than most people, including yoga aficionados, recognize. The word yoga, from the Sanskrit verbal root yuj, is a cognate of the English yoke. An exact lineage for yoga cannot be traced, since individual gurus passed various disciplines to their students, who in turn created diverse styles. But many of India’s yoga traditions share a religious goal: attaining human salvation, variously defined as release from suffering existence and the cycle of rebirths (samsara), union with ultimate reality, realizing the true Self, which is divine, or spending eternity in relationship with the divine.3 The earliest-known written references to yoga are in what people today identify as Hindu texts. The Upanishads (c. 800–400 b.c.e.) and the Bhagavad Gita (c. 200 b.c.e.–200 c.e.) describe yoga primarily as meditative disciplines, the purpose of which is to withdraw one’s senses from the world to yoke with the divine, or Brahman. The Gita can be interpreted as teaching that

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the highest discipline, or path, of yoga is devotion through meditation on a benevolent, omnipotent supreme being. The divine, identified with Krishna, is “the Syllable Om,” and “He who utters Om with the intention ‘I shall attain Brahman’ does verily attain Brahman.” The Yoga Sutras, attributed to the Indian sage Patanjali (c. 200 b.c.e.–200 c.e.) and often honored today as defining “classical yoga,” prescribe eight limbs: restraint (yama), observances (niyamas), posture (asana), breath regulation (pranayama), withdrawal of the mind from the senses (pratyahara), “fixation” or “fixity” (dharana), meditation (dhyana), and concentration or bliss (samadhi).4 Over a period of several hundred years, a great many Hindu, Buddhist, and Jain texts elaborated yoga theory and practice, for instance, describing prana, or vital breath, as an external manifestation of universal spirit, Atman, and identifying nadis, or breath channels; chakras, or wheels; and kundalini, or female serpent energy. The nadis refer to nonmaterial energy streams, the junctures of which form chakras, spinning energy vortexes where one can receive, absorb, and distribute vital energy. Moving kundalini is the object of many yoga practices. Kundalini is a force represented as a female serpent and sometimes envisioned as a goddess, who lies dormant, coiled at the base of the spine. Her male counterpart and lover is Shiva, who resides in the crown of the head or brain. Practicing yoga awakens kundalini so that she uncoils and travels up the spine, opening chakras along the way. When kundalini reaches the sahasrara chakra, at the crown of the head, kundalini and Shiva unite, and one attains mahasamadhi (bliss) or moksha (liberation from the cycle of birth and death). Kundalini is closely associated with sexual energy, and physical sex plays a role in certain (especially some Tantra) yoga forms.5 Practitioners of modern postural yoga, the form most familiar in Europe and North America, claim precedents in hatha yoga, or the “yoga of forceful exertion,” which emerged in India between the tenth and the eighteenth centuries c.e. Medieval hatha yoga used a series of shatkarmas, or purifications (for instance, cleansing the stomach by swallowing a long, narrow strip of cloth); asanas, or postures; and, most important, pranayama, or breath control, to make the body immune to mortal decay. Hatha yoga purifies and unites the pingala nadi and the ida nadi, associated with the right and left nostrils and envisioned as microcosms of the sun and the moon. As pranayama heats the breath, kundalini shoots upward through the central sushumna nadi, piercing chakras to generate intense heat. For the male yogi (scholars debate the extent to which women yoginis served the needs of yogis for ritualized sexual fluid exchanges or acted as agents in their own yogic paths), semen stored in kundalini’s body becomes so hot that it transmutes into the “nectar of immortality,” which the yogi drinks from his own skull to gain supernatural powers,

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possibly including flight, telepathy, omniscience, or an ability to take over other people’s bodies.6 The only premodern South Asian religious order known to have selfidentified as yogis, the Nath Yogis, practiced hatha yoga. They defined the goals of yoga to include bodily immortality, sexual pleasure, and supernatural and political power. As India entered the modern era, many Indians and European observers feared yogis and castigated them for choosing personal power over yoga’s “true” purpose of liberation. South Asian yoga practitioners increasingly rejected asanas because of their association with yogis, who sometimes performed asanas as street entertainers to earn enough money to survive. By the late nineteenth century, hatha yoga (but not other forms of yoga) had been largely rejected by Indian elites. Paradoxically, it was Westerners enthralled by Indian religions—particularly the metaphysical Theosophical Society, founded by the Russian-born Helena Blavatsky in 1875—who revived hatha yoga by reprinting neglected texts. Even so, Blavatsky found asanas distasteful and omitted them from her selective re-presentation of yoga to the West, influencing Indian Hindu modernizers to do likewise.7 Only in the 1920s did asanas make a comeback in India, in the context of British colonial rule (until 1947) and global cultural flows among Europe, North America, and South Asia. Beginning in the nineteenth century, metaphysically oriented Western health reformers attracted to a variety of New Thought (an outgrowth of Christian Science) and nature-cure movements promoted “physical culture” as intrinsically spiritual (and especially well suited to women). In the 1920s, YMCA physical-education programs in India interpreted asanas as an indigenous form of physical exercise conducive to spiritual development. Sri Tirumalai Krishnamacharya (1888–1989) taught asanas as “physical culture” at the Mysore Palace in India and trained several individuals (including K. Pattabhi Jois and B. K. S. Iyengar) who popularized yoga in the West. Krishnamacharya developed the now-famous (and allegedly ancient) “Sun Salutation” (Surya Namaskara) by combining practices used in worship of the solar deity Surya with hatha yoga asanas, regional gymnastics and wrestling, and British military calisthenics. The historian Mark Singleton argues that postural yoga classes advertised as “hatha” yoga today more closely resemble Western metaphysical gymnastics than Indian Hindu yoga traditions.8

Yoga Science Wins an American Audience Yoga became popular in the United States not because droves of Americans wanted to practice Hinduism but because yoga marketers advertised a healthpromoting, scientific technique. Yoga arrived in America in 1805, when William

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Emerson, father of Ralph Waldo Emerson, published an English translation of the Bhagavad Gita. The younger Emerson, who read widely in Hindu texts, wielded his literary influence to raise sympathetic awareness of Hinduism among American intellectuals. Henry David Thoreau did his best to practice yoga during his now-famous experiment in deliberate living at Walden Pond.9 The nineteenth-century influx of Christian missionaries to India inspired a Hindu reform movement that sought to compete, using Christian missionaries as a model for how to spread their views to all people. The term neo-Hinduism refers to a nationalist reform and independence movement within India with the aims of modernizing Hinduism and recasting it as a “missionary religion” suitable for an international audience. Swami Vivekananda (1863–1902), a Vedanta monk, worked to persuade other Indians to abandon what he viewed as backward religious practices, such as the asanas of hatha yoga. The World Parliament of Religions in 1893 gave Vivekananda an opportunity to counteract Western stereotypes of Indian culture and Hindu religion and to raise money for philanthropic work in India. Much as fellow delegate Soyen Shaku presented Zen Buddhism as “science,” Vivekananda framed yoga as science, meaning that it was empirical; generations of practitioners had used it and experienced observable results: realization of the Self, or the Brahman within. Employing biological language, Vivekananda compared kundalini to “nerve force” and described chakras as nerve “plexuses.” He referred to physiological structures to confirm that the “nerve centre at the base of the spine near the sacrum” housed dormant kundalini and that the “pineal gland” in the brain was home to Shiva. This description appealed to then-current scientific sensibilities, given René Descartes’s suggestion that the pineal gland is the seat of the soul.10 In arguing that Hinduism is scientific, while blurring boundaries between science and spirit, Vivekananda borrowed from Theosophy. In an 1888 “synthesis of science, religion, and philosophy,” Blavatsky had lauded “Hindu mystics” for recognizing the pineal gland as the “eye of Shiva,” or biological evidence that humans evolved an “organ of spiritual vision.” (Modern scientists understand the pineal gland as an endocrine organ that secretes the hormone melatonin.) A later, Indian-born Hindu, Paramhansa Yogananda, portrayed yoga for American audiences with his best-selling Autobiography of a Yogi (1946). Like Vivekananda, Yogananda identified yoga as science, defined as empirical methods put toward spiritual ends: “Yoga is a system of scientific methods for reuniting the soul with the Spirit.” The goal of yogic science is to transcend merely intellectual knowledge and directly experience truth. This understanding of science contrasts with how conventional scientists use the term, but the difference was lost on the growing number of Americans whose esteem for yoga rose as they imagined it as scientific.11

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Yoga’s Secular Reincarnations Yogananda’s warm reception in the United States after World War II marked a new era for yoga in America. Previously, most Americans who had heard of yoga disparaged it. Early-twentieth-century news headlines capture yoga’s marginal religious and cultural status: “Police Break in on Weird Hindu Rites: Girls and Men Mystics Cease Strange Dance as ‘Priest’ Is Arrested,” from the New York American in 1910; “A Hindu Apple for Modern Eve: The Cult of Yogis Lures Women to Destruction,” from the Los Angeles Times in 1911. Such headlines reflect a view of yoga as an intrinsically “heathen,” sexually threatening, foreign, un-American, religious ritual.12 Yoga publicists breathed new life into the discipline by downplaying yoga’s religious context while advertising health benefits and winning celebrity sponsorship. Indra Devi (born Eugenie Peterson in Latvia to Swedish and Russian parents; studied yoga with Krishnamacharya in India) attracted actors and actresses (among others, Robert Ryan and Greta Garbo) to her Hollywood yoga studio by presenting hatha yoga as a health and beauty aid. Devi’s book, Forever Young, Forever Healthy: Simplified Yoga for Modern Living (1953), reduces hatha yoga to postures and breathing. Devi disregarded spiritual purposes to avoid offending readers. Once Devi had exalted yoga’s physical activities, her second book, Yoga for Americans (1959), reinserted religious references. Devi described kundalini as “Serpent power,” associated with “fundamental sex energy.” She expounded that postures and breathing raise kundalini through the “chakra system,” bringing the yogi to the “highest goal” as “his individual consciousness unites with Universal Consciousness, and he enters a state of ultimate bliss, called Samadhi.” Once Devi’s clients had experienced physical benefits, spiritual rationales seemed less threatening. The counterculture picked up on yoga as a spiritual pursuit. Interest mounted as newspapers broadcast the Beatles’ pilgrimage to India in 1968 to study yoga and TM to curb their drug addiction. Still, those not yet favorably disposed to yoga required gradual tasters.13 Television introduced a secularized version of yoga. A Los Angeles TV station aired Yoga and You with Virginia Denison in 1961, quickly followed by the competing program Yoga for Health with Richard Hittleman. Hittleman, who taught yoga on TV for thirty years and wrote fifteen best-selling books, believed that the “entire essence” of yoga is the attainment of “pure bliss consciousness.” He had, however, learned from experience teaching yoga since the 1940s that most Americans related not to spiritual enlightenment but to exercise, sport, and health. Hittleman kept silent about the spiritual dimensions of yoga, confident that performance of physical postures would prepare

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students to inquire into spirituality. Cincinnati’s public television station aired Hatha Yoga with Lilias Folan in 1974; within months, 124 other PBS stations had picked up the broadcast. In winning a place for yoga on the air, Folan—as she later reflected in an interview—had had to convince the television network that “yoga wasn’t peculiar, strange and un-American, that it isn’t a religion— that was the big one.” Folan, like Hittleman, presented yoga as a secular health practice because she had to in order to win an audience.14 Yoga Journal was founded in 1975, with the explicit goal of convincing people that yoga “wasn’t weird” or “voodoo.” The first issue sold three hundred copies. The journal’s pool of subscribers grew to 55,000 by 1990 and 350,000 by 2007; meanwhile, the journal quadrupled its advertising revenues. Yoga Journal reached a widening readership as editors selected articles that focused on physiological benefits. When reporters broached metaphysical subjects, they adopted clinical-sounding terminology to appeal to popular scientific sensibilities. For example, a 2011 article advocates practicing the Sun Salutation several times during the workday to break up sitting time and reduce risk of cardiovascular disease and diabetes. Another article in the same issue offers instructions for performing the “eagle” pose (garudasana). The author explains that the pose is named after Garuda, a “mythical bird in the Hindu and Buddhist traditions” that carried the god Vishnu. Physically, the pose “stretches and broadens the area between the shoulder blades, releasing upper-back tension and opening the back of the heart. It also stretches your shoulders, ankles, hips, and wrists.” The “inner work of the pose” is to “open to the notion that you can find balance even when you are all twisted up.” The article introduces spiritual nuggets amid instructions on how to do the pose and promises of health benefits.15

Yoga Becomes a Commodity The commercialization of yoga in the 1990s and 2000s made it a mainstream and lucrative commodity. The superstar Madonna helped make yoga a household word. In 1998, she released the CD Ray of Light, which includes several Sanskrit chants and a song, “Shanti Ashtangi,” based on a Hindu prayer recited at the beginning of her yoga classes. Translated, the song begins: “I worship the gurus’ lotus feet/Awakening the happiness of the Self revealed.” Despite—or because of—the song’s references to worship, enlightenment, Self-realization, and bliss, the album sold 4 million copies.16 Charging fees for yoga marks it as a commodity rather than a religious obligation. People do not pay to gain admission to church services (although they may resent feeling pressured to make donations), but they certainly pay

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to attend most yoga classes. When the Indian-born Bikram Choudhury began teaching yoga in San Francisco in 1973, he did not charge. When Choudhury introduced lavish fees, the popularity of his classes increased dramatically. By 2013, certification as a Bikram Yoga teacher cost $11,400. Choudhury copyrighted his brand of yoga in 2001, aggressively prosecuting violations. Including sales from books, CDs, clothing, and jewelry, Choudhury boasts, his yoga empire earns him $10 million a month. Choudhury attracted both men and women by presenting yoga as intense exercise, producing physical strength and sexual prowess. He also appealed to spiritual sensibilities, lecturing on the “chakra system” alongside the skeletal, muscular, and endocrine systems. Choudhury’s CDs include lyrics written by himself, such as “I believe in God: it is me.” Choudhury has been known to open class registration on Easter Sunday, perhaps symbolizing that his brand of yoga offers an alternative to Christian religious observance.17 Whatever else it may be, yoga is big business. Market researchers estimate that in 2012, 22 million Americans practiced yoga—7 percent of the total population, up from 3 percent in 1973. By 2012, Americans were spending $7 billion a year on yoga and Pilates. Mainstream retail chains such as Walmart prominently feature yoga-related merchandise. High-end department stores such as Dillard’s advertise fashionable and pricy yoga clothing to “unlock your inner ‘Om.’” Designer yoga clothing is sold by Prana (bought by Liz Claiborne in 2005), Be Present, Inner Waves, and Lululemon Athletica, and by mainstream brands such as Nike. Yoga marketing targets healthy and fitness-minded adults and children, the chronically or terminally ill, and the elderly. Advertisers showcase benefits of yoga for pregnancy, weight loss, kids, seniors, golf, dogs, and Christians. One can find yoga in community centers, hotel fitness centers, nursing homes, and public schools.18 Because yoga has become an industry, most Americans perceive it as secular. This creates a positive feedback loop. Offering yoga for sale lends credibility to the claim that it is nonreligious, which reinforces the idea that yoga is a fitting object for commercial exchange in a secular market.

Is Yoga Exercise or Religion? The question of whether yoga is Hindu, religious, spiritual, or secular is hotly disputed. When yoga supporters deny that yoga is religion, they mean that yoga is not like Christianity. The American Yoga Association (AYA), formed in the 1970s to manage yoga’s reputation, asserts that “yoga is not a religion. It has no creed or fixed set of beliefs, nor is there a prescribed godlike figure to be worshipped in a particular manner.” Yoga Journal columnist Phil

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Catalfo explains that yoga has “no singular creed, nor does it have any ritual by which adherents profess their faith or allegiance, such as baptism or confirmation. There are no religious obligations, such as attending weekly worship services, receiving sacraments, fasting on certain days, or performing a devotional pilgrimage.” Swamiji of the Divine Life Society affirms that yoga is a “universal science that has risen above religion,” since “no particular dogma is laid down. . . . It does not call a man sinner. Man is God who has lost his way home. . . . Yoga rejects hell and heaven also.” Differences between yoga and Christianity code yoga as nonreligious.19 Promoters further distinguish yoga from religion by presenting yoga as pure spirituality. Claiming that yoga is older than Hinduism validates yoga as a universal practice, untethered to any religion. According to the AYA Web site, “Yoga actually predates Hinduism,” and although Hinduism adopted yoga techniques, “the practice of Yoga will not interfere with any religion.” Swamiji contends that yoga is “purely spiritual and does not contradict anyone’s faith. Yoga is not a religion, but an aid to the practice of the basic spiritual truths in all religions.” When Aseem Shukla, a surgeon and cofounder of the Hindu American Foundation, argues that yoga can make someone a “better Hindu, Christian, Jew or Muslim,” he means that “yoga, like its Hindu origins, does not offer ways to believe in God; it offers ways to know God.” The director of a yoga education program at a Midwestern Hindu temple similarly reasons that “yoga is not a religious practice,” because it offers a way “for all human kind” to “join individual consciousness to higher consciousness.” Yoga is universal in the same sense that Hinduism is a universal path to join with the divine.20 Identifying modern yoga with “classical” Hindu yoga sometimes functions as an authenticating strategy for appealing to consumers in search of ancient wisdom. An avowedly secular textbook, Yoga the College Way: A Textbook for College Yoga (1996), explains the Sun Salutation by quoting an “ancient” Hindu verse: With praying hands I face the sun, feeling love and joy in my heart. I stretch up my hand and let the sun fill me with warmth. I bow before the sun’s radiance and place my face to the ground with humble respect. I lift my face to the sun and then remember that to achieve such heights I must be as the dust of the earth. I stretch up towards its light trying to reach the greatest heights and again surrender. I stand tall as I remember the true sun within me.

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The poem’s speaker prays toward the sun, bows and surrenders before it, and remembers that the “true sun” is within. Some modern yoga instructors similarly explain the “downward-facing dog” asana as historically associated with mythological guardian animals or the “mother goddess,” the “cobra” pose as representing kundalini, and the “tree” pose as an opportunity to see oneself as a deeply rooted tree receiving vital energy from the earth. Posing as a “corpse” at the end of class, modern yogi aspirants may visualize themselves stepping outside their physical bodies in anticipation of being liberated from the cycle of life and death. The word namaste, typically said while gesturing with praying hands (anjalimudra) to close class, is often translated as “I bow to the god within you.” A mudra is a “seal,” a position of the hands or body, believed to direct spiritual energy.21 Even when distancing yoga from Hinduism or religion, advocates emphasize that yoga offers more than exercise. Marge is a yoga instructor in a Midwestern town who denies that yoga is “religion,” while insisting that “yoga is not an exercise. You get exercise from it. But the true part . . . is the life force.” Yoga is to Marge “sacred” and helps her “enjoy my own spirituality. . . . I feel at one with the universe.” Alejandra, an intern in the same studio, distinguishes yoga from religion “because to me, religion has a common belief system.” Yet for Alejandra, yoga is about “loss of ego and self, then you’re yoking.” Another intern, Brianna, attests that yoga is “definitely a spiritual practice.” When Deborah Desmond, owner of Namaste Yoga & Tranquility Center in Brooklyn, New York, says “yoga is not a religion,” she means that yoga is broader than any one religious tradition: “it is a way of life.” Desmond’s yoga studio is not specifically Hindu, but neither is it secular. She takes an “intuitive, shamanic approach” to select among “Sacred Holistic Body Therapies,” including yoga, Reiki, aromatherapy, herbalism, acupuncture, and Thai massage, in “channeling divine life force (chi or ki) from the universe to the recipient.” While rejecting the label religion in preference for terms such as spiritual, sacred, or divine, such accounts set yoga apart from secular exercise.22 Although often seeking to distance yoga from religion, at times promoters have reason to argue that yoga is religion. This was the case in 2009, when the Missouri government imposed a 4-percent sales tax on yoga classes. Studio owners protested that “yoga is a spiritual practice. It’s not a purchase,” and it should therefore enjoy a religious exemption, an argument that had previously halted taxation efforts in Connecticut and Washington. Virginia yoga instructors filed suit in 2009 to stop plans for state regulation of yoga studios, alleging that government oversight violates First Amendment rights to free exercise of religion.23 A number of Hindu spokespersons insist that yoga is not only spiritual and religious; it is Hindu. Subhas Tiwari, a yoga instructor at the Hindu University

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of America, claims that “the simple, immutable fact is that yoga originated from the Vedic or Hindu culture. Its techniques were not adopted by Hinduism, but originated from it.” Tiwari calls the invention of “Christian” yoga “religious schizophrenia.” Yogi Baba Prem argues that “offering yoga classes allowed the Christian to secretly practice Hinduism without having to renounce their Christian tradition.” Swami Jnaneshvara Bharati concedes that yoga is only one piece of Hinduism: “Yoga is in religion, but religion is not in Yoga,” making it possible to practice yoga apart from its Hindu context. Bharati thus pleads with Christians not to “distort and denigrate the true goals and nature of Yoga so that it matches your religion.” Aseem Shukla charges that unscrupulous profiteers intentionally obscured yoga’s Hindu origins: “Hinduism, as a faith tradition, stands at this pass a victim of overt intellectual property theft, absence of trademark protections and the facile complicity of generations of Hindu yogis, gurus, swamis and others that offered up a religion’s spiritual wealth at the altar of crass commercialism.” Shukla complains that “the most popular yoga publications are also in on the act.” Such journals “abundantly refer to yoga as ‘ancient Indian,’ ‘Eastern’ or ‘Sanskritic,’ but seem to assiduously avoid the term ‘Hindu’ out of fear, we can only assume, that ascribing honestly the origins of their passion might spell disaster for what has become a lucrative commercial enterprise.” In the view of these Hindu leaders, yoga is not just exercise or commodity but is an expression of Hinduism.24 Many Americans think of modern postural or hatha yoga as the most physical—and secular—type of yoga. This raises the question of whether postural yoga can be practiced solely for its physical benefits or whether this type of physical exercise leads into religious exercise. Theos Bernard, an Americanborn yoga proponent who wrote his Ph.D. dissertation on yoga at Columbia University in 1939—at a time when few Americans had heard of yoga— advocated hatha yoga as the school best suited to Americans. Bernard reasoned that in a materialistic culture, people need the help of physical means to arouse kundalini, “and if you transform your body, you can’t help but transform your ‘vital forces.’” The German-born Swami Sivenanda Radha (born Sylvia Hellman) specifies in her book, Hatha Yoga (1986; 2006), that “asanas are a devotional practice . . . to bring the seeker into closer contact with the Higher Self.” According to Radha, “as an asana is perfected through practice, at a certain stage it becomes spiritual; . . . the practice of Hatha Yoga is not limited to the physical. It begins there because human awareness is, in the beginning, physical. . . . Asanas are a discipline of the body, but they are not without an effect on the mind.” If Bernard and Radha are correct that the physical practice of asanas induces spiritual experiences, it may be difficult to practice postural yoga without practicing religion.25

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Although most Americans know little about South Asian religious culture, many consumers associate yoga not only with exercise but also with a vaguely “Eastern” or “New Age” spiritual mystique, a construct that inspires both fear and curiosity. A testimonial featured on an Indiana University Recreational Sports brochure highlights this perception: “Before my first Recreational Sports yoga class I was curious about yoga but also a little bit skeptical about the value of chanting ‘Om’ repeatedly while listening to a bunch of new age music.” This individual’s resistance melted when he found that the classes provided “first rate workouts.” Journalist Stefanie Syman proposes that “even if you’re just using practicing yoga as a form of exercise, in the back of your mind you know that if you perhaps pursued it further there’s this whole other dimension, this rich field of possibility of transforming your body and having spiritual realization [and this] is what really makes it so appealing.” Yoga offers not just exercise but a “sense of working toward something more meaningful than mere physical beauty and something more sensual than religion as they had previously understood it.” This promise of something “more” than exercise draws Americans to yoga from diverse cultural and religious backgrounds, including theologically conservative Christianity.26

Is Christian Yoga an Oxymoron? American Christians first became aware of yoga through reports of missionaries dispatched to India in the nineteenth century. Rather than adopting yoga, these missionaries regarded it as evidence of “heathenism,” “licentiousness,” and “superstition.” Relatively few Christians practiced yoga before the early twenty-first century. A 1998 survey found that most American yoga practitioners were urban, college-educated, baby-boomer, non-Christian women. Ten years later, Christians had joined the ranks of self-described American yogis. A survey conducted by Christianity Today in 2007 found that 2 percent of those “more active” in church used yoga to “grow spiritually,” compared with 4 percent of those “less active” in church. By comparison, 15 percent of all Christians used other forms of exercise for spiritual growth.27 As Christians took up yoga in community classes or created “Christian” yoga programs, Christian criticisms of yoga also proliferated. Of all the CAM forms popular in America today, yoga has attracted the most negative, and the most positive, attention in the evangelical media. Few Christian critics know much about yoga or South Asian religions, but many feel uneasy about yoga’s spiritual ramifications. An Assemblies of God position paper worries vaguely about “varying ties to eastern religions” and that certain instructors might inject “philosophies and ideas foreign to the Bible and Christian faith.” Christianity Today writer Holly

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Robaina stopped practicing yoga soon after converting to Christianity because, she says, “I sensed something spiritual about yoga that made me uneasy. (I later discovered yoga’s Hindu origins and understood why I’d felt uneasy.)” Sarah Pavlik, a writer for Today’s Christian Woman, became alarmed when the same friend who had invited her to her first yoga class converted to Buddhism three months after beginning hatha yoga. Sister Marta Alves recounts that she has “a Catholic friend, Ana, who years ago started practicing yoga, and today believes that God is energy, that we are all part of God, that there is no devil, that there is no hell, and that there is reincarnation.” Such critics imprecisely associate yoga with non-Christian spirituality or cite personal experiences of yoga seemingly leading friends away from orthodox Christian beliefs.28 A central question addressed by evangelical evaluators is whether yoga can be severed from non-Christian religions by practicing it “just” as exercise, or by relabeling it as “Christian” yoga. John MacArthur, pastor of a California megachurch, Christian college president, and host of a nationally syndicated radio show, offered his perspective for a CNN interview in 2007. MacArthur loosely denigrated yoga as an “expression from a false religion, from pantheism.” Yet MacArthur allowed that a “strong Christian” could “probably” engage in yoga that was “just purely exercise” without jeopardizing faith. MacArthur did not elaborate on how yoga could be practiced as just purely exercise for either CNN or the evangelical detractors who pressed him on this point during an ensuing Christian media controversy. Albert Mohler, president of the Southern Baptist Theological Seminary, denies the possibility of practicing yoga just as exercise, because “yoga cannot be neatly separated into physical and spiritual dimensions. The physical is the spiritual in yoga, and the exercises and disciplines of yoga are meant to connect with the divine.” Evangelical critic Marcia Montenegro argues that “‘Christian Yoga’ is an oxymoron. . . . Just as there is no Christian Ouija board and no Christian astrology, so there is no Christian Yoga that is either truly Yoga or truly Christian.” Another evangelical censor, Dave Hunt, claims that “one cannot just adopt a religious practice and call it Christianity.” According to such critics, insisting that yoga is just exercise or calling it Christian does not negate the religious purpose of yoga: yoking with the divine.29

What About Pilates? An offshoot of the same physical-culture movement that birthed modern postural yoga, Pilates was developed in the 1920s and popularized in the 1990s. Joseph Pilates (1883–1967), the movement’s founder, adapted philosophies and forms from yoga, Zen Buddhist meditation, classical dance, and martial arts. Pilates is sometimes called “yoga in motion,” and many studios offer

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combination yoga-and-Pilates classes. Marguerite Ogle, who teaches yoga and Pilates, observes that “when people think of yoga and Pilates, they sometimes think that yoga is ‘spiritual’ and Pilates is not.” Pilates classes omit chanting a mantra to meditate, postures differ from yoga asanas, and there is more emphasis on strengthening core muscles using physical apparatus. Nevertheless, Ogle argues, Pilates, too, is a “body/mind/spirit” discipline “infused” with yoga and meditation philosophies. Rael Isacowitz, one of the most influential modern Pilates instructors, affirms that the “flow of energy and life force” and “mindbody relationship lies at the heart of Pilates.” Isacowitz compares the Pilates view of mindfulness, centering, and energy with that of “ki in aikido, chi in tai chi, tan tien in chi gong, and cakra in yoga.” As with yoga, proponents envision Pilates as more than exercise.30 Christians who reject yoga as intrinsically religious accept Pilates as secular exercise. Because Christians know even less about Pilates than they do about yoga, and because Pilates classes use less spiritual language, Christians assume that Pilates is devoid of religious content. One vocal evangelical critic of the “New Age,” Douglas Groothuis, suggests that Christians might try Pilates as a secular alternative to yoga, since “any health benefit you could derive from yoga you can get from outside of yoga such as through Pilates or physical therapy.” (Groothuis appears to be unaware of physical-therapy instructors who view the profession as having a “philosophical and practical affiliation with CAM.”) The evangelical Web site Gotquestions.org denounces yoga as “pantheism” and “self-worship” but vindicates Pilates as a “physical fitness system” and finds “nothing to alarm Christians or cause us to fear or mistrust Pilates.” Even if some Pilates instructors “incorporate aspects of Eastern religions or New Age thought,” the site attributes this propensity not to Pilates per se but to the “overly-zealous instructor who has himself or herself been indoctrinated into New Age philosophy and has brought it into all aspects of life, including exercise.” Given this general impression of Pilates as secular exercise, Christians who want to practice Pilates do so in generalinterest classes rather than by developing “Christian” Pilates.31

Baptizing Yoga Explicitly Christian exercise programs are nothing new. In the 1970s and 1980s, various Christian aerobics programs found a market. As yoga replaced aerobics as an American fitness craze, Christians got on the bandwagon. Christians sometimes get defensive when challenged by other Christians about their yoga practice, because yoga seems to offer more than either secular exercise or church attendance. When Southern Baptist Theological president

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Albert Mohler commented in an Associated Press interview in 2010 that he was “surprised” by Christians’ commitment to yoga, Yahoo posted the story on its front page, and several hundred angry Christian readers e-mailed Mohler to protest. One reader volunteered, “I get much more out of yoga and meditation than I ever get out of a sermon in church.” Another Christian yogi reasoned, “the churches are emptying; the yoga centers are full.” Similarly, an Amazon.com customer disclosed her reason for purchasing a Christoga: Faith in Fitness DVD: “I bought this DVD because I was worried that my prayer life was lacking. This is an excellent way to incorporate Christ’s Word into your soul.” Another Amazon.com reviewer admitted that she had formerly used a non-Christian yoga DVD because she “loved doing Yoga, but hated that I was bringing Eastern religions into my home, and letting it infiltrate into my children.” Christoga allowed her to do yoga without feeling guilty, becoming “the most rewarding time of my day. It’s been like going to church, and the gym all in one!” Other Christoga reviewers who saw no incongruity in combining yoga with Christianity did debate whether it was immodest for a Christian yogini to reveal her belly button.32 The label “Christian yoga” functions, first, to rationalize participation in a practice learned from non-Christian religions and, second, to market a distinctive product. Promoters of Christian yoga use one of three major approaches to adapt practices from other religions to revitalize Christianity. The first, “liberal,” approach combines other religious traditions with Christianity. This approach is exemplified by Russill Paul, a Roman Catholic of Indian descent, born in South India and trained as a Benedictine monk in a “Hindu-Christian monastery” that “fully expressed itself in the culture of Yoga.” Paul left the monastery before taking final vows, married, moved to the United States, and cultivated an international reputation as a yoga instructor and musician. In his book, Jesus in the Lotus (2009), Paul advocates “interspirituality,” or “simultaneous practice of more than one spiritual tradition,” but condemns “syncretism,” or blurring differences. In Paul’s view, yoga offers Christians means of “undoing the separation” between humans and God presupposed by Christianity. Yoga reveals to Christians their “true Self,” which is “one and the same” as “union with the Divine,” since “the Christ nature within us, which Jesus identified himself with, is synonymous with Atman.” This interpretation holds that Hindu and Christian concepts can be equated or fill out each other’s meanings.33 The second, “liturgical,” approach elides differences between other religions and Christianity through ritual incorporation. Father Thomas Ryan is director of the Paulist North American Office for Ecumenical and Interfaith Relations and a certified Kripalu yoga instructor. He is the author of Prayer of Heart and Body: Meditation and Yoga as Christian Spiritual

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Practice, published by the Catholic Paulist Press in 1994, and of the DVD Yoga Prayer: An Embodied Christian Spiritual Practice, produced by Paulist Productions in 2005. Catholicism has long incorporated bodily practices as acts of prayer or worship: genuflecting or kneeling, making the sign of the cross, or fingering rosary beads. Ryan treats “yoga prayers” sacramentally, as rituals that can be isolated from and transferred between religious traditions to become for the Christian visible channels of divine grace. Ryan notes that “for centuries, yoga has been used to prepare the body for meditation and communion with the divine.” He remains silent about whether “the divine” communed with in yoga is comparable to the Christian God. Yoga appeals to Ryan because of its positive valuation of the body—in contrast with Catholicism’s historic emphasis on ascetic disciplines and physical suffering as routes to spiritual purity. (Ryan’s perception is key, since yoga can be interpreted as an ascetic, body-subduing discipline.) Ryan invites fellow Catholics to “imagine what it would feel like to pray with your whole body—how powerful your prayer could become.” Rather than preparing for the afterlife, the focus of many Catholic practices, Ryan’s yoga promises that “salvation doesn’t mean getting out of this skin, but rather being transfigured and glorified in it.” Participants in Ryan’s New York City yoga classes, held at St. Paul the Apostle Parish, express appreciation of this unique form of “communal prayer,” whereas “with most exercise you don’t get this spiritual component.” Rituals from Hinduism help Christians “renew and invigorate” their “connection to God,” in a way not offered by the Church’s sacraments.34 The third, “evangelical,” approach replaces non-Christian with Christian language. Evangelical appropriation can be divided into three subcategories, each of which offers progressively greater levels of linguistic separation from South Asian religious yoga. First, programs add Christian terms to yoga in the title, such as “Holy Yoga,” “Christoga,” “Christ Centered Yoga,” and “Yahweh Yoga.” Nancy Roth is an Episcopal priest and author of An Invitation to Christian Yoga (2001), published by the Society of Saint John the Evangelist, a monastic order of the Episcopal church. What marks Roth’s yoga as “Christian body prayer” is relabeling poses and mantras. The “Salute to the Sun” becomes the “Salute to the Son.” Roth affirms that the series was “traditionally performed by devout Hindus at dawn as a thanksgiving for a new day. As such, it is certainly within the realm of Christian prayer!” The Son, not the Sun, becomes the object of thanksgiving through verbal substitution, although the gesture of prostration remains unchanged. Roth advises reciting the Lord’s Prayer while doing the salutation. She appends verses from the Psalms to other asanas and proposes the “movement mantra” of “Creator, Redeemer, Sanctifier.” Roth

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discovered yoga in non-Christian classes that “affected both my body and my spirit.” Roth was not bothered that she “chanted ‘Om’ or that the exercises had Hindu names,” because the “relaxation and visualization became for me a doorway into prayer.” She experienced the practices as Christian prayer by relabeling them as such.35 A second evangelical subcategory removes the term yoga from the title. Some evangelicals object to the word yoga because it constantly reminds them of the goal of yoking with the divine. This subcategory includes variants such as “Outstretched in Praise,” “Outstretched in Worship,” and “Breath & Body.” Susan Bordenkircher, who maintains a certification in mind/body fitness with the Deep South Alliance of Fitness Professionals, started “Outstretched in Worship” as an “outreach ministry” of a United Methodist church in Alabama and produced a related video series in 2002. The United Methodist Conference recognized Bordenkircher with an “evangelism” award in 2003. She says she learned yoga in classes that she felt were negatively affecting her “psychologically and spiritually,” leading her to create a Christian alternative. Once Bordenkircher attracted evangelicals with the “Outstretched” label, she reintroduced the term yoga, publishing Yoga for Christians in 2006, with a major Christian press, Thomas Nelson. She redefined the goal of yoking as the “bringing together of one’s mind and body” to find that “God’s presence is in your breath.” Pranayama became “‘breathing in’ the Holy Spirit” to make one “physically healthy and spiritually healthy.” Yoga is for Bordenkircher more than exercise; it is “different—and better—than other forms of exercise because of the focus on the breath.” Picking up on an evangelical idiom that Christians should “challenge” one another to get out of their “comfort zones” and pursue a radical life of faith, Bordenkircher turns the marginal status of yoga in Christian culture into an endorsement: “So let God’s word and this practice together challenge you to get out of your comfort zone in worship of our Lord and Savior, Jesus Christ.” Yoga becomes Christian when it is dedicated to Jesus.36 Such linguistic moves do not assuage all evangelicals. In 2007, the Southern Baptist Convention removed Bordenkircher’s books, along with Boon’s Holy Yoga, from its Lifeway online bookstore. Lifeway’s fitness expert, Branda Polk, also came under fire. In response, Polk renamed the series of yoga classes she taught at Germantown Baptist Church in Tennessee from “50+ Yoga,” “Beginner Yoga,” “Mommy & Me Yoga,” “Yoga Flow,” “Evening Yoga,” “Yoga/Pilates Fusion,” and “Yoga Basics” to a newly titled sequence of “Breath & Body” and Pilates classes that offer a “Christian alternative to yoga.” The Web site describes Pilates as “similar to yoga,” but the term does not raise danders the way yoga does.37

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The first two subcategories of evangelical adaptation result in programs that retain the same names for asanas and the same sequences found in most postural yoga classes, rededicated to Christian worship. Some programs introduce new poses; “Shalom Yoga” models postures on Hebrew alphabet letters. Other programs give popular poses Christian labels, such as Christoga’s “Prodigal Son, “Noah’s Arch,” “Lazarus,” and “Holy Rollers.” Programs may add linguistic gestures to reframe overt references to non-Christian worship. The Sun Salutation is typically renamed the Son Salutation. Evangelicals translate namaste as “The image of God in me honors the image of God in you” and relabel prana as “Holy Spirit”: “Breathe in. Breathe out. Holy Spirit in. Anything that’s not from God out.” Programs Christianize meditation by suggesting Bible verses for each asana or replacing the mantra “Om” with “Shalom” or the “Jesus prayer”: “Lord Jesus Christ, Son of the living God, have mercy on me.” Logos append Christian imagery to symbols associated with Hinduism. Marylyn Mandeville teaches yoga at Parkwood Southern Baptist Church in Virginia while wearing a T-shirt picturing a gold cross resting on the Om symbol. Becky Martin’s trademarked “Christ Centered Yoga” uses as its logo a drawing of a woman sitting in a lotus pose with a cross superimposed on her chest. Such programs insist on their Christian identity while marketing a product clearly identifiable as yoga.38 The third evangelical subcategory jettisons all yoga language while promising the same benefits—physical and spiritual—as yoga. These programs are not “just exercise”—which most Christians agree is religiously neutral and physically beneficial—but yoga-inspired strategies for using the body to express prayer and worship. Laura Monica, a self-described “born-again committed Christian,” founded “WholyFit,” a “Christian Mind-Body Fitness certification organization” that has certified more than one hundred instructors in the United States and Canada. Monica has more than twenty-five years of experience as a certified health and fitness instructor through the American College of Sports Medicine. Monica renounced “yoga” after taking a Yoga Alliance certification class that required studying Hindu texts and mantras and reciting a Sanskrit chant to “give your soul completely to Shiva.” Despite rejecting yoga, including “Christian yoga,” along with t’ai chi, Monica still identifies herself as a “Martial Arts Expert” and boasts a black belt in Chun Kuk Do karate. WholyFit’s cofounder, Leah Nelson, is a “Certified Pilates Instructor.” According to Molly, who teaches WholyFit classes at a Midwestern evangelical church, the program “provides all the proven health and fitness benefits of Yoga, Pilates, & Tai Chi, presented from a biblically Christian worldview.” In Molly’s estimate, “WholyFit is NOT yoga, because we do not incorporate the yoga philosophy plus we employ different exercise techniques

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and goals than yoga teaches” (see figure 2.1). The goal of WholyFit is to “worship our Creator, Jesus Christ, with our bodies. We do this through movement, infusing Scripture, healing worship music, meditation on His promises, and prayer as we exercise. Our mind/body focus is centered on Christ, not on other gods, other persons, other traditions” (see figure 2.2). Molly also emphasizes WholyFit’s medically certified health and safety benefits: “We follow American College of Sports Medicine safety guidelines that are standard safety rules for the fitness industry. We utilize eccentric, static, isometric, contractions. WholyFit also follows guidelines of the National Academy of Sports Medicine for progression, stability first, then strength, then begin training for flexibility.” WholyFit is “Better than Yoga!”—to quote its official Web site—for both spiritual and physical reasons.39 More popular among evangelicals than WholyFit is the “PraiseMoves” program. Laurette Willis is a former yoga instructor turned self-styled “Christian fitness expert,” who founded PraiseMoves as a “Christian alternative to yoga,” including “Christian yoga,” which she considers implicated in Hindu and “New Age” spirituality. Willis recalls that as a seven-year-old, she began doing yoga with her mother while watching a television exercise program; this was

figure 2.1 A WholyFit Certified Instructor demonstrating the “Helmet of Salvation” pose, which looks similar to yoga’s “upward-facing dog,” part of the Sun Salutation, 2011. (Courtesy Erin Garvey)

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figure 2.2 A WholyFit Certified Instructor performing the “Overcomer” pose in a church building with a Christian cross in the background, 2011. (Courtesy Erin Garvey)

“the door that led us into the New Age Movement,” which Willis remained involved in for the next twenty-two years before becoming a Christian. Wanting to offer Christians an alternative to yoga—and sensing an untapped market—Willis self-published a PraiseMoves book and video in 2003, which quickly captured national media attention. Willis followed up with additional instructional materials, teacher-certification programs, conferences, PraiseMoves and PraiseMoves Kids TV shows, and a more secular-sounding PowerMoves Kids curriculum for pre-K through high-school classrooms. The PraiseMoves program avoids emulating obviously religious gestures such as “praying hands” and replaces many asanas with newly developed poses linked to Bible verses or concepts. The program includes “The Eagle,” “The Angel,” “The Rainbow,” and “The Altar,” with a Bible verse for each. Willis admits that some PraiseMoves postures “resemble yoga postures,” a similarity she justifies because “there’s not an infinite number of ways the human body can move.” But she attests that PraiseMoves is a “redemptive work,” comparable to redeeming notes on the musical scale for Christian worship although the same notes have been used for ungodly music. Even evangelical critics who object most strenuously to Christian yoga place Willis’s program in a class by itself as having captured yoga’s physical and spiritual benefits without

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succumbing to Hindu or New Age spirituality. Willis’s popularity among evangelicals also seems to be helped by her distinctively modest dress, long sleeves and leggings, no belly button showing here.40 All three evangelical subcategories of Christian yoga derive from the Protestant Reformation emphasis on faith versus works and Word versus tradition. The crucial assumption is that “intent,” or belief, determines whether a practice is Christian. If someone engages in a practice intending it to be Christian, then it is by definition Christian. The evangelical emphasis on personal testimony makes it hard to refute the experiential claim that practices bring one into closer relationship with Christ. Agnieszka Tennant, a writer for Christianity Today, accuses Willis of “fear mongering (or is it fear marketing?) among evangelicals” and defends her own yoga practices on the evangelical grounds that they “draw me closer to Christ. They are my bodily-kinetic prayer.” Stephanie Dillon, owner of PM Yoga studio in Louisville, Kentucky, implies that yoga’s critics are unduly “religious” in a legalistic sense. In Dillon’s view, yoga “enhances a person’s spirituality. . . . I don’t like to look at religion from a law standpoint but a relationship standpoint, a relationship with Jesus Christ.” Brooke Boon summarily dismisses the charge of one critic that Holy Yoga is “Satanic” by asserting that “my own experience has taught me that this view is not the truth.” In a chapter entitled “Answering the Objections,” Boon closes off further discussion by declaring her evangelical identity: “remember that in Holy Yoga, the answer to practically every question is two words: Jesus Christ.” Claiming devotion to Jesus is the ultimate evangelical argument stopper.41

Conclusion Yoga’s mainstreaming is a success story of strategic marketing through selective self-presentation by promoters who recognized what would sell to American consumers. Advocates distanced yoga from Hindu religious associations by relabeling yoga as scientific techniques, nonsectarian spirituality, exercise, commodity, and Christian worship. Consumers embraced yoga because they wanted to be physically fit and relieve stress and also because they wanted more than secular exercise; they wanted bodily experience of the sacred. Christianized variants minimized perceived tensions between yoga and Christianity, while adding to Christian experience an element that seemed lacking in churches. The rise of yoga in America, and particularly the invention of Christian yoga, is a fascinating story of cultural reinterpretation made possible by incommensurable understandings of “religion.” Most Americans do not identify yoga as religious because they restrict their definition of religion to

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statements of doctrine rather than recognizing that bodily practices can be religious. Because the physical and spiritual aspects of yoga intertwine, failure to acknowledge yoga’s religious purposes does not automatically transform yoga into secular exercise. Neither does relabeling yoga as Christian necessarily purge other religious meanings. Packaging yoga for secular or Christian consumption may result in semantic more than substantive changes. Later chapters show how doing yoga “just as exercise” in secular settings or Christian churches can provide a stepping stone to other forms of yoga and monistic worldviews. This raises the larger question, explored in chapter 3, of what happens when evangelicals appropriate CAM for Christianity.

3

Is CAM Christian?

complementary and alternative medicine has gained a clientele of theologically conservative Christians. This is a recent development that can be traced to the late twentieth century. Before World War II, few holistic healers made a bid for acceptance by Christians, and few Christians were convinced that CAM is compatible with Christianity. Today Christians actively debate CAM’s legitimacy. Some Christians approve CAM as nonreligious wellness activities or aids to Christian devotion, while others condemn CAM as thinly veiled religion antithetical to Christianity. This chapter argues that Christians who oppose CAM are basically correct that prevalent CAM worldviews diverge from how many theologically conservative Christians have historically defined their tradition. Nevertheless, both sides in this intramural debate base conclusions on scant information, confuse the issues, and make unsubstantiated claims. This points to a fundamental limitation in how evangelicals navigate the “religious” and the “secular,” a constraint that may imperceptibly lead evangelicals toward religious practices they might otherwise seek to avoid.

Boundary Setting and Appropriation Since the first century, Christianity has contained within it twin impulses: appropriation of “non-Christian” means for “Christian” purposes and boundary setting or proscription of particular beliefs and actions that seem inherently corrupting. Which specific ideas and activities fall in or out of favor at a given time or place depends on cultural and historical factors in addition to religious factors. During the Reformation, Protestants rejected the authority of the Catholic hierarchy to regulate doctrine and practice, instead affirming the “priesthood of all believers,” that every Christian has a right and responsibility

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to use the Bible to navigate questionable matters. This led to a proliferation of “Christian” viewpoints on many issues, including healing. American evangelicals do not all agree on where to draw the boundary between legitimate and illegitimate healing practices, but they share a common understanding of how legitimacy should be determined. Evangelicals classify disputed practices either as religiously neutral “science” or as “New Age” religion. Since the Enlightenment, many Christians have reasoned that empirical demonstration of a method’s effectiveness constitutes evidence from the “book of nature” (a complement to the “book of revelation,” the Bible) of its conformity to natural laws God used in creation. Efficacy implies that God created resources for human benefit. As antagonism between science and religion grew by the late nineteenth century, Americans tended to categorize things as either scientific or religious but not both. Because Christians wanted to use scientific technology, they distinguished between religiously neutral technology and the ideology of scientific naturalism that birthed the technology. They then categorized effective methods as legitimate scientific procedures rather than atheistic materialism or illicit spirituality. Evangelicals followed a circular train of assumptions: science provides empirical evidence of God’s created order; any effective method is scientific; if scientific, then religiously neutral; if religiously neutral, then available for legitimate use.1 By the 1970s, the term New Age functioned in popular evangelical culture as code for anything that spokespersons evaluated as illegitimate for Christians. The New Age label groups together pejoratively diverse beliefs and practices perceived as expressing “heretical,” “Eastern,” “pantheistic,” “panentheistic,” and “unscientific” ideas of tapping into spiritual energy in ways unauthorized by the Bible. The New Age moniker works in tandem with the demonization of “Old Age,” “Eastern,” religious traditions and the presumably “occult” tendencies of peoples in or from the developing world. American Protestants agonized over the new immigration of the post-1965 era, fearing theological and cultural contamination. Evangelical author Frank Peretti’s best-selling novel, This Present Darkness (1986), put many readers on their guard to block a “hideous New Age plot to subjugate . . . the entire human race.” Most European-American Protestants responded to their growing anxiety over New Age infiltration by keeping their distance from unfamiliar cultural groups, rather than by systematic investigation. This is because evangelicals worry that occult knowledge corrupts. As a result, few evangelicals know much about the “Eastern” or “New Age” traditions they condemn. These terms denote vaguely illicit, exotic, superstitious religions that it seems spiritually dangerous to learn too much about. For instance, Dr. Taylor, a theology professor at an evangelical college, approves of acupuncture as a medical technique but expresses concern that “certain forms of yoga and meditation

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might be incompatible with faithful Christian spirituality.” He says, “I do think it would be possible to remove aspects of the practices that are incompatible with Christian commitments.” But Taylor does not seem to know enough about any of these practices to specify which aspects should be removed.2 Lack of in-depth knowledge does not stop evangelicals from issuing judgments about which practices seem New Age. In the absence of a central governing hierarchy, such as the Catholic church, self-appointed evangelical watchdogs, typically labeled “discernment ministries,” see themselves as exposing heretical threats to Christianity. Different discernment ministries reach opposite conclusions about the legitimacy of particular practices, and even the same ministries reach self-contradictory verdicts. Discernment assessments of t’ai chi provide an example. The Christian Research Institute (CRI) is one of the most theologically conservative and outspoken of all evangelical discernment ministries. The CRI denounces the “Eastern religions from which [t’ai chi] emerged” and “all chirelated activities that supposedly enhance one’s ability to harness, circulate, and unleash this mystical power,” even if superficially renamed “Holy Spirit.” (The CRI inaccurately conflates chi/ji [极], translated as “ultimate,” with ch’i/qi [气], translated as “vital breath”). Yet the CRI deduces that the “physical aspect of the art may be isolated from the philosophical/religious context,” making it legitimate for Christians to practice t’ai chi. Gotquestions.org (“the Bible has the answers, we’ll find them for you!”) is the discernment ministry of choice for Focus on the Family, a high-profile evangelical opinion shaper. Like CRI, Gotquestions. org confuses chi with ch’i but reaches the contrary conclusion that t’ai chi is illegitimate for Christians. It is “based on a Taoist spiritual view of the body and the chi,” whereas the Bible teaches that “Jesus Christ created and holds the world together, not the Tao or an invisible force called chi.” In examining acupuncture, by contrast, Gotquestions.org decides that “while a Christian should wholeheartedly reject the Taoist yin-yang philosophy, there is nothing inherently unbiblical about the acupuncture procedure itself.” This is because “many people have found acupuncture to provide relief from pain,” and “the medical community is increasingly recognizing that in some instances, there are verifiable medical benefits.” If Gotquestions.org becomes aware that studies also report medical benefits from t’ai chi (as discussed in chapter 5 below), it seems possible that the group might likewise accept t’ai chi as medical science rather than Taoist religion.3

Roots and Fruits Evangelical Christians typically determine the legitimacy of a practice by using the paired litmus tests of evaluating “roots” and “fruits.” In so doing,

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they allude to Jesus’s teachings that “I am the vine; you are the branches. If a man remains in me and I in him, he will bear much fruit,” and “every good tree bears good fruit, but a bad tree bears bad fruit. . . . Thus, by their fruit you will recognize them.” In appraising practices, evangelicals first ask: Are the roots good? Historical origins seem important on the premise that there is an organic connection between progenitors and progeny. Evangelicals ask of CAM whether roots are religious. If roots are not religious, then evaluators class CAM techniques as religiously neutral resources provided by God. If roots are religious, then, by evangelical reasoning, to be legitimate, roots should ideally be Christian, pointing back to Jesus Christ. If practices emerged from non-Christian religions, evangelicals have more trouble justifying appropriation yet may feel able to do so if roots appear to be complementary, or at least compatible, with Christianity. Evangelicals also ask: Are the fruits good? Evangelical Christians want to know whether CAM works to achieve thisworldly benefits such as health and other-worldly benefits, primarily salvation, by promoting evangelism and missions toward non-Christians and spiritual growth of Christians.4

Bad Roots There is a large body of evangelical literature decrying the roots of CAM in New Age or Eastern religions. Neil Anderson and osteopathic physician Michael Jacobson’s The Biblical Guide to Alternative Medicine (2003) generalizes that “practically all energy-based touch therapies trace their philosophical roots and practices back to ancient India” and the concept of prana. Assessments of spiritual roots tend to blur “Eastern” and “Western” metaphysical traditions in a manner that indicates a superficial understanding of both. For instance, evangelicals express scant familiarity with the history of homeopathy’s development in Germany. Critics instead disparage homeopathy as “the fruit of a philosophy and religion that are at the same time Hinduistic, pantheistic, and esoteric,” or note that “talk of the vital force” sounds “very similar to the teachings which have been brought to the West by Gurus and Yogis.” Although it is true that homeopathy’s German founder, Samuel Hahnemann, embraced religious ideas from Asia, evangelicals seem less interested in the Western metaphysical tradition from which homeopathy more directly emerged. Evangelicals seem equally unconcerned with differentiating among diverse forms of practice, such as meditation. Equating meditation with “mindlessness,” The Biblical Guide cautions that “God never bypasses our minds. . . . This is one way to detect a counterfeit spirit. If the mind is being bypassed, it is a . . . cheap counterfeit for the peace and joy that only comes by the indwelling

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presence of God’s Spirit.” Paradoxically, this line of reasoning implies the legitimacy of practices such as Buddhist mindfulness meditation, which emphasizes mental concentration.5 Bad roots arguments flow along two major currents, reflecting a split in modern Christianity between pentecostal and cessationist camps. Warnings issued by one stream may be rejected by the other as unduly alarmist. On the one hand, many cessationists consider pentecostal talk of demonic oppression superstitious. On the other hand, pentecostals are offended when the same discernment ministries that denounce CAM also charge that supposed “gifts of the Holy Spirit,” such as divine healing, are “occult.” A 2007 “DiscernIt” blog classes together the “healing waves” of “Network Chiropractic,” “yogic kundalini,” the Charismatic “Pensacola/Toronto outbreaks,” and high-profile pentecostals Rodney Howard-Brown and Benny Hinn. The blogger concludes: “this power is demonic because it is metaphysical in nature, so it is unbiblical for the Christian to participate.” In reaction to such generalizations, pentecostals may dismiss all discernment warnings, including those against CAM.6 Pentecostals assume that two kinds of spiritual power act in the physical world. Spiritual power is personal and value-laden; it is either good (reflecting activity of God and angels) or evil (expressing work of Satan and demons), so it cannot be impersonal or morally neutral. Some pentecostals prefer CAM’s spiritual premises to biomedical materialism. Other pentecostals worry that wielding spiritual energy is unbiblical. As nursing professor Arlene Miller reasons, if “the Spirit is seen as a personal member of the Godhead, the very idea of directing and modulating [energy] from within oneself into another person approaches blasphemy. . . . The Holy Spirit is not an impersonal energy to be directed and modulated by us!” Although CAM practices, such as laying on of hands, may superficially resemble Christian practices, they are occult “counterfeits” for praying for God to heal through the power of his Holy Spirit. Sharon Fish Mooney, a Christian with a Ph.D. in nursing, identifies Therapeutic Touch as a “counterfeit of Satan” that is “clearly associated” with divination, which is “explicitly forbidden in Scripture.” Christians cannot practice Therapeutic Touch—a purportedly nonreligious form of laying on of hands to “touch” and redirect energy fields—and “divorce themselves from its occult associations” because “it is rooted and grounded in psychic soil and it bears related fruit.” Pentecostals allow that CAM may produce healing. The Nurses Christian Fellowship, affiliated with the national student ministry InterVarsity Christian Fellowship, proposes that Therapeutic Touch involves the “manipulation of spirits. Evil spirits, or demons, are beings whose intention is to deceive us concerning the truths of God and they control us, ultimately destroying us.” By this logic, because Satan is the source of energy

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healing, and Satan’s goal is to destroy rather than heal, short-term healing is purchased at the price of ultimate destruction.7 Pentecostal critics warn that CAM may cause demonic oppression. An evangelical guidebook, Healing at Any Price? The Hidden Dangers of Alternative Medicine (1988), written by Christian psychiatrist Samuel Pfeifer, associates dowsing with “sins of sorcery” and warns that the “spiritual passivity” involved “carries with it the risk that powers beyond a person’s control may take over the mind.” The Swiss physician H. J. Bopp’s Homeopathy Examined (1985) cautions that “homeopathy is dangerous” because it uses “substances made dynamic, that is to say, charged with occult forces . . . transmitted to the individual, bringing him consciously and unconsciously under demonic influence.” Brenda Skyrme’s Martial Arts & Yoga: A Christian Viewpoint (1995) commences with an anecdote of a young man named Simon who became “deeply involved” with judo, karate, jujitsu, aikido, and kendo before becoming a Christian. After conversion, Simon stopped practicing martial arts, but he continued to struggle with an aggressive personality and other problems that were only resolved after receiving prayer for deliverance from evil spirits.8 Pentecostals such as Skyrme worry that even Christians can be oppressed by evil spirits and require deliverance ministry. In Simon’s case, this ministry involved renouncing “Eastern philosophy and religions,” including Hinduism, Buddhism, Shintoism, Confucianism, and Taoism, and “cutting off and releasing” Simon from the “totally demonic” ki power and the yin and yang symbols and all they represent. Simon confessed as sin injuries done to others, addressing instructors as “Sensei” or master, and bowing toward Senseis and dojo shrines (see figure 3.1). Christians ministering to Simon prayed for release from mantras used in meditation; the power of every position, breathing exercise, and belt award; spirits of destruction, self-destruction, hatred, anger, violence, suicide, death, and murder; the spirit of Nippon over Japanese martial arts; and Mars, the Roman god of war. Prayer ministers commanded every unclean thing to come out in Jesus’s name and prayed for healing of Simon’s body, mind, and spirit. Skyrme warns, moreover, that the “dangers” of martial arts and yoga are greater for those who are already Christians, because this brings opposing spiritual powers into open conflict. Christians undertake martial arts naively, because “the full knowledge of all that group represents is only known as one advances through the levels and grades. It is only then that an awareness of the full details become gradually clearer, and a deeper understanding is gained. By that time it is more difficult to extricate oneself from further involvement.” And it is not enough simply to stop practicing, because involvement has already opened the door to evil spiritual forces.9

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figure 3.1 Tae kwon do students bow to their instructor in a martial arts studio. (Courtesy Erin Garvey)

For certain pentecostals, CAM seems dangerous because it invokes spiritual power. Cessationists, by contrast, influenced by the antisuperstition legacy of the Reformation, deny that there is spiritual power present to tap into even if people worship other gods or practice divination. The American studies scholar Andrew Delbanco titled his account of American culture The Death of Satan: How Americans Have Lost the Sense of Evil (1995). The depersonalization of evil may reshape twenty-first-century culture more than the “death of God” noted by a previous generation of analysts. For cessationists, the real danger of non-Christian beliefs is not demonic oppression but intellectual infidelity.10 Cessationists worry, first, about the presence of false doctrines and, second, about the absence of what they judge to be true faith in Jesus. Critiques of acupuncture illustrate these concerns. One Christian Ministry is an international association of Christian ministers that promotes “strict, conservative, nondenominational, evangelical, ‘Jesus Christ is the only way to Heaven’ preaching, Holy Bible Word of God Believing.” A writer for One Christian Ministry advises consumers to be “very cautious that no one is praying to a false god over you, practicing an occult function, or possibly even a satanic ritual.” Actual demonic powers need not be feared, because “if you are a saved Christian, and have the Holy Ghost upon your life, this type of stuff has absolutely no power

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over you whatsoever,” so even if something like this happened, one should “just renounce it in the name of Jesus Christ.” Christians can avoid problems by finding an acupuncturist who is a “professing Christian” and “does not believe in the false doctrines wrapped up in acupuncture” or by researching where the acupoints are and self-administering acupressure: just “pray for protection from lies and evil and do the research, but again, be prepared to identify and renounce false doctrines associated with this research.” The problem with false doctrines, according to physician Walt Larimore and professor of nursing Dónal O’Mathúna’s Alternative Medicine: The Christian Handbook (2006) is that acupuncturists “may try to convert patients to their Eastern world view,” whereas an over-the-counter acupressure wristband “avoids exposure to the Eastern religious beliefs underlying chi.” For Albert Dager, “the real danger of acupuncture lies in the philosophical system.” Rather than emphasizing the presence of false beliefs, Dager cautions that “there is one extremely important ingredient missing in holistic medicine: a living faith in Jesus Christ—the only source of true ‘wholeness.’ . . . There can be no healing of the whole person (body, mind and spirit) without faith in Jesus Christ.” Dager’s reasoning implies that if there is only an ingredient missing, acupuncture can be Christianized by supplying the missing ingredient.11 Seeds for defending Christian participation in CAM are implicit in the logic through which Christians denounce CAM. If idolatry consists in false beliefs rather than illicit actions, most actions can be legitimized by affirming that one’s own views are orthodox. In assessing CAM, biblically oriented evangelicals draw inferences from passages such as 1 Corinthians 8:4-13: “We know that an idol is nothing at all in the world and that there is no God but one.” In the context of eating meat sacrificed to idols—a practice common when the New Testament was written—“food does not bring us near to God; we are no worse if we do not eat, and no better if we do.” But “be careful, however, that the exercise of your freedom does not become a stumbling block to the weak. For if anyone with a weak conscience sees you who have this knowledge eating in an idol’s temple, won’t he be emboldened to eat what has been sacrificed to idols? . . . Therefore, if what I eat causes my brother to fall into sin, I will never eat meat again.” Some evangelicals take this passage to mean that Christians should avoid CAM. Christianity Today’s Holly Robaina argues that even if a Christian is “strong” enough to engage in practices such as yoga while rejecting idolatry, there is still an unacceptable danger of encouraging weaker Christians to practice yoga in a manner that would be idolatrous.12 Other Christians find reassurance that since false gods have no real power, they can be safely ignored. The Biblical Guide states that “if someone walks into a health-food store and purchases a homeopathic remedy, thinking it is

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an herbal preparation, there does not seem to be any adverse effect spiritually. There is no transfer of faith. However, if they place their faith in healing or protection from disease into homeopathy, adverse circumstances seem to follow.” What the participant believes determines whether practices are idolatrous. A Christianity Today editorial recounts the experience of an evangelical pastor visiting a massage therapist. Already on the massage table, he noticed “New Age” crystals in the room. He considered leaving, because he felt “fearful of subjecting himself to spiritual forces. Then he remembered that in Christ ‘all things in heaven and on earth were created . . . whether thrones or dominions or rulers or powers—all things have been created through him and for him’ (Col. 1:16, NRSV). This pastor decided the ‘all things’ included these crystals. So he prayed that Christ would exercise his lordship over them and any evil spirits in the room.” The pastor, and the author, concluded that Christians can simply overlook idolatrous beliefs because Jesus Christ has defused their power.13

Bad Fruits Christian censors seek to show that not only the roots but also the fruits of CAM are bad. Criticisms focus on lack of scientific evidence that CAM is effective or works through scientifically plausible mechanisms. The Catholic Bishops’ Committee on Doctrine charges that Reiki “lacks scientific credibility. It has not been accepted by the scientific and medical communities as an effective therapy. Reputable scientific studies attesting to the efficacy of Reiki are lacking, as is a plausible scientific explanation as to how it could possibly be efficacious.” The authors of Alternative Medicine: A Christian Handbook worry that “modest results found in research” for acupressure imply that “occult spiritual powers are called upon during treatment.” Healing at Any Price? notes that even “the acupuncturists themselves admit that these meridians have nothing in common with nerves and blood vessels.” This guide also warns that there is “no other explanation” for how homeopathic remedies could work “than an occult one, or a placebo effect.” Dónal O’Mathúna rejects CAM therapies that have “failed to demonstrate significant benefits in controlled trials, e.g., iridology, homeopathy, and aura healing,” and concludes that “given the scientific controversy regarding its effectiveness and its spiritual foundations, Christians should question their involvement” with homeopathy and related practices. Of even greater concern to O’Mathúna is that “almost half of these active as TM trainers reported episodes of anxiety, depression, confusion, frustration, mental and physical tension, and inexplicable outbursts of antisocial behavior. Other studies have documented adverse effects as serious as

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psychiatric hospitalization and attempted suicide.” These examples illustrate reduction of the fruits test to questioning medical benefits. By implication, if CAM can be medically validated, these same Christians might decide that the fruits are good.14 Christians do sometimes worry about spiritual roots, even when physical fruits seem desirable. Journal of Christian Nursing editor Judy Shelly worries that “the predominant attitude is, If it works, use it.” John Newport’s The New Age Movement and the Biblical Worldview (1998) challenges the logic of evangelicals who “contend that scientific evidence supporting Therapeutic Touch methods are in short supply, and that until the ‘Does it Work?’ issue is resolved, Therapeutic Touch should be avoided.” Newport argues that “the crucial question is not just whether objective (or subjective) healings actually take place, but what they mean. In the area of universal energy the interpretation proceeds from the spiritual precepts of the New Age movement.” Critics such as Newport return to the roots standard as a check on claims that CAM produces the good fruit of medical efficacy.15

Patterns in Evangelical Cultural Appropriation Application of the roots and fruits standard delineates boundaries between evangelicals and the “world” and regulates which cultural resources can be appropriated. The appropriation process typically proceeds through predictable stages. First, Christians express wariness that new cultural trends may be inherently corrupt. Recalling the biblical image that the devil prowls “like a roaring lion” trying to devour Christians, evangelicals worry about being caught unaware by insidious influences masquerading as innocent cultural practices. When, for example, extrabiblical song lyrics, novels, movies, and rock-and-roll musical styles first gained popularity, many Christians rejected these cultural forms. Evangelicals reasoned, along the lines of media critic Marshall McLuhan, that “the medium is the message” or that regardless of content, particular media forms affect society in similar ways. Yet as newness fades, so does perceived threat. Each once-new practice becomes normalized as one among many cultural options. Today many theologically conservative Christians comfortably adopt popular musical, literary, and cinematic styles. A similar progression seems to be occurring with CAM. When the holistic health-care movement first became prominent in the 1970s, evangelicals expressed alarm. John Wimber, founder of the Association of Vineyard Churches, articulated a typical warning in his book Power Healing (1987): holistic medicine is “at odds with historic Christianity” since it brings with it “Eastern religions,” “pantheism,” and the “occult,” and teaches that

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“all creation is God.” By the 1990s, concerns were muted as CAM became commonplace.16 In borrowing resources from the surrounding culture, evangelicals pick up on the most popular cultural trends as offering the greatest opportunities for achieving evangelical goals. First, they seek to evangelize non-Christians by creatively presenting the gospel in culturally relevant ways. Second, Christians want to help one another grow spiritually. Finally, evangelicals may be least vocal about, but most motivated by, a third goal: finding a legitimate way to access perceived benefits without compromising Christian identity. Concerned about the presence of false beliefs and the absence of true ones, evangelicals wanting to use CAM subtract non-Christian religious concepts and add Christian ideas. First, evangelicals redefine practices often used for religious purposes as religiously neutral physical techniques. Second, the threat of contagion seems nullified by replacing the organic metaphor of roots and fruits with the inorganic image of container and contents. If cultural forms are merely neutral containers rather than the message itself, then problematic content can be removed or replaced, much as ingredients may be substituted in a recipe. Third, evangelicals rename practices by adding the modifier Christian to the title and relabeling accompanying concepts with Christian terms. If the usual title appears to have too many non-Christian connotations—such as yoga—evangelicals may replace that name with Christian language.17 Several of these strategies may be illustrated by defenses of martial arts. Wendy Williamson’s Christian Martial Arts 101 (2004) argues that “there are two ways that Christians can Biblically be involved in the martial arts: 1. By completely removing Eastern religious concepts that may be attached and doing physical techniques as a form of exercise or sport. . . . 2. By replacing Eastern religious concepts with Christian ones.” Williamson reasons that “grapefruits and oranges are comparable because they are both fruits, but baskets and apples are not comparable in the human scheme of logic. On the other hand, martial arts are a lot like a basket.” The Christian Martial Arts Network avers that “just as a basket is capable of holding any fruit, martial arts are capable of holding the beliefs of any religion. Much like rock music can be used to minister to youth and glorify God by changing the lyrics and focus to Christ, so can martial arts.” The basket simile severs the organic connection between roots and fruits by which non-Christian origins presumably taint offspring practices. This allows Michael Chen, in Christianity & Martial Arts Power (2002), to define “Christian chi” as the “power of God active within the individual,” the “power provided through Jesus Christ becoming the life energy for the Christian,” and “the power provided by the Holy Spirit and

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not physical power or strength.” Taking the concept of qi from Taoism, Chen Christianizes it by pronouncing that for the Christian, the root of this power is God/Jesus Christ/Holy Spirit rather than the Tao.18 The addition of Christian language reframes CAM as Christian. Mary Ann Finch’s book Care through Touch: Massage as the Art of Anointing (1999) “places massage in the context of Christian care and Gospel values” by applying Christian language such as “anointing,” “incarnational service,” and “sacrament”—to identify the human body as a “sacrament and manifestation of God.” Healing from the Heart: A Guide to Christian Healing (1998) affirms that the hands of a Christian energy healer are “moved to where the mystery of God’s Holy Spirit is particularly acting. . . . The healer is filled with all the fullness of God.” Bruce and Katherine Epperly’s Reiki Healing Touch and the Way of Jesus (2005) avows that the Reiki symbols join “the spirit within us with God’s ‘sighs too deep’ for words”—an allusion to the Holy Spirit in Romans 8:26—since the same energy “known as chi in Chinese spirituality and medicine, and as ki in the Japanese culture from which reiki arose, and as prana in Hindu Ayurvedic medicine . . . may be identified with the Christian and Hebraic images of pneuma, the spiritual life force in all things.” The ChristianReiki.org Web site delineates a Christian version in which “God, Jesus Christ and the Holy Spirit” act as “spirit guides,” aided by “additional healing power from Archangel Michael, Gabriel and the other angels.” A Reiki healer, Judith White, attests, “I was already a Christian when I began to use Reiki, so I already knew that my spiritual guide is the Holy Spirit.” Robin Littlefeather Hannon asserts that when she practices Reiki, “Jesus always comes to attend and help with my sessions.” Linda Smith “‘reframes’ Healing Touch within the Judeo-Christian heritage” by instructing 1,200 students annually to see themselves as a “channel, a conduit or facilitator for the flow of divine energy.” As Healing Touch practitioners meditate on the “Spirit,” they “tap into the whole universal energy form field which is present within us.” Christians sanitize energy healing by using Christian vocabulary to describe concepts—such as human embodiment of divine energy and invocation of spirit guides—learned from other religious traditions.19 Holistic healing becomes accepted as Christian through the speech act of calling CAM Christian. Word-oriented evangelicals define a Christian as someone who will “confess with your mouth the Lord Jesus” or verbally self-identify as Christian. Thus, creation of a Christian alternative to any religiously suspect practice consists most basically of verbally denying non-Christian religious allegiances and affirming that Jesus Christ is at the center of this version of the practice. South African Sallee Don-Wauchope’s In Support of Homoeopathy in the Light of the Bible (1993) defuses Christian suspicions by

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indicating her awareness of the charge that homeopathy is “New Age” and works through “an occult energy and could make one vulnerable to Satanic forces.” Instead of directly refuting this claim, Don-Wauchope accuses critics of being “on a witchhunt” and “seeing Satan in everything.” By requiring homeopaths to “prove scientifically what the ‘vital force’ is,” critics subscribe to “an anti-Christian philosophy that tries to insist on a scientific answer to a moral question.” The theory of vital force is moral rather than scientific because it is “how Hahnemann described fallen man’s immune system struggling with diseases in a world of stress he was not designed to live in.” Homeopathy advances the gospel by redeeming humans from consequences of the Fall. The text asks rhetorically, “Does God want human beings to be healthy? If either allopathic medication or homeopathic medication help them to achieve this, then I believe God rejoices, especially if, in addition, this helps man to achieve the peace that comes from a personal relationship with Jesus.” Implicitly, homeopathy is superior to allopathic medicine, because it rejects anti-Christian philosophies and cultivates a personal relationship with Jesus. Rather than explain how homeopathy achieves these goals, Don-Wauchope assures readers that this is the case by professing her own Christian identity.20 Christian defenses of CAM presume innocence by association: if committed Christians engage in a practice, the practice appears consistent with Christianity. Monte Kline, a self-identified “Christian Clinical Nutritionist” and director of Pacific Health Centers in Oregon, justifies dowsing since his training “came from a committed, doctrinally-sound, Spirit-filled Christian.” Kline, in turn, “trained two other above reproach Christian men (one of them is a pastor) in dowsing.” He implies that if dowsing were not Christian, Christians would not do it. Dowser Lloyd Youngblood asserts that even “Moses and his son, Aaron [Aaron was Moses’s brother, not his son, according to the Bible], used a dowsing device referred to as ‘the Rod’ to locate and bring forth water.” Youngblood also quotes Hosea 4:12: “My people consult a wooden idol, and a diviner’s rod speaks to them.” The next verse adds that “a spirit of prostitution leads them astray; they are unfaithful to their God,” but Youngblood does not cite this verse, since it identifies divination with spiritual prostitution.21 For evangelicals, the language selected to describe a practice is all-important to its meaning. One Christian Ministry speaks appreciatively of a “wonderful pressure point located on the left wrist that helps relieve anxiety.” What matters in assessing the legitimacy of acupressure is how one describes the pressure point: “Now it’s known as two different things: ‘H7,’ which (obviously) I have no problem describing it as that, or thinking of it that way. However, it’s also known as the ‘spirit gate,’ or ‘spirit door.’ If you are a Christian, that should be a big red flag for you! . . . To believe that points such as H7 or any other point

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stimulates some sort of ‘spirit gate’ is not only blasphemous against the Holy Spirit, but ignorant of the truth in Jesus Christ.” The author does not seem to be aware that his preferred name—more accurately, HT 7—refers to the heart meridian, thereby invoking qi theory. Nevertheless, One Christian Ministry expresses confidence that non-Christian associations can be avoided by shunning religious language.22 Even theologically conservative Christians exhibit optimism that Christian CAM providers can administer purely physical techniques untainted by non-Christian religion or else substitute Christian for non-Christian content. Sabrina Rocca, in “Reiki Christian,” declares that Reiki is “not at all a religion; it is a technique that is designed to combat stress and disease in order to improve one’s life.” Sara Wuthnow, chair of the Department of Nursing at Eastern College in Pennsylvania, acknowledges that “centering” in Therapeutic Touch and Healing Touch has “Eastern” origins, but it “is merely a technique, however, not a religion.” In evaluating martial arts, the Christian Research Institute concludes that the “instructor of a given school . . . becomes the deciding factor. The instructor might present a martial art to students as a strictly physical activity for fitness and protection, or as an all-encompassing world view that involves religious elements.” Wendy Williamson maintains that although “martial arts was invented and developed in the Far East, and therefore, took on by association the culture, religion, and philosophy of its many teachers and students,” the practice is not religious “in and of itself,” and can just as easily take on “the beliefs of Christian teachers.” The Christian Martial Arts Network affirms that “we call ourselves Christian martial artists not because we are martial artists and also Christian, but because we subscribe to the following tenets (ideals). . . . I pledge allegiance to my Lord, Jesus Christ. . . . Like a soldier physically, mentally, and spiritually prepares to protect a nation, and her freedoms and beliefs, a Christian martial artist physically, mentally, and spiritually prepares to love God and do His will on earth. . . . Black belt is not the end of a Christian walk, it is a new beginning.” So rendered, martial arts are not only compatible with Christianity, they are a Christian practice.23 Christian versions of CAM arise in reaction to charges that practices are not Christian. The more certain Christians censure a practice, the more likely it is that other Christians will create Christian variants in order to avoid criticism while engaging in the practice. There are Christians who practice chiropractic, acupuncture, and Therapeutic Touch, but there are discrete fields of Christian yoga, Christian Reiki, and Christian martial arts. Karate for Christ International president Daryl Covington’s Purpose Driven Martial Arts (2006)—a title that plays off evangelical megachurch pastor

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Rick Warren’s best-selling Purpose Driven Life (2002)—begins with a characteristically evangelical purpose statement: “Our Mission: To proclaim the Gospel of Jesus Christ . . . via the medium, lessons, and discipline of martial arts.” Christian martial artists “separate” their practice of “specific fields of scientific study”—in Covington’s case, karate, tae kwon do, hapkido, and judo—from the Buddhist or Shinto beliefs of the founding teachers. Covington denies that ki is a “mystical or magical force”; it is the “normal” result of a “synergy of strength, speed, technique, timing, and willpower coming together in harmony of purpose.” Christian martial artists combine “the way”—a lifelong journey or philosophy of how to live, grow, and succeed—taught in the Hwa Rang “Code of the Ancient Warrior” with Bible study to become “warriors for Christ.” The “Warrior Honor Code” of the Christian martial artist is “Love the Lord your God with all your heart and honor Him above all things. Believe in Jesus as Son of God, Savior, and resurrected Lord.” The “highest goal in life” of the Christian martial artist is “relationship with God through Christ.”24 Whether or not they feel the need to create a Christian variant, Christians who want to use CAM also want to affirm their Christian identity. Deborah is a nurse who enthusiastically told her colleagues about Therapeutic Touch, only to be rebuffed with the charge “That’s the work of the devil!” The accusation “bothered me a great deal,” even though Deborah had “left most of my regimented parochial schooling behind.” She still did not want to be called un-Christian. So she looked up all the healings in the New Testament and “could find no suggestion of the devil’s work there; rather, I got the distinct feeling that Jesus expected us to have faith in our ability to heal.” Having embraced Therapeutic Touch but not wanting to renounce Christianity, Deborah justified the practice as rooted in the Bible and producing the fruit of healing. Like Deborah, many Christians defend their adoption of practices from outside historic Christian traditions by declaring that the roots and fruits are good.25

Good Roots The good roots argument has several variants, the selection of which depends on how much work is deemed requisite to distance particular CAM practices from non-Christian religious roots. First, supporters look for biblical roots, or at least biblical parallels. Second, promoters claim that nonreligious techniques have their origins in God’s created order. Third, Christians deny that practices are inherently religious because they originated before non-Christian religions or subsequently shed religious associations.

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Christian proponents seek biblical roots for CAM. The Bible and Homeopathy (1989), written by Ronald R. Male and published by the London Missionary School of Medicine, consists largely of Bible verses, interpreted as analogs to homeopathic principles. When “Galatians 2.20 says, ‘I am crucified with Christ,’ . . . it means Christ was crucified IN FACT but I was crucified IN SIMILAR,” indicating biblical support for the homeopathic law of similars, or like cures like. The Bible also backs the homeopathic “law of the infinitesimal [that more dilute medicines are more potent]. Homeopathy works in the infinitesimal: So does faith. ‘Faith as a grain of mustard seed.’ Matt. 17.20.” The homeopathic “Law of Succussion and Attenuation” (potentization of medicine by step-by-step dilutions plus shakings) parallels Philippians 2:6–8’s account of the step-by-step process of “attenuation by which the Son stripped himself” and “Christ Jesus”: 1. 2. 3. 4. 5. 6. 7.

thought it not robbery to be equal with God, but made himself of no reputation, and took upon him the form of a servant, and was made in the likeness of men, He humbled himself, And became obedient unto death, Even the death of the cross.

By breaking the biblical passage down into seven steps, Male argues that “in both the spiritual realm and in homeopathy attenuation does not detract from the remedy’s usefulness, but increases it,” revealing the complementarity of the Bible and homeopathy.26 Not only do biblical and homeopathic principles seem parallel, but biblical heroes allegedly practiced homeopathy. The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy (2007) interprets Exodus 32, in which Moses forces the Israelites to drink water containing gold dust from an idol they had worshipped, as a homeopathic prescription: “it is impressive and even amazing to note that the Bible perfectly describes how homeopathic medicines made of mineral (gold) are manufactured—ground up (the technical word is ‘triturated’) and then diluted in water. What is so fascinating about Moses’ decision to make a medicine out of the golden calf is that gold is known to cause various physical and psychological symptoms when a person is exposed to it in overdose. . . . Gold has been found to cause feelings of despair and hopelessness. . . . It seems that Moses determined that the Israelites’ worshiping of false gods was the result of feelings of despair and hopelessness and that their actions in this desert represented self-destructive

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behaviors that were suicidal.” Although the cited chapter does not say anything about medicinal intentions—rather, Moses’ “anger burned,” and his gold-drinking decree punished the Israelites for their idolatry—the interpolation of homeopathic theory transforms the Bible into a textbook on how to practice homeopathy.27 Defenders of CAM ideally trace a history of practice back to the Garden of Eden, before sin and sickness entered the world. The Hallelujah Diet, developed by the Reverend George Malkmus (1934– ) after being diagnosed with colon cancer in 1976, purportedly returns Christians to the diet originally intended by God. In Genesis, God instructed his new creation: “I give you every seed-bearing plant on the face of the whole earth and every tree that has fruit with seed in it. They will be yours for food.” It was only after the Flood—when God destroyed most life because of rampant sin—that God allowed consumption of animal foods, while also reducing the human life span to “a hundred and twenty years” and then to “seventy years, or eighty” from antediluvian lengths in excess of nine hundred. In developing his dietary regimen—which consists of “85 percent raw, uncooked, and unprocessed plant-based food” and “15 percent cooked, plant-based food”—Malkmus modified the Gerson and Kelley diets, reframing their vitalistic premises within biblical language. As Malkmus retells the Creation account, God’s very own spark of life was breathed into the dust and became alive in the world! And the pattern was set in Genesis 1:29 for sustaining that life—transferred from one life form to another by the consumption of living foods. But in man’s ignorance—which he mistakes for wisdom— the simplicity of God’s system became lost. The modern views of nutrition and health became as corrupt as anything else. . . . The life-force in a plant is sustained by collecting sunlight via photosynthesis. That lifeforce is then transferred directly to the human’s physical body that consumes the plant—like a flame passed from one candle to another. This is the simple yet brilliant way God designed to pass along the life-giving energy from one living thing to another in the form of living foods. Although criticizing modern food preparation as a corrupt departure from the simplicity of God’s creation, Malkmus improves upon Edenic perfection by using modern machines to extract just the juice from plants and to formulate proprietary plant concentrates. His for-profit company, Hallelujah Acres, advertised as a “non-denominational Christian ministry,” sells juicers for $530 and Barley Max, “a certified organic whole-food concentrate . . . 100 percent pure juice powder” for $44 per 8.5 ounces. Concentrated products avowedly

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compensate for deficiencies in plants grown in a corrupt modern world, allowing consumers to reclaim prelapsarian health.28 Supporters of diverse CAM practices trace biblical origin stories. Wendy Williamson proposes that the history of martial arts began in the Garden of Eden, since “everything and everyone in heaven and on earth belong to God (Ps. 24:1–2; Col. 1:16–17).” Because they are rooted in the Bible, martial arts present “another example of a gift given to us by God that Satan has tried to steal” but that can be redeemed to fulfill its original purposes. Moreover, the Old Testament sanctions warfare; the most frequently quoted proof text is Psalm 144:1 (AV): “Blessed be the Lord my Strength, which teacheth my hands to war, and my fingers to fight.” The Christian Martial Arts Network (CMAN) cites Deuteronomy 20:1: “As for the towns of the nations the LORD your God is giving you as a special possession, destroy every living thing in them. You must completely destroy the Hittites, Amorites, Canaanites, Perizzites, Hivites, and Jebusites, just as the LORD your God has commanded you. This will keep the people of the land from teaching you their detestable customs in the worship of their gods, which would cause you to sin deeply against the LORD your God.” The CMAN uses the verse to authorize fighting, without noting the context of warning against learning new religious practices. Instead, the CMAN asks rhetorically, “Isn’t fighting unbiblical?” and responds that “after all, it was God who invented the sword and the fight, to bring glory and honor to Him.” Such reductions of martial arts to fighting techniques deflect attention from religious aspects.29 Since, however, Jesus advocated peacemaking, justifications also portray martial arts as parallel to the New Testament theme of spiritual warfare. Danny White’s trademarked program, “ChristJitsu: The Way of Christ,” is “designed to train Anointed Fighters for Christ in the art of spiritual warfare against the evil forces in spiritual realms.” Although ChristJitsu instructors all hold traditional black belts, as members of a “Bible based, Christ-centered organization,” they teach students to use God’s Word to “fight the good fight of the faith (1 Timothy 6:12),” by participating in short-term overseas mission trips sponsored by Martial Arts Ministries. Wendy Williamson’s Martial Arts the Christian Way (2002) alludes to Ephesians 6:11–16, which charges Christians to “put on the full armor of God.” When Christian martial artists “dress in their uniforms and tie on their belts, they dress themselves in ‘righteousness’ and tie ‘truth’ around their waists. When they practice their techniques, they block with the ‘shield of faith’ and punch and kick with the ‘sword of the spirit’ (the word of God).” Christian martial artist F. Jaramillo admonishes students that they “should NEVER come to class without their Bibles in hand.” A 2007 article, “How Would Jesus Fight?” published by Focus on the Family, quotes

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Ultimate Fighting Championship titlist Quinton Jackson’s explanation of why he took up mixed martial arts (MMA): “so I could beat up folks without getting into trouble, and get paid for it.” Asked “Do you have any heroes?” Jackson unhesitatingly answers: “Jesus Christ.”30 By emphasizing similarities between CAM and biblically authorized practices, defenders gloss differences and imply common roots. Reiki healers reason that since the Bible teaches healing through laying on of hands and Reiki teaches healing through laying on of hands, Reiki is consonant with the Bible. Sister Mary Mebane performs Reiki because “Jesus Himself told us (Mk 16:18) that we would lay our hands on the sick and they would recover.” Reiki master William Rand reasons that since Jesus had secret teachings and Reiki has secret teachings, Jesus likely used Reiki. Asking “Was Jesus a Reiki Master?” Rand notes “many similarities between the laying on of hands healing Jesus did and the practice of Reiki. . . . The fact that Jesus had secret teachings he gave only to those he had given healing power to is clearly indicated in Matthew 13:10–11 and Mark 4:10–12 & 34. Secret knowledge is also part of the Reiki teachings in that the symbols are secret as well as the process of doing the attunements.” Therefore, “the available evidence clearly indicates so many similarities it is likely the laying on of hands healing Jesus practiced must have been very closely associated with an early form of Reiki.” Reducing Jesus’s healing and Reiki to apparent similarities implies that all systems of touch healing share common roots.31 Where it is difficult to make a case for specifically biblical origins, CAM promoters instead argue that nonreligious techniques are rooted in the created order. Given the assumptions that God created everything and that Satan can only counterfeit rather than create anything new, Satan cannot ultimately be at the root of any technique. If God created techniques, it follows that God intends people to use them. A writer for the journal Homeopathy cites 1 Timothy 4:1–5’s warning against following “deceiving spirits” that forbid receiving God’s gifts, since “everything God created is good, and nothing is to be rejected.” Homeopathic medicines are good because they are made by “diluting something that God created.” Describing homeopathy as a God-created gift not only negates non-Christian origins but also hints that those who reject homeopathy follow deceiving spirits. Mixed martial arts fan Chris Kah reasons: “I don’t think God would give someone the gifts or the opportunity to fight if He didn’t believe that it would further His kingdom”— a logic that could be extended to justify almost any behavior. One Christian Ministry authenticates acupuncture “since we have points in our bodies that when pressed may help to cause healing to the body, that is something that God made for us.” Because “the Chinese people did not create these points”

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but only “discovered what God gave us . . . pressing these points and receiving healing is in no way an anti-Christian action. After all, God wants you to use these points. He wouldn’t have put them into all of our bodies if He didn’t!” One Christian Ministry likewise notes that when people meditate, “endorphin chemicals are released from the brain, and travel throughout the body. They feel good! They feel like they are healing. This is something that God created for us. Whether we call it ‘meditation,’ or ‘slowing down,’ ‘taking a break,’ ‘relaxation,’ it’s something He wants us to do.” By this rationale, any healing technique activates God-given properties of the body.32 Where non-Christian religious ties cannot be denied, Christians claim that techniques originated before the religion or later became distanced from it, so are not inherently religious. If religion was added later, it can just as easily be peeled off as a superficial accouterment. Biblical Discernment Ministries argues that karate is a physical technique “founded on scientific principles of body movements.” Over time, “an Indian Buddhist priest named Bodhidharma in the 6th century a.d. in China, synthesized karate techniques and Yoga meditation.” The author classifies karate as “science” but yoga meditation as “religion” and cautions that the mixture is contaminating. One Christian accepts the “God given function” of meditation but rejects “false religious or false ‘spiritual’ doctrines that most ‘meditation’ techniques are wrapped up in!” A Christianity Today editorial affirms that the “best approaches” to health care “blend conventional and alternative medicines,” warning only that “alternative treatments sometimes come packaged in world-views more akin to New Age philosophies and plain old paganism than to orthodox Christian faith.” The implied solution is to unwrap the packages.33

Good Fruits For many Christian interpreters, more pressing than the origins question is evaluating the fruit of current practice. While affirming that other-worldly salvation is the most important fruit, Christians often equate good fruits with efficacy in achieving this-worldly goals of relieving pain, increasing fitness, or delivering other health benefits. Margaret is a “devout Catholic” who turned to acupuncture after becoming “disenchanted with western medicine’s approach” of prescribing multiple drugs for a painful condition. Margaret worried about “any New Age or Taoist philosophies or practices” that the acupuncturist might be using but decided to try it after a parish priest “said that if it helped me, I should go for it.” A 1994 journal article on “Homoeopathy in the Service of the Gospel” recalls that “pastors, Christian doctors and missionaries have had great cause to thank God for this gentle, effective and inexpensive

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additional form of therapy which for years has brought benefit and relief from acute and chronic illness.” “Away with wimpy Christians!” admonishes Karate for Christ’s Daryl Covington, citing fruits of patience, discipline, and motor skills to argue that karate benefits youth who suffer from learning disabilities and poor coordination.34 Advocates emphasize that CAM is effective not only physically but also spiritually, promoting evangelism and world missions and encouraging spiritual growth of Christians. Covington stresses that martial arts serve as an “evangelistic tool” to “draw a crowd” and “reach children and teenagers with the gospel of Jesus Christ.” The Champions for Christ karate team at Bob Jones University—an institution in South Carolina that “exists to grow Christlike character” in its students—brings “the Gospel to needy people throughout the Southeast” as karatekas learn to “sharpen their soul winning skills, be an encouragement to others, and use their skills to glorify God.” Campus Crusade for Christ sends students on short-term mission trips in which they teach tae kwon do because it “opens hearts to the gospel”; the Campus Crusade Web site quotes an eighteen-year-old Guatemalan former gang member who, through one such trip, not only found tae kwon do but “found God.” “Fight Pastor” Brandon Beals of Canyon Creek Church in Washington uses MMA to “make Jesus look good” and relate to “those who otherwise would not attend a traditional church.” The church-based Clarksville Mixed Martial Arts Academy in Tennessee—“Where Feet, Fist and Faith Collide”—has the “unique ministry” of using “knowledge of MMA to lead others to Christ” by reaching “young men which many feel have been abandoned and neglected by the modern church.” The guidebook Healing from the Heart similarly acclaims Christian participation in Healing Touch, Therapeutic Touch, Reiki, and Reflexology, because “some who have been away from the church, perhaps for years, are finding their way back, having made a new and real connection with God through bioenergy work.” Nurse Judy Chuster praises Therapeutic Touch as a “wonderful way to witness my Christianity.” Such justifications present CAM as bearing the fruit of being more successful than the usual slate of Christian activities in connecting people with God.35 Christian proponents present CAM as encouraging those who are already Christians to grow spiritually. The “Benefits of Christian Meditation” vaunted by Rhonda Jones on her Web site, thechristianmeditator.com, include not only “Greater Health” and “Peace of Mind” but also “More Intimacy with God” and “Greater Sensitivity to the Holy Spirit.” Meditation helps Christians to “quiet our minds so we can move from knowing about God to knowing and experiencing God in a personal way.” By implication, Christianity seems intellectually abstract and divorced from experience. As a remedy, Jones advises

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“sitting quietly before the Lord” and choosing a “Scripture or Mantra . . . a word or scriptural passage (called a mantra) to anchor your mind, such as ‘the Lord is my Shepherd’ or ‘Peace be Still’ or ‘Jesus.’” Jones attests that as you become “fully present by paying attention to your breathing and your mantra. . . . you’ll sense a greater feeling of God’s presence and a greater sensitivity to hearing his voice.” The Christian Meditator masthead pairs a Bible verse, “Be still & know that I am God.—Psalm 46:10,” with a picture of a woman holding the kind of praying hands position (anjalimudra in Sanskrit, gassho in Japanese) commonly used by Hindu and Buddhist meditators, reframed as cultivating Christian spiritual growth more effectively than do more traditionally Christian devotional disciplines.36 Promoters of Christian CAM sometimes suggest that good fruits outweigh bad roots. Gotquestions.org describes acupuncture as “rooted in superstition, occultism, and false religions that are in direct opposition to God’s Word” yet vindicates Christian participation by asking rhetorically, “If inserting acupuncture needles into a person’s body at strategic points results in physical healing or relief from pain, does it matter if the practitioner is wrong about why it works?” After all, “much of Western medicine has its origin in practices/individuals that were just as unchristian as the developers of acupuncture.” The author reasons that there are physical reasons that Western medicine works to heal and relieve pain, and acupuncture also works to heal and relieve pain; therefore, there must be physical reasons that acupuncture works, making religious roots inconsequential. United Methodist Reverend Jonathan Chadwick argues that the scientifically demonstrated health benefits of TM offset any conflicts with Christianity. Chadwick, who attended TM weekend retreats while in high school and spent one year of college at Maharishi International University before attending seminary, asserts that the “practice of TM really does not conflict with any religion.” Or “at least,” concedes Chadwick, “whatever perceived ‘rubbing points’ there might be in the opinion of some, are greatly outweighed by the benefits of TM, many of which have been documented by years of scientific research.” By this logic, practical benefits outweigh theological orthodoxy.37

Conclusion The same American Christians who insist that Christianity is the only way to salvation, who criticize Christians in other cultures for falling prey to syncretism, and who would fastidiously avoid going to hear the Dalai Lama, having their palms read by a psychic, or playing with a Ouija board do experiment with health-promotion practices drawn from other religions. Christians who

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want to use CAM recall that conventional medicine has roots in Greco-Roman religion, just as Easter eggs once represented pagan fertility rituals, yet these associations faded over time. Calling attention to relatively rare “New Age” practices such as channeling spirits or crystal therapy conjures exotic images of non-Christian spirituality that normalize, or bring under the radar, more common practices, such as taking a t’ai chi class or learning Reiki, even though religious overtones of these practices are still alive. The degree to which Christians acknowledge their religious borrowing varies widely. In some cases, practices derived from religious traditions other than Christianity have become so thoroughly integrated into the secular marketplace that most Christian practitioners are unaware of religious valences. In other instances, Christians may be at least vaguely aware of religious connotations but hopeful that they can appropriate non-Christian resources for Christian purposes. The Christian identity of many CAM practices remains hotly disputed among theologically conservative Christians. Nevertheless, CAM’s foot is in the door. And as CAM becomes an even more familiar feature of the American cultural landscape, there is reason to expect that evangelicals will perceive CAM’s popularity less as a threat and more as an opportunity to use worldly means for godly ends. Christian detractors and supporters of CAM employ a common repertoire of standards for determining legitimacy but reach divergent conclusions, because few evangelicals know enough about CAM to develop consistent lines of reasoning. Paradoxically, fear of investigating beliefs categorized as New Age or Eastern religions makes it more likely that evangelicals will engage in practices that express the very worldviews that they find suspect, without recognizing the religious implications. A classic teaching moment occurred when a student approached me to say that his evangelical parents were worried about his taking a religious studies class from me that discussed “other” religions; his parents had not voiced concerns about his participation in a college yoga class, and they had referred him to the family chiropractor. Presenting certain CAM practices as rooted in Christianity and as producing evangelical beliefs requires Christians to make factually inaccurate statements and internally inconsistent arguments. By the same token, arguments wielded against CAM bear the seeds of CAM’s legitimization by implying that all that is needed is to unwrap techniques from religion, supply missing ingredients, and scientifically validate efficacy. The assumption that something can be either scientific or religious but not both leads evaluators to overlook religious aspects of procedures categorized as scientific techniques. The roots and fruits metaphor provides a pathway for persuading Word-oriented evangelicals that CAM is Christian, by denying heterodoxy and affirming that CAM is rooted in Jesus

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Christ and produces the fruits of physical and spiritual health. Evangelicals remove lingering worries of contagion by shifting to container-contents imagery to claim that CAM can become Christian by filling neutral containers with Christian linguistic content. Many Christians appear motivated to classify CAM as complementary to Christianity. Desiring perceived benefits but not wanting to become tainted by New Age or Eastern religions, Christians rationalize therapeutic experimentation. Despite caring a great deal about whether CAM is religious and whether it is Christian, evangelicals get sidetracked from these questions by more immediate concerns with whether CAM improves health. Focusing on whether CAM works deflects attention from asking why CAM is supposed to work. Although evangelicals stridently defend orthodoxy, the efficacy standard inhibits, instead of stimulating, theological reflection about CAM worldviews. De facto, efficacy trumps concerns about non-Christian origins. Troubling roots seem less relevant when fruits look good. Scientifically supported, Christian CAM promises guilt-free benefits, making it seem possible to have it all, a healthy body and a satisfied soul. This process is illustrated by a case study of chiropractic in chapter 4.

4

I Love My Chiropractor!

betty is a middle-aged pentecostal Christian who avoids yoga, acupuncture, energy medicine, and other CAM therapies because of their “Eastern” religious roots. But Betty feels quite differently about chiropractic. She has gone to chiropractors since age sixteen, seeking relief from pain suffered through spinal cord injuries and whiplash. Betty describes her current chiropractor as a “very devout Christian who prays over all her patients as she works on them.” Betty adds affectionately that “most of the chiropractors I know are Christians. I think that speaks something for the discipline itself.” Betty’s husband, Bob, marvels, “I have always been impressed with the number of chiropractors we’ve met who are also Christians. It seems, from my observations anyway, that there is a relationship between Christianity and chiropractic.” Bob reasons that the “essence of righteousness” is to stand “upright” or “vertical” before God, rather than “lean” on one’s own understanding (Proverbs 3:5), and chiropractors restore the body’s “perfect balance and alignment.” Thus, “it is the core issue of balance, alignment, and uprightness that brings Christianity and chiropractic into a relationship.” Yet Betty and Bob both “reinforce” that chiropractic is “mostly mechanical, and definitely not spiritual.” Betty likens chiropractors both to medical doctors whom “God uses” and to “natural phenomena”—like the Bible’s “lump of figs for Hezekiah’s boil (2 Kings 20:7)” and “wine for Timothy’s frequent infirmities (1 Timothy 5:23).” If chiropractic were spiritual, then the content of chiropractic philosophy would have to be unambiguously Christian to meet Betty and Bob’s evangelical standard of legitimacy. But viewed as a mechanical, medical, natural technique, chiropractic seems religiously neutral, or even related to Christianity.1 Betty and Bob’s enthusiastic acceptance of chiropractic exemplifies the attitude of many twenty-first-century Christians. Indeed, Betty and Bob helped shape popular Christian attitudes as published authors of pentecostal literature

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denouncing practices such as Freemasonry as un-Christian. Despite rationalizations like Betty and Bob’s, chiropractic developed from Western metaphysics, and its modern premises are more like those of yoga, acupuncture, energy medicine, and Freemasonry than biomedicine or evangelical Christianity. Chiropractic’s founders renounced Christianity and modern medicine, and for its first seventy-five years, most Americans rejected chiropractic as a medically and religiously suspect “medical cult.” Today chiropractic is mainstream: its offices can be found in strip malls; medical insurance plans cover adjustments; and evangelical Christians applaud chiropractic as a God-given method of pain relief. Although efforts to transplant chiropractic overseas produced weak offshoots, chiropractic thrived in American cultural soil. The number of chiropractors grew from 16,000 in 1930 to 66,000 in 2000, 57,000 of whom worked in the United States, making chiropractic a distinctly American phenomenon. Treating 5 million people annually, practitioners have adjusted 10 percent of the U.S. population. Chiropractors and medical doctors practice in the same clinics and hospitals, often in formal partnerships. This is not to say that expressions of disdain for chiropractic, especially by those invested in allopathic or osteopathic medicine, have disappeared. But the major cultural contest over chiropractic is over, and chiropractic has won the day.2 The cultural mainstreaming of chiropractic invites explanation. How did a practice once widely classified as medically and religiously illegitimate come to be reclassified as legitimate by many Americans, including evangelical Christians? Many people assume that chiropractic has always been a nonreligious health-care option much like modern medicine but less interventionist and more natural. Those who are aware of chiropractic’s metaphysical origins may assume that the practice gained acceptance because it shed its religious philosophy. But chiropractors entered the mainstream not by jettisoning controversial religious views but by straddling metaphysical, biomedical, and evangelical vocabularies to appeal to diverse constituencies. Chiropractic thrived on the borders of competing epistemologies. It developed as a tradition-in-tension within itself to establish dual cultural citizenship, claiming the prestige of modern science while appealing to antimodern longings for natural, spiritually pure remedies. Strategic marketing by chiropractors seeking a clientele met a culture poised to embrace therapeutic benefits. In a bid for inclusion within mainstream medicine, spokespersons for the major chiropractic organizations developed promotional literature using scientific-sounding terminology that muted religious overtones. Simultaneously, chiropractors who combined ideas from Western metaphysics and theologically conservative Christianity

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appealed to spiritually hungry seekers and pain-motivated evangelical coreligionists. Evangelical patients who worried about theological orthodoxy yet desired pain relief reclassified chiropractic from an illegitimate, New Age spiritual practice to a legitimate, scientific complement to medicine and prayer. In a culture in which pain has been emptied of positive religious meanings, the drive to avoid pain led many Americans to nuance their understandings of science, chiropractic, and Christianity so that they are experienced as complementary.3

The Metaphysical Philosophy of Early Chiropractic Chiropractic developed out of Western metaphysical traditions, including mesmerism, spiritualism, and vitalism. Daniel David Palmer (1845–1913) reputedly “discovered” chiropractic in 1895, when he performed the first “adjustment,” using spinal manipulation to restore hearing to an African-American janitor named Harvey Lillard. During the nine years preceding his discovery, Palmer practiced animal magnetism, or mesmerism. A self-styled “Spiritualist,” Palmer attributed chiropractic philosophy to spiritual “communications” from a deceased physician. Palmer coined the term chiropractic in 1896, after asking a patient, the Presbyterian Reverend Samuel Weed, to suggest several Greek names. Combining the words cheir (“hand”) and praktos (“done”), chiropractic means “done by hand.” Palmer may have selected the term over alternatives after seeing references to “cheiromancy,” or palm reading, in metaphysical literature, which Palmer read avidly. Chiropractors read spines much as palmists read hands, both of which were interpreted as windows onto human destiny.4 Given Palmer’s eclectic religious interests, it is not surprising that he considered defining chiropractic as a “religion.” Instead, though, he heralded chiropractic as a middle ground between Christian Science (founded in 1875) and medicine. Palmer articulated his understanding of chiropractic as uniquely integrating spirit and matter in a 985-page textbook titled The Chiropractor’s Adjuster: Text-book of the Science, Art and Philosophy of Chiropractic (1910). “The New Theology” of healing or the “religion of chiropractic,” to quote Palmer, stood on a “religious plank” termed “Innate Intelligence,” or simply “Innate.” Palmer expounded: “That which I named innate (born with) is a segment of that Intelligence which fills the universe,” a “part of the Creator.” Innate is synonymous with “the Greek’s Theos, the Christian’s God, the Hebrew Helohim, the Mahometan’s Allah, Hahneman’s [sic] Vital Force, New Thot’s [Thought’s] Divine Spark, the Indian’s Great Spirit, Hudson’s Subconscious Mind, the Christian Scientist’s All Goodness, the Allopath’s Vis Medicatrix Nature.” Palmer insisted that chiropractic could not be practiced effectively

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apart from a philosophy that affirmed the essential unity of all the world’s religious and medical systems.5 Palmer adopted vitalistic ideas abroad in the culture, and his genius lay in his ability to theorize a mechanism by which a spiritual force—Innate Intelligence—directs the material universe. “We are well,” Palmer announced, “when Innate Intelligence has unhindered freedom to act thru the physical brain, nerves and tissues. . . . Diseases are caused by a LACK OF CURRENT OF INNATE MENTAL IMPULSES.” Even a minor displacement, or “subluxation,” of spinal vertebrae causes tension or laxity in nerve “tone,” altering the vibratory transmission rate of the nerves. Vertebral “adjustments” restore nerve tone, allowing Innate to “care for and direct the functions of the body.” For Palmer, the necessity of keeping individuals adjusted to Innate had implications for the cosmic evolutionary process that gave the chiropractor a religious mandate: “Knowing that our physical health and the intellectual progress of Innate (the personified portion of Universal Intelligence) depend upon the proper alignment of the skeletal frame, prenatal as well as postnatal, we feel it is our right and bounden duty to replace any displaced bones, so that the physical and spiritual may enjoy health, happiness and the full fruition of earthly lives.” In Palmer’s view, chiropractors had a religious duty not only to remedy diseases but also to perform an act of service to Innate by adjusting human spines.6 As leadership of the fledgling chiropractic profession passed from Palmer to his son, Bartlett Joshua Palmer (1881–1961), its religious distinctiveness from Christianity intensified instead of fading. B. J. Palmer headed the Palmer School of Chiropractic in Davenport, Iowa (founded by D. D. Palmer in 1897) for fifty years, during which time he trained an estimated 75 percent of all chiropractors. Despite bitter disagreements among chiropractors, for the first half of the twentieth century, no individual was as influential as B. J. Palmer in shaping and speaking for the profession. Although D. D. Palmer had been cautious not to offend those with Christian beliefs, his son argued provocatively that “the great men of all times, the men who have done things, have been either rank theological-Biblical-infidels or agnostics.” Revisiting his father’s idea of declaring chiropractic a religion, B. J. Palmer decided against it, because chiropractic has no use for a “deity to which we can direct instructions of how to run the universe, or a soul to save for heaven or from hell.” Asking Do Chiropractors Pray? in a book by that title, B. J. Palmer answered definitively that “no Chiropractor would pray on his knees in a supplication to some invisible power.” He conceptualized “Innate Intelligence WITHIN man as the all-wise, omnipotent, omniscient, omnipresent Director-General who asserts that THE ONLY possible cause and cure are WITHIN man.” Because

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“it is interference with the supply of mental impulse that is back of every disease,” instead of praying (or using medical treatments), “the thing to be done is to adjust the (cause) subluxation.” Given B. J. Palmer’s understanding of chiropractic as an incompatible alternative to Christianity and biomedicine, it is noteworthy that many of the chiropractors he trained attracted extensive clienteles by integrating the Palmers’ metaphysical philosophy with science, seeker spirituality, and evangelicalism.7

Adjusting Chiropractic’s Reputation: Mechanical Science or Harmonial Religion? At the turn of the twenty-first century, most chiropractors recognize D. D. and B. J. Palmer as the “discoverer” and “developer” of the profession, but there is not a consensus about the significance of the Palmers’ religious philosophy to the “science” and “art” of modern chiropractic. The relevance of early chiropractic philosophy to modern chiropractic is hotly contested not only among chiropractors but also among scholars of chiropractic and CAM, some of whose tone implies a personal stake in whether or how chiropractic is “religious.” The meanings of chiropractic are culturally charged, making neutral analysis difficult to achieve.8 Intense intramural rivalries marked the history of chiropractic from the beginning, often referred to as a division between “straights” and “mixers” (purists who held closely to the Palmers’ philosophy versus experimentalists who added therapies). Historian J. Stuart Moore suggests that it is more useful to think of a distinction between “harmonial” and “mechanical” chiropractors. Harmonial chiropractors seek to restore harmony with life-force energy; mixers make up an overlapping group of those who see parallels between Innate and other concepts of vital energy, such as prana, qi, or vital force, and incorporate practices, including yoga, acupuncture, and homeopathy, from these traditions. Mechanical chiropractors downplay the Palmers’ vitalism and insist that spinal manipulations are scientific.9 Chiropractic historians who feel uncomfortable with the Palmers’ seemingly premodern religious views, embarrassed by their antimedical statements, and eager for the profession to achieve scientific legitimacy have understated the influence of harmonial chiropractic. The National Chiropractic Malpractice Insurance Company Group (which insures 37,000 chiropractors) commissioned a history, The Chiropractic Profession (2000), written by attorney David Chapman-Smith. The book minimizes B. J. Palmer’s influence by characterizing him as the leader of a “vocal minority” in contrast with the “growing mainstream that set about developing mature standards of education and practice.”

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Instead of providing quantitative evidence, Chapman-Smith employs terms such as “growing mainstream” and “mature” to portray “scientific” chiropractic as normative and developmentally superior to the Palmers’ explicitly overtalkative and implicitly immature and, hence, decreasingly influential religious views.10 It is difficult to generalize about any practice as internally divided and externally contested as chiropractic. There is, however, evidence that the harmonial tradition plays an ongoing role in modern chiropractic (for both mixers and for straights), but this role has been underestimated, because mechanical chiropractors intentionally redefined chiropractic as “scientific.” Adopting what historian R. Laurence Moore calls a “rhetoric of denial,” spokespersons obscured the importance of religion to chiropractic. Peter Bryner’s 1987 article, “Isn’t It Time to Abandon Anachronistic Terminology?” laments that references to “innate intelligence” and “vitalism” pervaded professional journals published in the 1980s. Bryner, whose avowed goal is integrating chiropractic into the health-care system, considers religious-sounding terminology an impediment to scientific credibility. Unless chiropractors shed their “dogmatic”-sounding language, Bryner opines, “what justification is there that chiropractic is not a religion?” Bryner advocates replacing the terms “Innate” and “vitalism” with the religiously neutral terms “homeostasis” and “holism.” Homeostasis can, without mention of Innate, denote an “ability of the body to repair itself in certain optimal circumstances.” Holism can be unmoored from vitalism and still express an “inherent property of complex systems to maintain and enhance complexity against the dissipative tendency which is embodied in the second law of thermodynamics.” Bryner is less concerned with developing an alternative philosophy for chiropractic than with presenting the profession using scientific language.11 Chiropractors sympathetic to Bryner’s agenda of linguistic modernization shaped the policy statements issued by every major chiropractic organization in the 1990s and 2000s. The American Chiropractic Association’s (ACA) “Policy Statement” (1994) defined an “adjustment” in mechanical terms as “any chiropractic therapeutic procedure that utilizes controlled force, leverage, direction, amplitude and velocity which is directed at specific joints or anatomical regions.” Official brochures compare “Innate” with more scientific-sounding concepts such as “electricity” or “nerve force,” or dispense with the term altogether. Substituting “inherent” for “innate,” the Association of Chiropractic Colleges’ “Position Paper” (1996) defines chiropractic as a “health care discipline that emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery.” Innate is now one of several terms rather than a unifying concept, and it connotes a physiological rather

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than a spiritual property: the “body’s innate recuperative power is affected by and integrated through the nervous system.” The 5,000-member World Chiropractic Alliance’s (WCA) “Practice Guidelines for Straight Chiropractic” (1993) emphasize the physiological attributes of subluxations, redefined as an “alteration of nerve function and interference to the transmission of mental impulses, resulting in a lessening of the body’s innate ability to express its maximum health potential.” Remaining silent about chiropractic philosophy, promotional literature oriented toward the medical mainstream recasts chiropractic in language congenial to modern, scientific sensibilities.12 The prevalence of scientific-sounding language in policy statements does not mean that most modern chiropractors have abandoned metaphysics. Quackwatch researcher Jack Raso estimated in 1994 that “only a few hundred” chiropractors reject the Palmers’ philosophy and merely treat “neuromusculoskeletal conditions of a nonsurgical nature.” Among this group are the approximately one hundred members of the National Association for Chiropractic Medicine (NACM), founded in 1984, who “renounce the chiropractic hypothesis and/or philosophy” that “subluxation is the cause of dis-ease,” and “confine their scope of practice to the treatment of joint dysfunctional disorders.” The NACM’s national executive director, Ronald Slaughter, D.C., explained why his organization had disbanded by 2010: “We tried. We failed. Chiropractic is a ‘failed’ profession.” As a self-consciously minority organization, the NACM tried, and failed, to influence major organizations such as the 15,000-member ACA (the single largest chiropractic organization) and the 8,000-member International Chiropractors’ Association (ICA).13

The Harmonial Philosophy of Modern Chiropractic Harmonial religious views undergird modern chiropractic philosophy. The chiropractic historian Joseph Donahue estimated in 1992 that—regrettably, in his view—80 percent of chiropractors “subscribe to some version” of Innate, a doctrine whose influence has been “far greater than it should have been . . . considering its scientific merit.” The Philosophy of Chiropractic by Terry Rondberg, founder and CEO of the WCA as of 2013, identifies the “major premise” of chiropractic as being that “a Universal Intelligence is in all matter and continually gives to it all its properties and actions, thus maintaining it in existence.” It follows that “the expression of this intelligence through matter is the chiropractic meaning of life.” Thus, “all living things have inborn, or Innate Intelligence,” “health is the expression of the Innate Intelligence through Innate Matter, via Innate Energy,” and “when there is interference with the transmission of Innate Energy, the result is a decrease in the expression of Innate Intelligence,

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which chiropractors call dis-ease.” Such a notion of innate energy as purposefully expressing universal intelligence is more expansive and teleological than conventional scientific concepts.14 Large-scale survey research confirms that most chiropractors hold views consistent with those of the Palmers. The Institute for Social Research at Ohio Northern University published the results of the firstever profession-wide survey, How Chiropractors Think and Practice (2003), led by a chiropractor, William McDonald. The study concludes that “the profession—as a whole—presented a united front regarding the subluxation and the adjustment. . . . When it comes to broad [i.e., mixer] scope and focused [i.e., straight] scope chiropractors, the old stereotypes are misleading. . . . On most issues, broad scope and focused scope chiropractors differ more in degree, than in kind.” The “typical North American chiropractor,” regardless of whether a broad scope/mixer (34 percent), a focused scope/ straight (19 percent), or a middle scope (47 percent), believes that “adjustment should not be limited to musculoskeletal conditions” (90 percent), “subluxation” is a “significant contributing factor in sixty-two percent of visceral ailments,” and only 40 percent of prescribed medicines are beneficial; 50 percent question the value of immunization. Asked whether adjustments usually help in the following cases, chiropractors said yes for tension headache (99 percent), migraines (89 percent), dysmenorrhea/menstrual pain (84 percent), allergic-type asthma (76 percent), and otitis media/middle-ear infections (77 percent). The typical chiropractor “performs a broad spectrum of routine clinical services,” including “periodic maintenance/wellness care” (94 percent), exercise recommendations (98 percent), stress reduction (87 percent), nutrition advice (88 percent), vitamin/herbal recommendations (72 percent), and “teaching a relationship between spinal subluxations and visceral health” (77 percent). Supermajorities agree that chiropractic’s scope of practice includes acupressure (94 percent), acupuncture (77 percent), massage (93 percent), herbs (91 percent), and homeopathy (82 percent).15 Despite issuing policy statements that present chiropractic as mechanical science, when writing for one another and for patients who share metaphysical perspectives, many modern chiropractors do not hesitate to augment physiological rationales with harmonial explanations of why adjustments work. J. Stuart Moore noted in 1993 that “chiropractic journals are full of neofundamentalist appeals for ‘Revival in Chiropractic’ which embrace the oldtime views. . . . This strong harmonial resurrection within chiropractic orients these chiropractors to the Palmer legacy and focuses on differences rather than similarities with orthodox medicine.” Browsing peer-reviewed journals,

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commercial magazines, and books published by chiropractic associations from the 1990s to 2013 yields a wealth of texts that confirm Moore’s and the Ohio survey’s conclusions. Authors quote appreciatively from the Palmers, personify Innate Intelligence, and emphasize the philosophical distinctiveness of chiropractic relative to biomedicine. Authors use Innate Intelligence as a spiritual concept, reminding readers of the “power of your inner spirit, soul or innate intelligence,” since “we do not only consist of flesh and blood, but also of a soul and spirit. It is these intangible and unseen components that are often overlooked as potential interferences with our innate gift to be well.” Since “Innate Intelligence . . . already has the intention and control of all the components needed” for the “expression of health,” as long as the chiropractor makes “certain that the adjustment is given correctly . . . innate will step in and do the rest.” In his “Chairman’s Message” for 1998, Edward Maurer writes in the Journal of the American Chiropractic Association that chiropractic is “steeped in philosophy” that “always adheres to the basic premise of universal or innate intelligence.” Articles in the ACA journal published as recently as 2013 offer metaphysical descriptions of Innate and affirm its consonance with vitalistic practices such as Ayurvedic medicine, acupuncture, and t’ai chi.16 Although the ACA and the WCA disagree over whether the scope of chiropractic should be broad or focused, they are alike in crafting public-policy guidelines using the language of scientific reductionism while voicing a harmonial philosophy in publications directed toward chiropractors and patients. Chiropractor Mike Reid elaborates on the spiritual meanings of Innate in a 2007 article in the Chiropractic Journal: A Publication of the World Chiropractic Alliance: We are spiritual beings who are a piece of an entire bigger picture with a purpose in life. . . . As chiropractors, we already know that the universal intelligence, lies within us as innate intelligence, causes our heart to beat, digests our food, and allows us to think as free people. . . . We’ve got to get back into a vibrational alignment where limitations of thought don’t exist . . . because when we’re in a state of fear, worry, jealousy or hatred we vibrate at a different frequency that will not attract from the universe, but will repel from it, that which we want. . . . Listen to your innate. . . . Sit in a lotus position with your palms opened up. See yourself as one and the same with the universe. Although the WCA is an organization of straights, members such as Reid envision a complementarity between chiropractic and practices—such as

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sitting in a lotus position—from other vitalistic traditions that seek rapport with cosmic energy.17 Responding to published pleas of mechanical chiropractors to shed the “dogma” of Innate in order to achieve medical legitimacy, harmonial chiropractors publish calls for a “return to our roots of allowing the patients’ innate intelligence to perform freely and without interference.” One text after another begins with quotations from the Palmers and then concurs that “the philosophical basis of chiropractic is that the body is self-regulating and self-maintaining, directed by a vitalistic force called Innate Intelligence.” In a 2006 article for The Chiropractic Choice: A Publication of the International Chiropractors Association, Christopher Passalacqua declares that “our philosophy is what fundamentally sets us apart from the rest of the healthcare industry. . . . As chiropractors we believe that all healing comes from within, (above-down inside-out), we believe that there is a Universal Intelligence (Principle #1) that gives rise to all things, including our body’s Innate Intelligence. We believe that life is necessarily intelligent (Principle #2) and there can be interruption to the transmission of Innate forces (Principle #29) that would cause our bodies not to adapt.” Rearticulations of chiropractic philosophy similar to Passalacqua’s reverberate across journals published by major chiropractic organizations.18 How aware are patients of chiropractic philosophy? The official legal counsel for the National Chiropractic Malpractice Insurance Company, David Chapman-Smith (cited earlier as seeking to minimize the Palmers’ influence) helps answer this question. Despite wanting to rescue chiropractic from charges of religious backwardness, Chapman-Smith notes that consumers are “pulled towards” chiropractic because providers regularly communicate philosophical differences between CAM and biomedicine. Chapman-Smith estimates that two-thirds of chiropractors offer “lifestyle” prescriptions such as macrobiotic diets, megavitamin therapy, imagery, homeopathy, herbs, energy healing, biofeedback, hypnosis, and acupuncture (see figure 4.1). The motion picture Jacob’s Ladder (1990) illustrates the resonance between chiropractic philosophy and seeker spirituality that privileges experiences of spiritual energy over institutional loyalty or creedal orthodoxy. In the film, the emotionally traumatized protagonist, Jacob Singer, cannot trust anyone he meets, except his chiropractor, Louis, who gives spiritual advice while adjusting, offering the only convincing explanation of the meanings of his life, death, and immortality. Chapman-Smith suggests that in a variety of real-life situations, individuals who might go to medical doctors and pray for healing also feel pulled toward the vitalistic prescriptions of their chiropractors.19

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figure 4.1 Nutritional supplements for sale in a chiropractor’s office, featuring “vitalizing” herbs and an “easy cleanse,” 2011. (Courtesy Erin Garvey)

Chiropractic brochures targeted at patients—in contrast with policy statements prepared for medical professionals and funding agencies—express harmonial views. Chiropractic researchers Joseph Keating and others concluded from their analysis of ACA and ICA brochures that it is “commonplace in the profession,” in patient brochures and clinical practice, for chiropractors to couple the “vitalistic concepts of ‘Innate Intelligence’” with the “magic and mystery” of “subluxation dogma.” One evangelical patient describes how her chiropractor communicated his philosophy: “In the chiropractic waiting room (in the Bible Belt), I sit in one of the four chairs, all of which face a small television. Today and every other day for the last year, Rhonda Byrne’s breakaway hit, The Secret (2007), is playing on endless rotation, urging viewers to direct their thoughts toward achieving their desires.” The TV was surrounded by brochures for detoxifying foot baths, antistress capsules, kinesiology, and energy medicine; a list of “health resources” directed patients to Deepak Chopra, TM, acupuncture, homeopathy, naturopathy, Pilates, and yoga. When the chiropractor entered the waiting room, he explained that “we attract the positive or negative into our lives. He chose the video, he said, because he agrees with that message.” This particular chiropractor communicates a metaphysical message, even to Christian clients.20

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The Christianization of Chiropractic One mark of chiropractic’s arrival in the American cultural mainstream was its general acceptance, by the 1990s, in Christian subcultures, despite the antipathy of chiropractic founders toward Christianity and early-twentiethcentury Christian condemnations of chiropractic as un-Christian. A 1977 article defining “Pseudo-Science and Pseudo-Theology” groups together chiropractic, yoga, acupuncture, TM, Scientology, and Christian Science. All of these movements are “unchristian” as well as “unscientific,” because they are “essentially unanimous in their rejection of the Biblical doctrine of the Trinity and of the deity of Jesus Christ.” For most of the twentieth century, lists of spiritually illegitimate therapies included chiropractic.21 Chiropractors responded to charges of heterodoxy by defending their Christian identity. Although comprehensive data are unavailable, several surveys suggest that many chiropractors—by one count, 88 percent—self-identify as Christian. Promotional materials directed toward Christian audiences describe chiropractic in terms calculated to minimize perceived tension with Christianity. In “A Christian Concept of Chiropractic Philosophy” (1952)— dedicated in a handwritten note “to Dr. B. J. Palmer, leading chiropractor and Chiropractic Philosopher, from his appreciative pupil”—H. L. McSherry remains silent about Palmer’s overtly anti-Christian sentiments, instead arguing that chiropractic is not a “religion, yet its philosophy resembles Christian theology.” Identifying clergy as strategic allies against a powerful medical establishment, McSherry courts clerical support. Since chiropractors and clergy both strive to keep people adjusted to the created order, McSherry reasons, they are natural associates: “Through prayer the clergyman strives to keep man’s soul in tune with the Infinite! By manual vertebral adjustment, the chiropractor frees the nerve paths to keep man’s body in tune with the same Infinite Intelligence.” Playing upon Christian suspicions of modern science, McSherry denounces the “evil effects” of medicine as “‘MED-I-SIN’—and sin in any form we are definitely against!” McSherry appeals to Christian clergy: “may we merit your sincere co-operation in our efforts to spread our gospel of health to all the world.” Remaining vague about the meanings of Infinite Intelligence and sin, McSherry glosses the distinction between the “gospel” of chiropractic and Christianity, recasting chiropractic terminology to make it accord with Christian theology.22 The most well-organized national association of Christian chiropractors, the Christian Chiropractors Association (CCA), advertises its evangelical self-identity. The CCA formed as a student group at the Palmer School of Chiropractic in 1951 under the aegis of evangelical campus ministry

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InterVarsity Christian Fellowship, adding one thousand members nationwide by 2006. An official “Statement of Faith” identifies the CCA as “conservative in theology,” emphasizing world mission: “sending Christian Chiropractors out to many whitened harvest fields with the Gospel of Christ and chiropractic before Jesus comes.” In a linguistic flourish reminiscent of the Palmers’ cosmic vision reworked into the language of evangelicalism, the CCA presents chiropractic as a gospel parallel nearly equal to the New Testament.23 CCA promotional materials solicit Christian clients by addressing evangelical insecurities about their cultural position relative to secular medical science and the rapidly growing phenomenon of pentecostal Christianity. Official CCA spokesperson Glenn Hultgren contrasts chiropractic to the “reductionistic or mechanistic philosophy” of biomedicine and the alleged faith healings that pentecostal “Christians” perform by the power of “Satan and his false spirits,” while preaching “powerful messages in pulpits around the world, drawing huge followings, performing miracles of healing, casting out devils, (slaying in the spirit) and telling the people that it is all in the name of the Lord.” (Such denunciations make it all the more perplexing that pentecostals have in recent years become vocal proponents of chiropractic.) Having identified nonpentecostal evangelicals and chiropractors as allied against common opponents, Hultgren assuages potential evangelical concerns about chiropractic’s vitalistic philosophy by claiming biblical roots. In classic evangelical style, Hultgren deploys a series of biblical references to argue that Innate is “part of the immaterial nature which God breathed into man when He called man a living soul. (Gen. 2:7; Acts 17:25; Ps. 36:9; Job 33:4).” Heightening his credibility by positioning himself as critical of the Palmers for “deify[ing] the vitalistic nature,” Hultgren coins the phrase “theistic vitalism” to merge the concept of Innate Intelligence with the Bible’s view of a creator God. Hultgren deflects evangelical criticism by acknowledging that the Palmers held unorthodox religious views and insisting that his own beliefs are theologically conservative. Although a relatively small percentage of Christian chiropractors belong to the CCA, the organization’s rhetorical strategies reflect a broader impulse to represent chiropractic philosophy and Christianity as complementary.24 As chiropractors sought Christian clients, patients who desired pain relief responded favorably to chiropractic appeals. D. D. Palmer’s earliest clerical apologist was the Presbyterian Samuel Weed, the same minister credited with naming the profession. Having at first dismissed Palmer as an unorthodox charlatan, Weed reversed his opinion when his daughter and he experienced pain relief subsequent to Palmer’s treatments. Preaching Palmer’s funeral sermon in 1913, Weed sought to persuade his audience that chiropractic and Christianity converge. The term “Innate,” Weed asserted, appears in the New

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Testament. James 1:21 instructs the Christian to “receive with meekness the engrafted word, which is able to save your soul.” The phrase “engrafted word” could instead, according to Weed, be translated as “Innate.” Similarly, 1 Peter 5:10 uses the word “adjustment”: “But the God of all grace, who hath called us into his eternal glory by Christ Jesus, after that ye have suffered a while, make you perfect, establish, strengthen, settle you.” The word translated as “perfect” means “adjust” in the original Greek, Weed argued, indicating that Jesus performed the ultimate spiritual adjustment. Weed used biblical passages to demonstrate the congruence of chiropractic and Christianity, even when doing so required hermeneutical gymnastics. Chiropractic attracted a thin stream of clerical defenders throughout the twentieth century. Writing in 1977, the Baptist minister Ross Lyon used a series of biblical quotations to compare chiropractic adjustments with the “great spiritual adjustment [that] came on that cross.” Reverend George Boyajian, in an article written in the 1950s and posted on the CCA Web site in the 2000s, affirmed that as a Christian minister, he had “recommended Chiropractic as developed by the Palmer School to many people.” Such clerical endorsements of chiropractic were, however, rare for most of the twentieth century.25 By the 1990s, evangelicals sounded less certain that chiropractic should be classed alongside other CAM therapies rejected as New Age. Ruth Gordon, an author for “Watchman Fellowship: A Ministry of Christian Discernment” (1992), cautions that chiropractic is “easily integrated with many other new age therapies.” Yet Gordon quotes another evangelical publication, John Ankerberg and John Weldon’s Can You Trust Your Doctor? The Complete Guide to New Age Medicine and Its Threat to Your Family (1991)—out of context— to emphasize that there is a category of “legitimate chiropractic,” which is “within the realm of modern medical scientific practice.” Gordon omits the next sentence from Ankerberg and Weldon, which concludes that the “great majority” of chiropractors fall outside the category of legitimacy. Although disagreeing about where most chiropractors should be classified, both texts contrast New Age illegitimacy with “modern medical scientific” legitimacy. Neither text expresses any sense of tension between the materialistic assumptions of biomedicine and a Christian worldview.26 Rather than interrogate chiropractic’s origins in Western metaphysics, evangelicals asked whether chiropractic is guilty by association with New Age or Eastern religious practices. New Age Medicine: A Christian Perspective on Holistic Health (1987), from evangelical publisher InterVarsity Press, advises Christians to avoid the “minority contingent of chiropractors who promote acupressure, applied kinesiology and other questionable pursuits.” The authors find it “particularly unsettling to see members of the Christian community

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having their energies balanced by chiropractors and other therapists who claim a Christian commitment and who feel that they are not involved in any questionable practices. These practitioners may claim that Ch’i, yin and yang, and meridians are neutral components of God’s creation (similar to electricity and radio waves), available for anyone to use; but they ignore the roots of these ideas.” Although recognizing that “classical chiropractic theory” expresses the similar view that “spinal manipulations allow the Innate to flow more easily through the nervous system,” the authors worry only about the “minority” of modern chiropractors who combine spinal adjustments with “questionable,” “Eastern” practices. Historian J. Stuart Moore observes that “evangelicals seem to be unaware that, even though the Palmer ideology has certain affinities to Eastern mysticism with its direction of unseen life forces and energies, it is more clearly a popular manifestation of the Western harmonial tradition.” Instead of commenting favorably or unfavorably on chiropractic’s harmonial philosophy, evangelicals zeroed in on whether chiropractic is severable from practices coded as Eastern, New Age religiosity.27 Having identified chiropractic as separable from New Age roots, two steps remained to exonerate chiropractic from charges of illegitimacy: disentangling “physical” techniques from “spiritual” rationales and presenting techniques as “scientific” medicine. The Biblical Guide acknowledges that D. D. Palmer “spoke of the ‘innate’ as a healing force,” but, the text qualifies, “to what degree he ascribed a spiritual dimension to the innate is not clear.” The sparsely footnoted guidebook concludes that “a chiropractor who practices pure chiropractic musculoskeletal medicine—focusing on adjustment of the spine—is operating purely in the physical realm.” The text implies that as long as a technique is “purely” physical, and hence classifiable as “musculoskeletal medicine,” the method can be unmoored from a suspect “spiritual dimension.” Another Christian guidebook allows that chiropractic is spiritual “in the hands of some practitioners” and advises Christians to avoid that subset. Internet-based “Let Us Reason Ministries” determines that “out of all the new age practices that are used today this [chiropractic] is one of the few that can be practiced apart from its Occultic energy philosophy. This can only be done when physically adjusting your spine excluding the occult view that is attached to it.” What sets chiropractic apart from other “occult” practices is that it works to relieve pain: “we should be careful not to call ALL chiropractic care occult or quackery. Many Chiropractors do provide temporary and even permanent relief from pain, as structural misalignments are corrected and nerves are relieved.” None of these authors specifies how physical techniques can be disentangled from spiritual rationales, yet they all appear confident that doing so is relatively easy (see figure 4.2). The authors (who do not concern themselves with reviewing clinical

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figure 4.2 Chiropractor performing an adjustment. A wall poster encourages: “Expect Miracles. We do.” The clinic motto is “Creating Wellness,” 2011. (Courtesy Erin Garvey)

studies of efficacy, a topic of chapter 5 below) absolve chiropractic of the irreligious label of “occult” and the unscientific label of “quackery,” because they believe physical adjustments to be effective in relieving pain.28 Regardless of whether chiropractic is actually effective, its widespread acceptance among evangelicals as medical science rather than New Age religion depends on the perception that the fruit of chiropractic is pain relief. The CCA’s Glenn Hultgren asserts that Christian chiropractors differ from “New Age holistic healers” by using methods that are effective because they “conform to God’s created order.” Christian chiropractors deflect suspicions of New Age leanings through simple speech acts of denial and affirmation: they are not New Age; they are scientific. For evangelical health-care consumers, visiting a doctor of chiropractic seems much like going to a medical doctor, only better.29

Combining Chiropractic, Medicine, and Prayer Christians who need healing often combine chiropractic with medicine and prayer for healing of the same condition. A study of CAM usage in rural

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Illinois communities found that 63 percent had tried at least one alternative, and 90 percent of CAM users combined at least two approaches, among the most common of which were chiropractic and prayer. Sixty-six percent of CAM users went to a chiropractor, and 58 percent used “prayer/faith healing.” In a study of fibromyalgia patients receiving conventional medical therapies at the Mayo Clinic, 47 percent used chiropractic, and 45 percent used “spiritual healing (prayers).” Although neither study reported how many subjects used both chiropractic and prayer or expectations that patients brought to—or took from—healing encounters, high usage rates of both therapies alongside conventional medicine suggest that many of the same individuals integrated all of these approaches.30 Despite recent studies evaluating the combination of intercessory prayer with conventional medicine, scholars have not investigated whether individuals combine Christian prayer with chiropractic. Such an inquiry illumines one important point of connection between evangelical and metaphysical practices, as Americans in pain piece together therapeutic resources to meet practical needs. Sociological research supports historian Catherine Albanese’s “impressionistic” finding that evangelicals today constitute the “backbone” of American metaphysical religion. Indeed, evangelical backbones have in recent years received regular chiropractic adjustments.31 In reaching this conclusion, I supplemented a review of CAM studies with the collection and analysis of new data, gathered from written surveys and telephone interviews with pentecostals seeking prayer for healing. I designed and distributed a “Healing Survey” to more than two thousand self-identified Christians who attended conferences between 2005 and 2009 conducted by an itinerating pentecostal group in Toronto, Ontario; Harrisburg, Pennsylvania; and St. Louis, Missouri, and traveling as a group to Brazil and Mozambique. The organization trained and supervised prayer teams who articulated a shared theology of divine healing: a personal God supernaturally intervenes in the natural world to heal miraculously, in the name of Jesus of Nazareth, by the power of the Holy Spirit. Leaders of the pentecostal group singled out for in-depth study occasionally make passing references to personal visits to chiropractors within sermons on divine healing.32 The twenty-seven-question pre- and postconference questionnaires asked subjects to describe any illness, pain, or disability for which they wanted to receive healing through prayer. Questions inquired about medical and alternative medical or spiritual remedies that respondents had tried or would consider and about any healing they believed themselves to have experienced during the conference through prayer. Question nine on the preconference survey

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asked, “Other than prayer, have you ever tried alternative medical or spiritual remedies for healing of this condition? Please circle one or more of the following: chiropractic, massage, meditation, acupuncture, herbal, yoga, Reiki, naturopathy, homeopathy, Therapeutic Touch, Christian Science, Native American, Unity, Santeria, curanderos/as, psychic, other: ________, not sure, none.” The surveys were returned by 328 North American or European respondents. Of 224 respondents who indicated that they hoped to receive divine healing, 58 (26 percent) reported having visited a chiropractor. In 55 follow-up interviews, a similar proportion, 20 (36 percent), volunteered that they had received chiropractic adjustments. These percentages are consistent with general surveys showing 30-percent chiropractic usage rates among Americans experiencing back pain, suggesting that belief in divine healing makes it neither more nor less likely that one will visit a chiropractor.33 Christians surveyed voiced general approval of chiropractic as complementary to prayer for divine healing. Only one person noted that she had discontinued treatment for religious reasons: “I was struggling with back pain and was actually seeing a chiropractor rather frequently. And I was just convicted that I was really having more faith in the chiropractor meeting my need. . . . I decided I was going to trust the Lord for my healing rather than the chiropractor and it was when I made that decision that my back pain went away and I have not been plagued with it since.” This woman indicated that she had invested such a high level of trust in her chiropractor, whom she saw “rather frequently,” that she found herself placing less trust in God to heal her. Another respondent, an Assemblies of God Pentecostal, attested that God had miraculously healed him of terminal colon cancer seven years before. He considered medical doctors unproblematic and continued going to them for “surveillance.” But he wrote “NO” in capital letters several times across the entire section of the questionnaire that asked about alternatives, implying his sense that CAM cannot be incorporated within evangelical theology: “No— God gets all the glory.” This respondent distinguished between medical treatment, which he considered legitimate means through which God can heal, and CAM, which he saw as pointing to an ultimate source of healing other than the Christian God. Many interviewees considered chiropractic more acceptable than other CAM practices enumerated in the survey. Given an assumptive binary that practices are either scientific or religious, perceived efficacy in relieving pain made chiropractic philosophy seem less salient. One individual singled out chiropractic as the only alternative on the survey that he did not have “enough reservations about that I’d just as soon not do. Most of the other things would be called New Age. I’m a Christian and I don’t believe that they’re avenues

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I should pursue. Chiropractic is, I wish I had a better understanding of how it’s supposed to work, but it seems to work, and I’m willing to try that.” This individual classified most of CAM as New Age but made an exception for chiropractic—despite feeling uneasy that he lacked understanding of “how it’s supposed to work”—because it seemed effective. Another respondent reported having tried acupuncture but stated that she “wouldn’t do that again.” It had been painful and ineffective, and “I was in a different place in my life back then, and I am not sure that that is an approved way for a Christian to get healed.” This woman had a strikingly more positive evaluation of chiropractic: “I have never been to a chiropractor. I know people who do go and they say that it helps them a lot. I guess I’ve never been led to do it. I don’t think that it’s something the church doesn’t approve of. I think it’s perfectly OK. I just haven’t done it.” In the absence of clerical disapproval and convinced of its efficacy, this respondent felt comfortable identifying chiropractic as valid. Another interviewee reasoned: “I think chiropractic is scientific. The manipulations were forceful, and I heard my back crack.” Because he felt and heard physical effects of adjustments, this individual concluded that chiropractic should be classified as science rather than religion. Several respondents evaluated chiropractic as more effective than biomedicine. Individuals who said they disliked going to doctors or could not afford them reported seeing a chiropractor “from time to time”—often one or more times per week—for adjustments, whether or not anything seemed “out of place.” Asked to “circle any/all of the following from which you might seek aid if you ever need another condition healed: prayer, physician or other healthcare professional, alternative medical or spiritual remedies,” one respondent circled “prayer” and, tellingly, wrote in “my faithful chiropractor.” Another respondent expressed a broader willingness to experiment with CAM. She circled having tried chiropractic, massage, naturopathy, acupuncture, herbal, and homeopathy and specified that “all my healing has come from alternative medicine.” At the end of the conference, this woman, having experienced CAM as therapeutically efficacious, signaled her intention to continue combining CAM with biomedicine and prayer.

Conclusion After decades of mutual suspicion, chiropractic and Christianity have been reinterpreted as complementary. This major cultural adjustment occurred as chiropractic publicists deftly moved back and forth between physical and spiritual vocabularies, attracting clients whose need for healing made them receptive to chiropractic claims. Chiropractors gained approval from conservative

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Christians who reclassified chiropractic, based on perceived efficacy in relieving pain, as legitimate science rather than illegitimate New Age religion. Yet, as the concluding chapter below demonstrates, some patients initially attracted to chiropractic as science come to internalize chiropractic’s metaphysical philosophy. Although interpreted as nonreligious, chiropractic is premised on a vitalistic, harmonial philosophy and fulfills many of the same functions as religion. More than a medical service, chiropractic helps explain life’s struggles, cope with present stressors, and anticipate the future with hope. Chiropractic promises to heal “dis-ease” and meet felt needs of people in pain—for someone to listen, confirm the legitimacy of complaints, do something to provide relief, and restore a lost sense of control. Spending up to an hour with patients at each of frequent appointments, chiropractors do not demand a physiological cause in order to take pain seriously, the physical reality of which they corroborate with physical manipulations. Chiropractors win a loyal clientele as they spend time, in the language of J. Stuart Moore, “touching and listening, validating the often ambiguous pain associated with back ailments.” Chiropractic fills a vacuum of meaning with an appealing explanation of pain: something is simply out of adjustment, and balance can be restored without making either the hurting person or God morally culpable. The chiropractor takes control of the situation by doing something actively and by empowering patients to make lifestyle changes. Patients, who may have heard clergy defer hope of relief to the afterlife or physicians eradicate hope, gain reassurance that the situation will improve through ongoing adjustments. The intense loyalty and defensiveness toward their chiropractors exhibited by several Christians interviewed, through exclamations such as “I love my chiropractor!” suggest the tenacity with which they want to protect their means of meeting religious needs to identify causes, attribute blame, and find significance.34 The vagueness with which chiropractors typically describe adjustments allows Christian patients to hear what they want, finessing their understandings of chiropractic to line up with their theologies. Christians interviewed defend chiropractic because they get something from chiropractors that they do not get from medical doctors or churches and that most do not feel authorized to seek from techniques coded as New Age. One interviewee after another, who felt no need to comment on the religious beliefs of their medical doctors, volunteered that their chiropractors are Christians. One individual had taken extensive notes on her chiropractor’s citations of Bible verses, encouragements to attend a “Bible believing church,” and claims that he only referred patients to other Christian practitioners. She interpreted his frequent references to unblocking “nerve energy” as denoting “medical help”

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that restored the body to how “God has set it up.” Another interviewee admitted that she did not have a “good feeling” about going to a chiropractor. Faced with pain that her doctor had neither alleviated nor taken seriously, she tried chiropractic. She justified her decision because “everybody at church goes,” an influential member of her church was a chiropractor, and all of her Christian friends were “talking about how great they were” and saying “you should go.” Such respondents reasoned that if chiropractic were un-Christian, so many Christians would not be promoting it. Many of the same Christians who insist that “so many chiropractors are Christians!” do not believe that all people who call themselves Christians really are. But chiropractors are made less instead of more responsible for proving their orthodoxy because of the services they offer. The case of chiropractic illustrates how metaphysical, medical, and evangelical strands of America’s therapeutic culture intersect where those in need of healing assemble diverse resources to meet practical needs. Chiropractic’s claim to Christian identity hinges on perceived efficacy. This leads to the question, addressed in chapter 5, of whether there is conventional scientific evidence that chiropractic or other CAM approaches are effective.

5

Does CAM Work, and Is It Safe?

holistic health care’s reputation has never been better. News headlines reporting breakthroughs in CAM research appear almost daily, suggesting that scientists are at last finding evidence that the ancients were right all along, that nature is the best medicine. The era of integrative medicine is upon us, combining the best of old and new therapies. Conventional health-care providers who do not offer CAM will soon be in the minority, as there seem to be ever-receding grounds for questioning CAM’s medical pedigree. Despite CAM’s rising status as evidence-based medicine, most CAM approaches lack compelling scientific evidence of efficacy and safety. But the absence of medical confirmation has not stopped CAM from becoming mainstream. There are more-than-medical factors that explain the growing perception that CAM is scientifically validated. Many of the critiques presented in this chapter can be applied to certain conventional medical practices. Therefore, the implications extend beyond CAM to interrogate health-care research, marketing, and services more generally. Indeed, the overselling and underdelivery of conventional medical benefits motivate many patients to overestimate CAM’s scientific backing.

How Scientists Evaluate Efficacy Conventional biomedical science restricts explanations of health and disease to physical or material factors, in contrast with the metaphysical, or beyond physical, assumptions of religion and spirituality. Although an individual healing experience may be deeply significant from a religious perspective, scientists concern themselves with systematic study of reproducible phenomena, while assiduously avoiding the post hoc, ergo propter hoc fallacy that if a person recovers after receiving some treatment, then the treatment must have aided recovery.

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Clinical studies test whether other factors, including other treatments, expectations of recovery, or recuperation that would have occurred apart from any treatment, may account for observed improvements. One way this is done is to compare results for subjects in an experimental group with those for a control group. The gold standard of rigorous scientific research is the prospective, double-blinded, randomized controlled trial (RCT) which rules out as many potential confounds as possible. Even RCTs that appear to demonstrate positive effects from a treatment may be artifacts of chance, and for this reason, scientists use statistical tests to weigh relative probabilities that similar results could have occurred coincidentally. Scientists use repeated observation and experimentation to decide whether new data falsify theories or are consistent with them. Meta-analyses, or systematic reviews, of multiple comparable and well-designed trials increase confidence that treatments are both safe and effective. In particular, the Cochrane Database of Systematic Reviews consists of regularly updated systematic reviews that summarize and interpret cumulative results of medical research. Cochrane reviews are widely accepted as the best single source of reliable evidence about the positive and negative effects of health-care interventions. The Federal Food, Drug, and Cosmetic Act of 1938 gave the Food and Drug Administration (FDA) authority to use such evidence to determine the safety and efficacy of regulated products. The FDA does not, however, regulate many CAM interventions that do not claim to “diagnose, cure, mitigate, treat, or prevent disease.”1 Since the 1990s, evidence-based medicine has become a watchword in the health-care professions. Clinicians increasingly seek to select treatments validated through population-level studies, although conventional doctors do still prescribe weakly supported medicines and procedures, some of which produce serious side effects, including death. The intention of evidence-based medicine is to minimize use of treatments that lack strong evidence of therapeutic benefits. In the process, attention has shifted from explaining mechanisms toward exhibiting effects. Many people, including physicians, consider it less important to elucidate why treatments work, provided that it can be shown that treatments work.2 Holistic healers seized on the opening provided by the evidence-based medicine paradigm to market CAM as treatments that work, even if mechanisms are poorly understood. This has been done by publishing results of clinical studies in peer-reviewed journals and by using scientific language to describe CAM. And this is despite the fact that conventional medical technology has been unable to confirm the existence, let alone the medical efficacy, of vital energy, the mechanism by which many CAM therapies are supposed to work.

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Journals dedicated to publishing CAM research proliferated by the early 2000s. Before creating new journals, CAM authors had difficulty getting their articles accepted by conventional medical journal editors and peer reviewers. This is not merely a product of residual bias against holistic philosophy. A relatively small percentage of CAM studies are RCTs that show statistically significant effects. Many studies are “outcome-based” or “observational.” This means that an effect is observed to follow an intervention, but the conditions of the study were not rigorously controlled, for instance, by comparing the outcomes for experimental and control groups. This leaves open the possibility that factors not controlled for, such as a placebo effect, may account for an apparent correlation between the experimental treatment and observed effects. A systematic review of yoga studies found that only 40 percent used RCTs, and most of these were less reliable because they had thirty or fewer subjects. Cochrane reviews of yoga for anxiety, dementia, ADHD, and epilepsy found “no reliable evidence to support” the treatment.3 Holistic healers have been able to claim that scientific evidence for CAM is mounting because of the sheer number of studies published, even though few studies have been published in top-ranking medical journals or used robust methods. Mary Ruggie, a sociologist favorably disposed to CAM methods such as meditation, summarizes that “there is a large and growing literature on the biology of meditation, and despite the inevitable methodological inconsistencies, there is mounting evidence of health benefits.” Imprecise phrases such as “large and growing” and “mounting evidence” substitute for detailed evidence. Lack of specificity is problematic, because there are several potential sources of bias in medical research (whether conventional or CAM)—and these biases can lead to misinterpretation of the evidence.4 The first potential bias is poor study quality. Numerous studies report benefits from meditation, but systematic reviews characterize the quality of research as poor. The University of Massachusetts Center for Mindfulness lists thirteen publications by Jon Kabat-Zinn and colleagues championing mindfulness meditation. The official TM Web site gives a bibliography of more than six hundred scientific publications. But out of seven Cochrane reviews on meditation and biofeedback, none found sufficient evidence to recommend any meditation practice. An NCCAM-commissioned systematic review by the Agency for Healthcare and Research Quality (AHRQ) made an exhaustive search of meditation studies, evaluating separately the state of research for each technique (mantra meditation, mindfulness meditation, yoga, t’ai chi, and qigong) separately. The AHRQ characterized the 813 meditation studies as “predominantly poor-quality studies.” Previous meta-analyses that found

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reduced blood pressure or other benefits from TM, qigong, and Zen Buddhist meditation were “based on low-quality studies and small numbers” of subjects. Overall, the AHRQ determined that scientific research on meditation “is characterized by poor methodological quality.” Consequently, “firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results.” Nevertheless, lay readers can be expected to pay more attention to the number of studies reporting benefits than to the quality of those studies.5 A second potential source of prejudice is known as publication bias or the file-drawer effect. Researchers are more likely to publish positive results, while tucking away null results in their file cabinets. Although this is a concern in every research field, the problem is accentuated in fields in which many researchers want to show positive effects. Reiki researcher Mike Cantwell admits to “conducting clinical research in the hope of convincing insurance companies that complementary care is viable and will save them money.” The American Holistic Nurses Association claims that “there are numerous studies that support the efficacy of Reiki” but cites just two. The first, a review article by Anne Vitale (2007), calls for further research to “establish evidence,” given substantial problems with the few studies published. The second study cited, by Nancy Garrison (2005), is a doctoral dissertation completed at Holos University, a distance-learning school that, according to its Web site, specializes in “holistic mysticism, spiritual direction, counseling intuition, transformational psychology and integrative healthcare.” The school’s only accreditation is from the New Thought Accreditation Commission, a group “dedicated to global growth of New Thought philosophy.” The “Center for Reiki Research Including Reiki in Hospitals” (emphasis in original) exists for the purpose of making a scientific case for the credibility of Reiki. The center’s Web site lists Reiki studies and concludes that the “strongest evidence that Reiki has a demonstrable biological effect comes from the carefully controlled studies on rats by Baldwin and colleagues (2006, 2008).” One of these studies enrolled a total of three rats; the same rats were first given real Reiki, then sham Reiki. The other study enrolled sixteen rats, of which four received real Reiki, four had sham Reiki, and eight were controls. Positive effects were shown in a total of seven rats between the two studies. This is the “strongest evidence” of Reiki’s biological effects. It seems plausible that other studies would fail to find the same effects (in rats, let alone humans); it is even possible that other studies did fail to find positive effects, but these results were not published. A 2013 NIH summary of clinical trials of Reiki lists six completed studies (for

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stress, prostate cancer, fibromyalgia, AIDS, and neuropathy [two]), none of which lists resultant publications.6 Related to publication bias is citation bias, also known as sampling bias. The problem is that researchers—intentionally or unintentionally—may selectively refer to only those studies finding positive effects, while remaining silent about studies that fail to show an effect or indicate that a control group did better. The World Health Organization (WHO) issued a report on acupuncture in 2002. The report was drafted and revised by a prominent acupuncture supporter, Zhu-Fan Xie, honorary director of the Institute of Integrated Medicines in Beijing; U.S. medical acupuncture proponent Joseph Helms consulted. The report lists twenty-seven “diseases, symptoms or conditions for which acupuncture has been proved—through controlled trials—to be an effective treatment” and sixty-three “diseases, symptoms or conditions for which the therapeutic effect of acupuncture has been shown but for which further proof is needed.” The report concludes that “some of these studies have provided incontrovertible scientific evidence that acupuncture is more successful than placebo treatments in certain conditions. For example, the proportion of chronic pain relieved by acupuncture is generally in the range 55–85 percent, which compares favourably with that of potent drugs (morphine helps in 70 percent of cases) and far outweighs the placebo effect (30–35 percent).” (Confusingly, comparing proportion of pain relieved with percentage of cases in which patients claim improvement appears to treat two separate measures as if they are equivalent.) The WHO report uses strong language to endorse acupuncture: it is “proved . . . to be an effective treatment,” and there is “incontrovertible scientific evidence.” Such claims are striking given that scientists are usually very conservative in using terms such as “proved” and “incontrovertible,” since additional evidence may disprove apparent effects. In reaching its verdict, the WHO commission systematically excluded studies with negative results. This is because in many published placebo-controlled trials, sham acupuncture was carried out by needling at incorrect, theoretically irrelevant sites. Such a control really only offers information about the most effective sites of needling, not about the specific effects of acupuncture. Positive results from such trials, which revealed that genuine acupuncture is superior to sham acupuncture with statistical significance, provide evidence showing the effectiveness of acupuncture treatment. On the other hand, negative results from such trials, in which both the genuine and sham acupuncture showed considerable therapeutic effects with no significant difference between them, can hardly be taken as evidence

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negating the effectiveness of acupuncture. In the latter case, especially in treatment of pain, most authors could only draw the conclusion that additional control studies were needed. Therefore, these reports are generally not included in this review. This is an extraordinary admission of intentional citation bias. Given the foreordained conclusion that acupuncture is beneficial, the WHO report justifies excluding from its statistical analysis studies finding that genuine acupuncture is no more effective than sham acupuncture.7 A problem with omitting unwanted data is that it skews statistical results. In conducting systematic reviews—such as Cochrane reviews or the WHO report—researchers use statistical analysis to assess efficacy. For any experimental treatment, a certain number of studies can be expected to show effectiveness as a random fluke in the data even if there is no effect. Researchers conclude that treatments are effective when effects are so strong and frequently observed—even when including studies with negative results—that it is unlikely that findings are a result of chance. The question for meta-analytic reviews is not whether there is any study that reports effects but whether a large enough proportion of studies reveal a consistent effect. When studies showing no effects are left out of meta-analyses for whatever reason, it tends to make treatments appear more effective than they are. In order to evaluate consistency of effects, researchers perform replication studies, preferably including duplication of results by independent researchers. In the case of homeopathy, studies reporting positive effects have been published in well-respected medical journals. But these studies have generally not been replicated. Fritz Donner, one of the German physicians commissioned by the Third Reich in the 1930s to demonstrate homeopathy’s benefits, revealed in 1966 that the Nazi experiments had not been properly placebocontrolled, since subjects were told when they were given a placebo. When Donner blinded placebo recipients, effects disappeared. In 1991, the German pharmacologist Wolfgang Hopff failed to replicate Hahnemann’s original experiment with cinchona bark.8 One of the most dramatic failures to replicate followed the 1988 publication of a paper claiming remarkable effects for homeopathy in the flagship journal Nature. The paper, published by Jacques Benveniste’s lab in France, reported that very dilute, succussed (i.e., vigorously shaken) solutions of antibodies produced an allergic response in human blood cells. Since the solutions were so dilute (1 x 102 to 1 x 10120) that it was unlikely that any of the original molecules were present, the authors proposed that “transmission of

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the biological information could be related to the molecular organization of water,” a theory dubbed the “memory of water.” Nature’s editors appended a cautionary note: Readers of this article may share the incredulity of the many referees who have commented on several versions of it during the past several months. The essence of the result is that an aqueous solution of an antibody retains its ability to evoke a biological response even when diluted to such an extent that there is a negligible chance of there being a single molecule in any sample. There is no physical basis for such an activity. With the kind collaboration of Professor Benveniste, Nature has therefore arranged for independent investigators to observe repetitions of the experiments. A report of this investigation will appear shortly. Nature did dispatch a team of investigators (made up of Nature’s editor-inchief John Maddox, professional magician James Randi, and scientific fraud investigator Walter Stewart), who found that the studies were “ill-controlled” and failed to exclude “systematic error, including observer bias,” leading to the verdict that “the claims made by Davenas et al. are not to be believed.” The researcher who performed much of the work for the experiment, Elisabeth Davenas, subjectively evaluated which blood cells exhibited a reaction. In the original experiments, Davenas was not blinded regarding which test tubes contained the homeopathic dilutions and which were pure water. When investigators implemented blinding, the effects disappeared.9 The Nature paper inspired numerous studies, most of which also failed to replicate. A systematic review of 120 related papers concluded that “where a research team has set out to replicate the work of another, either the results were negative or the methodology was questionable.” Another systematic review found that most studies finding “memory of water” effects were of “low quality,” and the experiments were “performed with inadequate controls or had other serious flaws that prevented any meaningful conclusion.” In 2002, the BBC television program Horizon broadcast its own replication attempt. Statistician Martin Bland analyzed the results, summarizing that “there’s absolutely no evidence at all to say that there is any difference” between the homeopathic and pure water solutions.10 None of this deterred Benveniste, who proclaimed the revolutionary nature of his discoveries until his death in 2004. In 1997, he founded a company, DigiBio, to plug the idea that memory of water can be digitized and transmitted by e-mail to affect remote water samples. The DigiBio Web site boasts that

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from the first high dilution experiments in 1984 to the present, thousands of experiments have been made, enriching and considerably consolidating our initial knowledge. Up to now, we must observe that not a single flaw has been discovered in these experiments and that no valid counter-experiments have ever been proposed. . . . The probability that we are in the presence of an artifact and that our work has been erroneous for the past 15 years is diminishing day by day, and we are more and more convinced that we have brought to light a phenomenon essential to biology and to life. The U.S. Defense Advanced Research Projects Agency was sufficiently intrigued that it funded an effort to test DigiBio’s claims; the investigators reported in 2006 that “our team found no replicable effects from digital signals.”11 Researchers in the 1990s and 2000s published hundreds of replication studies for both classical and digital homeopathy. The Lancet published a systematic review in 1997 that found homeopathic remedies superior to placebos. But a follow-up paper by the same authors in 1999 qualified the original verdict by noting that “studies with better methodological quality tended to yield less positive results. . . . It seems, therefore, likely that our meta-analysis at least over-estimated the effects of homeopathic treatments.” A systematic review of eleven previous systematic reviews concluded in 2002 that “collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. . . . The best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.” A 2003 review found “a lack of conclusive evidence on the effectiveness of homeopathy,” so it “should not be substituted for proven therapies.” A 2005 Lancet review of 220 studies allowed that “there is indeed a positive effect for homeopathy, but it is very small and entirely compatible with the treatment being a placebo.” Cochrane reviews of homeopathy for attention deficit/hyperactivity disorder (ADHD), dementia, asthma, influenza, induction of labor, and hot flashes all found insufficient evidence to recommend homeopathy. Even the generally pro-CAM NCCAM admits that there is “little evidence to support homeopathy as an effective treatment for any specific condition” and that its “key concepts are not consistent with the current understanding of science.” Judged by the replication standard, homeopathy—one of the most-researched CAM therapies—has not been shown to produce replicable effects.12 An apparent exception to the lack of scientific evidence for homeopathy is “Zincum 3x.” A 2011 Cochrane review concludes that zinc “reduces the

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duration and severity of the common cold.” Zinc lozenges are marketed by conventional pharmacies—Walmart sells a generic “Equate” version—as an “All-Natural Homeopathic” remedy. Although the lozenges are 99.8 percent sugar, they include enough ionic zinc—13.3 milligrams—to provide a therapeutic dose. Calling the lozenges homeopathic boosts sales, given popular fascination with homeopathy, and implies that other products that share the homeopathic label—whether or not they include enough of a clinically validated substance to produce any effect—are also therapeutic (see figure 5.1).13

Patterns in Presenting CAM Research Given a lack of scientific support for many CAM therapies, promoters developed strategies for presenting research in the best possible light. For addressing popular audiences, scientific-sounding language may be sufficient to communicate that CAM is scientific. Homeopathy product labels look a lot like allopathic medicine labels. Each lists symptoms or conditions for which the remedy should be taken, specifies dosages that vary depending on age, and provides instructions for how and when to administer, including whether it should be with food. A sign prominently posted in the Boulder, Colorado, flagship of the Pharmaca Integrative Pharmacy chain describes homeopathy as a “non-toxic system of medicine” that is “practiced by licensed physicians and other qualified prescribers,” such as Pharmaca’s “certified” staff of “credentialed” pharmacists, naturopathic “doctors,” nutritionists, and herbalists who base prescriptions on two hundred years of “research studies known as ‘provings’ as well as documented clinical cases and recent scientific trials.” Rather than explain homeopathy’s vitalistic premises, the sign narrowly defines the “law of similars” as a medical concept that “since exposure to a substance can cause specific symptoms in a healthy person, the substance, when correctly prepared as a homeopathic remedy, can stimulate the body’s curative powers to overcome similar symptoms during illness.” Alternative Healing: The Complete A-Z Guide to Over 160 Different Alternative Therapies (1993) uses multisyllable words to describe the “law of infinitesimals” as “infinitesimal breakdown of the active ingredients, permitting ready diffusion and assimilation, thereby enhancing their therapeutic effectiveness.” So rendered, homeopathy is like allopathic medicine because it is based on scientific research but unlike allopathic medicine because it is nontoxic.14 In conjecturing how homeopathy might work, the language of quantum physics blurs the distinction between physics and metaphysics. A Nurse’s Handbook of Alternative & Complementary Therapies (2003) suggests that the “active ingredient leaves an electromagnetic ‘imprint’ in the water molecules”

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figure 5.1 Homeopathic zinc lozenges for sale at Walmart, 2012, (a) front, (b) back. (Photographs by author)

that can be detected by magnetic resonance imaging (MRI). Jeanette Winterson (a novelist, whose official biography does not mention scientific training) uses the mystique of quantum physics to argue that “recent discoveries in the world of the very small point to a whole new set of rules for the behaviour of nanoquantities. . . . Splitting the atom allowed inconceivable amounts of energy to be released. . . . In water, nano particles can remain suspended, neither floating nor sinking, but permeating the solution. Such particles are also able to pass through cell walls, and they can cause biochemical change.” A “Graphic

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Representation of the Workings of Homeopathy” (2006) follows “the lead of quantum physics” to “develop a scientific underpinning of homeopathy.” In this model, “the Vital Force of a patient is represented as a synchronous sine wave; miasmatic contagions [i.e., blocks to health] are similarly represented, and the intersections and relative influences of the two waves upon each other provide a graphical illustration of the disease state.” The authors present the metaphysical concepts of vital force and miasmatic contagions as science by plotting them on a graph.15 Popular descriptions of CAM capitalize on fascination with, and fears of, scientific medicine. Aromatherapy—an industry that grossed $300 million in 1998—is denoted as scientific by telling an empirical origins story. The French chemist Rene-Maurice Gattefosse coined the term aromatherapy in 1937, after allegedly discovering the healing properties of oil of lavender when he plunged his burned hand into a nearby beaker. A handbook on Aromatherapy (1991) vaunts the “medicinal use of natural plant compounds, exactly as do the conventional medicines,” but without the side effects of synthetic drugs. The text alludes to findings “from chemical analysis and from chromatography” that indicate the oils’ “therapeutic and olfactory qualities,” although the book does not specify what this research demonstrates. Cochrane reviews of aromatherapy for dementia and labor pains reached no “firm conclusions” or found “no difference” between experimental and control groups. A manual on Aromatherapy for Health Professionals (2007) describes how essential oils are absorbed into the skin through massage, inhalation, baths, steamers, compresses, creams, and lotions, while leaving unanswered the question of why oils might be beneficial. The term essential confers scientific legitimacy by implying that oils carry nutrients essential to life, much like essential vitamins and minerals, although the FDA has not confirmed that essential oils have nutritional value (see figure 5.2). Simultaneously, the label essential evokes an ancient, less dangerous world. Promoters trace “pure essential oils” to the “Ancient Egyptians,” Romans, and Greeks. Playing on fears generated by modern epidemics, The Practice of Aromatherapy (1990) alleges that Hippocrates stemmed the spread of plague in Athens by fumigating the city with aromatic essences but says nothing about the empirically demonstrated effectiveness of vaccines. Instead, the text exploits popular associations between contamination by disease-causing organisms and contamination by “toxic” chemicals of conventional medicines.16 Advocates for CAM sometimes make claims of scientific validation that exceed the evidence. Therapeutic Touch is reputedly based on “research findings,” showing improved hemoglobin levels, pain reduction, accelerated healing, and faster growth of plants after using one’s hands to redirect energy fields. Critics challenged the methodology of these studies for small, uneven

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figure 5.2 “100% guaranteed pure therapeutic grade essential oils” in Whole Foods aromatherapy section, 2011. (Photograph by author)

sample sizes; self-selection of subjects; the sole, undefined inclusion criteria that subjects be “self-actualized”; failure to account for intervening variables or differences between study groups; and improper use of the t-test statistic. An experiment designed by a nine-year-old science-fair entrant and published in the flagship Journal of the American Medical Association in 1998 concluded that Therapeutic Touch practitioners were no more accurate than chance in detecting the presence of a human energy field. Even Therapeutic Touch proponent Thérèse Meehan admits that replication studies found “no significant relationship” with hemoglobin levels and that patients may report improvements as a result of “implicit and explicit . . . suggestion by the nurse administering the intervention.” A study of dementia patients indicated no significant difference for real versus placebo treatments, although both groups exhibited less disruptive behavior than patients receiving no treatment, possibly because the experimental groups benefited from heightened interaction with caregivers. A systematic review summarized that out of eleven controlled studies of Therapeutic Touch, seven reported positive outcomes, three found no effect, and in one study the control group performed better.17 Therapeutic Touch is presented as a medical practice backed by scientific research by putting a positive spin on relatively weak results. One study

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claiming that Therapeutic Touch reduces the number of suppressor T cells (reflecting improved immune-system function) among the bereaved had a subject pool of four patients and two nurses; the study did not specify how much time elapsed between pre- and posttreatment evaluation, nor did it discuss possible intervening variables during the two-week study period, raising questions about the cause of observed improvements. The NCCAM notes the positive findings of “many small studies . . . in a wide variety of conditions, including wound healing [i.e., Wirth], osteoarthritis, migraine headaches, and anxiety in burn patients.” The one cited study by Daniel Wirth—a lawyer without a research degree, employed by an entity, Healing Sciences International, that markets energy medicine—appeared in Subtle Energies, a journal published by an advocacy group, the International Society for the Study of Subtle Energies and Energy Medicine. Wirth subsequently published (in a different journal) a replication study in which he found that subjects receiving Therapeutic Touch recovered more slowly than did those in the control group.18 When studies fail to show positive effects, supporters may redefine the purpose of an intervention or reject the value of scientific study. A textbook on The Theory and Practice of Therapeutic Touch (2001) maintains that even if the practice does not “help sick people recover,” it is beneficial for “comfort, relaxation, and sense of wellbeing and acceptance.” When nurse Janet Quinn failed to demonstrate that coronary patients did better with real Therapeutic Touch than they did with a sham version, she finessed the findings by rejecting the adequacy of scientific standards of evaluation, since “Therapeutic Touch continues to be experienced clinically as a uniquely rich and powerful mode of helping/healing. . . . There is a need to be cautious and sensitive in conducting this scientific study lest, like the butterfly that is pinned down for closer inspection, the phenomenon is destroyed in the attempt to understand it.” Quinn does not specify how empirical study might destroy a practice marketed as energy medicine.19 In discussing the state of CAM research, advocates often imply, rather than directly claim, efficacy. This may be done through bullet-point lists of conditions for which a treatment is commonly used or that might potentially be improved by a treatment. The NCCAM specifies that “Reiki has been used by people with anxiety, chronic pain, HIV/AIDS, and other health conditions, as well as by people recovering from surgery or experiencing side effects from cancer treatments.” The inference is that patients would not use therapies for particular conditions unless they were experiencing benefits.20 Another way to imply efficacy is through lists of in-progress studies and potential benefits. The National Cancer Institute Web site glosses the question of efficacy by noting that yoga is “being studied as a way to relieve stress and

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treat sleep problems in cancer patients.” Presumably, researchers would not be conducting studies if there were not already some evidence for yoga. There is, ostensibly, not more evidence because “additional research is needed.” In a 2008 fact sheet on “Yoga for Health,” the NCCAM provides a bullet-point list, headed “Research suggests that yoga might” [emphasis added]: Improve mood and sense of well-being Counteract stress Reduce heart rate and blood pressure Increase lung capacity Improve muscle relaxation and body composition Help with conditions such as anxiety, depression, and insomnia Improve overall physical fitness, strength, and flexibility Positively affect levels of certain brain or blood chemicals Although hinting that yoga has been shown to produce the enumerated benefits, the NCCAM concedes that “more well-designed studies are needed before definitive conclusions can be drawn about yoga’s use for specific health conditions.” Since additional research may potentially confirm a therapy’s benefits (although more research may instead falsify apparent effects), the implication is that further research will likely support yoga. A 2012 revision of the fact sheet—updated in light of completed studies—strikes a more moderate tone, adding a parenthetical note that “other forms of regular exercise” may produce the same benefits as yoga, “some research suggests yoga may not improve asthma,” and arthritis studies are “inconclusive.”21 Those wishing to authenticate CAM imply a biological basis by describing anatomical structures and physiological processes purportedly affected. The NCCAM proposes that meditation “might work” by “reducing activity in the sympathetic nervous system and increasing activity in the parasympathetic nervous system,” which together control heartbeat, sweating, breathing, and digestion; the NCCAM adds plausibility by detailing that the sympathetic nervous system causes the “fight-or-flight response” in which “heart rate and breathing go up,” “blood vessels narrow,” and “muscles tighten,” whereas the parasympathetic nervous system causes the opposite “rest and digest” responses. Other promotional materials include names of chemicals, such as endorphins and cortisol, that may be mobilized.22 Clinical-sounding descriptions of procedures, including quantification of distances at which treatments are given and durations and frequency, connote medical value. The NCCAM provides a detailed description of how Reiki is administered: “The client lies down or sits comfortably, fully clothed. The

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practitioner’s hands are placed lightly on or just above the client’s body, palms down, using a series of 12 to 15 different hand positions. Each position is held for about 2 to 5 minutes, or until the practitioner feels that the flow of energy— experienced as sensations such as heat or tingling in the hands—has slowed or stopped. The number of sessions depends on the health needs of the client. Typically, the practitioner delivers at least four sessions of 30 to 90 minutes each.” So described, Reiki sounds like other medical procedures. Similarly, a Nurse’s Handbook specifies that the “charge” of a psychically “programmed” crystal lasts “up to 28 days.” Crystals influence the “etheric layer, located 2” to 4” (5 to 10 cm) from the body and just outside our visual range.” Exact numerical values—with the added precision of metric equivalents—imply that forces that can be measured and quantified are real. The handbook adds the detail that “healthy chakras” spin in a clockwise direction in the northern hemisphere but counterclockwise south of the equator. By implication, subtle energy behaves in predictable ways that correspond with behavior of known physical forces, in this case the Coriolis force. (In point of fact, cyclones spin clockwise in the southern hemisphere and counterclockwise in the northern hemisphere. Drain water does not, contrary to myth, exhibit this effect.)23 Proponents sometimes claim that CAM should be offered to patients based on health benefits not unique to CAM. Authors may, as a first step, show a correlation between emotional states and health; the next step is to demonstrate that people who receive CAM report improved emotional states; this justifies the conclusion that CAM should be used because it may enhance health via the emotions. The NCCAM observes that people use meditation for “Anxiety, Pain, Depression, Mood and self-esteem problems, Stress, Insomnia, Physical or emotional symptoms that may be associated with chronic illnesses and their treatment, such as: Cardiovascular (heart) disease, HIV/AIDS, Cancer.” If emotions affect chronic illnesses, it follows that treatments that act on the emotions affect health. In one study of t’ai chi, researchers administered a health survey to thirty college students. Subjects self-reported better physical and mental health after participating in a three-month t’ai chi program; there was no control group, blinding, or randomization. Higher posttest survey scores may reflect expectation that t’ai chi would improve health, especially since all subjects were enrolled in a university course on “Tai Chi—A Philosophy for Health and a Therapeutic Exercise,” and most were graduate students preparing for careers in physical therapy. The authors recommend that “colleges/universities might consider offering Tai Chi as a component of their ongoing physical activity programs available to students,” a far-reaching conclusion, given that the study did not show t’ai chi to be any more beneficial to physical and mental health than other activities.24

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A similar line of reasoning begins with the observation that relaxation and exercise promote health; CAM provides relaxation and exercise; therefore, CAM should be integrated into patient care. The Mayo Clinic’s Dr. Amit Sood marvels at the “literal rewiring of the brain by our recurring thought patterns and experiences.” Since meditation turns thought patterns in a more relaxed direction, Sood reasons that people should meditate. Yet meditation is not unique in its potential to train the brain; comparable effects are reported in studies of adult learning, prayer, exercise, music, and even eating a nutritious meal. There are many ways besides CAM in which people can experience positive emotions, relaxation, and exercise.25 Notably few studies use control groups to compare CAM with nonmetaphysical practices that provide similar emotional, relaxation, and exercise content. A study of carpal tunnel syndrome published in JAMA compared patients who added yoga to their medical regimens with those who received standard medical treatment and found that yoga patients fared better. But the study did not ask whether yoga is more effective than other forms of relaxation or exercise. Controlled studies of t’ai chi typically compare an experimental group that practices t’ai chi with a control group that either receives health education or does not engage in any form of exercise. An NIH-funded study found that older Americans who took t’ai chi lessons demonstrated more immune resistance to shingles than those given health counseling. A study of chronic heart failure compared patients who did t’ai chi with those who did not exercise at all and found that t’ai chi positively affected quality of life and exercise capacity; the authors conceded that “in patients with comparable disease severity, similar changes in exercise tolerance have been seen with conventional [exercise] training.” Such studies corroborate the value of physical exercise, which has long been established in conventional medical literature.26 Systematic reviews do not indicate that t’ai chi is better than other forms of exercise. A 2004 systematic review of forty-seven studies of patients with chronic conditions did not find sufficient evidence to conclude that t’ai chi produces more benefits than other exercise. A 2008 review article reported that “tai chi exercise may reduce BP [blood pressure]” but also found that some studies showing positive effects from t’ai chi indicated “no difference when compared with conventional exercise.” The only Cochrane review specific to t’ai chi, on rheumatoid arthritis, found in 2004 that “the studies were not high quality” and t’ai chi had “no clinically important or statistically significant effect on most outcomes of disease activity.” One of the four studies analyzed compared t’ai chi with participation in “traditional ROM exercise/ rest programs” and found that t’ai chi subjects had improved range of motion and “reported a significantly higher level of participation in and enjoyment of

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exercise”; in two studies that used no-exercise control groups, “people’s ability to do daily chores, the tenderness in their joints, the number of swollen joints they had and the strength of their grip [were] about the same whether they did Tai Chi or not,” but one-third of t’ai chi subjects complained of soreness. A 2009 Cochrane review of “Interventions for Preventing Falls in Older People” concluded that “exercising in supervised groups, participating in Tai Chi, and carrying out individually prescribed exercise programs at home are all effective.” Such evidence does not demonstrate the superiority of one form of exercise over another.27 Endorsements of CAM over other exercise blur medical and metaphysical rationales. T’ai chi is widely vaunted as a form of exercise that is so “gentle” and “balancing” that it seems especially well suited to the elderly. The Mayo Clinic includes t’ai chi on its “Top 10” list of best alternatives because it promotes “stress reduction, greater balance and increased flexibility—especially for older adults,” using movements that are so “gentle, it has virtually no negative side effects.” The word gentle conveys that risk of injury is minimal. The word balance bridges physiological and philosophical concepts. The vestibular system regulates the body’s sense of balance, preventing falls among the elderly. T’ai chi, according to the NCCAM, maintains a “healthy balance of yin and yang, thereby aiding the flow of qi.” The statement hints that energetic balance aids physical balance. A 2004 review of vestibulopathic postural control studies describes t’ai chi as a technique to “‘balance the flow of ch’i (life force).” The authors suggest that t’ai chi may benefit elderly patients with balance impairments because the “concept of balance is at the heart of the yin-yang, or tai chi symbol.” Although the review found “few data” to “support the contention that Tai Chi specifically targets the impairments, functional limitations, disability, and QOL [quality of life] associated with peripheral vestibulopathy,” the authors assert that there are “compelling reasons to further investigate Tai Chi”—reasons that appear to have less to do with scientific data than with yin-yang philosophy.28

The Evidence for CAM There is scientific evidence that certain practices labeled as CAM benefit health. The clearest case is for eating a healthier diet (coupled with physical exercise). Studies show correlations between diet and obesity and between obesity and serious disease, including cancer, heart disease, and diabetes. The WHO has declared obesity a “global epidemic.” In the United States, two of three adults and one of three children are overweight. The growing problem of obesity has been correlated with increased consumption of

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animal and processed foods and decreased consumption of whole grains and produce. U.S. Department of Agriculture surveys conducted between 1910 and 1976 indicate dramatic dietary shifts in per capita consumption of plant and animal foods. For instance, consumption of beef rose 72 percent, poultry 194 percent, and cheese 322 percent, while consumption of fresh vegetables fell 23 percent, wheat 48 percent, and legumes 46 percent. Total per capita annual meat consumption increased from 120 pounds in the early 1900s to 222 pounds in 2007, and total per capita annual dairy consumption rose from 294 pounds in 1909 to 605 pounds in 2006. The National Academy of Sciences issued a report on Diet, Nutrition, and Cancer (1982) that called for reduced consumption of fat and increased consumption of whole grains, vegetables, and fruit. T. Colin Campbell and Thomas M. Campbell’s best-seller, The China Study: Startling Implications for Diet, Weight Loss and Long-term Health (2006), argues that animal foods are problematic not only because of their high fat content but also because animal proteins (but not plant proteins) feed cancer growth. Consumption of dairy foods increases production of a hormone, insulin-like growth factor, linked with breast and prostate cancers. The Physicians Committee for Responsible Medicine proposed in 1992 the “New Four Food Groups”: whole grains, vegetables, fruits, and legumes. Conventional medical backers of a whole-food, plant-based diet were featured in a 2011 documentary film, Forks over Knives, whose title implies a choice between healthy eating and the need for surgical intervention.29 Conventional dietary recommendations have shifted from touting the nutritional density of meat and dairy toward emphasizing benefits of unprocessed plant foods. The Academy of Nutrition and Dietetics conducted a review of the medical literature in 2009, concluding that “vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases”; in particular, “vegetarians tend to have a lower body mass index and lower overall cancer rates.” The American Cancer Society (ACS) estimates that roughly one-third of cancer deaths result from poor nutrition and physical inactivity. An ACS report issued in 2012 advises a “mostly plant-based diet that limits red and processed meats and emphasizes a variety of vegetables, fruits, and whole grains.” The ACS defends “properly planned” macrobiotic diets but warns that “eating only brown rice and water has been linked to severe nutritional deficiencies and even death.” The ACS likewise confirms that “some ideas put forth as part of the Gerson regimen, such as eating large amounts of fruits and vegetables and limiting fat intake, can be part of a healthy diet if not taken to the extreme” but warns that coffee enemas and liver extracts pose

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serious risks. The ACS emphasizes the lack of medical evidence that macrobiotic or Gerson regimens prevent or cure cancer.30 There is evidence for the value of certain nutritional supplements. Lest one suspect that Cochrane reviews inevitably fail to find sufficient evidence to recommend any therapy, Cochrane reviews conclude that cranberries prevent urinary tract infections and Saint-John’s-wort reduces depression. Individual studies report that omega-3 oils improve cardiovascular health, flaxseed and curcumin (active ingredient in turmeric) inhibit cancer growth, and fish oil helps cancer patients maintain weight. By contrast, studies show that antioxidants, selenium, and thyroid either do not reduce cancer risk or cause side effects such as severe bleeding.31 There is limited medical evidence favoring physical manipulations such as massage or chiropractic. A 2008 Cochrane review of massage for low-back pain concluded that “massage might be beneficial for patients with subacute and chronic non-specific low-back pain, especially when combined with exercises and education,” but “more studies are needed.” A systematic review of systematic reviews of chiropractic published in 2006 evaluated spinal manipulation for back and neck pain, headache, nonspinal pain, dysmenorrhea, infantile colic, asthma, allergy, and dizziness. The review found that “collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition.” In the case of back pain, “spinal manipulation was considered superior to sham manipulation but not better than conventional treatments. . . . Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.” A 2010 Cochrane review assessed combinations of spinal adjustments with massage, exercise, and nutritional advice in treating low-back pain. The review indicated that “while combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute and subacute low-back pain, there is currently no evidence to support or refute that combined chiropractic interventions provide a clinically meaningful advantage over other treatments for pain or disability in people with low-back pain. Any demonstrated differences were small and were only seen in studies with high risk of bias.” A 2011 Cochrane review did not find spinal manipulation to be more effective than other treatments for chronic low-back pain. Cochrane reviews for dysmenorrhea, carpal tunnel syndrome, asthma, and nocturnal enuresis (bedwetting) found insufficient evidence to endorse spinal manipulation. In sum, massage and chiropractic may offer relief from back pain, but there is insufficient evidence to conclude that these CAM approaches are effective for other conditions or even that they are more effective than other therapeutic options for back pain.32

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The Safety of CAM By definition, CAM treatments lack sufficient conventional scientific evidence of efficacy and/or safety to be included in standard treatment protocols. But from the perspective of patients in pain or diagnosed with serious diseases such as cancer that conventional medicine may not be able to cure, CAM offers hope. As long as CAM has not been conclusively disproven to provide benefits, the possibility remains that CAM may work and eventually prove conventional authorities wrong. Federal regulations prohibit U.S. doctors from prescribing certain CAM therapies—including Cancell, Essiac, and Laetrile—as cancer treatments. But in a free market, consumers can purchase even questionable products.33 Since patients do use CAM, physicians and government agencies classify CAM options as those that might be reasonably recommended, accepted, or discouraged. The Annals of Internal Medicine, with the NCCAM, published a guide for clinicians in 2002. Recommended treatments include exercise, acupuncture and massage for symptom relief, and vitamin E for latent prostate cancer. Among acceptable approaches are reduced-fat and macrobiotic diets, soy for prostate cancer, vitamin E, shark cartilage, mind-body therapies, acupuncture, and massage. The guide discourages high-dose vitamin A or C; restrictive diets; anticoagulant supplements, acupuncture, or forceful massage if there is bleeding; antioxidants and Saint-John’s-wort concurrent with chemotherapy or radiation; and Essiac, ginseng, macrobiotics, or supplements high in phytoestrogens for breast cancer. The FDA Web site lists “187 Fake Cancer ‘Cures’ Consumers Should Avoid,” including Essiac, Protocel/ Cantron, shark cartilage, and flaxseed oil.34 Conventional medical assessments of CAM anticancer therapies range from unproven to implausible to dangerous. Shark cartilage has not been shown to fight cancer, but the NCCAM deems it acceptable because “adverse effects generally seem to be minor.” The NCI determined Cancell/Cantron/ Protocel to be “a mixture of common chemicals, none of which is known to be effective in treating any type of cancer.” Although mistletoe/Iscador is commonly prescribed in Germany and France, the NCI and the ACS do not recommend it. A 2008 Cochrane review found evidence for mistletoe to be “weak,” allowing that it “may offer benefits on measures of QOL [quality of life].” Electronically charged foot baths—marketed under names such as Aqua Detox—purportedly “detoxify” cancer patients, evidenced by turning the water brown or orange. British psychiatrist Ben Goldacre, author of the best-seller Bad Science (2008), explains the color change as a “simple electrochemical reaction which rusts the iron contacts on the side of the footbath.”

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When Goldacre tested water from an Aqua Detox treatment, it turned brown, and the iron content increased by a factor of fifty, but the posttreatment water did not contain any identifiable toxins. Goldacre next gave a Barbie doll a foot bath; Barbie must have needed detox, since she, too, turned the water brown.35 Certain CAM therapies generate not scorn but alarm among conventional doctors. Concerns are twofold: first, that patients will refuse or delay conventional treatments while pursuing ineffective therapies, sometimes waiting so long that otherwise treatable conditions result in death; second, that CAM treatments may be not just ineffective but harmful. Essiac/Flor Essence has been so popular among consumers that the FDA, the ACS, the NCI, Canadian medical authorities, and the Memorial Sloan-Kettering Cancer Center have all evaluated it, without finding evidence of efficacy; conversely, studies show that Essiac accelerates cancer growth (see figure 5.3). Laetrile, the trade name for a synthetic substance similar to amygdalin in apricot pits, was assessed by the ACS, the NCI, the California Cancer Commission, and a Cochrane review, none of which found benefits. Mild to severe side effects include nausea, vomiting, headaches, dizziness, and death from cyanide poisoning. Clinical studies of coffee enemas and colonic irrigation report electrolyte imbalance, dehydration, constipation, colitis

figure 5.3 Flor Essence sold alongside an array of “cleanse” treatments at Whole Foods, 2011. (Photograph by author)

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(inflammation), polymicrobial enteric septicemia (infection), rectal perforation, burns, heart failure, and death.36 Conventional doctors worry that CAM practitioners may not inform patients of risks. A 2005 survey found that only 23 percent of chiropractors always discuss serious risks with patients before treatment. Adverse effects include headache, stiffness, discomfort, fatigue, disk herniation, vertebrobasilar accidents (dissection of a vertebral artery, which may lead to stroke), and cauda equina syndrome (nerve compression, which may cause paralysis). Chiropractors are also more likely than medical doctors to administer routine X-rays, and research links X-rays with increased cancer risk.37 Yoga is widely regarded as a safe, gentle form of exercise suitable for almost any person, and possibly one’s pets. A college yoga textbook asserts that “it is rare for people to injure themselves while under the tutelage of good yoga instruction.” Internationally renowned Swami Gitananda Giri proclaims that “real yoga is as safe as mother’s milk.” Conventional medical journals, such as the British Medical Journal and JAMA, have, however, found serious injuries, including death from stroke. Although most yoga injuries are never reported, the Consumer Product Safety Commission cited seven thousand yoga-related medical visits in 2010.38 Although many instructors tout yoga’s safety, some yoga proponents warn of physical, psychological, and spiritual risks. Swami Swatmarama, of Yoga Vidya Gurukul University, cautions that performing pranayama in hatha yoga awakens kundalini energy rapidly: “But if one is not prepared to take on this high level energy awakening then this may have negative effects on mind and body.” Swami Narayanananda is more specific about what negative effects might entail: “if a person does not know how to check the currents and to bring down the partly risen kundalini shakti to safer centers, one suffers terribly and it may ruin the whole life of a person or lead one to insanity. This is why we see many become insane, many get brain defects, and many others get some incurable diseases after deep sorrow.” In 1978, psychiatrist Stanislov Grof and his wife, Christina, founded the Spiritual Emergence Network (SEN) after Christina experienced a “Spontaneous Kundalini Awakening.” The SEN reported in 1988 that 24 percent of “spiritual emergency” phone calls it received had been occasioned by distressing kundalini experiences that resembled psychotic episodes.39 Clinical studies of TM report psychiatric hospitalization and attempted suicide, in addition to anxiety, confusion, depression, and antisocial behavior. The U.S. District Court for the District of Columbia awarded plaintiff Robert Kropinski $138,000 to pay for psychiatric treatment following eleven years of TM involvement. The case is instructive for the issues it raises, although

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the judgment was overturned on appeal. The original jury held that the TM movement “defrauded” the plaintiff with “false promises of mental bliss and neglected to warn him about the possibility of adverse side effects.” Implicitly, Kropinski might not have decided to practice TM had he been informed that it could trigger a “pathological state.” Former Maharishi University legal counsel and professor of law and economics Anthony D. DeNaro submitted an affidavit during the Kropinski trial charging that A disturbing denial or avoidance syndrome, and even outright lies and deception, are used to cover-up or sanitize the dangerous reality on campus of very serious nervous breakdowns, episodes of dangerous and bizarre behavior, suicidal and homicidal ideation, threats and attempts, psychotic episodes, crime, depression and manic behavior that often accompanied roundings (intensive group meditations with brainwashing techniques). . . . The consequences of intensive, or even regular, meditation [were] so damaging and disruptive to the nervous system, that students could not enroll in, or continue with, regular academic programs. . . . [The Maharishi] was aware, apparently for some time, of the problem . . . but his general attitude was to leave it alone or conceal it because the community would lose faith in the TM movement. DeNaro claimed, moreover, that the TM organization was “so deeply immersed in a systematic, willful pattern of fraud including tax fraud . . . designed, in part, to misrepresent the TM movement as a science (not as a cult), and fraudulently claim and obtain tax exempt status with the IRS” that he felt ethically obligated to resign from his position at the university.40 The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) has since 1994 used the diagnostic code “Religious or Spiritual Problem” to label adverse reactions to practices such as yoga and meditation. The code is intended to avoid unnecessary medication for apparently psychotic behavior when a more conservative approach is available. Jack Kornfield, a clinical psychologist who founded the Buddhist Insight Meditation Society, discusses conservative treatment options for what he describes as the “perils” of “spiritual life.” For instance, one “overzealous young karate student” spent a day and a night meditating without moving or sleeping. When he did get up, the young man had built up such “explosive energy” that he stormed into a room of one hundred silent karate retreat attendants to exhibit his karate movements “at triple speed” and yell, “When I look at each of you, I see behind you a whole trail of bodies showing your past lives.” Kornfield recognized this behavior as a side effect of excessive

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meditation. He prescribed replacing meditating with jogging ten miles morning and afternoon, frequent hot baths and showers, digging in the garden, and consumption of red meat for its “grounding effect.”41 Despite such reports, CAM’s safety is generally assumed, and providers contribute to this perception. The Nurse’s Handbook affirms that homeopathic remedies can be regarded as “safe” because the FDA regulates them, and most are sold over the counter. The cited exception is that “high-potency compounds that are intended for serious conditions must be dispensed by a licensed practitioner.” The exclusion likely reflects the FDA’s concern to discourage those diagnosed with serious diseases from replacing medical supervision with self-prescribed treatments. But it is interesting that the Nurse’s Handbook (following homeopathic convention) describes the regulated remedies as “high-potency compounds,” given that there is an inverse relationship between concentration and presumed potency. In other words, homeopaths consider the most dilute remedies to have the highest potency and to be least reliably safe. This makes sense if the “potency” referred to is spiritual rather than chemical, an interpretation supported by the Nurse’s Handbook’s observation that “homeopathic practitioners believe in a vital spiritual force.” By implication, spiritual forces may not always be safe.42 Both consumers and health-care providers have become increasingly aware of risks of natural substances such as herbs, especially when combined with prescription drugs. Acupuncturist Brian Carter acknowledges that “herbal medicine is powerful and dangerous.” One of the reasons given by Carter is that every individual has a distinctive “yin-yang constitution,” so herbs that bring one person into spiritual “balance” disrupt another person’s balance. This reasoning suggests that natural substances can be dangerous for spiritual reasons. Holistic approaches that presume the power of spiritual energy to benefit health entail concepts of risk that expand beyond known biomedical properties. Analogous to harmful drug interactions, holistic philosophy implies potential for adverse spiritual interactions. For instance, combining energies involved in yoga and pentecostal healing practices could theoretically produce unwanted side effects.43 If vital spiritual energy exists, very little is known about it. It cannot be assumed that spiritual energy is wholly benign and that its manipulation is free from risks. Evidence from evolutionary biology indicates that physical processes are often vicious rather than benevolent. It is reasonable to expect that if “spiritual” processes are real, they may behave in a manner comparable to physical processes. Biofeedback founders Elmer and Alyce Green have cautioned since the 1970s that “the physical frontiers of our planet have presented many dangers to humans; can it be safely assumed that the inner frontier

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has no corresponding perils?” Whether considered from the “traditional psychological point of view or from the parapsychological point of view, there is risk involved for students.” The Greens cite examples of commercial mindtraining programs and hypnosis leading to paranoid neuroses, psychosis, and “astral entities” apparently controlling behavior.44 Although holistic healers often proclaim the inherent safety of energy work, they do sometimes caution that directing spiritual energy may not be risk-free. Reiki master Peggy Jentoft stresses that “an underlying principle of Reiki is that it can do no harm and cannot be used for any harmful purpose.” While likewise insisting that “Reiki can never do harm,” Diane Stein concedes that “some of the things people carry and transfer in their energy work are not Reiki.” Healers who are “very ill or overloaded with problems . . . may unknowingly transfer their attachments, entities, possession, and more to you. Certainly never allow someone who is angry or enraged, or intoxicated or high on drugs, to exchange energy with you.” The “physical symptoms” of “detoxification,” subsequent to receiving Reiki, include “runny nose, frequent urination, diarrhea, skin rash, pimples, or body odor.” Anne Charlish and Angela Robertshaw admit that “sometimes, people may feel worse or experience a strong emotional reaction to the reiki treatment. This may take the form of sobbing, hysterical laughter, or overwhelming fatigue. This can be disturbing for both the receiver and the inexperienced reiki practitioner, who may feel unable to help or unsure what to do.” Increased “intuitive” sensitivity presumably increases spiritual “vulnerability.” Physical pain may become “a little worse before disappearing for good,” or “a totally unrelated pain may manifest,” or people may experience other “physical symptoms, such as colds,” during the “first 21 days after attunements.”45 Similar problems are sometimes reported for Therapeutic Touch. One nurse trained by Dolores Krieger observed that several of her colleagues, also trained by Krieger, “experienced psychotic breaks” because they failed to “focus properly.” Krieger herself warns that an emotionally upset or ill healer can “transfer negative energy” and that “indiscriminate and persistent interaction [with human energies] can overload the human system; a healee can overdose on human energies.” The potential for energy “overdose” has received little, if any, study, and providers may not inform patients that such risks have been theorized.46

Conclusion The mainstreaming of CAM is not a product of overwhelming scientific evidence of efficacy and safety. But CAM practitioners are motivated to portray CAM as benefiting health, in part because of conventional medicine’s failures,

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a topic further explored in chapter 7. The widespread acceptance of CAM has not required strong scientific support given the proliferation of studies reporting positive results and careful presentation of findings in a favorable light. Advertisers succeed in capturing a receptive market by implying, if not demonstrating, that CAM works, regardless of mechanisms. The ease with which CAM has been integrated into the health-care system is an unintended consequence of the move toward evidence-based medicine. Until recently, many medical authorities rejected CAM on two counts: lack of a plausible physical mechanism for effects and lack of empirical evidence of effects. Although the purpose of evidence-based medicine is to provide patients with clinically validated treatments, a side effect is reduced concern with mechanisms. Holistic healers need only present evidence of efficacy, while asserting vaguely that a biological mechanism exists but is poorly understood. Even slim evidence for any one approach labeled as CAM functions indirectly to authorize other approaches that share the CAM rubric. Psychologists refer to a “halo effect.” Lesser-known entities presumably share properties of better-known entities with which people associate them. If one method in a category (whether conventional or CAM therapeutics) can be validated, people infer that other methods in that category also work. In the case of CAM, scientific evidence is strongest for plant-based diets and nutritional supplements that can be shown to work through biological processes and that can be used without internalizing a metaphysical worldview. Consumers conclude that other therapies branded as CAM—even those that seem to hinge on metaphysical explanations—may be, or even most likely are, also effective. People assume that evidence of efficacy and insight into physical mechanisms may eventually be discovered once more research has been published.47 People who desire better health often use multiple strategies. This holds true even when people are convinced that one approach is more effective than others, a phenomenon that psychologists call “matching law.” Rather than abandon outright less effective options, even when using a less effective method temporarily precludes using a more effective method, people try various sources of aid roughly in proportion to perceived reward. Economists debate whether “rational choice” explains selections among alternatives. People pursuing health do not always appear to behave rationally. Emotional reactions, such as fear, panic, affection, or hope, prompt selection of lessthan-optimal choices. Desperation leads to reckless experimentation. Goaded by an urgent need for pain relief or a compelling drive for peak wellness, people sample market offerings, giving scant attention to why they should work.48

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The question of safety receives more attention from conventional doctors and regulatory agencies than from CAM practitioners. Data indicate that CAM providers do not always discuss risks with clients, even though physical, psychological, and spiritual risks have been reported. Yet patients select CAM because they perceive it to be effective and safe, perhaps more effective and safer than conventional medicine. We turn in chapter 6 to a case study of acupuncture— the CAM approach widely regarded as having the strongest scientific support— for deeper insight into the roles of medical evidence and scientific language in bringing about CAM’s mainstreaming.

6

Acupuncture Reclaiming Ancient Wisdom

the home page of ChristianAcupuncture.com describes founder Brian Carter as a “Bible-believing,” “evangelical Christian” who is also a “medical professor” at Pacific College of Oriental Medicine in California. Carter attests that he once went through a “spiritual buffet” period, a decade in which he “explored Buddhism, yoga, Taoism, Zen, and Native American spirituality (especially Lakota) . . . meditation, tai chi, chi gong, sweat lodges, spirit journeys.” He gleaned “a little of this or that tradition, taking only what I liked, whatever worked for me,” and considered “spirituality” to be “superior to religion,” which seemed “closed-minded and ignorant.” One day, however, Carter had a Christian conversion experience and renounced yoga, meditation, and martial arts as incompatible with Christianity.1 Carter no longer considers himself a spiritual eclectic, yet he still combines evangelical Christianity with acupuncture. He does this by distinguishing between everyday health needs met by acupuncture and eternal, spiritual needs met by Christianity: “Chinese medicine, to me, is a brilliant, important medicine that provides answers for many of our physical, mental, and emotional problems, but as for supernatural and eternal issues, my answers are in the Bible.” Carter sees Christianity as largely irrelevant to physical health, although as an evangelical, he affirms that “God and Christian faith come first in importance and priority. Healing and medicine come after that.” Since the Bible does not mention acupuncture, Carter seeks to “apply Biblical principles” to evaluate it. He admits, “I would like to find out it is compatible with Christianity, but I also am willing to move on if that turned out to be incorrect.” Carter says he researched the historical, religious, and scientific foundations of acupuncture for himself, and he encourages other members of

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the priesthood of all believers to do likewise by studying suggested readings listed on his Web site. At the head of this list is the reassurance that widely respected evangelical opinion shapers such as David Jeremiah, James Dobson, and Focus on the Family’s Physicians Resource Council all endorse acupuncture. (In point of fact, Jeremiah warns Christians to avoid acupuncture, since it is “based on the occultic religion of Taoism.”)2 Carter acknowledges that Chinese medicine’s developers were “Buddhists, Taoists, and Confucian[ists]” who included “spiritual views” of qi, yin, and yang in their medical theories. But “the main point about acupuncture in a Christian context is that the acupuncture points work regardless of how the acupuncturist THINKS they work.” Although “metaphysically minded” acupuncturists may “think they’re unblocking qi,” acupuncture really “works via the nervous system, immune system, and blood complement system.” Carter cites a book by Donald Kendall, The Dao of Chinese Medicine, which “answers these problems in scientific terms.” Carter incorrectly identifies Kendall as “an acupuncturist with a Ph.D. in Engineering and Physics”; Kendall has an undergraduate engineering degree from the University of Illinois and a doctor of Oriental medicine (O.M.D.) degree from the California Acupuncture College. But because Kendall convinced Carter that acupuncture works through scientific mechanisms, Carter concludes that the only potential danger faced by Christian patients would be incorporating “new age ideas into your life.” Christians should “pray for protection, stay in the Word, even ask the acupuncturist if they just needle the points medically or if they try to ‘add’ something energetically or spiritually.” Ideally, Christian patients should seek out “medically minded” or Christian acupuncturists. Carter’s Web site links to other Christian acupuncturists and gives a “Bible Verse of the Day” to keep Christians grounded “in the Word.”3 In today’s cultural milieu, there is little medical or religious controversy over acupuncture despite its foundations in qi theory. Since the 1970s, conventional doctors and Christian patients alike have welcomed acupuncture as a scientifically validated, ancient corrective to overly technological modern medicine. This occurred as sympathetic medical doctors downplayed qi theory in favor of scientific studies reporting positive results and proposed biomedical theories for how acupuncture might work. Simultaneously, the “ancientness” of acupuncture seemed to bear witness to its effectiveness, since presumably no medical system would have endured for thousands of years if it did not work. This chapter shows that acupuncture has stronger scientific backing than do many CAM approaches, but there is inadequate medical evidence to conclude that acupuncture works or that it is always safe. Rather than reflecting extraordinary effectiveness, acupuncture’s integration

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into the U.S. health-care system is a product of widespread dissatisfaction with modern medicine and reactionary longing for ancient, natural, exotic healing wisdom.

The Forgetting and Reimagining of an Ancient Healing Tradition The term acupuncture (chen-shu) is a composite of the Latin acus, translated as “needle,” and puncture, translated as “pricking.” Acupoints are “gates” that can presumably be opened and closed by inserting and manipulating needles (or applying external pressure, as in acupressure) to adjust the circulation of qi along meridians, or channels, that connect distant bodily organs. Classical acupuncture theory—founded on the assumption that the human body is a microcosm of reality—recognized 365 points (one for each day of the year) and twelve main meridians (one for each month or each of China’s great rivers). Modern acupuncturists may refer to two thousand points and twenty meridians.4 Although it is true that acupuncture has been practiced in China “for thousands of years,” as proponents frequently note, it is simplistic to conclude that acupuncture endured “because it worked.” The history of acupuncture is not one of continuity or linear advance. Histories written by those who want to portray acupuncture as “science” instead of “religion” emphasize ancient, empirical beginnings and hint that Taoist meanings were only added later and can be just as easily removed. Some scholars claim that Chinese artifacts dated to 1000 b.c.e. reveal the use of acupuncture and that remains of a fivethousand-year-old-man, “Otzi the Iceman,” discovered in Europe provide even earlier evidence of acupuncture’s geographic diffusion. Other scholars deny that there is any clear evidence that acupuncture was practiced in China before the mid-second century b.c.e. This evidence consists of four gold and five silver needles discovered in the tomb of a prince who died in 113 b.c.e.5 None of the earliest-known Chinese medical texts—fourteen of which were discovered in graves sealed in 168 b.c.e.—mentions acupuncture. One of the most important Chinese medical guides is the Huang-ti Nei-ching (c. 600 b.c.e.–1,200 c.e.), often translated as “The Yellow Emperor’s Classic of Internal Medicine.” The Nei-ching is based on a Taoist philosophy of maintaining health by living a balanced life that accords with virtues of humankind, laws of nature, and changing seasons. This classic provides theoretical foundations for concepts of qi and meridians but remains silent about acupoints for needle insertion. According to the Nei-ching, “the sky is the source of our virtue, and the earth is the source of our vital air [qi]. Virtue flows to combine

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with vital air to create life.” The Nei-ching indicates that qi theory may have predated medical experiments with needling.6 The earliest-known written reference to “needling” (chen) was found in a historical rather than a medical text. The Shih-chi (c. 90 b.c.e.) or “Records of the Historian” of Ssu-ma Ch’ien includes a single reference to needling (to resuscitate a dead prince by placing a needle in the back of his head) but does not mention acupoints, meridians, or qi. The first uses of needling are disputed. One hypothesis is that ancient peoples pricked the skin with pointed rocks to release blood, thereby expelling disease-causing spirits. Other accounts suggest roots in “observational science,” specifically the observation that soldiers wounded by arrows sometimes recovered from previous illnesses. Observers may have reasoned that recoveries had something to do with where arrows punctured the body, leading to experiments with piercing the skin intentionally to mimic effects from arrows; only later did theorists append the goal of rebalancing the flow of qi. This line of reasoning does not, however, negate early evidence of qi theory in medical texts such as the Nei-ching. Such evidence suggests that early acupuncturists who observed that needles inserted at specific points seemed to affect other parts of the body could draw upon concepts of qi and yin-yang to map out acupoint and meridian networks. Taoism supplied a theory, and empiricism a method, for gaining knowledge about the body.7 As medical knowledge developed, it came to be distinguished from religious knowledge. Between 1000 b.c.e. and 200 c.e., a self-conscious medical profession emerged. By the mid-eighteenth century, authors lamented forgetting the ancient acupuncture tradition. Between the seventeenth and the mid-twentieth centuries, Chinese officials seeking modernization evaluated acupuncture as a superstitious and irrational religious practice. The Chinese emperor banned acupuncture from the Imperial Medical Institute in 1822. The Japanese government prohibited acupuncture in 1876. With the growing acceptance of Western medicine, the Chinese government outlawed acupuncture altogether in 1929.8 For political reasons, Chinese authorities reinvented acupuncture with a newly secular face in the mid-twentieth century. After the Communist revolution of 1949, Mao Tse-tung reinstated acupuncture and other TCM practices during the Great Leap Forward (1950s) and the Cultural Revolution (1966– 1976). Nationalistic and pragmatic goals motivated this policy reversal, since the alternative was no health care at all for most people. Mao ordered the purging of Taoist references and encouraged scientific research.9 By the late twentieth century, Chinese interest in TCM again waned, in preference for Western medicine. Today, emergency medical centers

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and hospitals in China use Western biomedicine for trauma and serious disease, often reserving TCM for posttrauma recuperation and rehabilitation and treatment of minor conditions and repeated stress injuries (see figure 6.1).10

The Invention of Medical Acupuncture Even as Western medical technologies displaced acupuncture in China, Americans and other Westerners became enthralled by their discovery of this ancient medical system. A 2007 survey found that 3.1 million Americans had visited an acupuncturist in the past year, up from 2.1 million in 2002. Acupuncture accounts for an estimated 1 percent of all U.S. CAM usage but 90 percent of all visits to a CAM provider—some 9 million to 12 million visits annually, costing $500 million per year in 1993. Those undergoing treatment average forty sessions a year. Additionally, herbal medicine, much of which is based in TCM, involved 30 percent of Americans and generated $80 billion in revenues in 2009.11 Europeans learned of acupuncture as early as the thirteenth century and experimented with it off and on throughout the early-modern period.

figure 6.1 Acupuncture for migraine headaches at “Traditional Eastern Medical Hospital” in China, 2009. (Courtesy Yi Cai)

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Information came from Jesuit missionaries, traders, diplomats, and physicians who traveled to China or Japan. A sixteenth-century Jesuit missionary to China, Matteo Ricci (1552–1610), sought to convert Chinese intellectuals to Christianity by demonstrating that Christianity was not opposed to Chinese concepts of religion or medicine but was the most perfect manifestation of what the Chinese had already discovered. Today the Matteo Ricci School of Acupuncture and Chinese Medicine and the Matteo Ricci Foundation advance acupuncture instruction and research in Italy. Chinese immigrants to the United States brought knowledge of TCM with them during the California Gold Rush (1848–1855) and construction of the Transcontinental Railroad (1860s) and after the Immigration Act of 1965. Nevertheless, TCM remained largely within immigrant communities.12 While Chinese officials were backing away from acupuncture in the early nineteenth century, British and American medical journals, possibly inspired by the era’s Transcendentalist turn toward Asian religion and philosophy, published articles on acupuncture. Sir William Osler’s influential textbook, Principles and Practice of Medicine (1892), mentions acupuncture. By the early twentieth century, British and American interest in acupuncture had faded. A turning point came in 1971, when President Richard Nixon sent Henry Kissinger to China in preparation for his own visit the following year, symbolizing a new era of friendly relations. One of Kissinger’s traveling companions was New York Times reporter James Reston. During the trip, Reston underwent an emergency appendectomy at the Anti-Imperialist Hospital in Beijing and received acupuncture for postsurgery pain relief. Reston wrote about his experience in the Times and captured the American imagination. His article came at a moment in American cultural history when the holistic health-care movement was gaining momentum.13 As many Americans grew increasingly disillusioned with modern biomedicine, they were conversely fascinated by “ancient,” less technological, more “natural” medical systems. Theories of qi and yin-yang balance resonated with the life-force concepts of other ascendant CAM practices in the 1970s, and the growing popularity of such movements was mutually reinforcing. People equated ancientness with health and purity, and they equated modernity with sickness and decline. Today NCCAM brochures note that acupuncture has been “practiced in China and other Asian countries for thousands of years.” The Mayo Clinic Web site introduces acupuncture as having “originated in China thousands of years ago.” Age implies efficacy. This correlation is stated directly by Donald Kendall in Dao of Chinese Medicine: Understanding an Ancient Healing Art (2002): “Chinese medicine has survived for many centuries for

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the very reason that it has been effective in addressing a wide range of human ailments.” Peter Gilligan’s book What Is “Tai Chi”? (2010) pursues a similar line of reasoning: “The Chinese themselves have always been a very practical and empirical people. Their medicine could not have survived as long as it has without actually working.” The fact of TCM’s survival (overlooking the years during which the Chinese abandoned it) is interpreted as evidence that it must work—the only question is how.14 Explanations offered by modern acupuncturists often presuppose classical qi theory. The Acupuncture and Oriental Medicine Alliance Web site describes qi as the “vital energy behind all life forms and life processes.” Writing for the Journal of Alternative and Complementary Medicine in 2007, Jian Kong, an acupuncturist and psychiatrist at Massachusetts General Hospital, describes the objective of acupuncture as “de qi,” meaning to “obtain” the “vital energy.” Kong moves inserted needles until they feel heavy and full, indicating that “qi has arrived.” When a patient senses coldness at the insertion site, this is “Yin qi,” whereas warmth corresponds to “Yang qi.” Connie, a “National Board Certified, licensed acupuncture therapist” who also practices homeopathy, was less precise when she explained how acupuncture works for an interviewer in 2009: “all I know is that people are experiencing a blockage of energy, and it is my job to unblock it.” Connie cultivates “spirituality”—but not “religion”—in her acupuncture practice, creating ambience with a bubbling fountain, soft music, and aromatic candles.15 Since the late twentieth century, acupuncture has gained widespread conventional medical acceptance as promoters emphasized efficacy, confirmed by clinical studies, while downplaying qi theory in favor of biomedical theories. In 1978, Joseph Helms, M.D., coined the term medical acupuncture when he taught his first continuing medical education workshop on the subject, sponsored by the American Holistic Medical Association. Helms designed a controlled clinical trial of acupuncture for dysmenorrhea, wrote a textbook, and founded the American Academy of Medical Acupuncture. He established the Medical Acupuncture for Physicians Program in 1983 at the UCLA School of Medicine (offered with the Stanford School of Medicine since 2003), which has trained six thousand doctors. The renowned Mayo Clinic has advocated for acupuncture since the 1970s. The clinic’s Complementary and Integrative Medicine Program has licensed acupuncturists on staff to treat patients for such stubborn conditions as chronic pain in the back, neck, shoulder, and face, plus migraines, fibromyalgia, and infertility (see figure 6.2). Acupuncture heads the “Top Ten” list of CAM treatments recommended by the Mayo Clinic Book of Alternative Medicine.16 Supporters of medical acupuncture reinterpret classical concepts of qi and yin-yang balance using scientific language to appeal to modern

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figure 6.2 Electroacupuncture for chronic fatigue and pain in neck, shoulders, and lower back, 2009. (Courtesy Yi Cai)

American audiences. Herbal Healing Secrets of the Orient (1998) defines qi simply as a “foundation or structure.” Pocket Atlas of Chinese Medicine (2009) couples references to qi and blood flow to imply near equivalence, since acupuncture boosts the “functions of organs to produce more qi or blood.” An overview of acupuncture written for nurses in 2000 compares yin with the nonreligious principles of femininity, receptivity, stillness, and passivity; yang corresponds to masculinity, strength, force, and activity. Donald Kendall denies that qi and yin-yang were ever metaphysical concepts; he blames poor translation of a difficult language for creating misunderstanding. The Chinese character for qi has, in Kendall’s view, inaccurately been translated as “energy” instead of “air,” while the character rendered as “meridians” (mai) really refers to the “blood vascular system.” Once these translation errors have been remedied, it becomes “obvious that the mechanisms do not involve mysterious energy circulation, but involve extremely complex physiological mechanisms that can be described in Western terms.” Admitting that “there are many Chinese practitioners who embrace the energy-meridian view, sometimes promoting the mystical aspects of Chinese thought,” Kendall insists that “energy-meridians do not represent the original theories of Chinese medicine.” A 1992 report to the

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NIH, Alternative Medicine: Expanding Medical Horizons, describes acupuncture without reference to qi or yin-yang; acupuncture “involves stimulating specific anatomic points in the body for therapeutic purposes.” The NIH report claims that “modern theories of acupuncture are based on laboratory research conducted in the past forty years. Acupuncture points have certain electrical properties, and stimulating these points alters chemical neurotransmitters in the body.” In this rendering, vital energy merges with electrical energy, as acupoints become chemical gateways.17 Acupuncture’s American popularizers established medical credibility by articulating biologically plausible though unspecific theories for how acupuncture might work. Three principal explanations are posited. The “opioid release” theory is that needling stimulates nerves in the muscles, thereby releasing endorphins into the central nervous system. The “spinal cord stimulation” or “gate” theory holds that needling releases pain-suppressing neurotransmitters. The “blood-flow changes” theory is that needles affect the amount of blood flow at the points of insertion, thereby supplying nutrients or removing toxic substances from the local area. These postulates may be combined and associated with known aspects of anatomy and physiology. The medical doctors who wrote An Introduction to Western Medical Acupuncture (2008) adopt medical vocabulary to hypothesize “local effects” and “chain reactions” of nerve stimulation, neurotransmitter release, blood-flow increase, and improved function of local glands, in addition to “segmental” and “extrasegmental analgesia” and “central regulatory effects” to extend the chain reactions to the spinal cord, dorsal horn, brainstem, and midbrain. A physician-authored Alternative Medicine Sourcebook (2002) specifies that acupoints conduct electromagnetic signals that may trigger the release of endorphins or the movement of immune-system cells. Related suggestions are that needling produces distant effects on nerve cells, the pituitary gland, and the brain, leading to changes in blood pressure, body temperature, and immunity.18 Clinical language identifies acupuncture as a medical technique. The NCCAM explains that “the acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.” Words such as “penetrating,” “thin,” “solid,” “metallic,” “needles,” “electrical,” and “stimulation” identify acupuncture as sophisticated medical technology. The NCCAM describes meridians as “14 main channels ‘connecting the body in a weblike interconnecting matrix’ of at least 2,000 acupuncture points.” Numerically specific language makes the meridian concept sound anatomically precise. Nevertheless, medical promoters remain vague about how and why acupuncture works. The Mayo Clinic

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Web site admits that “scientists don’t fully understand how or why acupuncture affects the amount of pain you feel.” The important point is that acupuncture relieves pain.19

Interpreting the Empirical Evidence Acupuncture’s growing integration into the American health-care system depends on its emergent status as evidence-based medicine. Hundreds of acupuncture studies have been published since the 1970s, both in China and in the West. Individual studies report that acupuncture relieves pain and cures blindness, paralysis, cancer, psychiatric and neurological disorders, infections, skin diseases, gynecological and obstetrical problems, and disorders of the respiratory, digestive, and cardiovascular systems (see figure 6.3). Meta-analyses of this literature do not, however, confirm most such claims. A summary published in the Annals of Internal Medicine in 2002 notes that systematic reviews “most often report that trials of acupuncture efficacy are equivocal or contradictory.” The 2001 White House Commission on Complementary and Alternative Medicine Policy (which acupuncture proponent Joseph Helms shaped) found medical evidence favoring acupuncture to be strongest for low-back pain and recurrent headaches, noting that “a number of Cochrane Collaboration systematic reviews of this worldwide research literature have identified the potential benefits of CAM and related approaches and products for a small number of chronic conditions.” The White House report cites exactly two systematic reviews of acupuncture, neither of which was actually published in the Cochrane database and neither of which strongly supports acupuncture. The first is a 1999 review of acupuncture for acute and chronic lowback pain, which concludes that “because this systematic review did not clearly indicate that acupuncture is effective in the management of back pain, the authors would not recommend acupuncture as a regular treatment for patients with low back pain.” The second cited review, also published in 1999, found that “overall, the existing evidence suggests that acupuncture has a role in the treatment of recurrent headaches. However, the quality and amount of evidence [are] not fully convincing.” Alongside the White House investigation—which endorsed acupuncture based on relatively scant evidence—an NIH review panel reported in 1997 that there are “promising results” for acupuncture for postoperative and chemotherapy-induced nausea and vomiting and postoperative dental pain.20 Given “promising” though inconclusive findings, research on acupuncture has proliferated. A 2004 review of systematic reviews notes that “evidence of clinical effectiveness is also still elusive for many conditions such as chronic pain.” The review did, however, find that systematic reviews demonstrated acupuncture’s value in treating nausea, dental pain, back pain, and headache.

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Consumer information issued by the NCCAM in 2010 reports “promising findings in some conditions, such as chronic low-back pain and osteoarthritis of the knee,” and advises that patients suffering from a “wide range of conditions . . . may wish to ask your doctor whether acupuncture might help.” But the NCCAM warns: “Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training” (emphasis in original). Acupuncture may help where conventional medicine cannot, but even from the sympathetic perspective of the NCCAM, acupuncture cannot replace modern medicine.21 Cochrane reviews of acupuncture are largely inconclusive. A search of the Cochrane Library for acupuncture reviews completed through July 2012 yields forty-nine distinct review areas. Within this body of literature, pain is the problem most frequently studied. Cochrane reviewers have assessed acupuncture’s value in managing fifteen types of pain. For eight pain areas—shoulder, low back, cancer, rheumatoid arthritis, lateral elbow, whiplash, carpal tunnel syndrome, analgesia for oocyte retrieval during in vitro fertilization—reviewers found insufficient evidence to conclude that acupuncture is effective. Reviewers found some evidence of acupuncture’s possible advantages relative to sham

figure 6.3 Cancer patient receiving acupuncture to treat side effects of surgery, chemotherapy, and radiation: dry mouth, low energy, and red scarring, 2009. (Courtesy Yi Cai)

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or control groups for seven pain categories. Specifically, a 2009 meta-analysis for tension-type headaches infers that “acupuncture could be a valuable nonpharmacological tool,” based on results from six studies that found “slightly better effects” for real versus sham acupuncture; however, this same review found that in four studies in which acupuncture was compared with control groups receiving physiotherapy, massage, or relaxation, patients in the control groups had “slightly better results for some outcomes.” A 2009 migraineheadache review found “no difference between the effects” of real and sham acupuncture, although both groups seemed to benefit. A 2006 neck-disorder review found “better pain relief” for real acupuncture than for sham or waitlist control groups, but weaknesses in the evidence made it possible only to “draw limited conclusions.” Acupuncture showed “better results” than physiotherapy in a 2007 study of pelvic and back pain in pregnancy, but there was “high potential for bias, so results must be viewed cautiously.” A 2011 review of pain in endometriosis found “limited” support based on a single study that compared acupuncture to Chinese herbal medicine. A 2011 review found that acupuncture “may reduce period pain, however there is a need for further welldesigned randomised controlled trials.” A 2011 review suggests that acupuncture and acupressure “may have a role with reducing pain” in labor, but there is a “need for further research.” No Cochrane review rendered a strongly positive verdict in favor of acupuncture’s efficacy in relieving pain.22 Cochrane reviews have assessed acupuncture for a variety of physical and mental health problems. Out of thirty-four reviews of acupuncture for conditions other than pain relief, twenty-eight found insufficient evidence to recommend acupuncture: autism spectrum disorders, ADHD, schizophrenia, depression, antenatal depression, insomnia, myopia, glaucoma, smoking cessation, cocaine dependence, chronic asthma, vascular dementia, epilepsy, Bell’s palsy, traumatic brain injury, induction of labor, acute stroke, stroke rehabilitation, incontinence after stroke, dysphagia in acute stroke, uterine fibroids, polycystic ovarian syndrome, restless legs syndrome, irritable bowel syndrome, nausea and vomiting in early pregnancy, hot flashes, breast engorgement during lactation, and breathlessness in advanced disease.23 Cochrane reviews report benefits from acupuncture for six conditions other than pain. For chemotherapy-induced nausea or vomiting, a 2006 review found that “electroacupuncture reduced first-day vomiting, but manual acupuncture did not. Acupressure reduced first-day nausea but was not effective on later days. Acupressure showed no benefit for vomiting. Electrical stimulation on the skin showed no benefit.” A 2008 review of assisted conception concludes that “acupuncture does increase the live birth rate with in vitro fertilisation (IVF) treatment when performed around the

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time of embryo transfer. However, this could be attributed to placebo effect and the small number of trials included in the review.” The review warns that “acupuncture may have potential harmful effects in early pregnancy.” A 2011 review of nocturnal enuresis found “weak evidence to support the use of hypnosis, psychotherapy, acupuncture, chiropractic and medicinal herbs but it was provided in each case by single small trials, some of dubious methodological rigour.” A 2009 review of anesthesia induction in children noted a single study reporting that acupuncture given to parents reduced parental anxiety, making children more cooperative, but this “needs to be investigated further.” A 2012 review found “limited evidence to support the use of moxibustion [burning mugwort herbs on an acupoint in the feet] for correcting breech presentation [in childbirth]. . . . However, there is a need for welldesigned randomised controlled trials.” The only Cochrane review reporting unambiguously positive results was a 2009 study of postoperative nausea and vomiting (PONV); P6 acupoint stimulation worked as well as antiemetic drugs in preventing PONV.24 Although most completed Cochrane reviews reach negative or equivocal judgments, a steady stream of new Cochrane reviews of acupuncture are in the registered title and protocol stages. The volume and variety of ongoing research—in the absence of strongly positive findings in previous studies— suggest widespread interest in establishing acupuncture’s therapeutic value. Motivation to find evidence that acupuncture works may bias results of individual studies and meta-analyses. Cochrane reviews are highly regarded as the best single source of information on the safety and efficacy of health interventions. In the case of acupuncture, however, there is reason to question how much can be concluded even from Cochrane reviews. A 2005 meta-analysis of Cochrane reviews on acupuncture found ten review areas: low-back pain, headache, lateral elbow pain, rheumatoid arthritis, dysmenorrhea, induction of labor, smoking cessation, chronic asthma, Bell’s palsy, and PONV. Review authors made “conclusive statements” in just two reviews, dismissing the value of acupuncture for smoking cessation and classifying acupuncture as equally as effective as antiemetic drugs for PONV. But for all ten reviews, the meta-analysis found significant “methodological limitations in the original clinical trials” that reduce their evidential value. Although the resultant Cochrane reviews are of “superior methodological quality and less prone to bias compared to reviews published in conventional medical journals”—let alone individual trials—the methodological diversity of database searches used makes even Cochrane reviews “prone to bias and adds another layer of complexity in interpreting the acupuncture literature.” The lead author of the meta-analysis, Amit Sood, does not appear to be prejudiced against acupuncture; to the contrary, Sood has taken a lead in

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promoting acupuncture. Yet Sood concludes that medical evidence for acupuncture is limited by poor study quality and high risk of bias.25 Designing high-quality studies of acupuncture is no easy matter. One particular challenge is selecting a control group. Acupuncture studies typically use one of three types of control groups: conventional (or no) medical therapy; other nonmedical active therapies or relaxation, such as massage or music; or sham acupuncture. Systematic reviews (Cochrane included) tend to include a variety of control-group types, making comparisons among studies difficult. The major drawback of comparing acupuncture with conventional or nonmedical treatment groups is that any observed effects for the acupuncture group may be the results of “nonspecific” or “placebo” effects. In other words, patients receiving acupuncture may experience improvements because they expect to benefit, not because of acupuncture per se. The bulk of acupuncture studies reporting positive findings are for pain relief. A Cochrane review of placebo research concludes that placebos play a role in pain reduction. Comparisons of acupuncture with other forms of therapy or relaxation present similar problems, since it is possible that subjects in the “control” groups may also experience benefits (or harms) for nonspecific reasons; studies may inadvertently show which type of placebo is more effective, rather than demonstrate that either experimental or control therapies are effective in themselves.26 Comparing real and sham acupuncture presents special problems. Researchers performing sham acupuncture select nonacupoint locations and/ or insert needles more superficially—in some studies, two to four inches less deep, or not penetrating the skin. If a placebo effect is involved, sham needling—which may feel different, especially to patients accustomed to real acupuncture—may not produce as much expectation of benefit, which could account for any apparent superiority of real acupuncture.27 Some studies do report benefits for real as compared with sham acupuncture. A 1989 study found that alcoholics who received real versus sham acupuncture had half the number of drinking episodes and were half as likely to be admitted to detoxification centers following treatment. A 2008 study of chronic prostatitis and chronic pelvic pain found real acupuncture to be twice as effective as sham treatments. A 2005 systemic review of research on chronic low-back pain found real acupuncture to be more effective than sham acupuncture but found no evidence that acupuncture is any more effective than other active therapies, such as exercise, massage, physical therapy, spinal manipulation, and medication. The Cochrane pain reviews discussed above similarly found some advantages of real versus sham acupuncture but also revealed instances in which patients in active therapy or relaxation control groups did better.28

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Other research reports no significant difference between real and sham acupuncture, a finding that supports the placebo hypothesis. A 2002 study of pregnant women with nausea and vomiting compared acupuncture, sham acupuncture, and a no-treatment control group; there was no significant difference between the outcomes for real and sham acupuncture, although both groups had better outcomes than those given no treatment. An analysis published in JAMA in 2004 determined that findings of comparable benefits from real and sham groups “indicate, but do not conclusively demonstrate, a therapeutic placebo effect of acupuncture.” Even the pro-acupuncture Mayo Clinic concedes that “simulated acupuncture appears to work just as well as real acupuncture,” and acupuncture works best in people who expect it to work.” The Mayo Clinic’s J. D. Bartleson, M.D., minimizes the impact of this admission by hypothesizing that “it’s possible that acupuncture points can be stimulated by even surface pressure.” By implication, supposedly sham acupuncture may work by the same nonplacebo mechanisms as real acupuncture. Although acknowledging that “effects of acupuncture are sometimes difficult to measure,” Mayo Clinic promotional materials nevertheless aver that “many people swear by it as a means to control a variety of painful conditions.” This is a fascinating instance in which the attempt and failure to provide evidence of the efficacy of a practice is dismissed—by no less a medical authority than the Mayo Clinic—in favor of patient testimonials.29 The apparent safety of acupuncture is commonly cited to justify its promotion even without definitive medical evidence. The WHO acknowledges that acupuncture is less effective than drug therapy, such as corticosteroids for rheumatoid arthritis, but calls acupuncture a “reasonable” option because it lacks serious side effects. The Mayo Clinic Book of Alternative Medicine honors acupuncture with a “shining green light” to signify that it is “generally safe for most people to use, and studies show it to be effective.” The Mayo Clinic Web site advises that “since acupuncture has few side effects, it may be worth a try if you’re having trouble controlling pain with more-conventional methods.” Nevertheless, serious complications from acupuncture have occasionally been reported. Some patients exhibit symptoms of addiction and withdrawal, such as nervousness and agitation, and visit their clinics several times a week asking for more and longer needles and lengthier sessions. There are cases of unsterilized needles causing infections and needles puncturing organs, resulting in death.30

Conclusion Medical acupuncture has become an almost conventional component of the American health-care system. Acupuncture appeals because it seems to fill

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gaps left by modern medicine with ancient medical wisdom and also to be corroborated by scientific research. Many people regard the ancientness of a technique as prima facie evidence that it works. It is, however, a logical fallacy that practices of long duration are necessarily effective; another possible explanation is that no better methods were discovered. The endurance narrative bypasses the complex history of acupuncture in China, including seasons of decline and outright prohibition. Ironically, periods of American enthusiasm for acupuncture coincided with eras of relative neglect in China. Acupuncture is widely accepted by Americans as a nonreligious, medical technique. This perception underestimates acupuncture’s religious premises and overestimates its medical evidence. Confusion may arise because many Americans assume a rigid separation between “science” and “religion” that did not exist in ancient Chinese culture and that does not fully characterize modern American culture. The same Chinese developers who interpreted acupuncture as a science backed by empirical results also conceived of the practice in terms of qi and yin-yang concepts. Even today, many Chinese and American practitioners envision the objective of acupuncture as unblocking the flow of qi and restoring yin-yang balance, although acupuncturists may choose not to communicate these views to patients, a topic developed in the concluding chapter below. In creating “medical acupuncture,” promoters found it expedient to downplay qi theory in favor of biomedical hypotheses of possible mechanisms. The articulation of medical postulates does not, of course, prove that acupuncture works in ways theorized—or even that it works. Neither does using medical language calculated to make acupuncture palatable to consumers necessarily indicate abandonment of Taoist ideas. In any case, many Americans care less about why acupuncture works than that it appears to work. The efficacy of acupuncture appears to be confirmed by the large volume of clinical studies reporting benefits. Meta-analysis of systematic reviews shows, however, that the quantity of acupuncture research masks uneven quality, methodological challenges, and risks of bias. There is more and better evidence for acupuncture compared with many CAM approaches. Nevertheless, medical evidence suggests that acupuncture—real and sham—may be most effective in relieving symptoms such as pain and nausea because acupuncture functions much like a placebo. Yet increasing numbers of Americans believe that acupuncture leads the pack in frontline integrative medicine. If acupuncture and other CAM practices became mainstream because people developed an exaggerated perception of the medical evidence, this raises a larger question of how this came about. Chapter 7 investigates cultural factors contributing to CAM’s mainstreaming.

7

How Did CAM Become Mainstream?

during the last quarter of the twentieth century, CAM products and services, obtainable for modest fees in the secular marketplace, introduced many Americans to religious practices inspired by Western metaphysics and Hindu, Taoist, and Buddhist traditions. Holistic health care seemed less exotic, foreign, and threatening—and less religious—because it was available for purchase at the gym and the hospital instead of gratis in the temple. This chapter explains that many CAM therapies became mainstream not because they are nonreligious, Christian, or scientifically validated but because promoters successfully marketed them as secular and spiritual complements to biomedicine compatible with any or no religion, including theologically conservative Christianity. This happened for demand-side and supply-side reasons. As consumers sought health and wellness options to fill gaps left by religion and medicine, CAM providers advertised techniques that seemed to fit the bill. The sale of CAM in secular settings through targeted marketing to cultural subgroups brought CAM within reach of virtually every American employee, shopper, student, patient, and health aspirant.

Consumer Demand Bodies in Pain Today’s customers want therapies to relieve pain and deliver better bodies and more peaceful minds and spirits. Yet physical comfort has not always been a high priority for American doctors or clergy. Until the mid-nineteenth century, many physicians interpreted pain as indicating therapeutic progress. As medical understandings of disease advanced, doctors redefined pain as merely a physical sensation. Although physicians ceased to valorize painful, heroic therapies, they also became less likely to take seriously complaints of pain for

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which a physiological cause could not be located. Clergy commonly identified bodily pain as chastisement for sin or means of sharing the sufferings of Christ. Anesthesia was introduced in 1846, but its use did not become standard until the 1880s, partly because clergy worried that artificially produced insensitivity to pain represented disobedience to God’s will.1 As anesthesia and other painkillers made it possible to dull, if not altogether avoid, pain, especially during surgery and childbirth, clerical admonitions to accept pain passively lost appeal. Developing medical technologies made freedom from pain appear within reach, yet medicine’s failure to eradicate pain encouraged therapeutic experimentation. As many Americans refused severe medical regimens in favor of the body’s natural restorative powers, they rejected Calvinism’s view of the body as enemy of the soul. Some Christians reasoned that the devil sends affliction, whereas God promises divine healing. As pain lost its compensatory association with higher purposes, the suffering produced by pain intensified, increasing the urgency of finding relief.2 Desire for pain relief, pleasure, and overall wellness constituted a necessary but insufficient condition for growing, though by no means unanimous, approval of holistic healing by theologically conservative Christians. Having largely abandoned ascetic notions that Christians should harm the body to heal the soul, evangelicals remained anxious to avoid harming the soul to heal the body. Prerequisite to Christian acceptance of CAM was assurance that CAM is Christian or at least nonreligious. Implicitly, as Americans, Christians among them, reimagined pain as bad or at best morally neutral, they came to regard as good treatments that promised to relieve pain or provide pleasurable tactile sensations. The driving question in evaluating pain-relief methods shifted from “what does it mean?” to “does it work?”3

Disillusionment with Christian Churches Holistic healing appeals to Americans who feel frustrated with Christian religious institutions that have been culturally dominant through much of America’s history. Because Christian clergy have often devalued the body and its senses, blamed the sick for their afflictions, or discouraged prayer for miraculous healing, people have sometimes viewed Christianity as irrelevant to daily health needs and looked elsewhere for help. Christian Reiki healer Murielle Marchand notes, “something I have also always despised in so many Christians around me is what I call the ‘praise of suffering.’” The Reverend Dr. Daryl Greene, a minister in the United Church of Christ, found that the “first step” in finding relief from suffering—in his case, because of a progressive neurological condition—was to “throw off any sense that you deserve

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your suffering because you are a sinner, or that your suffering is a punishment from God.” Greene embraced the physical and “spiritual aspects of receiving massage therapy”—since “you must surrender yourself, body, mind and spirit to the therapist”—because massage relieved his suffering and strengthened his “life-force,” whereas what Greene heard from other church leaders seemed merely to justify rather than alleviate suffering.4 Anecdotes abound of Christians feeling dissatisfied by the inadequate healing resources offered by their churches. Robin Littlefeather Hannon sought Reiki after feeling beaten down by her Word of Faith pentecostal church: “I was not healed no matter how positive my confession, nor how many times hands were laid on me. Eventually the church questioned the quality of my faith and commitment. I was shamed, blamed for my illness, and eventually stripped of my ministry and asked to step down.” Roman Catholic Marita Aicher-Swartz “felt drawn to a ministry of healing and began to wonder what ever happened to the practice of hands-on healing that Jesus taught the twelve disciples and others around him,” since within the Catholic church, “the practice of hands-on healing was the ministry of the clergy and celebrated in the sacrament of the Anointing of the Sick.” Aicher-Swartz is among the 80 percent of Catholic parish ministers who are women; she felt disempowered in her ministry of Christian education as “more and more of the children and parents . . . were seeking emotional, mental, and spiritual healing.” AicherSwartz selected Reiki because, she says, “I felt a call to do something in the area of healing ministry but was stymied as to where to find any answers.” Christians turn to CAM when they do not find healing or empowerment to become healers in church.5 People look to CAM not just for medical help but also for firsthand spiritual experiences to supplement, or replace, inherited doctrines. Judy Chuster, a Christian nurse who practices Therapeutic Touch, reasons that “feeling the energy fields gives me something tangible, although certainly the Holy Spirit is greater than just the energy fields.” Christian pastor Scott Wyman describes his initiation into Reiki as “a very spiritual experience not unlike my experience of baptism, as I felt an increased connection to God and to His healing power,” which Wyman identifies with the “Divine or Universal Self. (Bodhicitta, Christ Consciousness, Buddha Nature, etc.) This is our true nature.” When religious studies professor Lola Williamson interviewed participants in Hindu-inspired meditation movements, she found that most were “raised in the Christian or Jewish faiths,” but “their upbringing did not teach them how to gain access to the transcendent realm . . . of awareness beyond the mundane.” Meditators were looking for “something that they do not receive in a church or synagogue,” spirituality “based on inner experiences rather than

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dogma.” The Catholic theologian Leo Lefubure explains that “people alienated from the traditional theistic beliefs of Christianity or Judaism may be attracted to a frame of reference that does not include a creating and redeeming God. Some converts to Buddhism have complained that Christianity merely talks about a loving God, whereas Buddhism offers effective strategies to change one’s awareness and cultivate a peaceful, loving attitude.” One of the most popular of these strategies is meditation.6 Christians adopt practices such as Buddhist meditation to fill gaps in their own religious traditions. The Trappist monk Thomas Merton’s (1915– 1968) best-selling autobiography, The Seven Storey Mountain (1948), used Zen Buddhist mysticism to revitalize Christian mystical spirituality. The Trappist order opened new monasteries to accommodate the rush of young men attracted by reading Merton. For Merton, the Mahayana Buddhist idea of shunyata, or emptiness, is the “same thing” as the Christian ideal of knowing God through dissolution of the self, but with a more practical approach. Jesuit missionaries, such as the Germans Hugo Enomiya-Lassalle (1898–1990) and Heinrich Dumoulin (1905–1995) gave fellow Jesuits Zen retreats instead of taking them through the Spiritual Exercises of St. Ignatius, on the premise that Christians can add an experience of satori, or enlightenment, to Christian practice. Kakichi Kadowaki grew up Zen Buddhist, was baptized by Dumoulin in Japan, and was ordained a Jesuit priest. Kadowaki found Ignatian training “intellectual and abstract,” whereas Zen offered the Christian a missing “religious practice (Sanskrit carya) that perfected the spirit through the training of the body.” He developed “Zen-Ignatian” retreats, which begin with an “initiation” (a term commonly used for Buddhist ceremonies). The practice of tanden-koku, described by Kadowaki as “breathing with the guts” or, more traditionally, from one’s “vital center,” ideally leads to experiencing the “breath (ruah, Spirit) of life of God (the Holy Spirit)” in “Genesis 2–7.” Retreat participants receive a “Christian Koan” and substitute recitation of “Abba, Father!” for “Mu,” meaning nothingness, to identify with Christ in kenosis, or emptying, to attain a “spiritual eye (a kind of Christian Satori).” The Irish Jesuit Robert Kennedy affirms that zazen (meditating to cultivate “no-mind,” or mushin) “can add much to our prayer.” Because “the fundamental doctrine of Buddhism teaches that the substance of all existence is emptiness. . . . There is no self. . . . Zen reminds us that Christian contemplation is not a looking at Christ, or a following of Christ, but a transformation into Christ. . . . All clinging and possessive love is a primordial delusion which brings terrible suffering.” The Irish Benedictine monk John Main (1926–1982) learned to meditate with a “Christian mantra” from the Hindu Swami Satyananda. According to Main, “one thing we learn in meditation is to abandon desire, and we learn it

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because we know that our invitation is to live wholly in the present moment.” So rendered, meditation offers not only a practical method for knowing God but, more comprehensively, a revised understanding of divine and human nature and the cause and remedy of suffering.7 In today’s religious market, churches that want to attract large memberships can ill afford to offend those who find CAM appealing. Nineteenthcentury preachers did not mince words in preaching against presumed heresies such as Christian Science or hesitate to eject church members for dabbling in practices labeled “occult.” Today, evangelical megachurches model a seeker-sensitive style designed to appeal to consumers in a pluralistic society. Pastors who wish to retain flocks may avoid preaching against holistic practices in which parishioners (especially wealthy, tithing ones, such as chiropractors) are passionately invested. Health-related sermons are rare, unless to encourage prayer for healing or to advise “stewardship” of the body as a “temple” of the Holy Spirit. The absence of preaching against common healing practices functions as an implicit endorsement. Moreover, a visible contingent of Christian clergy actively promotes Christian versions of holistic health.8

Ambivalence toward Modern Medicine The relationship between Christianity and scientific medicine has been tense through much of American history. Christians in the late nineteenth century worried that the new evolutionary paradigm did not seem to require an interventionist God. Those Christians who came to trust God for divine healing, especially early-twentieth-century Pentecostals, feared that using medicine might indicate lack of faith in God to heal. The perceived threat of atheistic materialism made holistic methods more attractive because they presumed a spiritual world. Some Christians found it easier to add missing Christian content to movements that do not rule out spiritual causality than to refute the naturalistic foundations of biomedicine. It seems more than coincidental that key figures in the nineteenth-century divine-healing movement also found homeopathy appealing. Methodist Holiness leader Phoebe Palmer’s husband, Walter, was a homeopathic physician, as was Episcopal divine-healing publicist Charles Cullis. Leaders of the ecumenical Charismatic renewals of the 1960s made divine healing appear culturally respectable by repudiating early Pentecostalism’s antimedical stance. Oral Roberts popularized the idea that divine and medical healing are complementary, and to make the point, he founded the $250 million City of Faith Medical Center (which failed financially). Healing evangelist Kathryn Kuhlman (1907–1976) recruited physicians

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who reviewed before-and-after medical records of those reporting healing in her miracle services. Several of Kuhlman’s medical supporters were doctors of osteopathy or otherwise endorsed CAM. It may be that openness to the “Holy Spirit” encourages openness to other concepts of spiritual energy and vice versa.9 The appeal of CAM stems in no small degree from frustrations with modern medicine. This is especially true when it comes to conventional cancer therapies. Cancer is the single most dreaded disease for many Americans. Even as life expectancy rose steadily since the turn of the twentieth century—from forty-seven years in 1900 to seventy-nine in 2010—cancer rates also skyrocketed. In 1900, one in twenty-five Americans could expect a cancer diagnosis at some point in their lives. In 2012, one in two men and one in three women had a lifetime cancer risk. (But in 1900, more people died from acute illnesses at younger ages, before their odds of developing cancer increased, and more people died from cancer undiagnosed.) Today cancer is the second leading killer, after heart disease, accounting for one in four deaths. The understandable antipathy that people feel toward cancer fosters antipathy toward conventional doctors and treatments that can make people sick without curing. The well-known side effects and failures of conventional therapeutics pushed consumers toward alternatives that promise to prevent and treat cancer or cure otherwise terminal cases.10 Desperation and fear fuel experimentation. When Anne Frähm was diagnosed with stage-four breast cancer in 1989, she underwent surgery, radiation, chemotherapy, hormone therapy, and a bone-marrow transplant, all of which failed to eradicate the disease. Anne’s husband, Dave, an ordained pastor and staff member of the evangelical Navigators ministry, explored CAM. Dave led Anne through intensive regimens of juice fasts, enemas, colon/liver cleanses, daily dry brushing (to keep the qi moving), reflexology and shiatsu massage, homeopathy, aromatherapy, iridology, applied kinesiology, acupuncture, magnets, chiropractic, Therapeutic Touch, and Reiki. Anne went into remission five weeks after starting CAM, inspiring Dave to become a naturopathic doctor, certified nutritional consultant, and master herbalist and to open HealthQuarters Lodge to help others battling cancer by addressing the root cause of “toxic stressor overload,” strengthening the “immune system,” and restoring “homeostasis.” The evangelically stated “mission of HealthQuarters,” which adds to other holistic therapies a “Bible class” and “prayer sessions and devotionals,” is to use the “opportunity” to talk to clients “about the importance of a personal relationship with God through Jesus Christ.” When Anne died ten years after her initial diagnosis, Dave blamed “the iron poisoning Anne had in her body as the result of having received

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over 150 blood transfusions during the failed bone marrow transplant.” He did not entertain the possibility that conventional treatments had extended her life or that arduous CAM regimens may have been unproductive or harmful. As of 2013, Dave still runs HealthQuarters Lodge; a five-day session at this self-described “non-profit ministry” costs $2,850. Evangelical Christians such as the Frähms and their clients may feel as helpless as other Americans in navigating the confusing, often frightening world of cancer and anticancer regimens. When neither conventional treatment nor prayer seems sufficient, people willingly pay for the hope CAM offers.11 The simplicity or oddity of “natural” remedies, even if—or especially because—they are rejected by conventional doctors, contributes to CAM’s mystique. Online chat rooms offer a window onto popular reasoning. Beliefnet.com user Paul W. recounted that another man treated for cancer at his clinic had been told to put his “affairs in order”; he “tried organic baking soda and maple syrup and went into remission.” Hearing this, Paul blogged: “Does it work? I am not sure but I am going to try it because it’s harmless and cheap. There is an oncologist in Italy using it with great success, so what the heck. If I could get to where I could work again rather than starve on SSD [Social Security Disability] I am all for it. There is a lot of information if you google it.” Paul did not express concern that much of the information that can be “googled” is unfiltered and the credibility uncertain. Blogger IAurR1987 answered a query from another cancer patient: “I don’t know how open you are to things but if you are, go to your search engine and type in Budwig protocol . . . (along with essiac tea which you can also do a search on) and belong to the flaxseed oil Yahoo newsgroup.” Kats5dogs wrote that “my father is going to be starting hormone therapy for prostate cancer, but he has also seen a spiritual healer who is having my dad practice some mindful meditation and imagery. Doesn’t hurt to try.” The lack of scientific support for CAM is not a deterrent when conventional treatments seem unlikely to cure.12 People turn to CAM therapies that seem to offer benefits of medicine and religion, while overcoming apparent limitations of each domain. Alan, a Christian prepared by his doctors to expect death from congestive heart failure despite medical treatments and prayers for healing, affirmed that he “still believes in miracles, and in light of the fatal medical diagnosis,” he planned to “go full-forward with alternative therapies.” Alan reasoned that God might heal miraculously through CAM, despite the failure of medicine or prayer to help. Self-identified evangelical Larry Burkett did not pray for healing of his metastasized kidney cancer, asking rhetorically, “Is it realistic to expect God to miraculously heal?” Instead, “the Internet is my primary resource to

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find alternative therapies,” which Burkett credited with extending his life— eight years at the time of his writing—through God’s “sovereign will.” Michael Fackerell, a regular Internet blogger on topics related to “Christian Faith,” advises against relying solely on prayer or medicine for healing; the first seems like “tempting” instead of “trusting” God, and the second is like trusting “in men” under the influence of the “evil one.” Fackerell equates “trust in God” with use of CAM therapies provided by God to “detoxify” and “properly feed” the body. Occupying a cultural space between conventional medicine and religion, CAM profited from disenchantment with both and longing for benefits promised but not fully delivered by either.13 Themes of disenchantment and longing resonate in the story of Mike and Cheryl Wilson. When Cheryl was diagnosed with inflammatory breast cancer in 2004, she and her husband, Mike, decided to take a “proactive approach rather than sit back and let nature take its course.” The Wilsons attended a cessationist Church of Christ, where Mike was a preacher, and did not expect God to heal miraculously. Cheryl did ask church elders to pray for her—thinking of James 5:14: “Is anyone among you sick? Let them call the elders of the church to pray over them and anoint them with oil in the name of the Lord.” The elders did not literally anoint Cheryl with oil, reasoning that “there are first-century cultural factors behind the ‘anointing with oil’ statement.” In recalling the incident, Mike quoted James 5:14 but not 5:15: “And the prayer offered in faith will make the sick person well.” Instead of praying for healing, the Wilsons asked “comfort and strength . . . regardless of the outcome,” while stressing that “dependence on God and human instrumentality are not mutually exclusive.” Mike worried that the “devil” had “poisoned” the “mainstream cancer industry” in the “West” through “power and big money interests.” By contrast, holistic methods “more common to the east . . . harnessed the lifeenergy” of “natural resources given by the Creator Himself in their purest state.” Mike looked to “Eastern” methods, rather than prayer or biomedicine, to access God’s healing resources.14 Cheryl underwent conventional medical treatments: surgery, chemotherapy, and radiation. But the couple also explored the “best natural remedies.” At first, this natural approach consisted of a mostly vegetarian diet and “fistfuls of vitamins and herbs known for their cancer-fighting or immune-building properties.” Several months into this process, the Wilsons decided to “go alternative one hundred percent” after another couple, who had recently started attending their church, introduced them to a Christian naturopathic doctor, Larry Rawdon. Rawdon is a licensed pharmacist who owns an “all natural health food and herb store” named “Osa’s Garden, Inc.: Health God’s Way.” The store, still in business in 2013, sells juicing machines and supplements,

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and offers nutritional consultations and toxic cleanses. In 2007, Rawdon curtailed his naturopathic practice after a Tennessee court fined him $1 million for practicing medicine without a license.15 From “Dr. Rawdon”—as the Wilsons called him—Cheryl and Mike learned to conceptualize health as God-given “life energy.” The premise is that God makes life energy available through fresh air, water, sunlight, good thoughts, and “living food.” Rawdon emphasizes that “it’s not me healing people, it’s God. . . . God sent Joshua into the Promised Land and told him not to destroy the fruit trees because in them is a man’s life that he can eat and live. . . . So the life force that is in the fruits and vegetables, it’s what our cells need.” The Wilsons combined Rawdon’s religious description of life energy with the scientific language of popular medical writer Andrew Weil, M.D., that “healing requires energy. Energy is supplied by metabolism.” The Wilsons spent a “fair amount of money” on “whole food supplements” from Rawdon’s store and commenced a raw-foods diet consisting largely of freshly extracted juices, uncooked oatmeal, and almonds. According to Rawdon’s living-foods philosophy, cooking “kills the foods,” and dead foods open the door to “parasite invasion and nutritional deficiency,” causing chronic disease. Living foods provide vital energy essential to life.16 Rawdon also taught Cheryl to eliminate toxins. She received regular massages, treatments with a “machine that did frequency specific acupuncture” (to administer precise doses of qi), self-administered twice-daily coffee enemas, and underwent weekly “ionic cleanse treatments.” Mike at first greeted the ionic cleanse—an “electrically charged” foot bath—as scientifically and religiously suspect “hocus pocus.” But when he observed the water “dramatically changing” to a dark orange color, Mike accepted Rawdon’s interpretation that toxins were being removed. Mike added a religious interpretation, that Cheryl was following “the Israelites of the Old Testament in exterminating ‘Hittites, Amorites, Jebusites, and parasites,’” without commenting on the biblical passage’s proscription against adopting new religious practices.17 The alternative route pursued by the Wilsons offered purpose and hope. It gave “something to do or consume almost every hour of the day,” rather than waiting in fear of the cancer’s return. Two years into the process, Mike self-published Christians and Cancer: A Journey of Hope (2006). It is uncertain whether the Wilsons’ approach resulted in physical cure. The type of cancer with which Cheryl was diagnosed has a five-year survival rate of less than 40 percent. As of 2013, Mike’s book could still be purchased online, but Mike was no longer listed on staff at his church, and no other information about the couple could be located.18

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Better than Biomedicine Alone There is demand for CAM because consumers desire more than biomedicine. Nineteenth-century drugstores sold homeopathic alongside allopathic medicines because customers wanted to buy them. The lack of side effects and palatability of homeopathic preparations (many of which consisted primarily of generous doses of sugar) gave homeopathy what historian Anne Taylor Kirschmann has called an “entering wedge” among mothers of sick children. Homeopathy also provided a route to a medical career for nineteenth-century women who were systematically excluded from conventional medical training and practice. Women’s rights activist and homeopathic physician Elizabeth Cady Stanton faulted both the Protestant and “medical ministries” for inflicting on women “cruel bondage of mind and suffering of body,” whereas homeopathy empowered women. Over time, homeopathic doctors began prescribing allopathic alongside homeopathic drugs, because patients wanted the best of both medical systems, and if one doctor would not accommodate this demand, there were increasing options to go elsewhere. After its heyday in the mid-nineteenth century, the popularity of homeopathy declined by the 1880s. Ironically, the success of homeopathy in becoming less obviously different from conventional medicine led to the movement’s downfall. Patients became less able to distinguish between homeopathic and allopathic medicine and less likely to seek homeopathic providers. Homeopathy enjoyed a renaissance of popular interest by the 1980s as advertisers reemphasized its distinctiveness from allopathic medicine. Growing awareness of conventional drug side effects spurred consumer interest in “natural,” “safe,” “nontoxic,” herbal remedies. Yet consumers also began to realize that “natural,” herbal remedies are not always “safe” or “nontoxic.” Herbs beneficial at low doses can be toxic at higher doses, and herbs can interact dangerously with one another or with synthetic drugs. By using highly dilute substances, homeopathy appeared to be better than herbal medicine. In 2002, overall U.S. sales of herbal remedies dropped 7 percent, while homeopathic sales grew 3 percent overall and nearly 50 percent in mainstream drugstores.19 Homeopathy appeals to the self-help-oriented, medically disillusioned consumer shopping in Walmart or natural-foods pharmacy aisles. Worldwide, people spent an estimated $1.5 billion on homeopathic medicines in 1999. Homeopathic sales rose by 500 percent in the United States between 1987 and 1999; in 1995, Americans spent approximately $200 million on homeopathic products. A 2007 National Health Interview Survey found that 4 million American adults and 900,000 children had used homeopathy during the past year. Many pharmacies offer homeopathic products for sale not

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because of demonstrated health benefits but because of consumer demand. According to Todd Dankmyer, a spokesperson for the National Association of Retail Druggists, pharmacies sell homeopathic remedies because they “see homeopathy as a valuable market niche.” Jerry Zlotnik, pharmacist and executive vice president of Ohio’s Medic Discount Drug chain, justifies his organization’s sales of homeopathic products by denying that he has an ethical obligation to sell only health-promoting merchandise, noting, “I also carry candy, cigarettes, beer and wine.” As another pharmacy owner, Gilbert Weise, Sr., of Jacksonville, Florida, explains his decision to stock homeopathic remedies: “When I advertise that I’m a pharmacist with homeopathic medicines, I can’t keep customers out of my shop.” Some consumers select homeopathy because of famous enthusiasts, a list that includes Pope Gregory XVI (1765– 1846), American author Mark Twain (1835–1910), Britain’s King George VI (1895–1952), Queen Elizabeth II, Prince Charles, former British prime minister Tony Blair, and former U.S. president Bill Clinton.20 Most people do not replace but supplement conventional medicine with CAM, because it offers something different, something more emotionally and spiritually satisfying. Although medical doctors today typically spend seven minutes with each patient, CAM appointments involve thirty to fifty minutes of empathetic touch between practitioner and patient. Holistic providers ask exhaustive lists of background questions and encourage clients to visit them regularly, as often as several times a week, which is much more contact than patients have with physicians or parishioners with pastors. Consumers find that CAM providers are willing to take time to listen, empathize with their suffering, and offer hope that ongoing treatments will result in progressive improvements.21 The healer-client relationship fulfills felt needs for intimate relationships. One woman visits a male homeopathic doctor because, she says, “I really connect with him, I have a relationship with him, I feel comfortable and trust the person. He’s not just your clinician, he’s caring.” Another woman says of her homeopathic provider, “he’s the third most important man in my life after my husband and son.” Yet another woman attests, “I unburden myself and he listens. . . . I still go now that I am well and talk to him about any old thing. But he has suggested that I do not see him for a while. I feel really quite sorry, my husband is away a lot and I enjoyed unburdening myself.” This woman experienced more emotional support from her healer than from her husband. A man suffering from multiple sclerosis affirms, “my massage therapist is the one person in my life who is able to listen to me. My wife and my kids are all tired of me complaining about my aches and pains. They are tired of my problems all together. But I can talk to my therapist and she is so empathetic,

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so positive, so encouraging. Just her caring attitude makes me feel better.” A Christian man with a neurological disorder describes the emotional and spiritual comfort he receives from his female massage therapist: “I have been to all kinds of doctors. I resent the fact that sometimes I have to wait an hour and a half in order to have the doctor spend two minutes with me.” By contrast, “it genuinely pleases me to pay my massage therapist. When I go to her office she is waiting for me! She gives me an hour of her undivided attention. She does not send me away for X-rays and more tests to find out why I am in pain. When she touches me with her hands and fingers, she can sense where my pain is and how to make me feel better. She listens to me. She comforts me. When I leave her office I feel blessed and healed.” Such anecdotes suggest that CAM relieves suffering by fulfilling a yearning for intimacy.22

Selling CAM Purging the Toxins of Modernity Those marketing CAM capitalize on popular fears that modern technology is inherently toxic. There are two general categories of detoxifying products: those that combat internal poisons through nutrition and cleanses and those that neutralize external dangers by identifying and defusing unhealthy energies. Within the first category, nutritional therapies redress the depletion of “vital nutrients” with special diets and megadose supplements, while cleansing regimens purge noxious chemical contaminants. Nutritional approaches seem intuitive to many people, since the very term nutrition sounds nurturing, healthful, and beneficial. People reason that if poor nutrition causes diseases such as cancer, exceptionally good nutrition can cure cancer. Diet is one thing that a person can control by exercising self-discipline, in contrast with undisciplined, out-of-control cancerous growth. Certain CAM promoters generate fears of contamination in order to create a market for products that alleviate fears. The Cancer Nutrition Centers of America online store carries a full line of supplements designed to “make up for what your diet might lack.” The “CNCA Essential Pack” of Immunomax (for “overall health and wellness”), EPAmax (for “immune system support”), and Oximax Complex (for “cell protection”) sells for $92 for a one-month supply. EvenBetterNow Natural Health Solutions offers NewGreens Organic SuperFood Blend—a combination of sixty-eight “super foods” in powder form—for a special online price of $47 for thirty servings. Jay Kordich, proponent of the Gerson therapy and self-described “Father of Juicing,” boasts that he “sells millions of juicing machines,” for $395 each. Such products offer

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assurance to Americans—who may feel apprehensive about eating unhealthy diets—that dietary deficiencies can be compensated for by taking supplements and drinking juices that provide concentrated nutrition (see figure 7.1).23 Related product lines provoke concern about ingested contaminants, thereby creating demand for products to cleanse the body of dangerous toxins. Christian television personality and naturopathic doctor Valerie Saxion’s book, Every Body Has Parasites: If You’re Alive, You’re at Risk! (2003), raises an alarm—that “85 percent of Americans are infected with parasites”—and helps readers “discover how to protect against ever becoming a parasitic host as well as the keys to eliminating any parasites that may have gained entrance.” Saxion’s answer is that “we need to use specific herbal formulas to deal with this issue,” all of which can be purchased through her Web site. Saxion’s “Premium 3 month Cleanse, Rebuild and Digestive Enzymes Program” includes “Paracease™ (cleanse) and Par Assist™ (healing & regularity herbs formulation), Ultra Pro™ (Probiotic) & Digestive Dynamics™ (enzymes formula),” for the less-than-retail price of $338. Similarly, the True Health Web site vows that “Dr. Cutler’s Liver & Kidney Cleanse™” is “vitally important for optimum health.” This is because “in our modern society, your liver is under constant attack. Every second of every day, it’s working to undo the

figure 7.1 GREENSuperFood fills any nutritional gaps remaining for the Whole Foods shopper, 2011. (Photograph by author)

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negative effects of unhealthy foods, alcohol use, prescription drugs, tainted water, household chemicals, pesticides, or even worse. Eventually, all the toxins from your daily life are bound to take a toll on the health of your liver”; this “vital organ” can be protected for $40 per month. Consumers who may not be experiencing any symptoms of ill health can purchase cleansing products as insurance against unseen attacks.24 A second CAM category guards against external toxins. These include “geopathic stress,” or “microwaves” of electromagnetic radiation emanating from underground water vein crossings and rock faults, which purportedly disturb the naturally occurring wavelengths of healthy cells, increasing susceptibility to cancer. These microwaves are allegedly so weak that only dowsing rods or radionic (i.e., radio-electronic or distant-energy) pendulums, but not standard scientific instruments, can detect them, yet disturbances “reach a height of 600 to 30,000 feet,” so it is just as dangerous to live on the twentieth floor as on the first floor of a building constructed within a geopathic field. Even more disconcerting is “abnormal, manmade electromagnetic radiation” in “our increasingly polluted environment” from orbiting satellites, high-voltage power lines, electric cables, broadcast towers, Wi-Fi hotspots, cell phones, electrical wiring and synthetic materials in buildings, and “common household appliances” such as televisions, computers, microwave ovens, electric blankets, water beds, hair dryers, and alarm clocks.25 Professional dowsers and “electromedicine” devices offer protection from environmental hazards. Modern dowsers direct the “ancient art” of divining or water witching—using a wooden or metal forked rod directed by one’s “hidden senses” or “E.S.P.”—to assess building safety and conduct health consultations. One “Health Dowsing” service helps property buyers locate safe home lots. If no areas “free of radiation” can be located, one can purchase a “NEUTRALIZER” that “absorbs and dissipates the harmful energy.” The neutralizer should be “replaced every 2 years,” a time interval long enough not to discourage would-be customers and short enough to retain an active clientele. Dowser Gary Skillen’s Internet-published article “ARE YOU SLEEPING IN A CANCER ZONE?” advertises “PROTECTIVE PRODUCTS.” The “LadyBug” is a “cute-looking bug, the size of a dime” that uses “special materials and antennae to attract and redirect harmful computer screen emissions.” The “Elf-Pak” is a “dielectric resonator” that can be “placed on the main electrical fuse box in the home or workplace to neutralize harmful electricity” and protect against “radiations from microwave dishes, power substations and power transmission lines.” As an additional safeguard, “Earth Crystals will neutralize harmful geopathic stress zones and create a healing vortex around

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your home or workplace.” The health risks of airline travel—from flying over numerous geopathic zones while seated above aircraft electronics—are so great that, according to dowser Kerry Gillett, people should either “avoid air travel or protect yourself while flying.” Protection requires purchasing “one of the two devices” that Gillett considers “thoroughly effective in shielding the flier from excessive aircraft radiations.” These are “The Energy Works Tripack, $44.00,” available from Gillett, or the higher-priced “MobileCare by MagmaCare, $382.00,” sold by another vendor. Dowser “Dr. Needle” offers to “vibrationally” detect, reverse, and cure cancer before the disease is discernible to conventional diagnostics; this claim is unfalsifiable, since Dr. Needle admits that he cannot help once cancers are advanced enough to be diagnosed. Consumers may also purchase a computer program that destroys “cancer-causing microbes” by generating “specific electromagnetic” frequencies; the “easy to use” three-step protocol consists of installing the CD and selecting “Auto Channel,” the program number, and “Run.” The marketing of such products depends on generating demand by first stimulating and then relieving fears of invisible toxins.26 Deemphasizing their own commercial motives, CAM boosters present themselves as saving consumers from a conspiracy between the government and profit-minded medical and food industries that want to keep consumers from obtaining simple, low-cost cures that would undercut big government and big business’s unethical pursuit of financial gain. A 1992 CAM guidebook alleges that “the American ‘cancer industry’—pours billions of dollars into investigating synthetic compounds instead of undertaking large-scale research into time-honored herbal remedies that have demonstrated success. The reason for this is simple: it is much easier to patent a synthetic compound, and reap enormous profits from it, than to patent a natural compound readily harvested from Nature.” Although criticisms of health-care industries reflect populist paranoia and glorification of a bygone premodern era, the charges are persuasive because there is some basis in fact. As Devra Davis, director of the Center for Environmental Oncology of the University of Pittsburgh Cancer Institute, observed in 2007, “if many of these critiques have been animated and angry, they were not necessarily, for that reason, wrong.” Scientists and government officials knew for decades before publicizing it that tobacco is a powerful carcinogen—in part, it seems, because of profits accrued from advertising and taxation. As early as the 1930s, medical textbooks reported experimental evidence that common industrial chemicals, arsenic, benzene, asbestos, synthetic dyes and hormones, and ionizing radiation (like that used in X-rays) are carcinogenic. Scientists employed in cancer research move, in Davis’s words, through a “revolving door . . . in and out of cancer-causing

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industries,” creating conflicts of interest. The ACS and the NCI have long accepted funding from pesticide, pharmaceutical, chemotherapy, and mammography industries. The American Dairy Association funds public nutrition campaigns, such as the “Four Food Groups” taught in schools from 1956 to 1992. Failures of government and industry to protect consumer interests opened a doorway of opportunity for CAM providers to step in and promote themselves as consumer advocates.27

Just Another Commodity in the Secular Marketplace Many people assume that any product or service widely available in the open market is secular. People identify “religion” as a private matter available free of charge or by donation through sectarian networks, rather than as something sold in the public sphere of commerce and professional services. Charging to enroll in instructional workshops or to receive services from trained professionals implies that techniques are scientific rather than religious. The TM Book, Transcendental Meditation: How to Enjoy the Rest of Your Life (1975) chastises readers for the “absurd” assumption that “just because the TM technique comes from India it must be some Hindu practice.” Rather, TM workshops teach a technique based on a “scientific discovery which happens to come from India,” a claim apparently substantiated by the Maharishi’s physics degree from Allahabad University. In the 1990s, a four-day TM course ran $1,000 ($600 for full-time students, free for children younger than ten), with follow-up courses free for life. By 2003, it cost $2,500 to learn the TM technique, reduced to $1,500 for a shorter course in 2009. In contrast with the antimodern strain of some CAM methods, marketing for TM presents an ultramodern technique for counteracting the stress-producing consequences of modernity. It is a successor to the “most recent discoveries” of industrial age, space age, and computer age science. As “thinking is transcended,” the “mind comes into direct contact with the source of thought,” which is a “field of pure creative intelligence,” and this mobilizes the “natural mechanisms of the body to neutralize stress and restore balance in its functioning.” The fact that TM is “taught through a nonprofit, tax-exempt educational organization” seals the case that TM is science, not religion.28 Promoters of holistic healing accessed secular institutions by emphasizing practical health benefits and simple instructions for how to perform techniques, coupled with stripped-down explanations of why techniques should be executed. Because the holistic philosophy presumes a “correspondence,” or equivalence and interpenetration, between material and spiritual realities,

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CAM providers can focus on physical techniques without being disingenuous. They choose to offer one, but not another, account of what CAM means to them, to broaden CAM’s appeal to potential customers. For instance, chiropractors explaining adjustments may provide detailed descriptions of anatomical structures and physiological functions, without mentioning that they believe that physical manipulations affect a spiritual force. A related strategy is to speak of health for “body, mind, and spirit” in language general enough for different audiences to interpret as they choose. Recognizing that the term New Age had become off-putting to many Americans, editors of the New Age Journal, after twenty-eight years of publication under that title, reinvented Body & Soul in 2002 to cast a wider net.29 The professionalization of CAM enhanced its secular public face. Holistic practitioners sought and won credibility by instituting more rigorous educational requirements, requiring training-school graduates to pass standardized examinations, awarding certificates, and regulating licensure. By 1974, all fifty states had chiropractic licensing laws, and the U.S. Office of Education established an accrediting agency for chiropractic colleges, expanding eligibility for federal funding. In 1976, California became the first state to license acupuncture. The Accreditation Commission for Acupuncture and Oriental Medicine and the Council of Colleges of Acupuncture and Oriental Medicine formed in 1982 and had accredited fifty-six schools by 2013. The National Certification Commission for Acupuncture and Oriental Medicine administers standardized examinations for certification in acupuncture, Chinese herbology, and Oriental body work. The American Academy of Medical Acupuncture offers certification for medical practitioners. The American Association of Acupuncture and Oriental Medicine, which encourages licensure, had twenty-three thousand members in 2012, out of perhaps forty-five thousand total practitioners. The Biofeedback Certification International Alliance formed in 1981 to administer written examinations for board certification. By 2011, forty-three states and the District of Columbia had laws regulating massage therapy, with oversight by the National Certification Board for Therapeutic Massage and Bodywork. There are more than three hundred accredited massage programs, which have certified ninety thousand therapists. Some states now restrict Reiki to Licensed Massage Therapists and require a nursing degree to practice Therapeutic Touch. The Yoga Alliance and the Yoga Research and Education Center likewise established professional standards and certifications to which yoga instructors may voluntarily conform, thereby augmenting yoga’s professional profile. Holistic providers appear more like other health-care professionals when they have initials after their names and diplomas on their walls.30

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Secular Settings Imply Secular Services Holistic health and wellness programs are widely available in such “secular” settings as business corporations, public schools, hospitals, and fitness centers. Meditation entered corporate America through stress-reduction workshops advertised as making executives and workers more efficient and profit-producing. The promise of enhanced performance attracted five hundred participants to the 2003 Spirit in Business World Conference in New York City, one of dozens of such annual gatherings that encourage professionals to rely less on rational thought and more on “inner wisdom.” When employers pay for personnel to attend workshops, employees assume that they will learn skills needed for business success, or else corporations would not foot the bill.31 Public schools introduce CAM programs, such as Transcendental Meditation, to improve the performance of teachers and students. Dr. George Rutherford, principal of the Ideal Academy in Washington, D.C., has been called the “Grandfather of the TM/Quiet Time program in America.” The David Lynch (filmmaker and TM aficionado) Foundation for ConsciousnessBased Education and World Peace has donated millions of dollars to sponsor TM in public high schools and middle schools, boys and girls clubs, and before- and after-school programs. The expansion of TM into public education did not stop even after a 1979 federal appeals court affirmed an injunction against teaching an elective class on the “Science of Creative Intelligence Transcendental Meditation” in New Jersey public high schools on the grounds that doing so amounted to an “establishment of religion.”32 Mindfulness meditation is surpassing TM for inclusion in public schools. The Association for Mindfulness in Education (AME) is a self-described “collaborative association of organizations and individuals working together to provide support for mindfulness training as a component of K-12 education.” Mindfulness seems conducive to classroom learning given the AME’s secular definition: “paying attention here and now with kindness and curiosity.” In arguing that mindfulness improves teaching, the AME begins with the uncontroversial premise that “good teachers share one trait: they are truly present in the classroom, deeply engaged with their students and their subject.” The AME implies that mindfulness makes teachers “present” and “engaged,” qualities that seem necessary to good teaching. The AME asserts that mindfulness helps students “focus and pay attention” so that they are “calmer and the class accomplishes more than on days when mindfulness is not practiced.” The claim sounds intuitive, since students who are not paying attention learn less. The AME reasons that since good teachers are present and engaged, and

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mindfulness makes teachers present and engaged, mindfulness makes good teachers. Since students learn more when they are calmer and more focused, and mindfulness makes students calmer and more focused, mindfulness makes better students. These conclusions do not, however, follow from the premises, since there is no evidence of a causal relationship. To assuage concerns about religious establishment, the AME insists that “mindfulness practice does not depend on or interfere with any religion, cultural context or belief system. Mindfulness can be completely secular.” The AME notes the entrance of mindfulness into secular businesses, hospitals, and schools: “Fortune 500 companies provide mindfulness instruction to their employees to reduce onthe-job stress, hundreds of hospitals refer patients to courses in MindfulnessBased Stress Reduction to develop skills to cope with physical and emotional pain, and dozens of schools (private and public) across the country are using mindfulness practices to help their students succeed.” Readers might infer that secular institutions would not endorse mindfulness if it were not secular.33 Public schools are also adding yoga to the school day. The “Yoga Ed.” program was introduced into Aspen, Colorado, and Los Angeles, California, public school systems by Tara Guber, wife of movie producer Peter Guber (whose films include Batman). By 2011, one hundred fifty schools in twenty-seven states and eight other countries had adopted Yoga Ed., and seven hundred public-school teachers were certified to teach yoga in their classrooms. Crucial to Guber’s success was distancing yoga from religion. She argued before school boards that “this is not a religious-, dogma- or faith-based program. We don’t chant or recite specific principles or philosophy. It is not connected to any belief system.” In order to overcome resistance from “fundamentalist Baptists” on school boards, Guber removed religious language, for instance, replacing samadhi with “oneness,” meditation with “time in,” and pranayama with “bunny breathing.” As one of Guber’s followers suggested during a 2002 school-board dispute, “semantics is all we are talking about. We can change a few words and make it all happen [i.e., get the curriculum approved].” And this is exactly what Guber did.34 After the Yoga Ed. controversy had died down, Guber revealed her motives in a 2004 interview with Hinduism Today. The article is titled “Tara’s Yoga for Kids: One Noble Soul Takes on the Public School System and Wins a Vedic Victory.” Guber confided to her interviewer that she had been disingenuous in presenting yoga as nonreligious as a necessary condition for getting it into the school system. She expressed confidence that the practice of yoga, whatever its components are called, would “go within, shift consciousness and alter beliefs.” Since participating classroom teachers receive yoga instruction at local studios before being certified to teach Yoga Ed., teachers “undergo some

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degree of personal transformation that would enable them to convey, primarily through example, the deeper and more meaningful experience of yoga to their students in class.” Thus, getting yoga in the K–12 schoolroom door, even minus Hindu language, constituted a “Vedic victory.”35 Yoga is also taught on college campuses. Brad teaches for-credit yoga at a public university. When he claims that yoga is “not religion,” what he means is that yoga is a “more complete system than many religions tend to be.” Yoga is more, not less, than religion. Although Brad denies requiring students to experience yoga “through a religious lens,” in his view, yoga and religion “come from the same source,” and yoga is the “hub for all Eastern religions.” Brad elaborated on the hub notion in an interview by saying that “yoga can be thought of as the energy surrounding all gods.” Brad’s course syllabus includes instructions on how to practice mindfulness meditation, which he recommends to students as the “core” of yoga and the “best way to appreciate the sacredness of everything.” Yoga the College Way identifies the “core” purpose of asanas and meditation as “salvation, enlightenment, or union with Brahman, the Divine,” goals that the author admits are “inappropriate for a public school setting.” The text proposes that university yoga instructors should describe asana as a “pose” with physical benefits and meditation as “‘positive thinking,’ stress reduction and/or relaxation techniques.” Professing that yoga’s “spiritual paths can be followed or bypassed,” the textbook explains how to meditate using the syllable “Om.” The “written word ‘om’ is a very powerful object at which to gaze. It visually represents the divine, but also conjures up the sound of the divine.” Om is a mantra, a “sacred sound repeated to bring one to a higher state of awareness of God,” and has an “essence that has divine, cosmic energy, giving it special power. It reflects on a specific deity with a certain meter or rhythm.” This language goes beyond description to teach students how to follow yoga’s “spiritual paths.” Such crossings of informational/inspirational boundaries raise questions about whether yoga is being—or can be— taught in public schools without establishing religion, an issue considered in the concluding chapter below.36 Hospitals present CAM as integrative medicine. The American Hospital Association reports that 42 percent of U.S. hospitals offered CAM in 2010, tripling since 2000. Some of the most prestigious hospitals—Duke University in Durham, North Carolina; M. D. Anderson in Houston, Texas; the University of California at San Francisco; and Memorial Sloan-Kettering Cancer Center in New York City—have integrative medical centers. The University of Massachusetts Medical Center Stress Reduction Clinic teaches mindfulness meditation and yoga. Boston’s Beth Israel Hospital has an integrative-healing wing that fosters a “Zen” environment. The Cancer Treatment Centers of

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America have a Naturopathic Medicine Department focused on “whole-body wellness, including the immune system, digestion, sleep, energy levels, diet, exercise and spirituality”; services include Chinese medicine, acupuncture, homeopathy, hypnotherapy, and biofeedback. Major health providers, such as Kaiser Permanente, offer discounted rates on yoga, massage, acupuncture, and chiropractic.37 Hospital administrators added CAM because market surveys show that patients want holistic care. Eighty-five percent of hospitals offering CAM cite patient demand as a rationale, compared with 70 percent claiming clinical effectiveness. Former CEO of Beth Israel Hospital Matt Fink explains, “If hospitals don’t get involved in these kinds of programs they will lose patients because patients will go elsewhere.” In an economically precarious health market, conventional providers must appeal to patients or lose to competitors.38 Offering CAM in conventional medical settings, especially when standard medical insurance covers costs, enhances CAM’s perceived medical legitimacy, creating a positive feedback loop that further increases demand. The Mayo Clinic identifies meditation as a medical, instead of a religious, practice by noting that “individuals are usually referred by their doctor to the meditation program” and that in the Mayo Clinic program, “a physician” teaches how to meditate—in person or downloadable as an iPod application. The AYA Web site advertises that “many physicians now recommend Yoga practice to patients at risk for heart disease, as well as those with back pain, arthritis, depression, and other chronic conditions.” A national survey found that 21 percent of people who used yoga as a CAM therapy in 2002 did so because a conventional medical professional recommended it. A college student interviewed, Rachel, recalled feeling disconcerted when a massage therapist balanced her energies, because the practice seemed spiritual; but when a medical doctor prescribed massage administered by a physical therapist, the context made the massage seem medically legitimate. Seeking to put patients like Rachel at ease, CAM backer Kay Koontz suggests that “if you are considering trying some form of energy medicine, a good place to start is at a universityor hospital-based center for complementary medicine. These centers typically offer the services of practitioners who have formal training and certification by a national membership organization.” Labeled energy “medicine” and dispensed by hospital-based, certified providers, CAM appears comparable to conventional medicine.39 Fitness centers portray martial arts as a distinctive brand of self-defense, exercise, or sport—one surrounded by the mystique of cultivating extraordinary physical and spiritual power. During the 1970s and 1980s, Englishdubbed Hong Kong and Hollywood films introduced Americans to kung fu

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and ninjas, generating curiosity and fascination. Hong Kong actors Bruce Lee and Jackie Chan and European-American Chuck Norris (an Air Force veteran who learned martial arts in Korea and an outspoken Christian) became cultural icons. Martial arts found a niche among youth and children through films such as The Karate Kid (1984) and animated series such as Chuck Norris: Karate Commandos (1986), Teenage Mutant Ninja Turtles (1987), and Pokémon (1990s), alongside related comic books, video games, action figures, trading cards, and cereal-box advertisements. More indirectly, the Star Wars series (1977–2005) disseminated mystical ideas of the “Force” as “an energy field created by all living things” that “binds the galaxy together”; one of the greatest Jedi warriors is named “Qui-Gon Jinn,” which sounds very much like “qigong.”40 Martial arts have become as American as baseball. Market researchers estimated in 2002 that more than 18 million Americans, including more than 3 million children and 5.5 million teenagers, had participated in martial arts in the past year. Of the 5 percent of Americans who practice martial arts, 28 percent affirm that they do so “every chance they get.” Men are slightly more likely than women to participate (52 percent versus 48 percent of the group). Asian-Americans and European-Americans join at approximately equal rates, but African-Americans (7 percent of this group) are more likely to be involved. Teenagers participate at higher rates than their parents (25 percent of boys, 22 percent of girls), as do children ages six to eleven (13 percent). Sixty-nine percent of karate-practicing teens also did yoga in the past year.41 The buffet of martial-arts classes available at gyms and public schools offers something for every demographic, including youth, the elderly, selfsufficient women, and muscular men. Whereas karate is marketed as teaching youth self-defense skills, t’ai chi provides gentle exercise for the elderly. Women who are like tae kwon do practitioner Emily Culpepper find selfdefense training physically and spiritually empowering; when a woman living in a “patriarchal world . . . realizes fully that she could fight back if ever she were attacked, she is experiencing the power of her re-being. . . . the oneness of my body/mind/soul” (see figure 7.2). People also identify martial arts as “combat sports, ” in which combatants use “fighting techniques according to a set of prearranged rules.” By this definition, martial arts are ideologically neutral competitive sports rather than philosophy, religion, or simple violence. Judo was recognized as an Olympic sport for men in 1964 and for women in 1988. Promoters portray judo as a sport that “demands a lot of the athlete . . . glycolytic energy production in energy bursts as well as the need for an aerobic capacity to maintain activity.” The label combat sports legitimizes the nearly unrestrained violence of mixed martial arts (MMA), a name coined in 1995.

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Before the 2000s, MMA was banned across the United States because of its violence. Today the sport is legal in most states and best known through the pay-per-view Ultimate Fighting Championship.42

Conclusion CAM did not become mainstream by chance. Consumers wanted holistic care for body, mind, and spirit and did not find it in hospitals or churches. Market-savvy CAM publicists advertised techniques to alleviate fears of the costs of modernity and to promise practical health benefits such as physical fitness and stress reduction, while downplaying religious rationales—at least, when communicating with administrators and beginning practitioners. Promotional campaigns appealed to diverse constituencies: relieving suffering of those in chronic pain or desperately ill, helping those harried by busy routines of modern life to relax, inspiring the already fit to stretch toward optimal health, equipping CEOs to gain a competitive edge, and socially and spiritually empowering those with minimal access to political or economic power. Young

figure 7.2 College students practicing tae kwon do and meditation in a public university gymnasium, 2011. (Courtesy Erin Garvey)

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and old, men and women, people of diverse racial and ethnic backgrounds all found CAM products that were just for them. As CAM spread virtually everywhere, with distinctive goods and services targeted to each subculture, it became more and more likely that everyone would try at least something. Equally as significant as intentional marketing is the unintentional logic of the market. Selling CAM alongside other commodities makes CAM seem secular rather than religious. As consumers spend billions of dollars on CAM annually, the economic value of CAM boosts its secular status, and secular status in turn powers the growth of CAM industries. Workers’ compensation and insurance investigations discovered that CAM can save insurers money, because—regardless of whether CAM produces specific benefits—people who use CAM visit conventional doctors less frequently and request fewer drugs or medical procedures. Although CAM use may have reduced prescription-drug spending, American consumers spent $17 billion on dietary supplements in 2000. The most common approach within the CAM rubric is use of “nonvitamin/nonmineral natural products,” employed by 18 percent of Americans in 2007. Consumers who have positive experiences with one form of CAM are more likely to try other products that share the CAM label. In effect, every option branded as CAM appears more normal, and once-obscure CAM modalities enter the mainstream. When First Lady Nancy Reagan visited an astrologist in the 1980s, it made national news headlines. Today few people raise an eyebrow when celebrities do yoga, receive acupuncture, or select homeopathic options. The more people can think of examples of CAM usage, the less CAM seems out of the ordinary, and this encourages still more people to give CAM a try.43 The processes through which CAM became widely available for sampling in secular settings can be better understood through a case study. Chapter 8 depicts the integration of energy medicine into the conventional health-care system.

8

Energy Medicine How Her Karma Ran Over His Dogma

marcia backos asks rhetorically, “Should Christians Practice Reiki?” on the ChristianReiki.org home page. Conceding that Reiki has an “Eastern origin,” Backos attests that Reiki helps Christians to “follow more closely the teachings and examples of Jesus healing the sick.” In typical evangelical fashion, Backos cites Bible verses, such as John 14:12 and 1 Corinthians 12: 7–9, that enjoin Christians to follow Jesus by healing. Backos appeals to the “long tradition” in the Christian church of adapting “many and varied practices” from popular culture—such as contemporary music and dance—to “come closer to God.” In deciding whether to adopt cultural resources, the priesthood of all believers should gather information that is “accurate and gives an honest and fair description” and pray “for guidance.” Backos suggests that the best source of information about Reiki is “those who have given or experienced Reiki,” rather than Reiki’s critics. The article concludes, “Scripture clearly indicates that healing is something appropriate for Christians to be involved with. Christians who have a solid foundation in their faith know that God will always protect and guide them.” Backos reasons that since the Bible teaches healing through laying on of hands and Reiki also teaches healing through laying on of hands, Reiki is consonant with the Bible. Since her readers presumably want to see themselves as having a “solid foundation in their faith,” Backos represents fear of Reiki as signifying weak faith and acceptance of Reiki as evidence of solid faith.1 The case study of energy medicine—a broad category that includes Reiki, Therapeutic Touch, and Healing Touch—illumines some of the processes through which CAM entered the secular and Christian mainstreams. Affirming that energy medicine is spiritual and scientific but not religious,

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providers use treatment and training practices inspired by Buddhist, Hindu, and Western metaphysical traditions. This chapter explains how practitioners accessed the conventional health-care system and Christian clienteles through two channels. First, providers disguised the metaphysical aspects of their practices when interacting with hospital administrators and patients in pain. Second, promoters appealed to female nurses already within the medical system who felt disempowered by a male-dominated medical hierarchy.

Reiki: Religious or Spiritual? The term Reiki, from the Japanese Rei, which can be translated as “spirit,” “sacred,” or “Universal Life,” and ki or “energy,” is often described as “universal life energy.” There has been much debate among researchers, practitioners, and consumers about whether Reiki is nondoctrinaire spirituality or has religious roots and, if the latter, whether roots are Buddhist or Christian. Despite contested origins and disavowals of religion, modern treatment and training draw explicitly on Buddhist and metaphysical concepts that fit a broad definition of religion.2

Origins There is not a single, unified Reiki tradition. There are multiple lineages, each of which claims authenticity and authority. Some practitioners believe that Reiki originated in Tibetan or Indian Buddhism more than twenty-five hundred years ago. Others trace origins to Mikao Usui’s (1865–1926) innovations in Japan in 1922. Details of Usui’s biography are contested, but according to some accounts, Usui was a Japanese Buddhist monk who lived in a Zen monastery. Before developing his method, Usui had reputedly studied Chinese qigong and Buddhist, Taoist, and possibly Shinto healing, and he had been traveling around to Buddhist monasteries in Tibet and Nepal. Such religious combinations were not exceptional or generally looked down upon in Usui’s social context. By contrast with evangelical Christians in the United States, who seek to exclude other traditions in a quest for religious purity, Usui and his peers valued inclusion of elements from multiple traditions as enriching. Reiki can be viewed as one of a number of new religious movements that have developed in Japan since the nineteenth century, building upon preexisting beliefs and practices and borrowing, combining, and augmenting them in novel ways. Tradition has it that Usui was ending a twenty-oneday fasting retreat on Japan’s Mount Kurama (site of Kurama-dera Temple, a

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popular destination for performance of ascetic practices) when he received a spiritual revelation or “shamanistic ecstasy” during which the Reiki symbols burned through his body. Usui passed on this Reiki “attunement,” or spiritual empowerment, to Chujiro Hayashi, who, in turn, attuned Hawayo Takata, a first-generation Japanese-American woman from Hawaii who was at the time visiting relatives in Japan. Takata has been credited with bringing Reiki to the United States and attuning the first twenty-five American Reiki masters.3 Those who wish to disassociate Reiki from Buddhism (to argue that the practice is religiously neutral) emphasize that Usui’s method “came to him spontaneously” during his spiritual experience. Other healers affirm that the Reiki symbols—several of which are Japanese Kanji characters put to ritual use—have been employed by multiple Buddhist sects for centuries. The Reiki attunement rituals resemble a series of four Buddhist empowerment initiations in which teachers transfer energy to students. The Buddhist Vase Empowerment, Mystical Empowerment, and Divine Knowledge Empowerment remove karmic obstructions, allow students to visualize specific deities, open the flow of ki, and give mantras their effectiveness; the Absolute Empowerment heals consciousness.4 In order to establish distance from Buddhist symbols and rituals, certain Reiki healers developed a founding myth of Christian origins. The story, which has morphed into several versions, goes that Usui was a Japanese Christian minister, a Christian professor of theology at Doshisha University, a Christian minister working at a Christian seminary, the president of a Christian school, the head of a Christian boys school in Japan, or at least a Buddhist who “lived with a Christian family and had Christian friends.” The traditional account is that “one day some of the students asked him if he believed in the miracles which Jesus did (healing, etc.). Being a Christian minister he answered ‘Yes.’ They asked if he knew how Jesus had done this. ‘No’ he said.” Disturbed to realize that “he had accepted the beliefs of Christianity without investigating them for himself,” Usui undertook a lifelong quest to discover how Jesus had healed. He reportedly traveled to the United States and spent seven years at the University of Chicago earning a doctorate in Christian theology before traveling to India to study Sanskrit sacred texts and returning to Japan to study scriptures of Japanese Buddhism.5 Some researchers deny that any element of the Christian origins story can be defended. There is evidence that Usui was a Buddhist monk. There is no evidence that he ever worked at a Christian school or associated with Christians. He never enrolled at the University of Chicago and probably never visited India. Yet, as one Reiki promoter explains, the myth was “probably created . . . to give Reiki more appeal to people in the West,” where Christianity is

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dominant. Those invested in making Reiki acceptable to Christians, such as self-identified Christian Reiki masters Bruce and Katherine Epperly, maintain that the Christian version “still contains an eternal truth that transcends a purely factual record.”6

Treatment Because the history and nature of Reiki are disputed, generalizations about how Reiki is practiced must allow room for exceptions. Reiki may be performed on oneself or another person. During treatments, clients may lie or sit down. The practitioner often begins a session with her (a majority of American practitioners are women) hands in “praying hands” or gassho position at the chest or face while mentally focusing in preparation (see figure 8.1). She moves her hands over various parts of the client’s body, applying a series of up to twenty-seven hand positions, each held for several minutes. These hand positions “cover the main chakra centers and the main meridian channels that the life force flows through.” Both clients and practitioners report that Reiki touch feels “warm, even hot, and deeply soothing.” Hand positions

figure 8.1 Reiki healer beginning session in gassho praying hands position, 2011. (Courtesy Erin Garvey)

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may be held between one and three inches above the body, “in the Aura without physical contact” (see figure 8.2). A full treatment can take between fortyfive and ninety minutes and may be repeated weekly or daily. Practitioners may end a session by thanking their “Spiritual Focus” for the gift of Reiki.7 Reiki may be performed at a distance in a practice called “beaming.” Distance healing requires Reiki symbols. The practitioner might “draw them with your hand or third eye and mentally say the power and connection symbol name/mantra,” repeating the mantra three times. The “third eye” is the “seat of the will and of clairvoyance” and provides “intuitive insight” into “areas of blockage or congestion.” Other approaches to distance healing include “drawing the symbols over a photo with the intention of sending Reiki to the person represented,” or using a “teddy bear or doll as a proxy,” or holding a piece of paper with the person’s name on it while sending Reiki. Some practitioners “ask Guides or helping Deva [Nature Spirits] to do the treatment as the practitioner holds the connection.” Peggy Jentoft, a Reiki master who practices in Los Angeles, California, and has a prominent Internet presence, affirms that Crystal Deva, Flower Deva, and color and sound energy are usually present

figure 8.2 Reiki position in the patient’s aura targeted at foot pain. This treatment session also addressed goals of weight loss and guidance with intuition on relationships, 2011. (Courtesy Erin Garvey)

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during her treatments. Jentoft also reports that during distance healing, she can “feel a ‘Reiki beam’ go from my hands and/or heart, etheric heart, crown and third eye [chakras], to the person.” Distance is not considered a barrier, because Reiki travels energetically and does not require a physical conduit. Some practitioners have extended this logic to imply that Reiki “attunements” (or initiations) can be given at a distance, for instance, over the telephone or the Internet or by auction on eBay, or that individuals can perform “self-attunements” with help from Web sites, books, or DVDs. Many Reiki masters reject the validity of distant or self-attunements (which, if accepted, would result in loss of status and income for formally trained Reiki masters).8 Reiki may be directed toward animals, plants, or inanimate objects. Jentoft suggests that “cut flowers can be given a Reiki treatment which may help to preserve them longer.” Jentoft has “given Reiki to wounded Dragonflies and they seemed to love it. Trees are an amazing reservoir of universal energy and often they respond to receiving Reiki energy by giving energy back to the giver. So go and hug a tree and feel them ‘blessing’ you. Some trees are really surprised to have people offer to give them anything.” Reiki can also be given to machines and used in “Earth healing” and “treatment of world events.” Reiki masters Anne Charlish and Angela Robertshaw’s book Secrets of Reiki (2001) recommends giving pets daily treatments, giving Reiki to house plants, and using distance healing on various rooms in the house “to help the energy flow.” One can aid “every meal to enrich you spiritually as well as physically by giving your food reiki,” and “if you are offering a special gift or keepsake to a loved one, treat it with reiki first.” Such practices reflect a belief that Reiki is the energy that enlivens all reality, both animate and inanimate.9

Training Teachers pass Reiki on to students. Instruction at one time consisted of three degrees, culminating in the designation “Reiki master.” Some instructors added a fourth degree to distinguish a level III Reiki master from a level IV “teaching” Reiki master who is ready to take students. In the early twentieth century, students had to wait at least six months between Reiki I and II and at least a year between Reiki II and III. Today some instructors offer workshops that progress through all three levels in one weekend.10 Diane Stein, a popular Reiki master who offers condensed classes to students who fly to her Florida headquarters, justifies her approach. Stein makes it easy for students to progress through all three Reiki levels quickly, because it is “crucial for Reiki to become universal” and “for as many people as possible to become Reiki teaching Masters.” This is because Reiki assists people (and

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animals) in “going beyond the mind to the Buddha Nature (Goddess within) in all of us . . . Oneness, You are Goddess,” or “ascension.” Once this state is achieved, “this releases the Be-ing from the wheel of incarnation,” because all “Earth karma has been resolved.” Then, “when enough people have cleared their karma and attained enlightenment, a critical mass will be reached,” and “everyone will be granted it. There will be no more karma for anyone, and the Earth itself will receive ascension.” Although the concept of karma may implicitly blame suffering people for making choices that led to their predicaments, attributing problems to karma offers hope that individuals can make better choices to escape karmic burdens.11 Reiki I, if offered by itself, is usually taught as a weekend seminar. Students learn a brief history of Reiki (sometimes including its allegedly Christian origins) and the basic hand positions. Instructors may opt for vague language in describing Reiki to beginners. Jentoft’s Reiki Level One Manual introduces the practice simply as a “natural system of energy healing” that “helps to cleanse the body of energetic and physical toxins.” The climax of Reiki I is an initiation ceremony during which the Reiki master gives each student individually a series of four “attunements” (sometimes condensed into a single attunement). Reiki veterans understand attunement to be a “sacred ritual” that “opens” the student to become a channel for the flow of healing energy.12 Different Reiki masters use various procedures in performing attunements. Some invite “angels, ascended masters, guides,” place a “healing grid or gateway in the room,” or use a pendulum to analyze energy patterns. Attunements sometimes involve rituals of “smudging with sage, chanting, bell ringing, drumming, speaking in tongues,” or “casting a circle.” A lit flame from a candle attracts the “Light and invites Reiki guides and other Light Be-ings to help with the healing.” Standing on sea salt helps the Reiki master go farther “psychically since the grounding is your safety line when going out of body.” Masters may ask an initiate to “bring his/her hands together as when praying . . . close your eyes and go within.” Masters “activate the Reiki energy” by drawing or visualizing the four Reiki symbols over initiates in the master’s own aura, silently stating an intent to attune the student and repeating the mantras that represent the symbols. The silent repetition of mantras serves to “create an energetic vibration that helps balance and realign the chakras and alter the flow of the body’s energy.” The master may touch the student’s shoulders and “smooth the aura three times from head to feet.” In a “crown to crown attunement,” energy flows through the teacher’s and student’s “crown Chakras . . . connecting the energies, permanently enabling the student to run Reiki.” This happens as the “Rei or universal energy makes adjustments in the student’s chakras and energy pathways to accommodate the ability to

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channel Reiki through symbols.” During attunement, “the Master’s aura is merged with the student’s for the time of the attunement. While this occurs, some piece of karma is removed and released from the student.” Those receiving attunement may “briefly experience past lives from when they had Reiki before, [or] see their Goddess in front of them.” After attunement, students can practice Reiki on themselves, family, and friends.13 During Reiki II, often offered as a weekend seminar, students learn symbols and connected mantras and receive an attunement to open a “special channel in the mind” to facilitate “intuitive” ability to “communicate with the subconscious mind of the client” and with the “client’s Higher Self.” Reiki II includes “advanced Reiki techniques,” such as using symbols for distance healing, meditation to enhance psychic abilities, spirit guidance from “Guides and angels,” and crystals, on the premise that “even rocks possess consciousness.” Early Reiki masters regarded symbols as “sacred” and did not reveal them to anyone not initiated into Reiki II. The symbols are, however, no longer a well-preserved secret, because certain Reiki masters published the symbols and instructions for how to draw them (important, since few U.S. practitioners know how to write Japanese characters). Jentoft includes the symbols in her online Reiki manuals because she comes from a Buddhist tradition that considers it a duty to show “sacred texts to people in order to plant a seed for future enlightenment.” Likewise, Diane Stein’s book Essential Reiki (1995), which has sold three hundred thousand copies, reveals the symbols.14 There are at least four major Reiki symbols and mantras. These are power (Cho Ku Rei), mental/emotional (Sei He Ki), distance (Hon Sha Ze Sho Nen), and master (Dai Ku Myo). The power symbol, as interpreted by certain practitioners, “calls in higher universal energy” and “signifies the highest place, that which humans cannot reach which is the source of Reiki.” This symbol is sometimes called the “Light Switch,” or “‘Put the power here,’ or ‘God is here,’” because it allows one to “focus power in one spot, by calling in the energy of the Goddess/Universe.” The power symbol may be used to “clear rooms and crystals and to charge food and water.” The mental/emotional symbol is used to “facilitate emotional and mental healing and to assist self programming and treating addictions and habits.” This symbol represents “Protection, Purification, Clearing/Cleansing, Releasing Attachments,” “‘The Earth and Sky come together; as Above, so Below,’ . . . ‘Key to the universe’ or ‘Man and God becoming one.’” The distance symbol, which is empowered by speaking it aloud, is for “sending the energies hands off, for absentee healing and treating Issues from the past including past life issues,” releasing karma, and projecting healing into the future. This is possible because “when you rise

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above the physical, all time happens at once.” The distance symbol represents “no past, no present, no future,” “‘Open the Book of Life and now read,’” “‘The Goddess in me salutes the Goddess in you’” or “‘The Buddha in me reaches out to the Buddha in you to promote enlightenment and peace.’” Reiki II may include only the first three symbols (possibly alongside additional symbols), reserving the master symbol for Reiki III.15 The master symbol transmits Reiki attunements and may be drawn at the beginning and end of distance healings “to open and close the receiver’s aura.” This symbol “increases the intuitive and psychic awareness,” activates the “7th chakra,” and “has its value in the function of connecting to sacred being and becoming part of it.” The master symbol (which can be translated as “great shining brightness”) represents “Self empowerment, Intuition, Creativity, and Spiritual connection,” the “Goddess’s double spirit,” “Buddha Nature,” “enlightenment,” or “the entire universe.” Together, the Reiki symbols reflect “levels of mind” or “nonduality of mind and object and the emptiness from ego that achieves the highest level of the end of the Path of Enlightenment (Buddhist nirvana)”—ideas commonly associated with religions.16 The last element of Reiki II, at least as taught by Stein, is instruction in “Power Exercises” similar to those taught in some advanced yoga and qigong classes. Stage One exercises “teach you to channel Ki energy,” focusing on “spiritual awareness and connection of the spiritual and physical through the controlled transmission of energy,” and bringing “unity of body, mind, and spirit.” Stage Two exercises pass Reiki attunements. Both exercise sequences channel spiritual energy through sexual means.17 For Stage One Power Exercises, practitioners should be “skyclad,” or nude. A woman should “sit with legs open, so that you can press the heel of one foot against your vagina and clitoris. Use a firm, steady pressure. If you cannot bend your body to do this, use a tennis ball or larger crystal to create the pressure. You may experience sexual stimulation or orgasm.” Next, “rub your hands together, creating friction and heat.” Then “place your hands on your breasts, feeling the heat from your hands,” and “move your breasts slowly up and out in upward circular motions.” A man should “rub your palms together rapidly, raising heat and energy in your hands.” Next, “cup the testicles with your right hand so that the palm completely covers them. Do not squeeze, use only slight pressure and the heat in your palm.” Then “place the palm of your left hand at the Hara [chakra], an inch below the navel. Using slight pressure, and feeling a growing warmth from your hand, rotate your left hand clockwise in a circle 81 times.” Finally, “when the energy connection is complete, you will feel a chill or tingling move through the spine to the head, similar to orgasm.” In this rendering, spiritual and sexual energy merge.18

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Stage Two Power Exercises require learning the “Hui Yin position” to connect the “Kundalini and Hara Line energy channels and their chakra systems.” For a woman, the Hui Yin position resembles “Kegel exercises” to enhance sexual performance or prepare for childbirth. One can hold this position of the perineum long enough to pass Reiki attunements by “drawing-in” the muscles of the anus rather than the vagina. Men also use the anus. One should place the tongue tip “on the roof of your mouth, in the groove behind the teeth on the hard palate” and “take a deep breath and hold it.” In passing attunements, one maintains this position for two or three minutes with breath held and then for as long as possible without holding the breath. Holding the perineum and the tongue in position “connects the Governing and Conception Vessel meridians, creating a closed energy circuit.” This diverts energy “through the Hara Line” and transmits it “through your body to release in your breath and hands.” One should “feel a charge of energy travel through the Microcosmic Orbit/Hara Line.” One may “sense the moving figure 8 of the Egyptian Infinity symbol” and “experience sexual arousal or orgasm, or become multi-orgasmic.” Reiki masters hold this Hui Yin position while passing spiritual attunements.19 Reiki III involves further instruction, often one-on-one, and a final attunement. This highest attunement “marks a shift from the ego and self to a feeling of oneness with the universal life-force energy.” Stein tells her students—who develop from novices into Reiki masters in a single weekend— that they are fully prepared to pass attunements. The reason is that “your Reiki guides, Goddess, or whatever Light Being works most closely with you will play a very large part in your attunements. It is she who passes them, in fact— you are only doing the hand motions. You will become very aware of a guided presence working through you when you do the attunement process.” For this reason, it is important to “make space in your healing work for psychic information and guidance.” Reiki masters should draw the symbols “exactly and correctly, with the lines in precise order.” But even if the developing Reiki master makes a “mistake in drawing the symbols, the Light Be-ing will correct it. ‘We fix’ is what I have heard so many times.” The Reiki master is only a conduit for the intelligent flow of life-force energy.20

Defining Reiki as Spiritual but Not Religious Despite referring to Buddhist and Western metaphysical concepts when performing Reiki treatment and training, practitioners claim that Reiki is spiritual but not religious. This distinction identifies Reiki as a worldwide practice that will not interfere with anyone’s religion and distances Reiki from negative connotations of religious “dogmatism.” Charlish and Robertshaw attest that

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“Reiki is not a religion and can therefore be practiced by people of different faiths. Unlike some forms of healing, it has no specific religious dogma associated with it. Instead, reiki is about encouraging people to have trust in themselves and in the universe.” Jentoft avows that “Reiki is not religious. There is no dogma involved with Reiki. . . . Being attuned to Reiki does not entail any conversion or adoption of spiritual beliefs or practices from any religion or particular set of beliefs. Reiki and other energy healing modes will harmonize with most spiritual belief systems that allow for the existence of energy work.” Stein affirms that Reiki is Buddhist but denies that either Reiki or Buddhism is religion: “Reiki is not a religion, and Buddhism is more a way of thinking, a philosophy of how to live, than it is a religion.” Reiki is, nevertheless, for Stein a “very sacred” way to channel energy from the “Goddess/Source.” Each of these authors articulates a narrow definition of religion—one strongly shaped by evangelical Protestant assumptions about the primacy of doctrine—and asserts that Reiki does not fit the definition. The authors nevertheless discuss Reiki in terms that could be considered religious by broader definitions.21 Although they distance Reiki from religion, promoters affirm that Reiki energy is not merely physical but spiritual. According to the International Association of Reiki Professionals, Reiki uses “spiritually guided life force energy.” Other practitioners say that Reiki “animates all living things, gives order to our world, and is the underlying creative intelligence of the universe.” Reiki energy possesses its own “higher intelligence” and “innate wisdom to guide itself,” so that it “goes wherever most needed in the body and aura.” The aura extends “two to five feet in most people” and consists of at least seven layers: etheric, emotional, mental, causal, etheric template, intuitive, and cosmic. Reiki energy collects in chakras, “energy vortexes that give life to your energetic body, which is another name for your spiritual body, the part of you that has eternal life.” It is common to refer to seven chakras: throat, heart, sacral, root, solar plexus, third eye, and crown. Reiki energy is “sacred . . . a divine gift,” similar to “the Chinese ling qi; the Indian maha para shakti; and the Western divine light.” The “many names” of Reiki include “Prana, Mana, Chi, Ki, Orgone energy, Bioenergetic plasma, Divine breath, Cosmic Pulse, Vital Fire, among them.” Or “those with an agnostic or atheistic belief system” may prefer to think of Reiki as “universal, natural, scientific healing energy” or an “electro-chemical energy system.” Advocates describe Reiki as spiritual and scientific but not religious.22 Practitioners bolster Reiki’s nonreligious status by charging substantial fees for treatment and training. People tend to view religion as free or donation-based but associate fees with professional services. In the 1980s, Reiki I cost $150 to $250, Reiki II $600 to $1000, and Reiki III $10,000. By 2007,

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all three degrees could be garnered in a single weekend for $500 to $600. The number of people learning Reiki grew as fees became more modest. In 1995, there were seven hundred fifty teaching Reiki masters worldwide, one-third of whom lived in the United States. Ten years later, there were several thousand Reiki masters globally. Once credentialed, healers charge for treatments; some establish sliding fee scales of up to a day’s wages for a single session. Reiki healers justify charging for their services based on the principle of “exchange.” The spiritual premise is that “one must give some exchange to receive full benefit and must balance any exchange of energy and that free treatment creates an unacceptable spiritual debt for the healee.” Requiring a financial commitment forces those seeking healing to “consider how reiki features as a priority in your life,” producing a “lifelong connection with reiki” (see figure 8.3).23

Therapeutic Touch and Healing Touch: Metaphysics or Medicine? By comparison with Reiki, Therapeutic Touch has a relatively brief and uncontested history, and the technique is simple. Dolores Krieger, a professor of

figure 8.3 Tourists travel to Sedona, Arizona, reputed to be a site where spiritual vortexes converge, to explore energy healing at businesses like this one, 2011. (Photograph by author)

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nursing at New York University, introduced the term Therapeutic Touch to the medical community in an article published in the American Journal of Nursing in 1975. Krieger self-identifies as a Buddhist and attests that she took ideas from hatha and Tantra yoga, Ayurvedic medicine, Tibetan medicine, Chinese medicine, and martial arts. Krieger credits Dora Kunz, president (from 1975 to 1989) of the Theosophical Society in America, with providing a theoretical foundation and acting as her primary mentor. Theosophy draws on Freemasonry, Hinduism, Buddhism, and Zoroastrianism, and it teaches reincarnation, karma, the presence of life and consciousness in all matter, and the power of thought to affect one’s self and surroundings. All of these ideas can be found in books by Krieger and Kunz. In addition, researchers trace some of Krieger’s ideas to mesmerism and claim that Krieger was a Reiki master before she developed her own technique.24 Although it uses religious concepts, Krieger classifies Therapeutic Touch as a technique that is spiritual and scientific but not religious. She acknowledges basing her concept of “energy” on the Hindu notion of prana. She asserts that prana is essentially the same thing as Chinese qi and Egyptian ka: “the life energy that is vital,” which flows through “nonphysical channels called nadis” and operates through the “chakra system.” Translating prana and related concepts for Western audiences, she frames them as scientific and modern. Krieger argues in her book, Accepting Your Power to Heal (1993): “According to this body of experiential knowledge [the Rig-Veda, texts important in Hinduism], there are three types of energies concerned with health. These are prana, previously mentioned as vital energy that underlies the organization of the life process; kundalini, which is concerned with creativity in the sense approximated by the psychological term libido; and energy that is somewhat akin to the Greek concept of eros, or love. The Therapeutic Touch process is primarily concerned with prana, although all three subsets of human energy are closely integrated.” The reference to “experiential knowledge” implies that Vedic principles have been empirically proven to be true through centuries of application. The religiously neutral term “creativity” and the modern psychological term “libido” domesticate the sexual connotations of kundalini. The invocation of Greek “eros” hints that Hindu ideas parallel Western intellectual traditions.25 The energy manipulated in Therapeutic Touch is spiritual. The basic theory is that human beings are “open systems” of “energy fields” that are both “psychic” and “physical.” Because people “do not stop at their skins,” healers can engage in the “human-energy-field interaction” that connects the “healer’s” and “healee’s” fields through the “wave phenomena.” Although scientists do not recognize the existence of nonphysical energy fields, Kunz argues that

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“these fields (like all those known to science) permeate space. Each individual is a localization (concentration) of energy within these universal fields. Moreover, these individual local fields interact with one another, being part of one whole, dynamic, and interdependent system.” Using this interdependence, the “healing act” consists of a “human energy transfer.” Krieger asks students to “conceive of the healer as an individual whose health gives him access to an overabundance of prana and whose strong sense of commitment and intention to help ill people gives him or her a certain control over the projection of this vital energy. The act of healing, then, would entail the channeling of this energy flow by the healer for the well-being of the sick individual.” Kunz affirms that she establishes “communication” with “angels and fairies” when channeling energy. She advises that healers incorporate “the recording of dreams, the drawing of mandalas [circular pictures considered sacred in Hindu and Buddhist traditions], and divination by means of consulting the I Ching,” an early Chinese text consisting of sixty-four symbolic hexagrams based on yin-yang that function as oracles.26 Recognizing the dominance of Christianity in American culture, Krieger advertised her method as an extension of the biblical practice of laying on of hands but superior because it is nonreligious and scientific. In Krieger’s words, “Therapeutic Touch derives from, but is not the same as, the ancient art of the laying-on of hands.” The “major difference” is that “Therapeutic Touch has no religious base as does the laying-on of hands; it is a conscious, intentional act; it is based on research findings; and Therapeutic Touch does not require a declaration of faith from the healee (patient) for it to be effective.” Krieger simultaneously invokes a Christian framework and distances her method from negative associations of religion or “faith healing,” appealing instead to the scientific authority of “research findings.” By replacing “faith” with “intention,” Krieger signals that practitioners do not need to hold any particular religious beliefs. Yet in order to perform Therapeutic Touch as a “conscious, intentional act,” the practitioner must believe that subtle energy exists and can be redirected.27 Despite the name (and regardless of allusions to laying on of hands), Therapeutic Touch does not require physical contact. The healer touches the patient’s “ether or vital layer of energy,” two to four inches from the body. This is different from Reiki, which includes both physical and spiritual touch. Also unlike Reiki, practitioners always perform Therapeutic Touch on another person, rather than themselves, other life forms, or inanimate objects, and they always do so proximally rather than at a distance. Training to practice Therapeutic Touch is less complicated or hierarchical than for Reiki, making it an easier addition to a crowded nursing curriculum. There are no separate

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degrees, no ceremonial attunements, and no distinction between “masters” and ordinary practitioners. A typical Therapeutic Touch session is briefer than a Reiki session, usually lasting between five and fifteen minutes—all the time on-duty nurses might be expected to have available.28 Performing Therapeutic Touch involves a simple, step-by-step protocol. The first step is “centering.” This is a “meditative perspective,” or “journey toward one’s inner being,” during which the healer envisions herself and the healee as a “unitary whole” connected by prana. Centering is, according to Krieger, “the undeniable source of the empowerment of Therapeutic Touch.” Step two is “assessment.” The healer places her open palms down several inches away from the healee’s body and “hand-scans” the energy fields from head to toe, allowing the “nonphysical structures” of the chakras to be “our teachers.” Areas of blockage or imbalance can be sensed as heat, cold, tension, congestion, thickness, heaviness, pressure, emptiness, leadenness, static, or pins and needles. In step three, “unruffling,” the healer focuses on a compassionate intent to heal while using circular sweeping motions to push energy away from congested areas, distributing the excess or sweeping it out through the feet. The healer gets the energy moving, providing “access to a mobile field” that facilitates “transfer of energy.” A crucial premise is that thoughts, emotions, and psychic intuitions touch and direct energy. Krieger teaches that what matters most in delivering an effective treatment is not “where you put your hands” but “how masterfully you use your mind.” Step four is “modulation,” or repatterning and reordering energy through “application of intentionality,” for instance, by visualizing colors. The fifth step is “re-assessment” of energy fields to confirm that they feel balanced and symmetrical. Finally, the healer shakes or washes her hands to remove excess energy. The delineation of discrete steps operationally defines Therapeutic Touch as a medical technique rather than a religious ritual, despite the spiritual aspects of each step in the sequence.29

Marketing Metaphysical Religion as Mainstream Medicine When the overtly metaphysical dimensions of Reiki and Therapeutic Touch are comprehended, the rapid integration of energy medicine into the modern health-care system presents a puzzle. There are at least two prongs to the solution. Reiki gained an audience among hospital administrators competing for patients. Therapeutic Touch and its offspring Healing Touch attracted female nurses already in the hospital system who desired empowerment in a healthcare hierarchy dominated by male doctors.

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Winning Over Hospital Administrators Efforts to market Reiki to hospital administrators as a nonreligious aid to stress reduction have been intentional, systematic, and successful. The American Hospital Association reported in 2007 that 15 percent of American hospitals, a total of eight hundred, offered Reiki. The 2007 National Health Interview Survey found that 1.2 million adults had used Reiki or another energy therapy in the past year. The “Center for Reiki Research Including Reiki in Hospitals” hosts a Web site dedicated to promoting “scientific awareness of Reiki” and advocating for inclusion in hospitals. The site provides a directory of seventy hospitals, clinics, and hospices that offer Reiki; summarizes published research; and sells a “Reiki in Hospitals PowerPoint Presentation” (for $25). The slide show, designed to persuade administrators to integrate Reiki into hospital care, reviews research and benefits of Reiki and lists “prominent hospitals that have Reiki programs”—suggesting that Reiki is an advanced therapy that the best hospitals offer. A significant feature of the Center for Reiki Web site is that vague general information pages are easily accessible to the public. In order to view other pages—including articles written by Reiki healers for other Reiki healers—it is necessary to register for a membership and log in. Membership is free, but this hurdle probably discourages the casual browser, making it less likely that unsympathetic audiences will “listen in” on in-group conversations.30 An article titled “How We Got Reiki into the Hospital” and posted in a members-only section of the Center for Reiki Web site, reveals how practitioners introduced Reiki into the Department of Oncology at Women & Infants Hospital in Providence, Rhode Island. In approaching the administration, two Reiki healers, Ava Wolf and Janet Wing, presented themselves professionally by crafting a polished introductory letter and proposal, dressing smartly for interviews, and submitting recommendation letters and client evaluations. But they also employed a psychic approach. Unbeknownst to hospital administrators, Wolf and Wing “used a visual affirmation to strengthen our inner intention to become active members of the Complementary Care Team. We each made a collage that included photographs of our faces, which we glued onto a photograph of the hospital staff. We also included images of material ease and abundance, directing our energy toward fair compensation for our services.” They sought to “follow the energy,” go where “the energy calls,” and “trust the energy” to gain entry. This intuitively led Wolf and Wing to develop “vocabulary so we could express our healing concepts in medical terminology.” To this end, “we spoke of Reiki’s value as a technique for stress reduction, defining it as ‘energy nutrition’ and an effective touch therapy. We

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found that the concept of Mind/Body/Spirit connection was acceptable, but avoided references to channeling, auras, energy fields, guides, and spirituality. We endeavored to ‘normalize’ Reiki, to meet pragmatic scientific people on their own terms.” Wolf and Wing say they also “enhanced our credibility” by winning approval to count Reiki training for the continuing education units required of nurses. When describing Reiki to patients, Wolf and Wing “kept it simple. We introduced ourselves, explained briefly that Reiki might help them with pain, fatigue, anxiety, post-operative recovery, and the side effects of chemotherapy.” They did not disclose the spiritual aspects of treatments. Reiki got into this and many other U.S. hospitals because promoters intentionally truncated explanations of Reiki when introducing it to administrators and patients.31 In writing for one another, Reiki practitioners offer advice on how to make Reiki welcome to medical audiences. In an article on “Reiki in Hospitals” posted in the members-only section of the Center for Reiki Web site, Patricia Alandydy, a Reiki master, registered nurse, and assistant director of surgical services at Portsmouth Regional Hospital in New Hampshire specifies that “in the hospital setting Reiki is presented as a technique which reduces stress and promotes relaxation, thereby enhancing the body’s natural ability to heal itself.” Patricia Keene, who succeeded in getting Reiki into the Maine Medical Center, notes that in describing Reiki to patients, “simple explanations, rather than technical, were often warranted. One nurse, who offers Reiki whenever she is able, might say to a patient, ‘I’ve been trained in a technique that can help you to relax and de-stress and could even help the healing process. It is a gentle hands-on method.’” ChristianReiki.org author William Rand advises that in hospitals, “if the issue comes up, it is important to explain that while Reiki is spiritual in nature, in that love and compassion are an important part of its practice, it is not a religion and that members of many religious groups including many Christians, Muslims, Hindus and Jews use Reiki and find it compatible with their religious beliefs.” Patricia Miles proposes that “every time you see the word ‘spiritual,’ substitute ‘vibrational’ and see if it makes sense.” Miles assures other practitioners that changing terms will not make the actual practice of Reiki less spiritually powerful, since “these vibrations, pulsations, or oscillations—whatever you want to call them—are the subtle form through which we experience Reiki. They are the spirit in spirituality.” Jane van de Velde, who has a doctorate in nursing, offers advice for how to publish case reports of Reiki’s effectiveness for medical journals. The practitioner should “tap into inner guidance when documenting” but restrict one’s terminology to that “commonly used within health care.” Such in-group conversations suggest that Reiki practitioners may routinely self-censor descriptions of

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Reiki when talking to hospital administrators and patients because practitioners know that fuller disclosure would provoke opposition.32 Part of the motivation for getting Reiki into hospitals is that practicing Reiki in mainstream settings with a steady clientele feels empowering for women frustrated by gender inequities. Diane Stein is explicit that “if there is one thing that Reiki heals, it is women’s self-confidence.” When women not only learn but teach Reiki, “they empower and heal every aspect of their lives.” Stein elaborates that “we who are women in a patriarchal culture have always been healers, midwives, herbalists, and psychics.” She tells her female students—and Stein allows only women to take her classes—that she “was given a promise by my Goddess, Brede. . . . The promise is this: There will be no more Inquisitions. We are safe to learn healing . . . you have the Light’s blessings and protection.” In a related vein, Mary, a Catholic nun interviewed, speaks of her work as a Reiki master and “Integrated Energy Therapy Master Instructor” in terms of empowerment. Mary learned about chakras, the third eye, and nine healing angels—one connected with each energy area—from Franciscan nuns. Her comments point to power struggles between female nuns and male priests. The priests—one in particular “hates what we do”— are invited by church officials to participate in exorcism trainings in another state, but nuns are excluded from this specialized training. The nuns protest by offering their own healing modality. Feeling disempowered by maledominated medical and religious institutions, some women turn to Reiki for authority to become healers.33

Empowering Nurses Empowerment may similarly drive female nurses, who are the primary practitioners of Therapeutic Touch. Sharon Fish Mooney, who wrote her nursing doctoral dissertation on Therapeutic Touch, describes the practice as “very much a symbol of what nurses ‘can do’ that physicians can’t do or won’t do. It is a practice ‘owned’ by nurses.’ Herein lies its power for nurses.” Arlene Miller, a nursing professor at Messiah College in Pennsylvania, explains the popularity of Therapeutic Touch as a “power issue.” Because nurses have “always felt a bit abused by medicine,” Therapeutic Touch represents what nurses have “uniquely to contribute. They are ‘noninvasive,’ so it is kind of an antitechnology move also. Nurses can do it without physicians’ orders.” Sally Satel, a psychiatrist and lecturer at Yale University School of Medicine, claims that the popularity of Therapeutic Touch reflects nurses’ protest against the “sexually oppressive atmosphere” of the hospital world. The Therapeutic Touch campaign is “fueled by . . . a fiery resentment of the medical

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establishment, the so-called male medical elite. Their antipathy represents a thoroughly postmodern rejection of the prevailing medical culture wherein doctors direct the patient’s treatment and nurses carry out many of those directives.” Suggestively, the official conference program for the American Nurses Association’s 1994 national convention printed a crystal symbol to designate workshops on the “healing arts practitioner,” one of which was titled “Crones, Nurses and Witching.” Some nurses trained in Therapeutic Touch break away from medical oversight by establishing successful private practices in which they charge as much as $100 per session. Although nurses who practice Therapeutic Touch rarely articulate their motives in print, explanations offered by critics such as Mooney, Miller, and Satel seem insightful.34 Because nurses are already essential contributors to the conventional health-care system, integrating Therapeutic Touch into this system only required recruiting nurses. Krieger exploited her standing as a professor of nursing in what was in the early 1970s one of the few doctoral programs in nursing in existence. A course first taught by Krieger in 1975 on “Frontiers in Nursing: The Actualization of Potential for Therapeutic Human Field Interaction” was required of all students in New York University’s M.A. and Ph.D. nursing programs. New York University’s dean of nursing, Martha Rogers, added legitimacy to Krieger’s innovative work by proposing a “human energy theory” in the 1980s.35 Krieger gained crucial support from leaders of the major nursing professional associations. The American Nurses Association (ANA), the primary professional association of registered nurses, gave its endorsement. The American Holistic Nurses Association (AHNA), founded in 1981, advocated Therapeutic Touch through its journal, with self-study of articles qualifying for CEU credits. In 1992, the National League for Nursing, at the time the only nursing-school accrediting organization in the United States, produced a three-part video series, Therapeutic Touch: Healing through Human Energy Fields, for nursing schools and CEU workshops. In 1994, Thérèse Meehan created the diagnostic category “energy field disturbance” for the North American Nursing Diagnosis Association (NANDA; NANDA International since 2002), an ANA division. Most U.S. nursing schools (according to a survey of Michigan schools, 91 percent) use NANDA nomenclature to define conditions that nurses can legally identify and for which they can order interventions. The NANDA guidelines define an energy field disturbance as “the state in which a disruption of the flow of energy surrounding a person’s being results in a disharmony of body, mind, and/or spirit” and specify that Therapeutic Touch is the preferred nursing intervention to remedy such disturbances. The Therapeutic Touch International Association, founded in 1997, enhanced

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professional status by developing standardized documents: “Guidelines of Recommended Standards and Scope of Practice for Therapeutic Touch,” “Therapeutic Touch Policy and Procedure for Health Professionals,” and a “Code of Ethics.” Therapeutic Touch is taught in more than one hundred nursing schools in the United States and seventy-five other countries. Krieger’s book, Therapeutic Touch: How to Use Your Hands to Help or to Heal (1979), remains a popular textbook. Attendance at workshops counts toward CEU credits. Estimates of the number of nurses who practice Therapeutic Touch range from twenty thousand to one hundred thousand, and even the higher figure may be conservative.36 An offspring of Therapeutic Touch, the trademarked Healing Touch certificate program, neatly packages metaphysics for modern nurses. Colorado nurse Janet Mentgen created the program in 1989, with AHNA sponsorship. Healing Touch combines aspects of Therapeutic Touch, Reiki, massage, and other energy-based therapies and markets them as a “medically-based energy training continuing education program” that counts as CEU contact hours for nurses and massage therapists. Brochures advertise that “the Healing Touch student undergoes a rigorous and comprehensive program that includes 114 to 118 hours of standardized curriculum with Certified Healing Touch Instructors.” The program consists of five levels of workshops for healers, with additional training and clinical requirements for instructor certification at levels I through V. Tuition ranges from $365 to $900 per class. The Healing Touch Certification Board credentials Healing Touch Certified Practitioners and Healing Touch Certified Instructors.37 The Healing Touch program identifies metaphysical sophistication as a requirement for the thoroughly qualified health-care professional. Level I workshops teach Therapeutic Touch. Level III students contact “spirit guides.” Seminar participants use crystals, pendulums, and hypnosis for psychic or clairvoyant diagnosis and treatment. Mentgen’s Healing Touch Level One Notebook (1994) introduces Healing Touch as a “sacred healing art” that involves a “spiritual process,” although disavowing that it requires a “specific religious orientation or organized religious systems.” The handbook teaches that “Life Essence (Chi, Qi, Life Force, Orgone, Prana, Life Energy, Universal Force, Soul) is the aspect of the person that continues to exist after physical life ends.” A guidebook by the Center for Healing Touch and Wellness affirms that “when we bring our consciousness to the seventh level of the [energy] field, we know we are one with the Creator . . . we contain the scripture. We contain divinity.” As part of instructor certification, practitioners submit a lengthy application that includes self-evaluations of skills mastered in previous levels. A Level III graduate should know how to “describe and practice Hara

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Alignment Meditation as the practitioner, including raising one’s vibrational frequency through spinning of one’s chakras and expansion of the core star,” and “demonstrate a full healing sequence, using Chelation, Spinal Cleansing, additional deep cleansing techniques and working with the 5th, 6th, and 7th levels of the auric body.” Healing Touch practitioners presumably use these skills on the job to become better nurses or massage therapists.38

Conclusion Energy medicine has become integral to the conventional health-care system. In grasping the implications, it is crucial that this merger was not unplanned but required intentional maneuvering. Although they marketed energy healing as medical science and nonsectarian spirituality instead of religion, the developers of Reiki, Therapeutic Touch, and Healing Touch drew extensively on Buddhist, Hindu, and Western metaphysics. The energy directed during treatment and training is not physical but spiritual. To gain secular and Christian audiences, practitioners portrayed energy healing as a nonreligious or Christian branch of medicine. This is more than a case of imperfect communication across cultural subgroups or of different people selecting from among multiple meanings embedded in ambiguous language. Practitioners who understand energy healing as one thing, metaphysics, present it as something else, medicine, to overcome resistance from secular or Christian critics. Providers disguise what they conceive of themselves as doing to make it acceptable to those with authority to permit or to block practice in conventional health-care settings. Practitioners use one vocabulary set when communicating with hospital administrators and patients but different language when talking to one another. When they do not think they are being overheard, energy healers admit to dissimulation and offer one another advice on how to smuggle metaphysics into mainstream medicine: replacing religious with scientific or generically spiritual terms, developing fee-based courses eligible for CEU credits, publishing in medical journals, and appealing to women who feel disempowered by their role in male-dominated medical or religious hierarchies. The concluding chapter explores the repercussions.

Conclusion Why Does It Matter If CAM Is Religious (and Not Christian)—Even If It Works?

although most conversations about CAM focus on whether it works, it is also important to ask why CAM is supposed to work, because answering this question reveals that CAM concerns both religion and health. At issue is not whether people opt for or against CAM but, rather, the processes involved in reaching this decision and the contexts of CAM sponsorship. Certain CAM providers—concerned with winning a clientele—conceal material information about why they believe CAM works. Pragmatic consumers do not ask indepth questions. Holistic health care has become so mainstream that there is little controversy when the government endorses CAM through public schools or directly funds CAM research and services. This concluding chapter contends that choosing CAM influences religious decisions. Making religious choices without intending to do so disrupts informed decision making necessary for the economic and political health of society. Selective, deceptive, or fraudulent representations of CAM impede freedom of choice. Government endorsement or funding of certain CAM practices violates the religious establishment clause of the Constitution’s First Amendment. Consumers, health-care providers, policy makers, and courts all have a stake in understanding the ethical and legal implications. Whether or not courts will agree that my claims are judicially enforceable in tort law or constitutional law, this chapter makes an ethical argument that based on the values of personal autonomy, self-determination, religious equality, and religious voluntarism, health-care providers should be forthright in their communications with patients; patients should use information available to make intentional choices; and government should not favor metaphysical religion above other kinds of religion or irreligion.

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Informed Consent and Shared Decision Making Since the civil rights and consumer revolutions of the 1960s, “informed consent”—a term coined in the medical malpractice case of Salgo v. Leland Stanford Jr. University (1957)—has, alongside companion phrases such as “shared decision making” and “patient-centered care,” become a watchword in America. Health-care consumers demand moral and legal rights to protection against unauthorized invasion of their bodies and facilitation of autonomous decision making, to ensure personal autonomy and self-determination. The American Hospital Association’s “Patient’s Bill of Rights” of 1972 and the Health Insurance Portability and Accountability Act (HIPAA) of 1996 reflect a cultural climate of growing rights consciousness. The World Medical Association’s Declaration of Lisbon (1981) affirms that patients have the “right to give or withhold consent to any diagnostic procedure or therapy. The patient has the right to the information necessary to make his/her decisions.” The British Medical Association (1993) defines necessary information as “what the individual patient requires and, failing that, what the average ‘prudent patient’ would want to know.” This is because ability to make choices autonomously requires substantial understanding of all material information.1 Because CAM has consequences for both religion and health, religious information is material to decision making about CAM. Material information is not limited to medical risks and benefits but also includes factors bearing on patients’ “long-range goals and values,” including religious commitments. In A History and Theory of Informed Consent (1986), ethicists Ruth Faden and Tom Beauchamp argue that “manipulative underdisclosure of pertinent information” fails to “respect autonomy,” and any denial of a “piece of information to which a person has a right or entitlement based in justice is an injustice.” This is because autonomous action requires understanding, voluntariness, and intentionality. As Beauchamp explains in The Ethics of Consent (2010), “for an act to be intentional, it must correspond to the actor’s conception of the act in question.” Patients cannot intentionally participate in CAM without understanding consequences of their actions for both health and religion.2 There are, in informed-consent law, competing standards for who determines what information should be disclosed for patients to be able to act intentionally. Ethicists criticize the professional-practice standard, although it is commonly used, because physicians may not be sufficiently knowledgeable or motivated to give patients information relevant to “nonmedical judgments” for or against medical care. By the reasonable-person standard, the patient, instead of the physician, defines what information is material to decision making. In the United States, where most people affirm belief in a personal God,

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a reasonable person can be expected to want to understand implications of health-care practices for theistic beliefs. The more demanding individual standard requires physicians to disclose information that each particular patient might want to know, even if most patients would not consider the information important; reflecting a view that high-quality treatment includes patientcentered care, by the individual standard, those patients who desire to protect religious purity, such as evangelical Christians, might need additional information. This book sides with analysts who hold that the professional-practice standard is inadequate to protect patient rights and that the reasonable-person or individual standard should be applied. This raises two questions: Do healthcare providers offer information material to decision making of a reasonable person? And do health-care consumers exercise rights and responsibilities to access information and make intentional decisions?3

The Responsibility of Health-care Providers in an Integrative Medical Market The backdrop to modern informed-consent requirements is that patients have in the past been treated unethically, or even lost their lives, because credentialed medical professionals and government employees administered or deprived patients of therapies without informed consent. The Nuremberg Code (1946) of research ethics addressed notorious abuses and lack of consent in human experimentation by the Nazi regime. The Belmont Principles (1974), which now govern all interactions between researchers and human subjects, responded to observed patterns of “lack of informed consent,” “withholding information” about available treatments or risks, “coercion or undue pressure on volunteers,” and “exploitation of a vulnerable population.” Between 1932 and 1972, the U.S. Public Health Service (PHS) offered free medical care, meals, and burial insurance to 399 impoverished rural black men in Tuskegee, Alabama. The PHS did not inform the men that they had syphilis, and neither treated them for the disease nor told them that penicillin had become the standard treatment by 1947. The government study, intended to observe the progression of untreated syphilis, only ended after a whistle-blower leaked information to the press. In 2011, it became public that between 1946 and 1948, PHS researchers had also intentionally infected with syphilis and gonorrhea (and then treated with penicillin) several hundred Guatemalans made vulnerable by their confinement in prison, army barracks, and a mental-health asylum. In both syphilis studies, the PHS justified violating individual rights as producing public-health benefits. The obvious motive

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for selecting vulnerable populations was that others could not be expected to consent.4 The courts have applied informed-consent requirements not only to research studies but also to clinical care of patients in civil cases or tort law. Like other vulnerable populations, patients in poor health might feel undue pressure to accept offered services although they lack substantial understanding of risks and benefits. As early as 1914, the New York Court of Appeals held in Schloendorff v. Society of New York Hospitals that “every human being of adult years and sound mind has a right to determine what shall be done with his own body.” The plaintiff had consented to being examined under ether to diagnose whether a fibroid tumor was malignant but withheld consent to remove the tumor. The physician removed the tumor anyway, violating the right of “self-determination.” The court reasoned that this violation entailed unauthorized touching—or battery—even if the treatment was skillfully executed and medically beneficial. In Natanson v. Kline (1960), a patient suffered severe burns after a physician failed to obtain informed consent for cobalt radiation therapy following a mastectomy. Rather than rely on battery theory, the Kansas Supreme Court found the physician liable for negligence, an unintended harmful action or omission that results from failure to exercise due care. Canterbury v. Spence (1972), heard by the United States Court of Appeals, District of Columbia Circuit, involved a patient who suffered paralysis subsequent to a recommended surgery for severe back pain; the patient had not been warned that the procedure was known to carry a 1-percent risk of paralysis. Applying battery and negligence theories, the court held that a physician should disclose risks when a “reasonable person” would likely take risks into account in decision making. As medical bioethics emerged as a research field, a growing number of voices argued that medical providers have both ethical and legal duties to respect patient choices to accept or refuse even lifesaving treatments.5 The best-known class of cases in which religious beliefs lead patients to refuse conventional medical treatments is that of Jehovah’s Witnesses’ rejection of blood transfusions. Most Jehovah’s Witnesses believe that blood transfusions, even when necessary to save life, violate biblical law. In the Canadian case of Malette v. Shulman (1990), the court found that clinicians should not provide emergency treatment if there is reason to believe that patients would have withheld consent for religious reasons. In Malette, the plaintiff carried a signed wallet card identifying herself as a Jehovah’s Witness and indicating that she did not want blood transfusions under any circumstances. The defendant administered a transfusion while the patient was unconscious, and the procedure saved her life, but the clinician was still

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found liable for battery. The judge ruled that the unwanted intervention was a violation of the patient’s “right to control her own body and show[ed] disrespect for the religious values by which she has chosen to live her life.” Such cases, in which a patient perceives a conflict between medical treatments and religious convictions, are relatively easy to adjudicate based on the value of self-determination.6 Instances in which patients do not see a religious conflict but in which they might be expected to perceive one if they knew more about the religious implications of health-care options involve more complex considerations. But here, too, the Jehovah’s Witnesses example is instructive. There is a minority movement within the Jehovah’s Witnesses of those who believe that blood transfusions are compatible with the Bible; many Witnesses are unaware of the movement or its arguments, because it must be conducted underground lest other Witnesses ostracize adherents. Some informed-consent theorists claim that Jehovah’s Witnesses requiring blood transfusions should be provided with information about pro-transfusion Witness arguments. The rationale is that if Witnesses knew more about their own religious tradition, some patients might change their views about the compatibility of blood transfusions with their beliefs. By this logic, providers should also be forthcoming about information that might cause patients to question the compatibility of treatment options with their religious traditions.7 The physician-patient relationship, which causes patients to trust information given by health-care providers, heightens the responsibility of providers to assist patients in gaining “substantial understanding of what is at stake in the consent decision.” Imbalances in knowledge and power give providers an affirmative obligation to supply information. Providers cannot predict every potential conflict with each patient’s religious beliefs. But providers have an ethical and legal obligation to inform clients if they suspect that offered goods and services may be incongruent with patients’ religious beliefs, especially if providers anticipate (or even hope) that practicing CAM may induce clients to change their religious beliefs. My point is not that providers should make written consent forms longer than they already are but that they should communicate suspected religious implications to their clients. Patients should be given control over the information they receive in order to protect them from manipulation, defined as getting someone to do “what the manipulator wants through a nonpersuasive means that alters a person’s understanding of a situation and motivates the person to do what the agent of influence intends.” The values of personal autonomy and self-determination suggest that CAM practitioners should be clearest in communicating their spiritual viewpoints not to those patients who already feel pulled toward vitalistic philosophies but

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to those who might reject certain CAM options if they better understood their religious and spiritual frameworks.8 The cultural move toward integrative medicine means that more CAM services are available in hospital and clinical settings. These contexts imply scientific legitimacy and secular status, making it all the more important that providers disclose all that offered services entail. Yet when CAM promoters call for patient choice, they generally do not have in mind their own responsibility to give full disclosure as much as the responsibility of conventional doctors to make patients aware of CAM and extend medical privileges to CAM providers. An article in Resonance: The Magazine of the International Foundation for Homeopathy (1998) avers that “patients are demanding to be given full information, freedom of choice, and self-responsibility. Relationships based on equality and trust are replacing those based on domination and fear.” Picking up on the theme of physician-generated fear, another article cautions against “homeophobia.” Such publications emphasize the importance of giving consumers information about the availability of CAM options such as homeopathy and cultivating egalitarian provider-customer relationships rather than pressuring patients to follow “doctors’ orders.” The chair of the World Chiropractic Alliance Chiropractic Advocacy Council, Matthew McCoy, carves out space for CAM within the conventional health-care system by insisting that “patients must have the right to choose the type of health care they desire and not be restricted or forced to acquire their care from practitioners they do not wish to see, to have procedures they do not wish to have nor engage with systems of healing with which they disagree.” An unexplored corollary is that some patients might disagree with systems of healing inserted into the healthcare system by CAM providers—if providers volunteered more information about them.9 The same CAM providers who rally for patient choice in health care do not always disclose vitalistic premises of offered services. The Nurse’s Handbook urges “communication and patient involvement and choice in decision making,” cautioning that some CAM services may “violate the patient’s basic beliefs.” Yet this same handbook recommends to nurses that they explain CAM to patients using language calculated to sound scientific rather than religious. The handbook includes a reproducible handout, “Learning about Acupuncture and Acupressure,” for patients requesting information. The handout identifies acupuncture and acupressure as “key parts of traditional Chinese medicine. This ancient form of medicine holds that specific body points (called acupoints) are connected or attuned to specific organs. If one of these organs has a problem, such as pain or swelling, stimulating the appropriate acupoints is believed to create balance and restore or improve the flow

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of qi (pronounced ‘chee’), or energy, thus relieving the problem and restoring health. Qi must be in balance to be healthy.” The handout equates qi with “energy” and frames acupuncture as a medical technique for balancing energy necessary for health, while remaining silent about Taoist philosophy.10 Failure to disclose information is often intentional and does not merely result from oversight or differing standards of what information is material. A report to the NIH, Alternative Medicine (1992), advises a strategy for overcoming resistance of Christian patients to “mind-body interventions” rooted in “Eastern religious practices.” In order to “ameliorate the objections of many Christian religious groups to meditation,” promotional materials should emphasize “commonalities between Christian prayer and contemplation and Eastern meditation.” Because Christian patients can be expected to reject meditation if it is perceived as non-Christian, the NIH report recommends shifting attention to Christian parallels. Likewise, a National Expert Meeting on Qi Gong and Tai Chi Consensus Report (2005) outlines a strategy for increasing acceptance in senior centers, hospitals, faith-based institutions, retirement homes, and elder communities: by translating descriptions of t’ai chi and qigong into “Western language” of “health practices” and publicizing secularized explanations through medical journal articles, press releases, TV and radio programming, and recruitment of sports stars and entertainers.11 Holistic providers who subscribe to vitalistic theories are sometimes quite deliberate in selecting medical language when communicating with patients who do not share their spiritual outlook. Dr. Smith is a conventionally trained physician who works in an “integrative holistic” clinic at a rehabilitation hospital. When asked by an interviewer how acupuncture works, Smith at first replied, “I will have to go with a scientific explanation on this.” She proceeded to theorize that stimulation of acupoints may prompt glands to secrete endorphins or that punctures may dilate blood vessels, thereby increasing local blood flow to cleanse the area of toxins and promote muscle relaxation. Intrigued by how Smith introduced her response, the interviewer asked whether Smith herself adhered to a different theory of how acupuncture works. Smith then acknowledged her belief that qi flows through meridians. Acupuncture allows “universal energy” to flow unimpeded through the body, which possesses “innate” healing power. Denying that acupuncture is a “religious” practice, Smith emphasized “spirituality,” since “acupuncture opens the door to link the spiritual world to the body.” When asked whether she usually tells patients about her spiritual ideas of how acupuncture works, Smith admitted that she does not. Since most of her patients feel “overwhelmed” by pain and disabilities, Smith does not think it is right to “bombard them with information that will just add to their feeling of being confused and overwhelmed,” presumably

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because of perceived conflicts with their own religious beliefs. Instead, Smith uses a “scientific explanation” to conceal her spiritual views.12 Smith is not an isolated example. Holistic providers who need to build and retain a clientele seek to minimize resistance from patients. Providers who have encountered resistance from Christian patients self-monitor communications. River Jordan is an acupuncturist writing for fellow members of the People’s Organization of Community Acupuncture (POCA), a cooperative whose “goal is to make acupuncture available and accessible.” Jordan offers advice to acupuncturists who do not “see the elephant that may be standing in your clinic—maybe going poop on your chances of running a successful clinic.” Jordan learned his lesson after being turned down in his request for clinic space in a downtown Seattle church. The evangelical pastor had informed Jordan that “there was concern about the Taoist roots of acupuncture.” Jordan responded to this rebuff by taking down a “large brocade painting of Medicine Buddha in one corner of the treatment room. I feel pretty confident that probably 95 percent of my patients are either indifferent to it, or like it, but I don’t want to make even 5 percent of my community uncomfortable.” Another POCA member, Acuguy, related a similar experience. Several “prospective patients” had, twenty years earlier, come to him with questions after “some church groups looked into acupuncture and sent word out through their networks that using acupuncture was contrary to Christian values.” Acuguy assuaged concerns by narrating a history in which acupuncture originated in “trial and error experimentation” that came “before any Taoist theory was eventually attributed to its effects,” implying that Taoism is an inessential add-on. Such providers explain acupuncture selectively to avoid turning away clients.13 Given the prevalence of evangelical Christianity in American culture, holistic providers may take particular care to do their homework on evangelicals. The POCA Web site contains a satirical post titled “Evangelical Community Acupuncture.” The post is supposedly written by an evangelical minister who discovered acupuncture when his aunt was seeking pain relief for an arthritic knee. The fictional pastor, John Carol, admits that he was “very suspicious and wary” of acupuncture because “it is foreign culturally.” Although acupuncture helped his aunt, Carol felt uncomfortable “with the manner in which it was supposed to work.” This was because it “is based on a metaphysical construct that is absolutely counter to everything we know and understand through western medicine. Now, I do not prescribe [sic] to everything that western medicine has to say, and frankly, I think that it can be an arrogant and Godless system that deifies science and man at the expense of morals, values and the Word of God. However, what we do know about the body and the way that God made

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man in His own image tells us that if the theories of Oriental medicine are to be taken as valid, the Bible and the Word of God would be somehow incomplete or lacking.” But as Carol looked more closely at acupuncture, he concluded that “the ancient Chinese may have been intuiting the coming of Jesus, and what is called qi in the Chinese classics was actually the Holy Spirit. Whether or not they understood this is inconsequential.” Now Carol uses acupuncture to “activate the Holy Spirit, faith in the Lord, so that the teachings of Christ can be brought out of the Bible to manifest into the believer’s activities here on earth.” Carol calls his distinctively Christian brand of acupuncture “body, mind, Holy Spirit medicine,” citing Bible verses such as John 3:6, Ezekiel 36:26–27, and 2 Corinthians 5:17 (which refer to “Spirit”). Carol replaces the term “needles” with “nails” and “acupuncture” with “regenerating.” Carol uses just two acupoints— pericardium 8 (center of the palm) and liver 3 (center of the foot)—because they are “an archetypal representation of the crucifixion and are apt entryways for the Holy Spirit.” Although it is a parody, the post presents insightful analysis of evangelical reasoning. The intended audience is other POCA members who want to understand evangelicals in order to craft self-presentations that maximize appeal and minimize offense.14 Evidence of self-censorship extends beyond acupuncture to other CAM fields. According to chiropractic historian Joseph Donahue, 80 percent of chiropractors “evade professional accountability” by firing at patients a “barrage of quasi-scientific information” about particular techniques, while remaining intentionally vague about the meanings of Innate Intelligence, because they realize that this “religious doctrine . . . if understood by the patient, would be reprehensible to many of them.” Medical bioethicist Michael Burgess charges chiropractors with using the “relative safety and non-invasiveness” of adjustments to excuse failing to meet medical standards of informed consent that would ethically and legally require them to disclose whether adjustments could, in the language of attorney Richard Steinecke, “offend a religious, ethical or personal belief of the patient.” By this reasoning, chiropractors should be clearest in communicating their viewpoints not to those patients who already feel pulled toward vitalism but to those who might reject chiropractic if they better understood its doctrines. By implication, chiropractors who are chameleonic in their self-presentation—personally holding vitalistic views but adopting vague or scientific-sounding vocabularies when addressing patients who may not share their outlook—should be held culpable for violating an ethical and legal responsibility to give patients information necessary to make informed decisions.15 Some CAM promoters admit to being very careful about what information they communicate to clients and how and when they do so. Sociologists

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label this tactic “camouflage.” The strategy involves “elaborate techniques of concealing and gradual exposure.” Holistic consultants introduce metaphysical spirituality to business professionals by systematically replacing suspect terms such as “meditation” or “spirituality” with more neutral words such as “intuition,” “authenticity,” “profundity,” “holism,” and “purity.” One consultant interviewed acknowledges that “only after I get the group’s trust do I start, very carefully. People are skeptical at first. When I suggest practicing yoga or meditation they are unconvinced about the whole process. I wait some time and then raise it again. It is a gradual process. Today I get into an organization with a topic such as time management, evaluation of employees or contact with clients, and via this window I start the process.” Other consultants lead with the benefits of “awareness” training in overcoming negative emotions such as anxiety or anger. Later, once resistance is down, these same consultants introduce unambiguously spiritual content in “advanced” training workshops. Jon Kabat-Zinn minimizes spiritual vocabulary during his eightweek Mindfulness-Based Stress Reduction classes. But as students graduate, he recommends that they find an ongoing meditation group such as an Insight Meditation Society, an organization that Kabat-Zinn describes as having “a slightly Buddhist orientation.”16 Holistic healers defend their rights to recruit clients. The rights of healthcare providers and patients may, however, conflict. In such cases, there are greater ethical and legal obligations to protect rights of patients as a vulnerable population. The AHNA contends that “denying a patient Reiki or prohibiting a nurse from administering Reiki violates the ethical principles of patient and nurse autonomy.” Responding to such claims, health-care attorney Michael Cohen distinguishes spiritual healing by clergy from that by people with secular jobs, such as Reiki or Therapeutic Touch by nurses. The latter practices should have a different legal status, one not immune from regulation, because the blurring of spiritual and secular functions increases the risk of abuse, defined as violation of fiduciary responsibility, or betrayal of trust, in the healer-client relationship. Susan Salladay, professor of nursing at Cedarville University in Ohio, makes a related point that patients—whose autonomy must be protected—may have difficulty distinguishing between a spiritual and a medical therapy when a health-care professional, rather than clergy, performs spiritual healing practices.17 Biomedical ethicists coined the phrase “therapeutic misconception” to express concern that patients may consent to participate in research experiments believing that their individual needs will determine treatment or because of an exaggerated perception of the likelihood of benefit. This book argues that therapeutic misconception may also arise when patients consent

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to CAM believing that they will receive medical therapies, not a gradual introduction to religious practices, and the probability of misconception increases when providers neglect to provide religious information from the start. Consent is compromised if patients do not understand how standard medical care differs from scientific research or religious practices.18 Holistic healers commonly claim that their interventions are noninvasive and therefore not subject to the same informed-consent standards as medical interventions. The Nurse’s Handbook, in a section titled “Informed Consent,” instructs that in “introducing a specific noninvasive therapy such as Therapeutic Touch . . . no formal informed consent would be expected. However, if you were planning to introduce a more intrusive therapy, such as aromatherapy, you’d have to obtain a clinical informed consent as it’s considered a patient choice option.” Such a distinction does not, however, account for the theory of energy medicine, that the practitioner is touching—that is, invading—the patient’s spiritual energy fields. In a different section of this multiauthored text, some two hundred fifty pages later, the writer advises that “some people regard energy work as an invasion of their personal space and boundaries. . . . Always ask for consent before proceeding with a Therapeutic Touch treatment.” An instructive example is provided by Anne, a woman whose husband was unconscious in a hospital ICU. A nurse approached Anne, admitting, “I should have asked your permission first, but I really wanted you to know that at night I go in to see your husband, and I’ve been doing a thing called therapeutic touch. What would you think if I did it with him, now that he’s alert?” Only after Anne’s husband was regaining consciousness, making it impossible to hide the use of Therapeutic Touch any longer, did the nurse seek permission, without, however, disclosing the spiritual premises of an apparently medical intervention.19 Anecdotal evidence suggests that it might be relatively common for energy healers to give treatments without seeking consent. Diane Stein teaches her students to seek “indirect permission from animals, infants, and unconscious people” by asking their “Higher Self in meditation,” rather than engaging in direct, nonpsychic communication with family members. Sister Mary Mebane, a Franciscan Sister and hospital chaplain, performs Reiki on unconscious patients: “I ask permission from unconscious patients on the mental level, knowing their Higher Self will respond. Sometimes the answer is yes, sometimes no, sometimes I do not get an answer. In that case I send Reiki with the provision that if the person does not want to receive it, that it go to someone who does.” Hospital chaplains Bruce and Katherine Epperly use Reiki on unconscious patients with consent from nurses but not from patients’ families. When John, an Anglican monk, uses laying on of hands in

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church services to pray for Christians seeking healing through power of the Holy Spirit, he incorporates Reiki and Buddhist meditation. To avoid alarming theologically conservative Christians, John conceals what he is doing: “You just call it the spirit.” For touch-based therapies, such as Reiki, Therapeutic Touch, chiropractic, massage, or laying on of hands, touching under pretense of administering a medical intervention while performing a religious practice (or masking one kind of religion as another) or touching a patient’s body or “energy fields” without permission might constitute battery.20 If CAM practitioners did not camouflage their interventions, there is reason to believe that some patients would reject CAM as religiously illegitimate. An article in the Journal of Professional Nursing cautions that “respect for the religious practices of others requires all of us to take care not to violate the belief systems of our patients.” In the view of the authors, “many dedicated religious people” would refuse Therapeutic Touch if it were explained to them. Although there is a relatively substantial evangelical literature denouncing Therapeutic Touch on religious grounds, this is not the case for other common CAM practices, such as chiropractic and acupuncture. It may be instructive at this point to return to two anecdotes that opened earlier chapters. Betty and Bob, whose story leads into chapter 4 above, are Christians who had been enthusiastic supporters of chiropractic for decades at the time of our interview. There is an addendum to this report. After the interview, Betty and Bob asked to read an early draft of my chiropractic chapter (written before I had added their story). After reading it, they wrote back that given the information presented, “there is no way that we can continue to be involved in any way with chiropractic,” having reevaluated it as an un-Christian religious practice.21 There is further insight that can be gleaned from the vignette of Brian Carter, the Christian acupuncturist whose story introduces chapter 6 above. It may be recalled that Carter reassures Christians that they can safely avoid suspect religious add-ons to acupuncture by asking their acupuncturists if they just needle medically or add something energetically or spiritually. Yet the interview with Dr. Smith hints that asking Carter’s question may not yield accurate information, since Smith confessed to holding spiritual views, but instead explaining acupuncture in medical terms. Acupuncturists such as Carter and Smith might cross paths with potential Christian clients such as Jim, an associate pastor at an evangelical megachurch who does not know much about acupuncture but who told an interviewer that “the fact that acupuncture comes from the East is not an immediate disqualifier for me. . . . If it proved to be morally credible and medically beneficial, I would feel free to explore the possibility.” The same interviewer who spoke with Jim had recently interviewed Dr. Smith and asked Jim what he thought of Smith’s view

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that acupuncture opens the “door to link the spiritual world to the body.” Jim responded with apparent alarm, stating unequivocally that he did not consider it legitimate to visit a practitioner who has such views. This is an interesting reaction, given Dr. Smith’s revelation that she does not tell patients (who perceive her as a medical doctor working in a secular hospital setting) about her spiritual understanding of acupuncture, precisely because she does not want this information to make them feel “confused and overwhelmed” by an apparent conflict with their religious beliefs. Such examples suggest that if CAM providers routinely disclosed religious information, some consumers would decide not to participate.22

Practices Changing Beliefs Failure to disclose information about CAM’s spiritual dimensions is significant, because the act of engaging in spiritually premised practices may lead to unpremeditated changes in religious beliefs. There is evidence of religious shifts occurring through participation in the least overtly spiritual CAM practices, such as chiropractic. Sociologists Meredith McGuire and Debra Kantor found that individuals who visit a chiropractor desiring only physical benefits “opened the door” to journey into metaphysics. One woman reflected that her chiropractor taught her to replace her inherited Christian idea that she has a soul with the notion that she is a soul. It is “not that I have an Innate Intelligence, but that I am Innate Intelligence in this physical shell.” Nancy is an internationally prominent pentecostal pastor who acknowledged in an interview going to a chiropractor “for many years” at the frequency of once every three weeks. Having grown frustrated by repeated failures to relieve painful breast cysts through prayer alone, she had recently added more frequent biofeedback treatments from an herbalist whom her chiropractor recommended. At one point referring to chiropractic as a category of “medical stuff,” Nancy subsequently admitted to not liking the “idea of medicine, so I thought I would take an alternative route and it seems to be working really, really well for me.” Nancy selected chiropractic because it was both like and unlike medicine and, especially, because it worked for her. Although Nancy still denounces the New Age and encourages prayer for healing, it appears that a theological change occurred: expectation of the accessibility of divine healing diminished as Nancy refocused her efforts on pursuing healing through a growing CAM repertoire.23 The full implications of such theological shifts lie beyond the scope of this book. Research on pentecostal divine-healing practices reveals a pattern in which individuals credit God’s love and power for perceived experiences

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of divine healing, motivating individuals to express greater love for God and other people through acts of benevolence, a phenomenon dubbed “Godly Love” by sociologists. The Godly Love model suggests that diminished emphasis on divine healing by pentecostals could result in decreased benevolence, unless it is replaced by other benevolence-generating practices. This provokes a number of questions. Whom do Christians credit for healing through CAM? Does participation in CAM change Christians’ understanding of who “God” is? Does practicing CAM generate “love energy” that results in increased benevolence? If so, how do effects compare with those reported for divine-healing practices? These are questions that invite further investigation.24 The study in this book indicates that participating in CAM may result in significant spiritual transformations even for those individuals who do not intend to become involved in CAM’s spiritual dimensions. Michael Raposa, a martial-arts scholar and practitioner, uses aikido as an example. Morihei Ueshiba (1883–1969) developed aikido in Japan to embody a new religious movement, Omoto-kyo, which draws on Taoism, Buddhism, and Shinto. For Ueshiba, the cosmos has a divine center, and meditation, or sinking into the center of one’s being, is a way of returning to the cosmic center. The cosmos gave rise to ki, the energy that animates everything, and breath, which is both physical and spiritual, embodies ki. Aikido students “breathe in and let yourself soar to the ends of the universe; breathe out and bring the cosmos back inside. . . . Blend the Breath of Earth with that of your own, becoming the Breath of Life itself.” Because aikido expresses its philosophy through bodily practices, “one need not have specific religious commitments or intend to pursue aikido as a spiritual discipline in order to be transformed by its actual practice in subtle but powerful ways.” British martial-arts scholar Stewart McFarlane argues that “many people, particularly in the West, have been drawn to Zen and other forms of Buddhist practice through an initial interest in and pursuit of Eastern martial arts.” Charlish and Robertshaw observe that “as you have regular reiki treatments, you may notice significant shifts in your attitudes toward and experience of life. . . . Many people gradually become aware that their trust in the universe is strengthening. . . . Their intuitive sense, sometimes known as the sixth sense, also grows.” Stein notes that shortly after Reiki II, students report “significant life changes. . . . She may have changed jobs or professions, moved cross-country, or found a new mate.” Such claims are noteworthy if one recalls that some Reiki masters give Reiki I graduates scant information about Reiki’s spiritual dimensions. By the time students learn the Reiki symbols and advanced techniques in Reiki II, the process of spiritual transformation may already be well under way.25

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Numerous examples could be cited of individuals changing viewpoints after practicing CAM. In an article titled “Reiki Helped Me Understand Christianity Better,” Murielle Marchand recalls that “it is when I turned Reiki II and learnt about the symbols that my understanding of the Christian faith drastically began to change. . . . When I started using the Reiki protection sign almost every day it suddenly occurred to me that the cross was the Christians’ protection sign (in one of its uses of course) and that each faith had just simply developed its own symbols.” After Reiki II, Marchand no longer perceived a conflict among different religions. When Roman Catholic Marita AicherSwartz started using Reiki, she wondered if she could be “both a Christian and practice Reiki.” But during treatments, “a transformation occurred in how I understood the gift of Reiki healing,” and she now calls for help from spirit guides without feeling uneasy. For Catholic Margaret Lee Lyles, the “jump from wary skepticism to totally embracing Reiki took eight years!” Lyles now feels comfortable speaking about her “aura” and notes that “Reiki leads us to other things that are an essential part in our healing process, such as Tai Chi or Qi Gong, yoga exercises, acupuncture, and different forms of meditation.” Nurse Janet Quinn acknowledges that “using Therapeutic Touch has changed and continues to change me.” This is because the practice “requires a certain philosophy, and this philosophy permeates one’s total existence.” Once one is permeated by a vitalistic philosophy, it is a short step from trying one CAM option to using other holistic modalities.26 Yoga has provided a gateway for many Americans into a monistic worldview. Cautious but curious Americans experiment with yoga in secular fitness centers or church-based yoga-inspired classes. A New York Times article observed in 2000 that “yoga’s practical, world-friendly character is having an impact on Americans who would never visit an ashram.” Popular yoga author Beryl Bender Birch notes that “people get turned on to yoga in health clubs, and if they’re looking to deepen their practice, they’ll go to the yoga studio. It’s definitely a way in.” Many, if not most, gym yoga instructors receive their training at religious studios but adapt their presentation of yoga for secular audiences. Marcy, a Cambridge, Massachusetts, yoga instructor, self-consciously puts on a secular face when going into fitness centers. Personally, “I love to immerse myself” in the idea that “we are divine beings, cloaked in human flesh.” But Marcy does not want to “turn people off, or offend them.” Pragmatically, she says, “I have to make my living at this. Now mind you, if I didn’t have to make my living, I might be able to advertise my yoga class as a spiritual yoga.” In the gym, Marcy offers yoga “for stress reduction, flexibility, muscle strengthening, and community. Which is all true. And all fine, you know. I censor myself sometimes because I want it to be as palatable as I can to everybody. I want to

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cast a wide net.” Yet Marcy always carries with her brochures for yoga retreats, hoping that her classes will whet students’ appetite for spiritual yoga.27 There is reason to conclude that Marcy’s strategy of self-censorship is effective, if not wholly honest. Phil Catalfo writes for the Yoga Journal that “while many Westerners come to yoga primarily for its health benefits, it seems safe to say that most people who open to yoga will, in time . . . come to see yoga as a spiritual practice.” Yoga Journal’s Anne Cushman points to the “millions of Americans for whom ‘yoga’ means ‘asana’—and for whom the physical postures are both the gateway into the practice and the vehicle for the spiritual teachings. . . . Hatha yoga taps into our lust for physical perfection, but at the same time, it . . . is an entryway to spiritual awakening.” Cushman notes that “for most people, it starts as simply as this: Yoga makes us feel good, and we like to feel good.” But “if you look closely at the serious yoga practitioner—the person who does it on a regular basis for more than a year or so—you’ll often find that asana has become not just an end in itself, but the medium through which he or she begins to explore other yogic teachings.” Yoga practice that starts off physical can become spiritual through repeated performance.28 The process through which yoga practice changes religious beliefs may be subtle. According to yoga promoter Victor Parachin, “there is no requirement that participants have any religious or spiritual outlook. Yet many who begin to practice yoga say they experience subtle shifts in attitude and thoughts.” Religion scholars Sabine Henrichsen-Schrembs and Peter Versteeg have noticed that regardless of why people begin doing yoga, “a shift seems to take place,” leading some to “a whole new spiritual awareness and totally identifying with the yoga philosophy.” Sharon, a yoga professor at a public university, tried yoga to “give time to myself,” an emphasis lacking in her Episcopal church. Sharon gradually “let go” of her “own religion” and, marrying a man with “Eastern” views, allowed yoga to fill the void left by her abandoned Christian beliefs. Following her divorce, Sharon returned to church, but she now feels more comfortable in a Unitarian congregation.29 Christians like Sharon who begin yoga for nonreligious reasons sometimes experience unanticipated religious transformations. Sannyasin Arumugaswami, the managing editor of Hinduism Today, attests that Hinduism is the “soul” of yoga and that “a Christian trying to adapt these practices will likely disrupt their own Christian beliefs.” The Hindu American Foundation’s Aseem Shukla warns that Christians who practice yoga may inadvertently enter the Hindu path to realize one’s own divinity: “But be forewarned. Yogis say that the dedicated practice of yoga will subdue the restless mind, lessen one’s cravings for the mundane material world and put one on the path of self-realization—that each individual is a spark of the

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divine. Expect conflicts if you are sold on the exclusivist claims of Abrahamic faiths—that their God awaits the arrival of only His chosen few at heaven’s gate—since yoga shows its own path to spiritual enlightenment to all seekers, regardless of affiliation.” Julia, the owner of an independent yoga studio in a Midwestern university town, agrees with Arumugaswami and Shukla that practicing yoga causes Christians to change their religious beliefs. Julia notes that the “YMCA’s made a difference” in alleviating the hesitancy of Christians to try yoga, but “you can’t practice yoga and not be affected by these deeper meanings of it, by what it really means,” that each person’s “inner being” is “like God,” a “perfect” and “eternally wise being.” One of Julia’s college-age interns, Kristin, grew up Catholic but tried yoga because it appeared to be “not religious. I mean they have yoga classes at the YMCA and that’s a Christian organization.” Kristin explored yoga “starting with the physical aspects,” since she enjoyed the stretching. But she says, “then I started reading” and discovered a “really good mind body spirit thing.” Kristin now considers the “eight limbs of Ashtanga” as taught by Patanjali to be “basically similar to the 10 commandments,” but better since the principles are “just like suggestions” by contrast with rule-oriented Christianity.30 A recurring pattern in the foregoing examples is that people, including theologically conservative Christians, seeking physical health benefits and failing to find help from medical doctors or churches experiment with CAM. Novices restrict participation to the physical side of the practice or replace metaphysical with Christian content. Over time, participants experience subtly coercive pressures to internalize a wider swath of meanings, leading to unpremeditated shifts in worldview. Technique teachers sometimes conceal theories for beginners, gradually introducing ideas as participation deepens. If participants become aware of shifting understandings and implicit retheorizing, they rationalize such changes, given their growing investment in reaping perceived benefits. One unusually self-reflective evangelical pastor interviewed acknowledged that he does not want to know more about philosophies undergirding CAM because he wants to feel able to participate. More often, perceived legitimacy of engaging in one holistic practice provides entry to other practices. Involvement in relatively mainstream practices eases the transition to more marginal practices and the worldviews they reflect.31 Failure of health-care providers to disclose material information about CAM’s religious implications violates ethical principles of truth in advertising and may involve illegal fraud, deception, or unfair business practices. In Schnellmann v. Roettger (2007), the South Carolina Supreme Court defined fraud as consisting of nine elements: “(1) a representation; (2) its falsity; (3) its materiality; (4) knowledge of its falsity or a reckless disregard for its truth or

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falsity; (5) intent that the plaintiff act upon the representation; (6) the hearer’s ignorance of its falsity; (7) the hearer’s reliance on its truth; (8) the hearer’s right to rely thereon; and (9) the hearer’s consequent and proximate injury.” Although the Supreme Court, in United States v. Ballard (1944), disallowed finding fraud based on the implausibility of religious beliefs, it allowed considering whether defendants sincerely believe their own claims. By this reasoning, CAM providers are culpable if they think they are providing religious services but mask their ideas with medical terminology to make their services palatable. The Federal Trade Commission (FTC)—defines deception as a “representation, omission or practice that is likely to mislead the consumer acting reasonably in the circumstances, to the consumer’s detriment.” Practices are unfair if they result in a substantial injury not outweighed by countervailing benefits, which consumers could not have themselves reasonably avoided. The FTC finds that “injury exists if consumers would have chosen differently but for the deception.” The FTC seeks to protect vulnerable groups, including children, the elderly, and the seriously ill, from unfair hindrances to free exercise of consumer decision making. Thus, “seriously ill” consumers might be “particularly susceptible to exaggerated cure claims.” Institutionalized elderly people are a captive audience who may be more easily manipulated. Children are “unqualified by age or experience to anticipate or appreciate the possibility that representations may be exaggerated or untrue.” There are instances in which CAM providers knowingly omit or misrepresent material information about products and services in order to win a larger market share or government funding. The healer-client relationship makes these representations persuasive, and the most targeted groups, including the desperately ill, elderly, and schoolchildren, are least equipped to detect omissions or misrepresentations. Consumers are injured, even if products and services are effective, when customers would have chosen differently but for the deception, especially if à la carte choices lead to unintended religious transformations.32

The Responsibility of Consumers in a Democratic Society In a market-driven health-care system, it is not always clear where provider responsibility to disclose information ends and where patient responsibility to gather data begins. David Eisenberg, M.D., one of the groundbreaking researchers on CAM usage, recommends a model of “shared responsibility for investigating options.” According to sociologist Mary Ruggie, “we can surmise that people are making their own decisions, perhaps searching for scientific information in libraries or on the Internet, perhaps coming across anecdotes, perhaps reaching deep inside themselves to discover their preferences.” In

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practice, however, it may be the case that neither providers nor patients take responsibility to collect substantial and unbiased information.33 The casualness with which health-care providers and consumers sometimes experiment with CAM comes through in an anecdote from field research. On a January morning in 2010, the staff members of a California subacute medical residence riveted their attention on TV’s The Dr. Oz Show as Oz advocated yoga, acupuncture, aromatherapy, and energy medicine. As Oz led his viewers through yoga postures, the residence’s assistant activities director, Marsha, nudged her supervisor, Delva, to catch her attention so that she, too, could do the yoga poses. Delva immediately and without question put her hands up in the air to follow suit, although she vocally self-identifies as an evangelical Christian. After doing yoga with Dr. Oz, Marsha read the news to facility residents, in the middle of which she read aloud her horoscope. Then it was time for a volunteer music therapist, Arlene—herself eighty-eight years old—to play piano for the residents. Arlene attributed her healthful longevity to reading Psalm 91 through three times every morning. Before beginning her music, Arlene commented on the virtues associated with one resident’s astrological sign. Then she played a sequence of Christian hymns from memory, pausing regularly to say “God bless you” to various people in the room. Yoga, horoscopes, astrology, and Christian language nonchalantly merged in this medical center’s daily routine.34 Americans, preoccupied by pragmatic goals of relieving pain or achieving optimal health, often combine therapeutic approaches without making conscious decisions to do so. The proliferation of health-care choices paradoxically makes it more difficult to investigate thoroughly any one option as a result of information overload. In an era of globalized advertising and the World Wide Web, it is challenging to sift through the abundance of unfiltered information available, much of which is designed to appeal to broad audiences and avoid offending particular constituencies. Earlier chapters in this book show that even presumably trusted information sources, such as the WHO, the congressionally commissioned NCCAM, the prestigious Mayo Clinic, and individual health-care providers, do not always disclose full, impartial information. As patients navigate the health-care market, the post-nineteenth-century reduction of pain to an adverse physical sensation and of wellness to a medical right accentuate questions of efficacy in comparing health-care options. Immediate goals (pain relief) and beliefs (in a treatment’s efficacy) may inhibit gaining substantial understanding of meanings commonly ascribed to a treatment. Apparently effective therapies may or may not advance longrange goals and values. This is significant given the phenomenon noted above of practices changing beliefs. Pragmatic health-care choices may lead people

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to do things they would not otherwise choose to do and to believe things they would not otherwise choose to believe, resulting in unintended and unnoticed restructuring of worldviews.35 The values of personal autonomy and self-determination imply that people may choose any or some combination of religious, spiritual, or medical practices or reject them all. People may exercise agency by choosing to delegate health-care decisions to someone else. But autonomous decision making requires intentionality. The problem of conscious choice is not unique to CAM but applies equally to selection of conventional medical treatments and more overtly religious practices such as church attendance. At issue—and this is an important point—is not whether any particular option is good or bad or whether it is “religious” or “Christian” but whether it is consciously or unreflectively selected. In the latter case, people may not even recognize that they are making a decision, because their course of action seems obvious given taken-for-granted assumptions and a pragmatic orientation.36 For America’s political and economic systems to function optimally, citizens and consumers must base their decisions on full and accurate information. This principle extends from health care to a wide range of human interactions, including sexual relations, voting for political candidates, employment, and commerce. The 2001 Nobel Prize in economics recognized the detrimental effects of asymmetric information in market interactions, resulting in power imbalances, adverse selection of low-quality products, and market failures. The law can go some distance in protecting freedom of choice, but for choices to be genuinely free, individuals must exercise civic responsibility to know what they are choosing and why. The sociologist Robert Wuthnow observes a post-1960s transition in American values from “freedom of conscience,” an ability to choose right over wrong without external restraint, to “freedom of choice,” an individual’s right to pick and choose from among market options. Commercialization minimizes the “problem of choice” by removing the element of sacrifice in choosing one alternative over another. Instead of committing to any one choice, consumers can, as a matter of convenience, sample them all on a temporary basis.37 Theologically conservative Christians influenced by the Reformation model of the priesthood of all believers share their nonevangelical compatriots’ individualistic, consumer orientation to health care. Christians often use relational language to describe themselves as seeking to “love God and love people” in all they do, since these are the “greatest commandments” of the Bible. Yet evangelicals envision health care as religiously neutral, and thus a matter of personal, albeit biblically informed, choice. Popular Christian medical writer Reginald Cherry, M.D., advises Christian consumers that “whether

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you should choose to pursue them [CAM] is a decision that should be made after much prayer. The Holy Spirit guides us.” The evangelical watchdog Gotquestions.org suggests that “with the freedom that we have in Christ, decisions like whether or not to use alternative medicine are to be based on our own biblically-informed convictions and preferences.” But “what we are not free to do is to force our own convictions on others, especially in debatable areas such as alternative medicine.” This decision-making model does not guarantee that individuals will base their choices on in-depth research or substantial understanding or contemplate how health-care choices might influence one’s own or other people’s religious choices. The propensity of Americans, evangelicals among them, to replace decisions of conscience with unthinking, pragmatic choices—especially when health is at stake—may have an unforeseen consequence for those who have freed themselves from external tyranny: subjection to internal tyranny of ignorance.38

CAM and the First Amendment The establishment and free exercise clauses of the First Amendment to the U.S. Constitution provide that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” Courts have grappled with the position of religion in public life given a Constitution that seeks to safeguard both free exercise and disestablishment of religion. There is a wide spectrum of opinion on how religion should be defined and which activities the First Amendment restricts or protects. Some judicial analysts hold that definitional questions are so thorny that courts should not attempt definitions. Scholar of religion and law Winnifred Sullivan concludes that “religion” is no longer a “useful term for U.S. law today, because there is no longer any generally accepted referent,” and disestablishment may be “anachronistic as a legal project.” Although I acknowledge the difficulties, I maintain that attempts to define religion—and interpret the First Amendment in light of such definitions—can and should be made.39 Throughout this book, I have argued for a uniformly broad definition of religion. Such a definition encompasses not only theistic beliefs but also bodily practices perceived as connecting individuals with suprahuman energies, beings, or transcendent realities or as inducing heightened spiritual awareness or virtues. By this definition, describing a practice as “scientific” or as “spiritual but not religious” (i.e., unlike “Christian” religion), especially for the purposes of making the practice appear more acceptable or gaining access to secular institutions or government funding, does not remove that practice from the realm of religion. This book contends that many CAM practices fit a

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broad definition of religion and that courts should use the same standards to evaluate CAM that they use to assess practices such as prayer and Bible reading that more people recognize as religious. Although the establishment clause is often paraphrased as requiring separation of church and state, at face value, the First Amendment more expansively precludes government from preferring or disfavoring “religion.” This language encompasses any religion, whether or not it is based in a church or even recognized as “real” religion by Christians. According to Harvard University professor of religion and law and advocate of religious pluralism Diana Eck, the “American Constitution guarantees that there will be ‘no establishment’ of religion and that the ‘free exercise’ of religion will be protected,” but the issues involved in “church-state relations . . . have become increasingly complex in a multireligious America, where the church in question may be the mosque, the Buddhist temple, the Hindu temple.” The courts have been relatively more attuned (though certainly not uniformly) to protecting free exercise of minority religions than to guarding against their establishment. In Torcaso v. Watkins (1961), the Supreme Court held that government cannot “aid those religions based on a belief in the existence of God as against those religions founded on different beliefs. . . . Among religions in this country which do not teach what would generally be considered a belief in the existence of God are Buddhism, Taoism, Ethical Culture, Secular Humanism and others.” In United States v. Seeger (1965), the Court defined religion broadly enough for free-exercise purposes to allow draft exemptions to conscientious objectors who did not affirm belief in God or a Supreme Being. In Employment Division v. Smith (1990), the Court applied a broad definition of religion that includes peyote use in the Native American church yet denied that practitioners should be exempted from neutral laws that incidentally inhibited religious practice.40 Some legal scholars claim that religion should be defined broadly when free exercise is involved and more narrowly in establishment-clause cases. Other constitutional analysts reject dual definitions as discriminating against commonly recognized religions in a manner unjustified by the wording of the First Amendment or judicial precedent. Harvard Law Professor Laurence Tribe, who argued for dual definitions in his 1978 constitutional-law textbook called his own proposal a “dubious solution” in a 1988 revised edition. This latter line of reasoning implies that the establishment clause, like the free exercise clause, extends to religions for which practice is more central than proclamation. The U.S. Court of Appeals for the Third Circuit made this logic explicit in Malnak v. Yogi (1979). A concurring opinion by Judge Arlin Adams inferred that “if a Roman Catholic is barred from receiving aid from the government, so too should be a Transcendental Meditator.” Yet there is

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a cultural reaction in America—one that affects legislation, funding allocations, and judicial interpretation—against what is perceived as centuries of unwarranted dominance by Christian institutions and discrimination against religious minorities. This reaction has—understandably and often with good reason—generated corresponding efforts to compensate by making room for other religions.41 Since the mid-twentieth century, courts have closely scrutinized Christian religious practices, especially in public schools, where compulsory attendance and the impressionability of children heighten risks of religious establishment. Few challenges arose earlier, because the First Amendment was originally interpreted as applying to the federal government but not the states. In Everson v. Board of Education (1947), the Supreme Court reasoned from the Fourteenth Amendment that the establishment clause applies to state and local governments, a doctrinal principle known as “incorporation.” The ruling upheld a New Jersey law that used tax money to reimburse parents for busing students to both Catholic and public schools, but the justices emphasized that the Court would not have allowed payments to go directly to schools. Justice Hugo Black delivered the opinion that “neither a state nor the Federal Government . . . can pass laws which aid one religion, aid all religions, or prefer one religion over another.” The Court reached a still more momentous decision in Engel v. Vitale (1962), ruling that even “denominationally neutral,” “voluntary” public-school-sponsored prayer violates the establishment clause. Black reasoned that the “power, prestige, and financial support of government” exerts an “indirect coercive pressure.” A concurring opinion by Justice William Douglas more pointedly denied that “Government can constitutionally finance a religious exercise.” Even if children are not required to participate, an “element of coercion is inherent,” because “every such audience is in a sense a ‘captive’ audience.” The following year, in School District of Abington Township v. Schempp (1963), the Court ruled against school-sponsored Bible reading. In writing for the majority, Justice Thomas Clark followed the reasoning of Justice Robert Jackson’s dissent in Everson: that public schools should provide a “secular education,” imparting “needed temporal knowledge,” while maintaining a “strict and lofty neutrality as to religion.” These landmark rulings found it impermissible for public schools, as government agents, to endorse even formally voluntary religious activities.42 When courts reason from case to case, justices look for similarities and develop doctrinal “tests” to apply a rule of law inherent in one case to another based on fundamental constitutional values. The dominant values for today’s Supreme Court are religious equality, or nondiscrimination, and religious voluntarism, or freedom to make choices without compulsion or subtly coercive

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influences. The Supreme Court has developed three tests for use in establishment-clause cases: the Lemon test, the endorsement test, and the coercion test. In Lemon v. Kurtzman (1971), the Court disallowed a Pennsylvania policy of reimbursing salaries and instructional materials for secular instruction in parochial schools, in the process articulating a three-part test. First, the statute must have a “secular legislative purpose”; second, the primary effect must be one that neither “advances nor inhibits religion”; third, it must not foster an “excessive government entanglement with religion.” Although the Lemon test has been widely criticized, courts still use it, though sometimes folding the entanglement prong into the effect assessment.43 Justice Sandra Day O’Connor devised the endorsement test as a “clarification” of the Lemon test in her concurring opinion for Lynch v. Donnelly (1984), which allowed inclusion of a crèche in a Christmas display. Courts ask whether a “reasonable” or “objective” observer, someone with sufficient information about history and context, would see in the government’s action a message that endorses a particular religion or religion in general over irreligion, either deliberately or in effect. In Edwards v. Aguillard (1987), the Supreme Court denied that an avowed secular legislative purpose, in this case protection of academic freedom, should be allowed to mask the purpose of endorsing religion, in this instance by promoting creationism.44 The Court added the coercion test in Lee v. Weisman (1992), which ruled against prayer at graduation ceremonies. Justice Anthony Kennedy (applying Douglas’s reasoning in Engel) delivered the Court’s opinion that even if students are not actively coerced to participate, they face “subtle coercive . . . public pressure, as well as peer pressure” to participate passively, and “this pressure, though subtle and indirect, can be as real as any overt compulsion.” The Court used all three tests in Santa Fe Independent School District v. Doe (2000) to invalidate a public-school policy of allowing student-led prayer at football games.45 It is my contention that public-school sponsorship of CAM practices such as yoga and meditation, as discussed in chapter 7 above, involves issues similar to prayer and Bible reading. Following Edwards, a stated secular purpose, such as making better students and teachers—a claim commonly made for mindfulness meditation—should not be allowed to mask the purpose or effect of advancing or endorsing religion. As part of Tara Guber’s Yoga Ed. program for K–12 public schools, federal grant money pays for public-school gym teachers to take certification classes at religious yoga studios. In order to grasp the significance of this self-proclaimed “Vedic victory,” one must recall that Guber admitted to—even bragged about—using subterfuge to get what she construed as a Hindu practice into public schools with direct federal funding,

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because she was confident that practicing yoga would change religious beliefs. Insisting that metaphysical practices are broadly spiritual rather than advancing any one religion parallels the assertion that prayers are denominationally neutral, an allegation that failed to save school prayer. Moreover, the Court has held that religion should not be advanced over irreligion. Evidence presented above illustrates that efforts by CAM promoters to advance religion influence students to make religious choices they would not otherwise make. An element of coercion is inherent in classroom yoga or meditation, even if students are allowed to opt out, which may not be the case in for-credit physical education. Although college students may be less religiously impressionable than younger students, they are more susceptible to other pressures, such as maintaining a high grade-point average to be competitive for jobs or postgraduate education. Ultimately, allowing yoga or meditation but not prayer or Bible reading in public schools distributes discriminatory benefits and burdens to different religions, contrary to the values of religious equality and religious voluntarism.46 Alongside the question of whether public schools should endorse religious practices is the question of whether government funds can be used for religious activities or institutions. Past courts ruled against the constitutionality of any government funding. To quote Everson, “no tax in any amount, large or small, can be levied to support any religious activities or institutions, whatever they may be called, or whatever form they may adopt to teach or practice religion.” Recent court rulings make two basic distinctions: between indirect and direct funding programs and between support of secular and religious activities. In Zelman v. Simmons-Harris (2002), the Supreme Court permitted government funding of school vouchers, since the money is distributed on a nondiscriminatory basis to individuals who may choose to use vouchers at religious or nonreligious institutions. Although recent rulings are also more lenient toward direct funding, they preserve the distinction that government cannot directly fund religious activities. Agostini v. Felton (1997) allowed supplemental instruction of disadvantaged students at religious schools by public-school teachers, and Mitchell v. Helms (2000) permitted federal loans of instructional materials to parochial schools.47 Despite judicial restraints on government support of religious activities—whatever they may be called and whatever form they may adopt—CAM promoters have secured government support, including direct funding for activities that fit a broad definition of religion. Thanks to lobbying by homeopathic patron U.S. Senator Royal Copeland, the Federal Food, Drug, and Cosmetic Act of 1938 incorporated the Homeopathic Pharmacopoeia of the United States, a list of accepted homeopathic remedies that has remained

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in continuous publication since 1897. In 1974, Congress authorized expenditure of $2 million to seek a scientific basis for chiropractic. Tom Harkin, Democratic Senator from Iowa since 1985, backs bee pollen and acupuncture; Orrin Hatch, Republican Senator from Utah since 1977, advocates chiropractic and dietary supplements. Together, Harkin and Hatch pushed to establish the NCCAM and White House Commission on Complementary and Alternative Medicine. An early leader in the TM movement, Deepak Chopra, M.D., served on an NIH Ad Hoc Panel on Alternative Medicine in 1992. The following year, the OAM (now NCCAM), gave Chopra $30,000 to look for scientific evidence supporting Ayurvedic medicine, even though Chopra apparently intended to use any evidence found to advance religious ideas, for instance, that “there is no other I than the entire universe. . . . I am omnipresent, omniscient; I am the eternal spirit that animates everything in existence.” In 1999, the NCCAM gave $8 million to the Maharishi International University of Management—a Hindu institution founded to promote TM—for the purpose of seeking scientific evidence of TM’s benefits. By 2004, Maharishi University had received $20 million in government support for TM research. These funding allocations came even after Malnak v. Yogi prohibited teaching TM in public schools because doing so established religion.48 Examples of direct government funding for CAM can be multiplied. In the 1990s, the U.S. Department of Health and Human Services Division of Nursing gave a $200,000 grant to D’Youville Nursing Center in Buffalo, New York, to train students in Therapeutic Touch, and the Department of Defense granted $355,000 to University of Alabama researchers to study Therapeutic Touch for burn patients. The OAM funded ten CAM research centers in 1993. In 2003, sixteen CAM research centers received NCCAM funding, including the Complementary and Alternative Medical Research Center at the University of Michigan, cofounded by Reiki healer Elena Gillespie. In 2013, the NCCAM funded seventeen CAM centers, among them the Palmer College of Chiropractic, programs using osteopathy and acupuncture, and two centers offering Mindfulness-Based Stress Reduction. Courts in New York City and Portland, Oregon, now mandate inclusion of acupuncture in drug-detoxification programs. Counties in Florida and Maryland give drug offenders a choice between acupuncture and jail. The Federal Acupuncture Coverage Act of 2011 introduced in the House of Representatives would amend Medicare and the Federal Employees Health Benefits Program to cover “qualified acupuncturist services.” Although not signed into law as of 2012, there is reason to expect passage of similar legislation in the not-too-distant future. A more amusing example comes from Cambridge, Massachusetts, where in 2010, the city government added to parking-ticket envelopes pictures of yoga asanas with

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instructions on how to do them. Officials interviewed said that the motive was to encourage a “peaceful exchange” between officers and the public, given that police distribute 340,000 parking tickets (for a population of 106,000) in Cambridge annually. At best, this is an idiosyncratic use of public funds and, at worst, governmental indoctrination that endorses religion.49 When government granting agencies allocate funds selectively through case-by-case evaluation rather than through general funding programs, there is heightened risk of discriminating in favor of certain religious groups and against others. Funding allocations do not simply reflect the standards of evidence-based medicine. In today’s cultural climate, it is hard to imagine the NCCAM funding research on the efficacy of Christian healing-prayer practices, although numerous published studies report health benefits from Christian prayer and churchgoing. Yet CAM advocates use studies claiming efficacy to justify government support of metaphysical healing despite an absence of evidence that practices such as meditation and yoga are more effective than Christian practices or nonreligious physical exercise and relaxation in reducing stress or conveying other health benefits. If the same logic were followed for CAM as for Christian prayer—in other words, if the law equally protected and restrained both sets of practices—neither would be funded by the public purse. The problem with government funding for CAM is not that government is backing unproven therapies nor even that CAM is religious but that in supporting CAM, government de facto endorses religion above irreligion and certain kinds of religion above others.50 Courts have been particularly sensitive to protecting religious minorities from dominant religions. Justice O’Connor observed that government endorsement of religion “sends a message to nonadherents that they are outsiders, not full members of the political community, and an accompanying message to adherents that they are insiders, favored members of the political community.” Government endorsement of once minority but now increasingly mainstream CAM practices might inflict a psychological assault on the irreligious and on other religious groups who do not accept vitalistic religion. For instance, some Muslim leaders warn that “religious elements” in yoga “can destroy the faith of a Muslim.” Moreover, evangelical Christianity is not as dominant in today’s culture as it once was, heightening the need for protection from disapproving messages.51 Government endorsement of CAM practices that take “ancient” or “Eastern” healing arts from cultures romanticized as mysterious, spiritual, and wise is ironic given outcries raised by traditional practitioners who resent what they view as neocolonial, therapeutic imperialism. Native Americans protest that European-Americans misinterpret and exploit without permission or

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remuneration sacred healing traditions, while obscuring histories of violence and ongoing social and economic struggles. The government of India established a task force on traditional knowledge and intellectual-property theft in 2005 to oppose “yoga piracy” by making digital copies of ancient drawings that show the provenance of more than four thousand yoga poses. Efforts by the U.S. government to protect rights of CAM practitioners and to encourage further adoption through sponsored research and services may come at the expense of the rights of those who own or at least developed borrowed traditions.52

Final Reflections The mainstreaming of CAM in America is a remarkable cultural progression. The preceding chapters tell the story of how health-care practices once widely regarded as medically and religiously illegitimate—largely because of their metaphysical goal of achieving harmony with life-force energy—are becoming integrated into secular and Christian settings. Various holistic providers have carved out somewhat different market niches as they appeal to diverse but overlapping clienteles who desire a range of physical, emotional, and spiritual benefits. From yoga’s promise of optimal wellness for the relatively fit to anticancer alternatives that offer hope to the desperately ill, some form of CAM appears to be right for everyone. To date, certain healing practices, such as acupuncture and chiropractic, have come further than others, such as energy medicine, in moving from the fringes to the center of American culture. Given current trajectories, we may soon expect to see even more now-marginal practices culturally reconstituted as at once spiritual, scientific, and comfortably accommodated within American democracy and evangelical Christianity. Contrary to secularization theories that posit the growing privatization of religion, religiously infused health-care practices are moving into secular settings and the political arena, as individuals demand their rights to use— and be reimbursed for using—the diverse array of therapies that they have intermingled all along. Privatization has not meant disappearance of religion from public spaces but emphasis on techniques over theories, practices over philosophies. As historian Robert Johnston argues, CAM has an extraordinary capacity to combine ideologies from the political left and right, such as antiprofessionalism and individual responsibility, thereby transcending political—and religious—categories to win a broad spectrum of defenders. In an era when the political power of evangelical and CAM constituencies is of great media interest, largely unrecognized intersections of these communities with one another and orthodox medicine warrant reflection. American liberal

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democracy may, as political scientist Fred Frohock cautions, prove ill equipped to develop neutral procedures for regulating practices that blend metaphysical, evangelical, and scientific assumptions about the nature of reality.53 Holistic healing has not become mainstream because it is nonreligious, Christian, or demonstrably effective and safe. Rather, CAM has, for reasons of demand and supply, become integrated into the health-care market despite the absence of strong scientific support. By a halo effect, selective presentation of positive findings for certain CAM therapies lends scientific legitimacy to all of CAM. We can expect that CAM will become even more commonplace in years to come and that conservative Christians will be among CAM’s most avid devotees. Even so, CAM has not become popular among Christians because its roots and fruits are distinctively Christian. Evangelicals who disdain religious combinations as idolatrous worship of other gods domesticate healing practices rooted in and productive of metaphysical religion by linguistically reclassifying these practices from the category of illegitimate “New Age” spirituality to that of scientifically legitimate, effective therapeutics. When health becomes the driving imperative, people who condemn theological relativism accept therapeutic relativism. This is significant given evidence of health-care practices changing religious beliefs. Therapeutic relativism can unwittingly lead to theological relativism. What people do with their bodies may express and influence what they value more transparently than what people say they believe. Where there is tension between beliefs and practices, actions may speak louder than words. Holistic providers have done more to investigate—and alleviate—Christian concerns than Christians have done to investigate CAM. Because monistic worldviews postulate that nonspecific spiritual interventions are compatible with all religious traditions, providers may in good faith perform practices without recognizing that they could conflict with exclusivist views of monotheistic patients. Yet there is evidence that certain CAM providers intentionally withhold religious information or occlude it with scientific or blandly spiritual language to make CAM acceptable to patients and gain access to secular settings and government funding. Holistic healers may be reluctant to provide information about CAM’s vitalistic premises because doing so could cause them to lose clients. Providers might demur that such information would unnecessarily confuse patients and make it more difficult to offer treatment that providers consider beneficial. Yet fundamental to autonomous decision making and self-determination is that individuals have a right to refuse beneficial treatments. It is problematic when CAM providers offer potentially objectionable services without equipping patients or legal representatives to give

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or withhold informed consent. It is equally problematic when patients fail to consider how treatment options fit their own long-range goals and values. The implications of CAM’s mainstreaming, the processes through which it has occurred, and the contexts where CAM receives institutional support merit consideration by health-care consumers, providers, policy makers, and courts. At stake are informed decision making in the health-care marketplace; protection of consumers, especially vulnerable ones, from selective, deceptive, or fraudulent representations that may induce people to make different choices from those they would make otherwise; and boundaries between religion and government. If more people knew more about CAM, some might think differently about how, where, or whether it should be used and who should pay the tab. Consumers might reevaluate CAM’s religious status and perhaps avoid participating or join in more selectively. Conventional doctors and policy makers might reconsider how or if CAM should be integrated into health-care markets. The courts might review government sponsorship of CAM where it entails endorsing religion. Asking why CAM is supposed to work informs choices about health and religion.

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Notes

in t roduc t ion 1. I use the older, Wade-Giles romanization system (Taoism) rather than the modern, Pinyin system (Daoism), following the usage of most of my primary sources and some scholars, who are divided. But because my sources usually refer to qi (Pinyin) rather than ch’i (Wade-Giles), I follow my sources for clarity at the expense of absolute consistency. I omit most diacritical marks for transliterations to enhance readability for nonspecialists. 2. Whorton 2002, 223; Beardsley 1924, 275; Eisenberg et al. 1993, 246; Eisenberg et al. 1998, 1572. 3. White House Commission 2002, 9; Ledermann 1986, xxi; Coward 2008, 31; Smuts 1926, 146. 4. Klassen 2011, 111; Fuller 1989, 92; Hufford and Bucklin 2006, 28. The term metaphysical may denote any belief that a spiritual realm exists (by which definition Christianity fits); I instead follow Albanese 2007, 6, in finding a narrower definition to be clearer. The term occult is sometimes used as a synonym for metaphysical, but, like Albanese, I avoid this term because of its confusingly pejorative and narrow connotations. 5. Whorton 2002, xii; Harrington 2008, 223. 6. Syman 2010, 5; Fuller 2008, 149. 7. Klassen 2011, 7; Benz 1989, 2; Barr 2003, 227–232; NCCAM 2007, 3. 8. Oschman 2000, 78; Hutchison 1999, 43–45; Koontz 2003, 103; Carroll 2010; NCCAM 2007, 3. 9. Koontz 2003, 102; Oschman 2002, 33–35; Poulin 2004, 11. Oschman’s online CV (Oschman 2013) indicates that his only nonvisiting faculty appointment was as an assistant professor at Northwestern University, 1970–1974. 10. Vickers 1984, 15; White 2013; Fernflores 2010; Sayre-Adams and Wright 2001, 6–7; Heisenberg 1930, 10–12. 11. Harrington 2008, 241–242; Sood 2010, 95. 12. Butler 1990, 230–233. 13. Ward 2006, 23; Mullin 1996, 13; Porter 1999, 373; Winiarski 2005, 163.

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14. Butler 1990, 231–233. 15. Numbers 1978, 226; Cayleff 1987, 6; Rosenberg 1979, 14–15. 16. Whorton 2002, 25; Braude 2001, 6; Rothstein 1988, 41; Nissenbaum 1980, 7–8, 19–20; Abzug 1994, 165–182; Graham 1837, 22, 102; Curtis 2007, 6. 17. Numbers 1978, 231; Edelson 1994, 67. 18. Numbers 2003, 266; Leavitt and Numbers 1978, 8; King 1984, 1079; Foucault 1975, 120; Whorton 2002, 246. 19. Reed 1932, 1; Numbers 1978, 233; Johnston 2004, 2. 20. Ariel 1999, 237. I capitalize Pentecostal for denominations that trace origins to the Azusa Street revival of 1906 and Charismatic for renewals birthed in the 1960s, using lower-case for pentecostal as an umbrella term. 21. Pope Paul VI 1964; Pope Paul VI 1965; Kennedy 1995, 11–14; Ratzinger 1989; Pontifical Council 2003; Lori et al. 2009, 4–5. 22. Whorton 2002, 245; “Maureen,” interview, October 30, 2009, in Vasko 2009, 13. I use pseudonyms (recognizable by the use of first or last name only) to protect informants; I use real names when quoting written statements by public figures or published authors. 23. White House Commission 2002, 14, 31; Deloitte Development 2010; O’Connell 2012; Goldstein 1999, 123; NCCAM 2012b; Brown 2009. 24. Whorton 2002, x, 243, 285, 295, 302; Committee on Quackery, quoted in Kaptchuk and Eisenberg 1998, 2219; JAMA 1998. 25. AARP and NCCAM 2007. 26. Field 2009, 6. 27. Barnes, Bloom, and Nahin 2008, 3–4, 6. 28. Lerner and Kennedy 1992, 185, 189–190; Bausell, Lee, and Berman 2001, 190; Eisenberg et al. 1993, 246; Langer 2005; Oldendick et al. 2000, 377; Richardson et al. 2000, 2505; Bishop, Yardley, and Lewith 2008, 1700. 29. Wallis, Horowitz, and Lafferty 1991. 30. Kosmin and Keysar 2009, 3; Barna Group 2008; Smidt et al. 1999, 120; Noll 2001, 31; Brown 2004, 1–7. 31. Noll 2001, 2; Brown 2004, 1. 32. Noll, Hatch, and Marsden 1983, 28–46; Whitten 1999, 3; Fea 2011, 7; Albanese 1990, 55–56; Hodapp 2007, 110; Campbell 1999, 52. 33. Deuteronomy 12:29–31; 1 Kings 9:9, 2 Kings 17; Jeremiah 44:17. Unless otherwise specified, biblical quotations are from the New International Version (NIV), the version most often used by my sources. 34. Bercovitch 1978, 93. 35. Ibid., 31–34; Eck 2001, 42. 36. James 1902, 337. 37. Festinger 1957, 3; Wuthnow 2007, 106; Hall 1997, viii. 38. Brown 2012, 192. All human subjects research received IRB approval: Saint Louis University 13946; Indiana University 06-11383, 0902000055.

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c h a p t er 1 1. Durkheim 1933, 131; Albanese 2013, 2–9; Pals 1996, 10–12; Smith 2004, 179– 196; Orsi 2005, 183–198; Tweed 2006, 73; Kunin 2003, 3; Barnes and Sered 2005. 2. Fessenden 2007, 4; Klassen 2011, 60; Bebbington 1989, 2–17; O’Toole 2004, 1. 3. King 1999, 3; Eck 2001, 4. 4. Fuller 2001, 5; Wuthnow 2007, 134; Stark 2008, 88. 5. Gould 1997, 19; Zurcher 1959, 141; Barnes 2005, 3; Croizier 1968, 13–35. 6. King 1999, 151; McMahan 2002, 219–222; Tweed 1992, 103–115; Seager 1999, 6, 90–92, 109, 129; Donahue 1993, 118. 7. Eck 2001, 186; King 1999, 157; Soyen 1896, 139; Habito, quoted in Seager 1999, 225; Maria Kannon Zen Center 2010. 8. McMahan 2002, 218. 9. Bauer et al. 2010, 16–17; Sood 2010, 95–96, 113. 10. Arriaza 2009, 287; Tan 2004, 170; Draeger 1996, 134–136; Funakoshi 1973, 3–6; Haines 1995, 172; Umezawa 1998, 10–11; Donahue 1993, 105, 113, 120–121. 11. McMahan 2009, 18–21; Zurcher 1959, 288–290. 12. Farnsworth et al. 1985, 966; Goldstein 1999, 62–64; Gladstar 1999, 24; Williams 1979, 22–27; Krippner and Colodzin 1981, 14; Trotter and Chavira 1997, 77–80; Brandon 1991, 58. 13. Khandavalli 2008; Berry 2007; Campbell and Campbell 2006, 21. 14. Albanese 2007, 76–78; Ahlstrom 2004, 51; Moore 1993, 7–9. 15. Still 1910, 145; Gevitz 1988a, 124–156; Albanese 1990, 142; NCCAM 2012a, 1. 16. Peterson 1998, 53; Spaeth 2000, 641; Osteopathic Medical College 2008, 6; Shulman 2007; Mercola 2013a; Mercola 2013b. 17. Haller 2005, 53; Whorton 2002, 18. 18. Rowe 2005, 83–84; Haller 2009, 19, 235; Hahnemann 1810, 9, 11, 20, 52; Hahnemann 1846, 141; Haller 2005, 30; Whorton 2002, 58–59; Coulter 1973, 57; Ramey and Rollin 2003, 37. 19. Shelton 2004, 58, 70, 267–272; Park 2008, 144–146; Economist.com 2012. 20. Kaufman 1988, 100–101; Haller 2005, 40–41, 59–66, 150–151, 238; Benz 2002, 487; Crompton 2005, 76; Hahnemann and Gram 1825; Coulter 1973, 102; Kent 2002, 108, 120; Dale 1989. 21. Shelton 2004, 48–49, 227–239; Bolte 1976, 12; Jayne 2013; “Tess,” interview, in Bender 2010, 25. 22. Lust, quoted in Whorton 2002, 224; “Dr. Matthews,” interview, in Grise 2009, 2; Connolly 2010; Association of Accredited Naturopathic Medical Colleges 2013; American Association of Naturopathic Physicians 2012. 23. Fischer-Rizzi 1990, 9; Worwood 1999, 8–9, 16. 24. Hess 2002, 87; Gerson and Walker 2001, 220; Lowell 2006; CDC 1981; Budwig 2010, 181; Breuss 1995, 29; Godin 2013;Winter 2013; Rudolf Steiner Health Center 2010; Essiacinfo.org 2007.

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25. Walters 1993, 155; Wigmore 1975, 31, 57; Jarvis 2001. 26. Raposa 2003, 40–41; Kuriyama 1999, 229, 266; Porkert 1974, 67; Carter 2004, 54–56, 59; Sutherland 2000, 41; Barnes 2005, 4. 27. Holcombe 1990, 422; T. A. Green 2001, 2: 382–391; Martinez 2009, 302; Raposa 2007, 167; Gilligan 2010, 13–27, 31–46, 59–68; Patience T’ai Chi Association 2012a; Patience T’ai Chi Association 2012b; Jou 1985, 181; Barnes, Bloom, and Nahin 2008, 10. 28. Kushi and Blauer 1985, xi, 94–107; Ohsawa 1965; Barrett 2010; Hess 2002, 81–88; Kushi 1977, xv, 66, 103–104, 119, 159–163 (emphasis in original); Kushi and Jack 2009, 20; Kushi 2004. 29. Knierim 2013; Seager 1999, 15, 24. 30. Seager 1999, 16; Loizzo, Charlson, and Peterson 2009, 133. 31. Psalm 1:2; Stock 2001, 105; McGinn 2006, 66; Williams 2006, 5. 32. Seager 1999, 254; Kabat-Zinn 1990, xvii, 21; Kabat-Zinn 1994, xvi, 4. 33. Kabat-Zinn 1994, 4–6, 263; Kabat-Zinn 1990, 12–13; Center for Mindfulness 2013b. 34. Kabat-Zinn 1990, 1–2, 12–13, 33, 38, 95; Kabat-Zinn 1994, 4. 35. Loizzo, Charlson, and Peterson 2009, 136–142. 36. Harp and Smiley 2007. 37. King 1999, 3; Worthington 1982, 5; Alter 2004, 247. 38. Woo 2008; “The TM Craze” 1975. 39. Yogi 1968, 177–178; TM.org 2012b; Smith 1975, 123. 40. Page and Hoyle 2008. 41. Biofeedback Certification Alliance 2012. 42. Wallis, Horowitz, and Lafferty 1991; Hartley and Hartley 1974; Green and Green 1977, 123; International Society 2012; Universal Awakening 2007; Green 1999, 221; Walsh 1992; Green 2001, 4; Green, quoted in Pressman 2003. 43. Brown 1980, 252; Pelletier 1977, 322; Moss 2002, 288. 44. Goldstein 1999, 108–109. People draw from multiple worldviews in ways that defy neat categorizations, as, for instance, Ward 2006, 11, shows for vitalistic evangelicals. 45. Cox 1999, 390.

c h a p t er 2 1. 2. 3. 4.

Boon 2007, 3-4; Boon 2010. Boon 2007, xv, 32; Boon 2010; Singleton 2010, 29. Singleton 2010, 4; White 2011, 6. Jacobsen 2005, 7; White 2011, 8; Shvetashvatara Upanishad 4:17, Taittiriya Upanishad 1.8.1, Bhagavad Gita 7:8, quoted in Babamani 2013; Yoga Sutras 1:2, quoted in Aranya 1963, 6–11; Lidell 1983, 15; Strauss 2005, 2–5; King 1999, 181; Raposa 2003, 68; Berry 1992, 94. 5. Rieker 1971, 101; Krishna 1975, 13; Syman 2010, 5.

Notes 6. 7. 8. 9. 10.

11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.

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Singleton 2010, 27–29; White 2011, 10–11, 16; Varenne 1976, 15. Singleton 2010, 70, 77; White 2011, 11–12, 17–18, 21. Singleton 2010, 5, 22, 91–92, 114, 129, 152–158, 175–180; White 2011, 21. Syman 2010, 14, 26; Macshane 1964, 322–323. De Michelis 2004, 3; Eck 2001, 100; Vivekananda, Works, vol. 8, quoted in Syman 2010, 45–49, 55–56; Singleton 2010, 4–5, 71, 80; White 2011, 21; Forstater and Manuel 2002, 142; Descartes 1649, 232. White 2011, 20; Blavatsky 1888, 289–306; Yogananda 1946; Yogananda 1993; Eck 2001, 105; Alter 2004, 32. Love 2006, 84. Singleton 2010, 175; Devi 1953; Devi 1959, 128–135. Hittleman 1969, 12–13, 135; Leviton 1993, 68; Brown 1979, 7; Syman 2010, 246–247. Judith Lasater, interview, September 24, 2008, in Syman 2010, 244, 248, 262; Lee 2011, 45–46, 50; Woodard 2011. Syman 2010, 283; “Madonna Lyrics” 2013. Bikram Yoga 2013; Shakespeare 2006, 38; Syman 2010, 281. Smith 2012; Moran 2006. AYA 2013; Catalfo 2001; Swamiji 2011. AYA 2013; Swamiji 2011; Shukla 2010; interview, September 15, 2009, in Lennox 2009, 11. Singleton 2010, 27; Banuet-Alvers 1996, 22; Advaita Yoga Ashrama 2013; Abhyasi 2010. “Marge,” “Alejandra,” “Brianna,” interviews, March 2–3, 2010, in Metroka 2010, 10–13; Desmond 2011. Huffstutter 2009. Tiwari 2006; Prem 2006; Bharati 2013; Shukla 2010. Bernard, “The Psychological Basis of Yoga,” c. 1939, BANC MSS 2005.161z, quoted in Syman 2010, 135; Radha 2006, 26, 33–34. Indiana University Recreational Sports 2010–2011; Syman, interview, in Mohler 2010a; Syman 2010, 100. Ward 1817, 1:xii, xxxix; Saper 2004, 44; O’Neal 2007. Assemblies of God USA 2013; Robaina 2005a; Pavlik 2001, 50; Alves 2003. Galanos 2007; Press 2012; Mohler 2010b; Montenegro 2009; Hunt 2006, 23. Ogle 2012; Isacowitz 2006, xiii, 9. Groothuis, interview, in Mohler 2010a; Gotquestions.org 2013e; Gotquestions. org 2013c. Lovan 2010; Mohler 2010c; Rock 2004, 96; Becca, March 13, 2008, and D. Sleezer, October 15, 2007, in Amazon.com 2013. Klassen 2011, 7; Paul 2009, 1, 4, 11, 34, 62–63. Klassen 2005, 382; advertisement for Yoga Prayer in Ryan 2004; interviews, in La Reau 2005, 15.

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35. 36. 37. 38.

Roth 2001, xvi–xvii, 1, 14, 75. Bordenkircher 2006, 3, 8, 17; Bordenkircher 2013. Press 2007; Germantown Baptist Church 2013. Ly 2006; Turner and Cunningham 2007; Tennant 2005; Alter 2003; Martin 2013. 39. Monica 2013; “Molly,” interview, August 31, 2011, by Erin Garvey. 40. Willis 2013; Robaina 2005b, 41. 41. Tennant 2005; Dillon, interview, in Lovan 2010; Boon 2007, 38.

c h a p t er 3 1. Noll 2001, 159. 2. Peretti 2003, cover; “Dr. Taylor,” interview, October 30, 2009, in Vasko 2009, 16. 3. De Castro, Oropeza, and Rhodes 1994, 2 (emphasis in original); Gotquestions. org 2013b; Gotquestions.org 2013a; Gotquestions.org 2013d. 4. John 15:15; Matthew 7:17, 20. 5. Anderson and Jacobson 2003, 242, 253, 257; Pfeifer 1988, 67 (emphasis in original). 6. DiscernIt 2007. 7. Miller 1987, 19; Fish 1995, 34, 38; Nurses Christian Fellowship, 1996, quoted in Wuthnow 1997, 226. 8. Pfeifer 1988, 103, 106; H. J. Bopp, Homeopathy, trans. Marvyn Kilgore, 1984, quoted in Cloud 2009; Skyrme 1995, 5. 9. Skyrme 1995, 5–19, 74, 105–118. Some pentecostals deny that Christians can be demonized. 10. Mullin 1996, 16; Delbanco 1995, 14; Nietzsche 1887, 108. 11. One Christian Ministry 2009a; O’Mathúna and Larimore 2006, 127, 131; Dager 1989, 2. 12. Robaina 2005a. 13. Anderson and Jacobson 2003, 176; “Discerning the Healing Spirits” 1998. 14. Lori et al. 2009, 4; O’Mathúna and Larimore 2006, 146, 149, 246–248; Pfeifer 1988, 40, 81–82; O’Mathúna 2001, 7. 15. Shelly, quoted in Maxwell 1996, 97; Newport 1998, 356. 16. Howard and Streck 1996; McLuhan 1964, 7; Wimber 1987, 6, 274–275 n. 4. 17. Burch 2010, 4. 18. Williamson 2004, 15–16, 19–20; CMAN 2012a; Chen 2002, 13–14, 26, 55. 19. Finch 1999, ix, 4; Graham, Litt, and Irwin 1998, 95; Epperly and Epperly 2005, 60, 79; ChristianReiki.org 2013; White 2013; Hannon 2013; Smith 2000, 116–117. 20. Romans 10:9 (NKJV); Don-Wauchope 1993, 3–4, 11, 32–33, 43–45. 21. Kline 2013; Monte Kline, quoted in Ankerberg and Weldon 1996, 174–175; Youngblood 2012. 22. One Christian Ministry 2009a; Yin Yang House 2013.

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23. Rocca 2010; Wuthnow 1997, 228; de Castro, Oropeza, and Rhodes 1994, 3; Williamson 2002, 13–15; CMAN 2012b. 24. Covington 2006, 5, 20–22, 47, 106; Covington and Lumpkin 2004, 13–15, 160. 25. “Deborah,” quoted in Krieger 1979, 132. 26. Male 1989, 1–9. 27. Ullman 2007, 303–304. 28. Genesis 1:29, 9:3, 6:1; Psalm 90:10; Malkmus, Shockey, and Shockey 2006, 63; Hallelujah Acres 2013b; Hallelujah Acres 2013a. 29. Williamson 2004, 14–15; CMAN 2012a. 30. White 2010; Williamson 2002, 12; Jaramillo 2007; Asay 2007a. 31. Mebane 2013; Rand 1991. 32. British Homoeopathic Association 1994, 44; Don-Wauchope 1993, 4; Kah, quoted in Asay 2007b; One Christian Ministry 2009a; One Christian Ministry 2009b. 33. Biblical Discernment Ministries 1992; One Christian Ministry 2009b; “Discerning the Healing Spirits” 1998. 34. “Margaret,” e-mail, in Carter 2010b; British Homoeopathic Association 1994, 44; Covington and Lumpkin 2004, 78. 35. Covington and Lumpkin 2004, 76; Bob Jones University 2013; Bob Jones University 1992; Cline 2012; Beals 2013; Beals 2011; Renkin 2012; Graham, Litt, and Irwin 1998, 46–47; Chuster, quoted in Maxwell 1996, 98. 36. Jones 2013. 37. Gotquestions.org 2013b; Gotquestions.org 2013a; Chadwick 2008.

c h a p t er 4 1. 2. 3. 4.

“Betty” and “Bob,” e-mails to author, March 31, 2006. White and Skipper 1971, 300; Wiese 2000, 245. Morris 1991, 4–5. Donahue 1987, 23–25; Palmer 1910, 18, 501, 718; Folk 2006, 109–125; Gibbons 1977, 721; Gielow 1981, 82–83; Albanese 1990, 149–150. 5. Vern Gielow, interview, summer 1982, in Albanese 1990, 151; Martin 1994, 213; Moore 1993, 23; Palmer 1910, 446, 491–493, 642, 691; Palmer 1914, 10; Donahue 1987, 26. Wardwell 1992, 180–181, denies that Palmer considered chiropractic a religion. After quoting a lengthy passage in which Palmer identifies the “religion of chiropractic” as belief in Universal Intelligence, “segmented into as many parts as there are individual expressions of life,” Wardwell protests: “If this is religion, it certainly is not Christian. Basically, D. D. did not consider chiropractic a religion.” Wardwell’s word choice indicates that Palmer’s explicitly “religious” views did not strike Wardwell as “Christian” and that Wardwell considered theistic religions such as Christianity to be the only genuine religions.

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6. The Chiropractor 5 (1909): frontispiece, quoted in Fuller 1989, 72; Palmer 1910, 8, 492. 7. Keating 1997, vi; Palmer, Do Chropractors Pray? 25 (emphasis in original), 27–28; Palmer 1949, 65; B. J. Palmer, lecture notes, October 21, 1908, 4, Palmer College of Chiropractic Archives, quoted in Martin 1993, 813; Palmer 1950b, 2; Palmer, The Lord’s Work, 9; Palmer 1966, 116; Palmer 1961, 56, 71–72; Palmer 1950a, 537–538 (emphasis in original). 8. See note 5 above. 9. Moore 1993, 49–50. 10. Chapman-Smith 2000, 14. 11. Moore 1983, 151; Bryner 1987, 53–57. 12. American Chiropractic Association, “Policy Statement” (1994), Association of Chiropractic Colleges, “Position Paper” (1996), quoted in Chapman-Smith 2000, 57–60; World Chiropractic Alliance, “Practice Guidelines for Straight Chiropractic” (1993), quoted in Raso 1994, 150. 13. Raso 1994, 148; NACM 2008 (emphasis in original); Dynamic Chiropractic 2010. 14. Donahue 1992, 23; Donahue 1986, 35; Rondberg 1989, 1, 3–4, 10 (emphasis in original). 15. McDonald 2003, 15–16, 20–21, 35, 49, 55, 60, 89–91, 101. 16. Moore 1993, 148; Gay 2007; Harper 2007, 19 (emphasis in original); Eriksen, Rochester, and Grostic 2007, 279; Hammer 2007, 427; Maurer 1998, 18; Kline 2012, 3. 17. Reid 2007, 28 (emphasis in original). 18. Abblett and Abblett 2007, 55; Amos 2006, 27; Passalacqua 2006, 21. 19. Chapman-Smith 2000, 69–70, 135; Keene 1999. 20. Keating et al. 2005; evangelical patient, e-mail to author, June 30, 2009. 21. Bube 1977, 23. 22. Moore 1993, 189–190, pieces together several studies. Biographical sketches of Oklahoma chiropractors from 1930 give the religious affiliations of 50 out of 112 practitioners: 11 Baptists, 11 Methodists, 8 Christian/Church of Christ, 8 Presbyterians, 4 Methodist Episcopals, 2 Catholics, 2 Quakers, 1 Lutheran, 1 Nazarene, 2 Church of Jesus Christ of Latter-Day Saints, and 2 attending Phillips Christian University “preparatory for Evangelistic work.” Many of the same individuals “belonged to the Masons, Shriners, and other fraternal bodies.” A study of 58 Missouri chiropractors in 1972 found 40 Protestants (70.7 percent), 10 Catholics (17.2 percent), 2 “other” (3.4 percent), and 5 with no religious affiliation (8.7 percent). Who’s Who in Chiropractic (1980) includes 875 entries: 310 with no religious affiliation (35.4 percent), 103 Catholics (11.8 percent), 421 Protestants (48.1 percent), 23 Jews (2.6 percent), and 18 “other” (2.1 percent), including 1 “Unitarian Atheist.” Gallagher 1930, 107–176; Lin 1972, 54; Lints-Dzaman, Scheiner, and Schwartz 1980, 23–265; McSherry 1952, 5, 10, 13.

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23. Hultgren 2003, 8; CCA official, interview by author, March 16, 2006; CCA 2013. 24. Hultgren 1999, 2, 5–8. 25. Whorton 2002, 168; Weed 1913, reprinted in Palmer 1951, 158–159; Moore 1993, 100; Lyon 1977, 31; Boyajian 2006. 26. Gordon 1992; Ankerberg and Weldon 1991, 206. 27. Reisser, Reisser, and Weldon 1987, 3–4, 37, 94; Moore 1993, 204. 28. Anderson and Jacobson 2003, 149, 152–153; O’Mathúna and Larimore 2006, 151; Let Us Reason Ministries 2009. 29. Hultgren 1999, 5. 30. Herron and Glasser 2003, 280; Wahner-Roedler et al. 2005, 55. 31. Brown 2012, 78–95; Albanese 2007, 510. 32. On survey methods, see Brown 2012, 162–193, 293–298. 33. Cherkin and MacCornack 1989, 351. 34. Kaptchuk and Eisenberg 1998, 2221–2222; Moore 1993, 141.

c h a p t er 5 1. Hufford 1988, 256; FDA 2006. 2. Sackett et al. 1996, 71; Willis and White 2004, 57. 3. Cahill et al. 2003, 35; Spiro 1997, 49; Khalsa 2004; Cochrane Collaboration 2013; Ramaratnam and Sridharan 2002. 4. Ruggie 2004, 170. 5. Center for Mindfulness 2013a; TM.org 2012a; Ospina et al. 2007, v. 6. Phillips 2004; Cantwell, quoted in Rand 2013a; AHNA 2009; Vitale 2007, 178; Garrison 2005; Holos University 2010; New Thought Accreditation Commission 2007; Center for Reiki Research 2013a; Baldwin, Wagers, and Schwartz 2008; Baldwin and Schwartz 2006; NIH 2013. 7. Ojasoo and Doré 1999, 81; Singh and Ernst 2008, 73; WHO 2002, 3–7, 23–25. 8. Nienhuys 2010; Hopff 1991. 9. Davenas et al. 1988; Maddox, Randi, Stewart 1988; Singh and Ernst 2008, 118–126. 10. Vickers 1999; Becker-Witt et al. 2003, 113; Pearson 2002. 11. Benveniste 2000 is quoted on numerous Web sites as of 2013, but the DigiBio Web site could no longer be located on August 30, 2011; Jonas et al. 2006, 23; Singh and Ernst 2008, 124–125. 12. Linde et al. 1997; Linde et al. 1999; Ernst 2002b, 577; Jonas, Kaptchuck, and Linde 2003, 393; Shang et al. 2005; Cochrane Collaboration 2013; NCCAM 2010b, 1–3. 13. Singh and Das 2011. 14. Pharmaca 2011; Logan 2010; Kastner and Burroughs 1993, 122. 15. Cahill et al. 2003, 104; Winterson 2007; Winterson 2008; Dupreem and Beal 2006, 73.

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16. Andersen-Parrado 1999; Ryman 1991, 3–5; Holt et al. 2003; Smith, Collins, and Crowther 2011; Price and Price 2007, 11–12; Barrett 2001; Schwartz 2008; Valnet 1990, 7; Aromaweb 2013. 17. Krieger 1975, 786; Mooney 2005, 38; Rosa, Rosa, Sarner, and Barrett 1998; Meehan 1999, 176; Woods, Craven, and Whitney 2005; Winstead-Fry and Kijek 1999. 18. Quinn and Strelkauskas 1993; NCCAM 2007, 3; Wirth 1990; Wirth et al. 1993. 19. Sayre-Adams and Wright 2001, 24; Quinn 1989. 20. NCCAM 2009, 2–3. 21. NCI 2013c; NCCAM 2012c, 2. 22. NCCAM 2010c, 1–3. 23. NCCAM 2009, 2; Cahill et al. 2003, 118, 145–146; Plait 2002, 21–27. 24. NCCAM 2010c, 1–3; Wang et al. 2004. 25. Sood 2010, 95; Draganski et al. 2006; Boelens et al. 2009; Colcombe 2006; Wan and Schlaug 2010; Gómez-Pinilla 2008. 26. Garfinkel et al. 1998; Irwin, Olmstead, and Oxman 2007; Yeh 2004, 542, 546. 27. Wang, Lau, and Collet 2004; Yeh 2008, 84; Han 2004; Gillespie et al. 2009. 28. Sood 2010, 114; NCCAM 2010d, 2; Wayne et al. 2004, 142–143, 150. 29. WHO 2000, 3; Stone 2011, viii; Assembly of Life Sciences 1982; Campbell and Campbell 2006, 157–182; Physicians Committee 2013; Fulkerson 2011. 30. American Dietetic Association 2009, 1266; ACS 2012a, 48–49; ACS 2008; ACS 2012b. 31. Jepson and Craig 2008; Linde, Berner, and Kriston 2008; von Schacky and Harris 2007; Chen, Stavro, and Thompson 2002; Aggarwal et al. 2005; Serraino 1999; Dwyer 1992. 32. Furlan et al. 2008; Ernst and Canter 2006, 192; Walker, French, and Green 2010; Rubinstein et al. 2011; Proctor et al. 2006; O’Connor, Marshall, and MassyWestropp 2003; Hondra, Linde, and Jones 2005; Glazener, Evans, and Cheuk 2005. 33. Dworkin 2001, 11. 34. Weiger et al. 2002, 891–892; FDA 2009. 35. Weiger et al. 2002, 895; NCI 2013a; NCI 2013b; ACS 2013; Horneber et al. 2008; Goldacre 2010, 4–7. 36. FDA 2009; ACS 2011; NCI 2012a; ACS 2012c; NCI, 2012b; Milazzo et al. 2006; Barrett 2006, 1770; Eisele and Reay 1980, 1608; Ernst 1997, 196. 37. Langworthy and le Fleming 2005; Ernst and Canter 2006, 192; Ernst 2002a, 41; Stevinson and Ernst 2002, 566; Cagnie 2004, 151; Plamindon 1995, 57; Ernst 1998, 249; de González, Berrington, and Darby 2004. 38. Banuet-Alvers 1996, 3; Giri 1997; Broad 2012, 121; Russell 1972; Corrigan 1969; American Academy of Orthopaedic Surgeons 2012. 39. Swatmarama 2010; Narayanananda 1970, 84–90; Grof 2013; Lukoff 1988.

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40. Perez-De-Albeniz and Holmes 2000; Institute for Youth and Society 1980, 4.6.6; Philadelphia Inquirer (January 14, 1987), quoted in Behind-the-tm-façade.org 2013; DeNaro, “Affidavit” (July 16, 1986), in Kropinski v. World Plan. In Kropinski (1988), the District of Columbia Court of Appeal was unconvinced that scientific opinion supported the brainwashing theory of the plaintiff’s expert witness, Margaret Singer. 41. American Psychiatric Association 1996; Kornfield 1993, 131–132. 42. Cahill et al. 2003, 34, 104. 43. Carter 2004, 7 (emphasis in original). 44. Avise and Ayala 2009, xvi; Green and Green 1965. 45. Jentoft 2006c, 3; Stein 2007, 25, 77; Charlish and Robertshaw 2001, 77, 144, 152. 46. Wuthnow 1997, 227; Krieger 1993, 3–4. 47. Nisbett and Wilson 1977, 250. 48. Rachlin and Laibson 1997, 252–254.

c h a p t er 6 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.

Carter 2010a; Carter 2004, 308–309. Carter 2004, 312; Jeremiah and Carlson 1995, 121. Carter 2004, 170–176; Kendall 2002, 2; Carter 2010b. Kuriyama 1999, 102, 236, 284 n. 102; Veith 1962, 478–479; Porkert 1974, 123; Kaptchuk 2002, 376; Singh and Ernst 2008, 52. Ceniceros and Brown 1998, 1121; White and Ernst 2004, 662; Yamada and Sentā 1998, 56; Ramey and Rollin 2003, 24. Harper 1997, 93–94; Keegan 1988; Akahori 1989, 19; NJLS 8, Origin of the Spirit, quoted in Kendall 2002, 116. Ramey and Rollin 2003, 24–25; Kaptchuk 2002, 374; Weintraub, Ravinder, and Micozzi 2008, 216; Kendall 2002, 17; Cook 2004, 109–134; de la Vallée 1993, 37. Croizier 1968, 15; Ramey and Rollin 2003, 26. Huard and Wong 1968, 150; Li 1994, 84; White and Ernst 2004, 663. Kendall 2002, 76. Lytle 1993, 13. Ricci 1953, 16, 32; Cronin 1955, 96–97; Dharmananda 2004. Veith 1975, 393; Reston 1971, 6. Harrington 2008, 208; NCCAM 2010a, 1; Mayo Clinic 2012; Kendall 2002, xi; Gilligan 2010, 37. Acupuncture and Oriental Medicine Alliance 2013; Kong et al. 2007, 1059–1060; “Connie,” interview, October 30, 2009, in Vasko 2009, 11. Helms 1987; Helms 1995, xv–xx; Bauer et al. 2010, 16. L’Orange 1998, 331; Ergil 2009, 158; Beal 2000, 75; Kendall 2002, xii–xiii, 2, 7, 13; Berman and Larson 1992, xvi; Reed 1992, 76.

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18. Bauer et al. 2010, 121; White, Cummings, and Filshie 2008, 2, 9–11; Matthews 2002, 37. 19. NCCAM 2010a, 1; Mayo Clinic 2012. 20. Kaptchuk 2002, 379; White House Commission 2002, 19; van Tulder et al. 1999; Melchart et al. 1999; NIH 1997, 1. 21. White and Ernst 2004; NCCAM 2010a, 1–3. 22. Cochrane Collaboration 2013; Linde et al. 2009b; Linde et al. 2009a; Trinh et al. 2006; Pennick and Young 2007; Zhu, Hamilton, and McNicol 2011; Smith et al. 2011b; Smith et al. 2011a. 23. Cochrane Collaboration 2013. 24. Ezzo et al. 2006; Cheong, Ng, and Ledger 2008; Huang et al. 2011; Yip et al. 2009; Coyle, Smith, and Peat 2012; Lee and Fan 2009. 25. Sood et al. 2005. 26. Hróbjartsson and Gøtzsche 2010; Spiro 1997, 49. 27. WHO 2002, 3–4. 28. Bullock, Culliton, and Olander 1989; Lee 2008; Manheimer et al. 2005. 29. Smith, Crowther, and Belby 2002; Miller et al. 2004, 603; Mayo Clinic 2012; Bartleson 2011. 30. WHO 2002, 5; Bauer et al. 2010, 17; Mayo Clinic 2012; Eisenberg and Wright 1995, 118–119.

c h a p t er 7 1. Scarry 1985, 6; Orsi 2005, 21–32; Coakley 2007, 90; Pernick 1985, 7–8, 13–14, 56; Leavitt 1986, 117. 2. Curtis 2007, 2, 15; Glucklich 2001, 62. 3. Chidester 2005, 26; Goldstein 1995, 220. 4. Marchand 2013; Greene and Greene 2001, 51, 111–116. 5. Hannon 2013; Aicher-Swartz 2013. 6. Chuster, quoted in Maxwell 1996, 98; Wyman 2013a; Wyman 2013b; Williamson 2010, 5; Lefebure 1996, 964. 7. Merton 1948, 203–205; Lefebure 1996, 964–968; Kadowaki 1977, 11, 36; Kadowaki 2008; Kennedy 1995, 26–27, 37, 59, 108–109; Main 1990, 79. 8. Griffith 2004, 2; Roof 1993, 244. 9. Haller 2005, 235–236; Opp 2005, 25, 31; Brown 2012, 105–111; Ward 2006, 11; Williams 2013, 158. 10. Efmoody.com 2008; Murphy, Xu, and Kochanek 2012, 1; ACS 2012a, 1; Davis 2007, 20; Bailer and Smith 1986, 1226. 11. Frähm 2000, 7–11, 19, 250–254; Frähm 2013. 12. Paul W., April 1, 2009, and IAurR1987, April 8, 2009, in Beliefnet.com 2009b; Kats5dogs, March 12, 2009, in Beliefnet.com 2009a. 13. Dworkin 2001, 6; Alan’s friend, e-mail to author, March 7, 2008; Burkett 2003, 117, 149–150; Fackerell 2009.

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14. Wilson 2006, 87–88. 15. Rawdon 2011. 16. Wilson 2006, 94, 105; Rawdon, quoted in Pinto 2007; Deuteronomy 20:19; Weil 1995, 160. 17. Wilson 2006, 96, 109. 18. Edwards Lake Church of Christ 2013. 19. Stanton, letter to Lucretia Mott, 1852, quoted in Kirschmann 2004, 7, 29; Coulter 1973, 116; PR Newswire 2003. 20. Dankmyer, Zlotnik, and Weise, interviews, in Toufexis, Cole, and Hallanan 1995, 47; Ullman 2007, 208–209, 271, 295, 305–306. 21. Lake and Spiegel 2007, xv; Naisbitt 1982, 48. 22. Interviews, in Cant and Sharma 1999, 40–41; interviews, in Greene and Greene 2001, 115, 118. 23. Cancer Nutrition Centers of America 2013; Evenbetternow.com 2013; Kordich 2012. 24. Saxion 2003; Saxion 2013; Truehealth.com 2011. 25. Schmid 2007; Walters 1993, 81. 26. Healthdowsing.com 2013; Skillen 1997; Gillett 2011; Needle 2010; Hiddencancer-cures.com 2004. 27. Walters 1993, 93; Ryan 1997; Davis 2007, xvii; Epstein 2011, 170. 28. King 1999, 12; Denniston and McWilliams 1975, 19, 39, 45, 223; TM.org 2012c. 29. Albanese 2007, 5–6; Luhrmann 1989, 270; Moore 2002. 30. AcupunctureToday.com 2013; Kaptchuk 2002, 380; American Association of Acupuncture and Oriental Medicine 2012, 1; Biofeedback Certification International Alliance 2013; American Massage Therapy Association 2011; Deutsch and Anderson 2008, 134. 31. Sellers 2003, “Business.” 32. DavidLynchFoundation.org 2012; Malnak v. Yogi 1979. 33. AME 2009. 34. Associated Press 2007; Tara Guber, quoted in Havlen 2002; Frazier 2002; Yogaed. com 2011. 35. HinduismToday.com 2004. 36. “Brad,” interview, March 27, 2009, in Dolezal 2009, 14; Banuet-Alvers 1996, 38–46, 77. 37. Ananth 2011, 3; Lemberg 2009; Cancer Treatment Centers 2012. 38. Ananth 2011, 9; Fink, quoted in Frontline 2003. 39. Sood 2010, 106–107; AYA 2013; Barnes, Bloom, and Nahin 2008, 6; “Rachel,” interview by author, October 10, 2006; Koontz 2003, 139. 40. Keenan 1990, 422; Harrison 2005; Harrington 2008, 223. 41. Fetto 2003. 42. Culpepper 1994, 259, 263; Gauthier 2009, 74; White and Rollitt 2009, 249; Schneiderman 2010. 43. Goldstein 1999, 212; White House Commission 2002, 69.

244

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1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33.

Backos 2013. Vincen-Brown 2010. Stein 2007, 7; Jentoft 2006a; Miles 2006, 11; Hambrick 1974. Rand 2013b; Jentoft 2006e, 4; Stein 2007, 59; Yamasaki 1988, 23. Hall 2010; Cook 2004, 152; Herron 2005. Jentoft 2006a; Lübeck, Petter, and Rand 2001, 28, 303–304; Stein 2007, 72; Epperly and Epperly 2005, 20–21. Miles 2006, 5; Jentoft 2006c, 15–17, 31; Charlish and Robertshaw 2001, 102. Jentoft 2006f; Jentoft 2006b; Valerie 2010; Stein 2007, 58. Jentoft 2006c, 20; Charlish and Robertshaw 2001, 210–211. Charlish and Robertshaw 2001, 84; Stein 2007, 3, 29. Stein 2007, 112, 142; English-Lueck 1990, 18–20; Goldstein 1999, 143–145, 228–229. Jentoft 2006c, 3; Charlish and Robertshaw 2001, 72–73. Stein 2007, 18–20, 60–66; Jentoft 2006e, 10–16; Vincen-Brown 2010. Streich 2007, 16; Newman 1994, 34; Jentoft 2006d; Stein 1995, 57–58. Jentoft 2006e, 6–9; Yamaguchi 2007, 69; Stein 2007, 129. Jentoft 2006e, 6–9; Stein 2007, 107, 142. Stein 2007, 133–134, 141. Ibid., 133, 141. Ibid., 96–97, 134. Charlish and Robertshaw 2001, 85; Stein 2007, 19, 64, 105. Charlish and Robertshaw 2001, 17; Jentoft 2006c, 6; Stein 2007, 9, 17, 113. International Association of Reiki Professionals 2012; Lipinski 2004; Jentoft 2006c, 3–5; Nemri 2004, 37; Vincen-Brown 2010; Fuchs 2006, 34. Stein 2007, 2, 9–10, 24; Jentoft 2006a; Jeftoft 2006e, 25; Charlish and Robertshaw 2001, 44, 62. Krieger 1975, 784; Krieger 1979, 11–13; Stein 2007, 15; Fuller 2001, 112; Albanese 2007, 508–509. Krieger 1981, 50; Krieger 1993, 112–113. Frohock 2000, 93; Krieger 1987, 33; Krieger 1979, 11–13, 80; Krieger 1981, 143; Krieger 1993, 75; Kunz and Peper 1995, 213–214; Kunz 1999, 167. Krieger 1981, 138. Cahill et al. 2003, 294. Meehan 1999, 181–184; Krieger 1997, 21–22, 37, 129. Center for Reiki Research 2013b; Barnes, Bloom, and Nahin 2008, 10. Wolf and Wing 2013. Alandydy, quoted in Rand 2013a; Keene 2013; Miles 2006, 193; Van de Velde 2009a, 35; Van de Velde 2009b, 50. Stein 2007, 4, 17; “Mary,” interview by author, April 22, 2010; Foucault 1978, 94.

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34. Mooney 2005, 48–49, 304; A. Miller, quoted in Maxwell 1996, 98; Satel 2000, 79; Colt and McNally 1996, 35–36. 35. Mooney 2005, 174; Cahill et al. 2003, 295. 36. Mooney 2005, 80–84, 89, 174; Quinn 1992; Keenan, Treder, and Clingerman 2001, 19; Carpenito 1995, 344, 355; Therapeutic-Touch.org 2005; Cahill et al. 2003, 295. 37. HealingTouchProgram.com 2013b; HealingTouchProgram.com 2008, 36. 38. HealingTouchProgram.com 2013a; Mentgen and Bulbrook 1994, 3–4, 81; Keck 1999, quoted in Salladay 2002, 32; HealingTouchProgram.com 2008, 25.

c onc lusion 1. Faden and Beauchamp 1986, 93–95, 145 n. 37; Miller and Wertheimer 2010, ix; World Medical Association 1981, 2; British Medical Association 1993, 67; Ernst, Cohen, and Stone 2004, 158; Schneider 2007, 10. 2. Faden and Beauchamp 1986, 8, 14; Beauchamp 2010, 66. 3. Faden and Beauchamp 1986, 30–34 (emphasis in original); Pew Forum 2008. 4. Schloendorff 1914, 92; Joffe and Truog 2010, 348; Miller 2010, 375; Bankert and Cooper 2012, 5; Tuskegee Syphilis Study Legacy Committee 1996; Reverby 2011, 6. 5. Faden and Beauchamp 1986, 28, 123–143; Ramsey 1970, 2; Jonsen 1998, 50–51. 6. Beauchamp and Childress 2009, 187; Benson 1989, 647; Malette 1990. 7. Muramoto 1998, 223–230. 8. Faden and Beauchamp 1986, 329; Miller 2010, 381; O’Neill 2003, 5; O’Neill 2007, 82; Beauchamp 2010, 70. 9. Watson 1998, 6; Winterson 2007; McCoy 2004. 10. Cahill et al. 2003, 50–51, 442. 11. Achterberg et al. 1992, 16; Chodzko-Zajko et al. 2005, 5. 12. “Dr. Smith,” interview, October 30, 2009, in Vasko 2009, 8–9. 13. POCA 2013; Jordan 2009a; Jordan 2009b; Acuguy 2009. 14. Zang Fool 2009. 15. Donahue 1992, 23; Burgess 1990, 24; Steinecke 1996, 44. 16. Zaidman, Goldstein-Gidoni, and Nehemya 2009, 605–606, 610, 614–616; KabatZinn 1990, 436. 17. AHNA 2009; Cohen 2006, 114–135; Salladay 2002, 28. 18. Appelbaum, Roth, and Lidz 1982, 323–324. 19. Cahill et al. 2003, 44–45, 298; “Anne,” quoted in Mooney 2005, 1. 20. Stein 2007, 17; Mebane 2013; Epperly and Epperly 2005, 118–120; “John,” interview, in Klassen 2005, 382; Kleinig 2010, 5. 21. Bullough and Bullough 1998, 254–257; “Betty” and “Bob,” e-mail to author, April 15, 2006. 22. Carter 2010b; “Dr. Smith,” “Jim,” interviews, October 30, 2009, in Vasko 2009, 16.

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23. McGuire and Kantor 1988, 29; Lubove, “Dual Evolution” (1909), 74, quoted in Fuller 2001, 119; “Nancy,” interview by author, November 3, 2005. 24. Brown 2012, 285; Lee and Poloma 2009, 7–10. 25. Raposa 2003, 13–14, 34; Ueshiba 1992, 25–26; McFarlane 1991, 361; Charlish and Robertshaw 2001, 64; Stein 2007, 61. 26. Marchand 2013; Aicher-Swartz 2013 (emphasis in original); Lyles 2013; Quinn 1991, 62. 27. Powers 2000; Birch, quoted in Isaacs 2003; Cadge and Bender 2004, 48; “Marcy,” interview, in Bender 2010, 42. 28. Catalfo 2001; Cushman 2000, 68–75. 29. Parachin 2007, 165; Henrichsen-Schrembs and Versteeg 2011; “Sharon,” interview, September 30, 2009, in Lennox 2009, 12. 30. Arumugaswami, interview, in Owens 2006; Shukla 2010; “Julia,” “Kristin,” interviews, March 5, 2010, in Metroka 2010, appendix. 31. Pastor, interview by author, September 26, 2007. 32. Conkle 2009, 69–71; FTC 1983; FTC 1980. 33. Eisenberg 1997, 62; Ruggie 2004, 186. 34. Field notes by author, January 6, 2010. 35. Glucklich 2001, 179. 36. Schneider 1998, 31. 37. Miller and Wertheimer 2010, ix; Kleinig 2010, 16; Nobelprize.org 2001; Wuthnow 2007, 38; Wuthnow 1998, 59; Wuthnow 1976, 206. 38. Matthew 22:37–39; Cherry 2003, 27; Gotquestions.org 2013a. 39. Berg 2004, 196; Knechtle 2003; Sullivan 2009, 18, 181; Sullivan 2005, 150–152. 40. Eck 2001, 320; Torcaso 1961, 495; Gordon 2010, 210, 273 n. 95. 41. Gordon 2010, 149–150, 165; Tribe 1978: 826–829, 1988: 1186; Malnak 1979, 212– 213. Compare Board of Education of Kiryas Joel Village (1994), which invalidated creating a separate school district for Hasidic Jews; Conkle 2009, 143–144. 42. Conkle 2009, 54, 157–159; Greenawalt 2005, 64; Gordon 2010, 60–68; Everson 1947, 15–16; Engel 1962, 431–432, 438, 443; School District of Abington 1963, 219. 43. Levi 1948, 1–2; Greenawalt 2005, 20; Conkle 2009, 39–42, 120–126; Alley 1999, 82–96; Kritzer and Richards 2003, 827–840; Lemon 1971, 612–613. 44. Lynch 1984, 688; Greenawalt 2005, 47; Conkle 2009, 126, 169. 45. Lee 1992, 593; Conkle 2009, 131. 46. HinduismToday.com 2004; Conkle 2009, 56. 47. Everson 1947, 15–16; Conkle 2009, 195–209; Minow 2002, 84; Gordon 2010, 210– 211; Sullivan 2009, 219–221. Hein (2007) rejected taxpayer standing to challenge executive-branch expenditures but did not challenge direct-indirect, religioussecular distinctions.

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48. Singh and Ernst 2008, 116; Gibbons 1977, 725; Johnston 2004, 4; Goldstein 1999, 112–113; Ruggie 2000, 138; Chopra 1992; PR Newswire 1999. 49. Maxwell 1996, 96; Koontz 2003, 140; NCCAM 2013; AcupunctureToday.com 2008; McConkey 2010. 50. Conkle 2009, 208; Koenig 1997, 7; Brown 2012, 194–233. 51. Abdul Shukor Husin, quoted in Associated Press 2008; “Indonesian Clerics” 2009; Lynch 1984, 689; Conkle 2009, 128. 52. Said 1978, 5; King 1999, 2; Smith 2005, 123; Vitello 2010. 53. Johnston 2004, 4; Goldstein 1999, 10–11; Frohock 1992, vii.

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Index

Academy of Nutrition and Dietetics, 129 Accreditation Commission for Acupuncture and Oriental Medicine, 171 Acuguy, 207 acupoints: acupressure, 74; acupuncture, 142, 151, 152, 206, 208; defined, 141, 147, 205; moxibustion, 36, 151 acupressure, 141; Christian critiques of, 75, 104; Christian use of, 74, 79–80; defined, 141; scientific language, 205; studies, 150; with other CAM, 30, 98, 104 acupuncture, 2, 20, 139–154; ancient, 141, 144; banned, 142; chiropractic, 95, 98, 99, 100, 101; Christian critiques of, 11, 73–74, 91, 102, 109, 140, 207–208, 212; Christian use of, 68, 69, 85, 86, 88, 109, 139–140, 160, 207–208, 211, 214; electroacupuncture, 32, 146, 150; government funding, 225; history, 141–144; Introduction to Medical Acupuncture, 147; medical, 140, 143–148, 154, 175, 205–206; placebo, 151, 152, 153, 154; professionalized, 171; qi theory, 141–142, 144–145, 154, 163, 206; safety, 153; science, 141–142;

sham, 116–117, 149–150, 152–153; spiritual, 206; studies, 12, 13, 116–117, 131, 145, 148–153; Taoism and, 141, 142, 154, 206, 207; usage, 11, 12–13, 143; with other CAM, 30, 32, 33, 35, 54, 218 Acupuncture and Oriental Medicine Alliance, 145 Adams, Arlin, 221 addiction, 150, 151, 152, 153, 186, 225 ADHD, 114, 119, 150 Africa, 7; South Africa, 3, 78 African-Americans, 7, 14, 15, 93, 176 Agency for Healthcare and Research Quality, 114–115 agnostics, 94, 189 Aicher-Swartz, Marita, 157, 214 AIDS/HIV, 32, 116, 124, 126 Alandydy, Patricia, 195 Albanese, Catherine, 107 alchemy, 28, 36 allergies, 130 Alternative Healing: The Complete A-Z Guide, 120 Alternative Medicine: The Christian Handbook, 74, 75 Alternative Medicine: Expanding Medical Horizons, 147, 206 Alternative Medicine Sourcebook, 147 Alves, Sister Marta, 57

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American Academy of Medical Acupuncture, 145, 171 American Association of Acupuncture and Oriental Medicine, 171 American Cancer Society, 129, 131, 132, 170 American Chiropractic Association, 96, 97, 99, 101 American College of Sports Medicine, 62, 63 American Holistic Medical Association, 145 American Holistic Nurses Association, 115, 197, 198, 209 American Hospital Association, 174, 194, 201 American Journal of Nursing, 191 American Medical Association, 9, 12 American Nurses Association, 197 American Psychiatric Association, 134 American Psychological Association, 12 American Yoga Association, 52, 53, 175 Anderson, Neil, 70 angels, 31, 71, 78, 185, 186, 192, 196 animal magnetism, 4, 29, 93. See also energy, vital; mesmerism anjalimudra (praying hands), 54, 88 Ankerberg, John, 104 Annals of Internal Medicine, 131, 148 anthroposophy, 32 anxiety. See under emotions applied kinesiology, 32, 101, 104, 160 aromatherapy, 54, 160, 210, 218; Aromatherapy, 122; Aromatherapy for Health Professionals, 122; Complete Aromatherapy Handbook, 33; essential oils, 33, 122–123; Practice of Aromatherapy, 122 arthritis, 124, 125, 127, 149, 151, 153, 175 Arumugaswami, Sannyasin, 215–216

asanas, 46–48, 49, 50–51, 54, 55, 60, 62, 64, 174, 215, 226; corpse, 54; downward-facing dog, 54; eagle, 51; Sun Salutation, 48, 51, 53, 60, 62, 63; tree, 54. See also yoga Asia, 1, 10, 19, 22, 25, 70, 144; China, 25, 27, 35–37, 140–144, 154; India, 37, 40, 42, 46–49, 50, 52, 56, 59, 170, 180–181, 227; Japan, 11, 25, 26–27, 36, 88, 142, 144, 158, 180–181, 213; South Asia, 40, 45, 46–48; Tibet, 180, 191 Asian-Americans, 176 Association for Applied Psychophysiology and Biofeedback, 42, 43 Association for Mindfulness in Education, 172–173 Association of Accredited Naturopathic Medical Colleges, 33 Association of Chiropractic Colleges, 96 Association of Transpersonal Psychology, 42 Association of Vineyard Churches, 76 asthma, 98, 119, 125, 130, 148, 150, 151 astrology, 7, 8, 28, 32, 35, 37, 57, 178, 218 atheism, 2, 68, 94, 159, 189, 207, 238n22 Atman, 40, 47, 59 aura, 32, 37, 183, 185, 186, 187, 189, 195, 199, 214; Christian critiques of, 75; in Kirlian photography, 5; layers, 126, 189, 192 autism, 150 Ayurveda, 13, 42, 78, 99, 191, 225 Backos, Marcia, 179 Bad Science, 131–131 Baldwin, Anne Linda, 115 Bartleson, J. D., 153 Beals, Brandon, 87

Index Beauchamp, Tom, 201 beliefs, 22, 220, 221; changed by practices, 17, 19, 21, 44, 57, 173, 204, 212–217, 218–219, 224, 228; conflicts with monotheistic, 201–202, 203–204, 205, 207, 208, 211, 212, 216, 228; disavowing religious, 25, 39, 52, 54, 173, 189, 192, 195; fear of false, 19, 73, 74, 75, 77, 89; pluralistic, 17, 31, 43, 180; Protestant emphasis on, 14, 16, 65, 67, 80, 103, 110. See also practices; religion; worldviews Bell’s palsy, 150, 151 Belmont Principles, 202 Benedict XVI (pope), 11 Benveniste, Jacques, 117–118 Bernard, Theos, 55 Bhagavad Gita, 46–47, 49 Bharati, Swami Jnaneshvara, 55 Bible: added to CAM, 46, 60, 62, 63, 64, 81, 88, 110, 160; authenticates CAM, 34–35, 77, 78, 79, 91, 104, 139–140, 158, 163, 179, 192; CAM not rooted in, 71–75; CAM replaces, 30, 94; CAM rooted in, 81–86, 103; meditation, 38, 46, 62; other gods in, 15, 74, 79, 82–83, 84, 163; Protestant emphasis on, 14, 23, 56, 67–69, 76, 101, 102, 162, 203–204, 208, 218, 219–220; in schools, 221–224 Biblical Discernment Ministries, 86 Biblical Guide to Alternative Medicine, 70, 74, 105 biofeedback, 42–43; Beyond Biofeedback, 42; Bioenergy, 42; Biofeedback, 42; Buddhist, 42, 43; Christian critiques of, 11; Christian use of, 212; chiropractic, 100; in hospitals, 175; Ozawkie Book of the Dead, 42; professionalized, 171; safety, 135; studies, 114; Taoist, 43; usage, 13. See also meditation

299

Biofeedback Certification International Alliance, 171 Biofeedback Research Society, 42 biomedicine, 3, 164; allopathic, 30, 79, 92, 120, 164; CAM integrated with, 2, 7, 12, 20–21, 92, 112, 174, 193, 199, 205; CAM critiques of, 33, 93, 95, 96, 98–99; Christian critiques of, 89, 102, 103, 109, 159, 207, 212; conventional, 3, 8, 9, 29, 112; costs, 11; disillusionment with, 7, 8, 10, 11, 86, 140–141, 144, 160–162, 164–165, 216; evidence-based, 112, 113, 137, 148, 226; heroic, 8, 156; history, 7–10, 11–12, 141–143; irregular, 9, 10, 12; mainstream, 7, 10, 44; professionalized, 10; quackery and, 2, 9, 12, 97, 105–106, 131–132; side effects, 20, 113, 124, 149, 160. See also drugs; science; scientific studies; techniques Birch, Beryl Bender, 214 Black, Hugo, 222 Bland, Martin, 118 Blavatsky, Helena, 48, 49 bliss, 41, 47, 50, 134 blood: flow, 146, 147, 206; transfusions, 161, 203–204 Bob Jones University, 87 body: asceticism, 41, 46–47, 60, 156, 180–181; biomedical view of, 10; God-given, 85–86; inferior to spirit, 44, 156; in meditation, 39; out of, 48, 54, 185; self-healing, 33, 96–97, 100, 170, 195, 206; sensations spiritual, 5, 11, 126, 145, 182, 187–188, 193; spiritual, 32, 33, 36, 78, 141–142, 159; spiritual reasons for manipulating, 4, 24, 29, 94, 158; unauthorized touch of, 201, 203, 204, 210, 211. See also body-mind-spirit; hands; meditation: sitting; pain; practices; suffering

300

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Body & Soul, 171 body-mind-spirit, 1, 3, 4, 7, 29, 58, 74, 157, 171, 176, 177, 187, 195, 197, 208. See also mind-body therapies Boon, Brooke, 45–46, 61, 65 Bopp, H. J., 72 Bordenkircher, Susan, 61 Boyajian, George, 104 Brahman, 40, 46, 49, 174 brain, 7, 42, 47, 49, 86, 94, 127, 133, 147, 150. See also mind breath: deep, 12–13; God’s, 83, 103, 189; Holy Spirit, 61–62, 88, 158; mindful, 39; spiritual energy directed by, 6, 35, 36, 47, 50, 69, 188, 213. See also energy, vital; prana; qi Breath & Body, 61 British Medical Association, 201 British Medical Journal, 133 Brown, Barbara, 42 Bryner, Peter, 96 Buddhism, 1, 19, 22, 43, 155; CAM and, 28, 42, 47, 51, 57, 72, 81, 207, 213; Christian critiques of, 11, 16, 71, 72, 81, 86, 139–140; Christian use of, 88, 157–158, 211; eightfold path, 37; energy medicine and, 21, 180–181, 185–189, 191–192, 199; four noble truths, 37, 39; initiation in, 157, 158, 181, 184, 185; Mahayana, 158; meditation and, 7, 10, 25, 37–40, 42, 57, 71, 88, 115, 134, 158, 209, 211; religion and, 24, 26, 27, 35, 40, 189, 213, 221; science and, 25, 26, 49; Vipassana, 42; Zen, 10–11, 25–26, 36, 49, 57, 115, 139, 158, 174, 180, 213. See also enlightenment; religion Buddhist Insight Meditation Society, 134 Burgess, Michael, 208 Burkett, Larry, 161–162

businesses, 2, 39, 172, 173, 209 Byrne, Rhonda, 101 California Cancer Commission, 132 Calvin, John, 8 Campbell, T. Colin, 129 Campbell, Thomas M., 129 Campus Crusade for Christ, 87 cancer: breast, 39, 129, 131, 160, 162– 163; colon, 83, 108; fear of, 160–161, 163, 166–169; kidney, 161; prostate, 116, 131. See also cancer treatments; detoxification; nutrition; nutritional supplements Cancer Nutrition Centers of America, 166 Cancer Prevention Diet (Kushi), 36–37 cancer treatments, 2, 13; acupuncture, 147–149; conventional, 33, 124, 131, 149, 160–162; Essiac/Flor Essence, 34, 131, 132, 161; Iscador/mistletoe, 34, 131; Laetrile/amygdalin, 131, 132; meditation, 39, 126; Protocel/ Entelev/Cancell/Cantron, 34, 131; reflexology, 160; shark cartilage, 131; yoga, 124–125. See also detoxification; nutrition; nutritional supplements Cantwell, Mike, 115 Can You Trust Your Doctor?, 104 Care Through Touch, 78 Carol, John, 207 carpal tunnel syndrome, 127, 130, 149 Carter, Brian, 135, 139–140, 211 Catalfo, Phil, 52–53, 215 Catholics: Benedictine, 59, 158; born-again, 14; Buddhism and, 11, 25–26, 158–159; CAM critiques by, 11, 23, 75, 57; CAM use by, 59–60, 86, 157, 196, 214, 216; Charismatic, 10; Christian Reflection on the New Age (Vatican), 11; Declaration on the Relation of the Church to

Index Non-Christian Religions (Vatican), 10; Franciscan, 196, 210; government and, 221, 222, 223, 224; Jesuit, 11, 25, 144, 158; miracles and, 8; Trappist, 158; U. S. Conference of Catholic Bishops’ Committee on Doctrine, 11, 75 celebrities: Beatles, 41, 50; Ben & Jerry, 40; Blair, Tony, 165; Chan, Jackie, 176; Charles, Prince of Wales, 165; Clinton, Bill, 165; Elizabeth II (queen), 165; Garbo, Greta, 50; George VI (king), 165; Gregory XVI (pope), 165; Griffin, Merv, 41; Lee, Bruce, 176; MacLaine, Shirley, 41; Madonna, 51; Namath, Joe, 41; Norris, Chuck, 176; Reagan, Nancy, 178; Ryan, Robert, 50; Twain, Mark, 165 Center for Healing Touch and Wellness, 198 Center for Mindfulness in Medicine, Health Care, and Society, 38, 114 Center for Reiki Research Including Reiki in Hospitals, 115, 194–195 Chadwick, Jonathan, 88 chakras (cakras): Christian use of, 45, 196; defined, 4, 6, 36, 47, 189; scientific language, 49, 126, 199; spiritual energy labeled, 50, 52, 58, 182, 184, 185, 187–188, 191, 193 Champions for Christ, 87 Chang San-feng, 36 Chapman-Smith, David, 95, 100 Charlish, Anne, 136, 184, 188, 213 Cheng Man-ch’ing, 36 Chen, Michael, 77–78 Chen Wang-ting, 36 Cherry, Reginald, 219 chi (ji), 69 ch’i (qi). See qi China Study, 129

301

chiropractic, 1, 2, 9, 19–20, 91–111; adjustment, 93, 94, 96, 98, 102, 104, 105–106, 109, 110, 171, 208; biomedicine and, 12, 92, 95, 98–99, 102, 103, 106–107, 175, 205; Chiropractic Choice, 100; Chiropractic Profession, 95; Chiropractor’s Adjuster (D. D. Palmer), 93; Christian critiques of, 11, 71, 102, 104–105, 211; Christianity renounced by, 92, 95, 102; Christian use of, 89, 91–93, 102–109, 159, 160; Do Chiropractors Pray? (B. J. Palmer), 94; government funding, 224; harmonial, 29, 95–101, 105; How Chiropractors Think and Practice, 98; informed consent, 133, 208, 211; Innate Intelligence, 4, 35, 93–105, 208, 212; mechanical, 95–96, 98, 100; metaphysical, 29, 92–95, 97–99, 101, 104, 110; mixers, 95–96, 98; osteopathy and, 29–30; Palmer philosophy, 95, 96, 97, 98–100, 104, 105; Philosophy of Chiropractic, 97; professionalized, 171; religion and, 93–95, 96, 102, 110, 208, 237n5; safety, 133; scientific language, 92, 95–97, 98, 99, 106, 110, 171, 208; straights, 95–96, 98, 99; studies, 12, 106, 130, 151; subluxation, 94, 95, 97, 98, 101; usage, 12–13, 92 Chopra, Deepak, 101, 225 Choudhury, Bikram, 52 Christ Centered Yoga, 60, 62 ChristianAcupuncture.com, 139 Christian America, 14–16 Christian Chiropractors Association, 102–103, 104, 106 Christianity Today, 56, 65, 74, 75, 86 Christian Martial Arts Network, 77, 80, 84 thechristianmeditator.com, 87 ChristianReiki.org, 78, 179, 195

302

In de x

Christian Research Institute, 69, 80 Christians, 1, 3, 10–11, 13–16, 43–44, 67–90, 155–159. See also Catholics; evangelicals; pentecostals; Protestants Christians and Cancer, 163 Christian Science, 9, 48, 93, 102, 108, 159 ChristJitsu, 84 Christoga, 60, 62; Christoga, 59 chronic illness, 116, 124, 126, 175 Chuster, Judy, 87, 157 civil rights movement, 10, 201 Clarksville Mixed Martial Arts Academy, 87 Clark, Thomas, 222 class, social, 13, 26, 29, 48, 197. See also power; race/ethnicity clergy: CAM critiqued by, 2, 8; CAM endorsed by, 103–104, 109, 159; courted as CAM allies, 102; divine healing discounted by, 8, 110, 155, 156, 157; individual, 9, 83, 88, 93, 103, 104, 156 Cochrane Database of Systematic Reviews (CDSR), 113, 117; acupuncture, 148– 151; aromatherapy, 122; biofeedback, 114; chiropractic, 130; cranberries, 130; homeopathy, 119; Laetrile, 132; massage, 130; meditation, 114; mistletoe/Iscador, 131; Saint-John’swort, 130, 131; t’ai chi, 127–128; yoga, 114. See also systematic reviews cognitive dissonance, 17 Cohen, Michael, 209 colic, infantile, 130 color therapy, 35, 183, 193 commercialization: detrimental, 219; fear used in, 166–169; government funding, 225; of health care, 11–12; insurance and, 175, 178; profit motives and, 48, 55, 83, 161, 194;

profits from, 31, 34, 42, 45, 51–52, 122, 143, 163, 164–165, 166–169, 178, 197; secularity implied by, 41, 170, 172, 178, 189–190, 198; value implied by, 52, 190 common cold, 1, 120 compassion, 26, 28, 40, 193, 195 Complementary and Alternative Medical Research Center (University of Michigan), 225 Complementary and Alternative Therapies Research, 12 Complementary and Integrative Medicine Program (Mayo Clinic), 145 Confucianism, 27, 31, 35, 72, 140 consciousness: in all matter, 7, 186, 191; transforming, 172, 173, 181; universal (divine), 40, 41, 42–43, 50, 53, 198 conspiracy theories, 162, 169–170 Constitution, 15, 220; coercion test, 17, 202, 216, 222, 223, 224; endorsement test, 223; First Amendment, 200, 220, 221, 222; free exercise, 54, 220, 221; Fourteenth Amendment, 222; incorporation, 222; Lemon test, 223; religious equality, 18, 21, 200, 222, 224, 226; religious establishment, 12, 18, 19, 21, 171, 172, 173, 174, 200, 220–227, 229; religious voluntarism, 18, 21, 200, 222, 224. See also court cases; government; schools; Supreme Court Consumer Product Safety Commission, 133 consumers: demand by, 11, 164–165, 175, 177; pragmatic, 17, 218–219, 220; responsibilities of, 19, 202, 217–220, 229; rights of, 19, 21, 201, 202, 205, 209, 218, 227. See also decision making; informed consent; tort law

Index continuing education unit (CEU), 145, 195, 197, 198 correspondence, 4, 28, 32, 170–171 Council of Colleges of Acupuncture and Oriental Medicine, 171 counterculture, 10, 50 court cases: Agostini v. Felton, 224; Canterbury v. Spence, 203; Dent v. West Virginia, 9; Edwards v. Aguillard, 223; Employment Division v. Smith, 221; Engel v. Vitale, 222, 223; Everson v. Board of Education, 222, 224; Lee v. Weisman, 223; Lemon v. Kurtzman, 223; Lynch v. Donnelly, 223; Malette v. Shulman, 203; Malnak v. Yogi, 172, 221, 225; Mitchell v. Helms, 224; Natanson v. Kline, 203; Salgo v. Leland Stanford Jr. University, 201; Santa Fe Independent School District v. Doe, 223; Schloendorff v. Society of New York Hospitals, 203; Schnellmann v. Roettger, 216; School District of Abington Township v. Schempp, 222; Torcaso v. Watkins, 221; United States v. Ballard, 217; United States v. Seeger, 221; Wilk v. American Medical Association, 12; Zelman v. SimmonsHarris, 224. See also Constitution; Supreme Court Covington, Daryl, 80–81, 87 Cox, Harvey, 44 crystals: Christian critiques of, 11, 75, 89; usage, 126, 168, 183, 186, 187, 197, 198 Cullis, Charles, 159 Culpepper, Emily, 176 Cushman, Anne, 215 Dager, Albert, 74 Dalai Lama, 7, 89 Dankmeyer, Todd, 165 Daoism. See Taoism

303

Dao of Chinese Medicine, 140, 144 Darwin, Charles, 9, 25 Davenas, Elisabeth, 118 David Lynch Foundation, 172 Davis, Devra, 169–170 Death of Satan, 73 deception. See under informed consent decision making: autonomous, 17, 201, 217, 219, 228; freedom of choice in, 3, 19, 200, 205; informed, 17, 18, 21, 200, 202, 203, 208, 219–220, 229; intentionality in, 201, 202, 219; shared, 201. See also consumers; informed consent Declaration of Lisbon, 201 Deep South Alliance of Fitness Professionals, 61 Deists, 15, 31 Delbanco, Andrew, 73 dementia, 114, 119, 122, 123, 150 demons, 31, 71–72, 75, 85, 196 DeNaro, Anthony D., 134 Denison, Virginia, 50 depression. See under emotions Descartes, René, 23, 49 Desmond, Deborah, 54 detoxification, 162; Aqua Detox/foot baths, 101, 131–132, 163; coffee enemas/colonic irrigation, 34, 129, 132, 160, 163; commercialized, 166– 169; dowsing/electromedicine, 32, 72, 79, 168; dry brushing, 160; energy medicine, 136, 185, 199; shatkarmas (stomach cloth), 47. See also cancer therapies; modernity; nutritional supplements: cleanse Devi, Indra, 50 diabetes, 128 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 134 Diet, Nutrition, and Cancer, 129 diets. See nutrition

304

In de x

digestive problems, 148, 150 DigiBio, 118–119 Dillon, Stephanie, 65 discernment ministries, 58, 69, 71, 80, 86, 88, 104, 105, 220 disease, 3; causes, 4, 30, 94–95, 112, 156–157, 166; dis-ease, 4, 97–98, 110; prevention, 28 distant healing, 6, 32, 168, 183–184, 186 divination, 15, 71, 72, 73, 79, 168, 192 divine. See God; universe divine healing, 9, 18, 71, 107–108, 135, 156, 159, 212–213; anointing for, 157, 162; miracles of, 8, 14, 15, 107, 108, 156, 161–162, 181. See also Protestants: cessationist; pentecostals; prayer Divine Life Society, 53 dizziness, 130, 132 Dobson, James, 140 Donahue, John, 27 Donahue, Joseph, 97, 208 Donner, Fritz, 117 Don-Wauchope, Sallee, 78 Douglas, William, 222, 223 Dr. Oz Show, 218 drugs: CAM preferred to, 11, 86, 116; side effects, 11, 33, 120, 122, 153, 164, 195. See also biomedicine dualism. See under worldviews Dumoulin, Heinrich, 158 D’Youville Nursing Center, 225 dysmenorrhea. See under pain Eastern religions: Christians guard against, 14, 58, 77, 89–90; defined, 68; fear of investigating, 19, 46, 68, 70, 74, 89; labels CAM as illegitimate, 2, 45, 59, 69, 72, 76, 91, 104; less threatening than term Hindu, 55, 56, 80, 105, 162, 179, 211; positive views of, 174, 206, 215; romanticized, 56,

226; science as opposite of, 19. See also Asia; New Age Eck, Diana, 221 efficacy, 20, 112–138; ancientness and, 20, 141, 144–145, 154; and asking why, 88, 90, 109, 113, 137, 140; assessing, 117, 124; implying, 124–128; quality of life, 127, 128, 131; rationalizing lack of, 124, 153; religious legitimacy inferred from, 20, 22, 68, 69, 75, 86, 105–106, 108, 110–111, 212, 228. See also safety; scientific studies Einstein, Albert, 6 Eisenberg, David, 217 electricity, 5, 6, 96, 105, 147 Emerson, Ralph Waldo, 49 Emerson, William, 48–49 emotions, 3, 137; anxiety, 75, 79, 114, 124, 125, 126, 133, 151, 195, 209; depression, 125, 126, 130, 133, 134, 150, 175; fear, 3, 99, 122, 137, 168–169, 205; healing of, 12, 43, 100, 126, 165–165, 186, 209; hope, 8, 24, 82, 110, 131, 137, 161, 163, 165, 185, 227. See also religion empiricism. See under science energy, vital : balance, 4–5, 30, 35–36, 43, 51, 128, 135, 142, 144, 154, 175, 185, 190, 193, 205–206; blockages, 4, 29, 35, 43, 110, 145, 154, 183, 193; channeling, 89, 185, 186, 187–188, 189, 192, 195; cosmic, 32, 33, 100, 174, 189; defined, 4, 9, 28, 113; divine, 54, 78; fields, 4, 5, 6, 29, 33, 34, 42, 71, 78, 122–123, 157, 176, 191–193, 195, 197, 198, 210; flows, 4, 29, 35–36, 58, 78, 126, 128, 142, 146, 154, 181, 184, 185, 188, 191–192, 197, 205–206; frequencies, 33, 34, 45, 99, 163, 169, 199; life-force, 28, 34, 77, 78, 83, 95, 156, 162–163,

Index 182, 189, 191; magnetic, 29, 32, 120, 147, 160, 168, 169; matter and, 4, 6–7, 30, 93–94, 97; moon, 28, 32, 47; patterns, 6, 32, 185; safety, 135–136, 166; scientific language, 110; sexual, 47, 50, 187–188, 191; spiritual, 4–5, 28, 32, 33, 54, 71, 75, 100, 160, 191 (see also power: spiritual); subtle/ putative, 5, 6, 35, 42, 126, 192; sun, 28, 47, 48, 53–54, 83; suprahuman, 22, 220; transfer, 33, 34, 83, 136, 181, 192, 193; universal, 76, 78, 180, 184, 185, 186, 188, 198, 206; veritable/ physical and, 5, 6, 126; vibrations, 5, 6, 28, 33, 34, 37, 45, 94, 99, 169, 185, 195, 199; vortexes, 47, 168, 189, 190. See also animal magnetism; chakras; electricity; Innate Intelligence; ki; kundalini; meridians; nadis; prana; qi; vital force; yin-yang energy medicine, 21, 124, 175, 179–199; Christian critiques of, 91; Christian use of, 78, 196; with other CAM, 100, 101, 218. See also Healing Touch, massage, Reiki, Therapeutic Touch Enlightenment, 8, 68 enlightenment (awakening), 37, 40, 45, 50, 51, 158, 174, 185, 186, 187, 215–216; Buddhist, 37, 158, 185, 186, 187; meditation for, 40, 43; yoga for, 45, 50, 51, 174, 215, 216. See also salvation Enomiya-Lassalle, Hugo, 158 epilepsy, 114, 150 Epperly, Bruce, 78, 182, 210 Epperly, Katherine, 78, 182, 210 ethics, 200; abuse, 202, 209; biomedical, 18, 21, 202, 203; CAM, 27, 28, 165, 198; conflicts of interest, 169–170; fiduciary responsibility, 209; manipulation, 17, 21, 201, 204; personal autonomy, 18, 21,

305

200, 201, 204, 209, 219; physicianpatient relationship, 204–205, 209, 217; religion and, 201–202, 208; self-determination, 18, 21, 200, 201, 203, 204, 219, 228; therapeutic misconception, 209; truth in advertising, 216. See also informed consent; vulnerable populations Ethics of Consent, 201 Europe, 1, 7, 22, 28, 34, 48, 141, 143; France, 117, 122, 131; Germany, 30–31, 34, 55, 70, 117, 131, 158, 202; Great Britain, 48, 81, 131, 133, 144, 165, 201, 213; Ireland, 11, 158; Italy, 144, 161; Switzerland, 72 evangelicals, 1; container-contents language of, 77, 80, 90; defined, 14; experience emphasis of, 65; fear of investigating non-Christian religions by, 19, 46, 56, 58, 68–69, 70, 74, 89; fruits standard of, 19, 69–70, 75–76, 86–88, 106, 212; language emphasis of, 60–65, 77–78, 79–80, 90, 106; legitimacy emphasis of, 68–70, 71, 77, 79, 89, 91, 92, 93, 102, 104–105, 108, 110, 211, 212; metaphysics and, 44, 92–93, 107, 227–228, 234n44; popular culture and, 14, 76–77; purity emphasis of, 14, 16, 44, 202; reasoning by, 67, 68, 207–208; roots standard of, 19, 45, 57, 69–75, 81–86, 91, 105, 180, 207, 211. See also beliefs; Bible; pentecostals; pluralism; practices; Protestants; and specific health-care practices EvenBetterNow Natural Health Solutions, 166 Every Body Has Parasites, 167 evidence-based medicine. See under biomedicine exercise: Christian use of, 56, 57, 58, 62, 77; not religion, 46, 50, 52, 77,

306

In de x

exercise(Cont.) 214; religion and, 48, 52–56, 58, 175; studies, 127–128, 130, 131, 152, 226; with CAM, 48, 98 Fackerell, Michael, 162 Faden, Ruth, 201 fatigue, 136, 146 FDA (Food and Drug Administration), 113, 122, 131, 132, 135 fear. See under emotions Federal Acupuncture Coverage Act of 2011, 225 Federal Employees Health Benefits Program, 225 Federal Food, Drug, and Cosmetic Act of 1938, 113, 224 Federal Trade Commission, 217 Fénelon, 38 fibromyalgia, 107, 116, 145 Finch, Mary Ann, 78 Fink, Matt, 175 First Amendment. See under Constitution fitness centers. See gyms Flexner, Abraham, 9 Focus on the Family, 69, 84, 140 Folan, Lilias, 51 folk healing, 7, 8, 34 Forks over Knives, 129 Frähm, Anne, 160–161 Frähm, Dave, 160–161 fraud. See under informed consent Freemasonry, 15, 31, 32, 92, 191 Frohock, Fred, 227 Garrison, Nancy, 115 gassho (praying hands), 88, 182 Gattefosse, Rene-Maurice, 122 Gautama, Siddhartha, 37 gender: women in CAM and, 13, 48, 182; intimacy and, 165–166;

masculinity and, 52, 87, 176–177. See also Goddess; power Gerson, Charlotte, 34 Gerson Institute, 34 Gerson, Max, 34 Gillespie, Elena, 225 Gillett, Kerry, 169 Gilligan, Peter, 145 Giri, Swami Gitananda, 133 Gladstar, Rosemary, 28 globalization, 48 God: experiential knowledge of, 49, 53, 87, 100, 158–159; one with, 40, 41, 43, 45, 46–47, 52, 53, 57, 59, 78, 174, 186, 198; personal, 44, 107, 201; power of, 77–78, 157; relationship with, 46, 60, 81, 87, 160. See also self; universe; worship Goddess, 185–187, 188, 189, 196; goddesses, 41, 47, 54 Godly Love, 212–213 Goldacre, Ben, 131–132 Gordon, Ruth, 104 Gotquestions.org, 58, 69, 88, 220 government: Congress, 11, 29, 218, 220, 225; Defense Advanced Research Projects Agency, 119; Department of Defense, 225; Department of Health and Human Services Division of Nursing, 225; endorsement, 200; funding, 12, 21, 118, 171, 200, 224, 225; religion and, 18, 21. See also Constitution; Supreme Court; specific agencies Graham, Sylvester, 9 Gram, Hans Burch, 32 Green, Alyce, 42, 135–136 Green, Elmer, 42, 135–136 Greene, Daryl, 156 Grof, Christina, 133 Grof, Stanislov, 133 Groothius, Douglas, 58

Index Guber, Peter, 173 Guber, Tara, 173, 223–224 guided imagery, 26, 100, 161 Guyon, Madame, 38 gymnastics, 48 gyms, 52, 155, 175–176, 214 gynecological problems, 148, 150 Habito, Ruben, 25 Hahnemann, Samuel, 30, 31, 70, 79, 93, 117 halo effect, 137, 178, 228 hands: in battery, 211; laying on of, 71, 85, 157, 179, 192, 210; praying, 53–54, 64, 88, 182, 185; spiritual energy redirected by, 4, 29, 54, 71, 78, 93, 126, 182–183, 184, 187–188, 193; therapeutic, 110, 165–166. See also body Hannon, Robin Littlefeather, 78, 157 Harkin, Tom, 225 Harp, David, 40 Hatch, Orrin, 225 hatha yoga. See under yoga Hayashi, Chujiro, 181 headaches. See under pain Healing at Any Price?, 72 Healing from the Heart, 78, 87 Healing Sciences International, 124 Healing Touch, 21, 78, 80, 87, 179, 198–199; Healing Touch Level One Notebook, 198 Healing Touch Certification Board, 198 HealthQuarters Lodge, 160–161 heart disease, 115, 124, 125, 126, 127, 128, 130, 148, 160, 161, 175 Helms, Joseph, 116, 145, 148 Henrichsen-Schrembs, Sabine, 215 Herbal Healing Secrets of the Orient, 146 herbalism: Christian critiques of, 11; Christian use of, 109, 160, 162–163, 167, 212; defined, 27–28; gender and,

307

196; moxibustion and, 36, 151; safety, 135; Taoism and, 25, 35; usage, 8, 120; with other CAM, 54, 98, 100–101. See also herbs; plants herbs: distinguished from herbalism, 13, 27–28; safety, 135, 164; studies, 12, 150, 151; usage, 143, 164. See also herbalism; nutritional supplements Hindu American Foundation, 53, 215 Hinduism, 1, 19, 22, 43, 155; Advaita Vedanta, 40, 41, 49; CAM and, 21, 28, 41, 180, 191–192, 199; CAM not, 53, 170; Christian critiques of, 16, 46, 50, 57, 62, 63, 70, 72; Christian use of, 59, 60, 61, 62, 64–65, 78, 88, 157, 158; defined, 40, 46–47; government funding, 223, 225; neo-Hinduism, 48, 49; religion and, 24, 25, 27, 221; Vedas, 40; yoga and, 46–49, 50, 51, 52–55, 57, 59, 62, 173–174, 215–216, 223. See also religion Hinduism Today, 173, 215 Hindu University of America, 54–55 Hinn, Benny, 71 HIPAA (Health Insurance Portability and Accountability Act), 201 History and Theory of Informed Consent, 201 Hittleman, Richard, 50 holism. See under worldviews holistic health-care movement, 4, 10, 11, 76, 144 Holos University, 115 Holy Spirit: emphasis on, 14, 23, 73, 87, 107, 159, 220; energy equated with, 32, 33, 77–78, 157, 158, 160, 208; energy not, 71, 80; energy relabeled, 61, 62, 69, 211 Holy Yoga, 45, 60, 61, 65; Holy Yoga, 45 homeopathy, 1, 2, 8, 30–32; Avogadro’s number and, 31; Bible and Homeopathy, 81; Characteristics of

308

In de x

homeopathy (Cont.) Homeopathy, 32; Christian critiques of, 11, 70, 72, 74–75; Christian use of, 78–79, 81–83, 85, 109, 159, 160; commercial, 164; consumer demand, 164–165; dilutions, 30–31, 82, 117–119, 135, 164; dynamizations, 31; emotionally satisfying, 165; government and, 224; Homeopathic Pharmacopoeia of the United States, 224; Homeopathic Revolution, 82; Homeopathy, 85; Homeopathy Examined, 72; in hospitals, 175, 205; infinitesimals, law of, 30, 82, 120; In Support of Homoeopathy in the Light of the Bible, 78; memory of water, 118, 120; Organon of the Rational Art of Healing (Hahnemann), 30; Oscillococcinum, 31; placebo, 119; provings, 30, 120; religion and, 31–32; Resonance, 205; safety, 135, 164; scientific language, 120–122; similars, law of, 30, 82, 120; studies, 117–120; succussion, 30–31, 82, 117; trituration, 30, 82; usage, 12, 13, 164–165; with other CAM, 30, 33, 95, 98, 100, 101, 145; zinc, 119–121 homeostasis, 5, 96, 160 Hopf, Wolfgang, 117 Horizon, 118 horoscopes, 218 hospitals: administrators of, 21, 175, 177, 180, 193–196; Beth Israel, 174–175; CAM in, 29, 39, 92, 206, 209; CAM legitimized by, 155, 173, 174–175, 205; Cancer Treatment Centers of America, 174–175; City of Faith Medical Center, 159; Duke University, 174; Hospital La Gloria, 34; Kaiser Permanente, 175; Maine Medical Center, 195; Massachusetts General Hospital, 145; M. D. Anderson, 174; Memorial

Sloan-Kettering Cancer Center, 132, 174; New York Presbyterian HospitalWeill Cornell, 39; Portsmouth Regional Hospital, 195; Stanford School of Medicine, 145; UCLA School of Medicine, 145; University of California at San Francisco, 174; University of Massachusetts Medical Center Stress Reduction Clinic, 38, 114, 174; Women & Infants Hospital, 194 hot flashes, 119, 150 Howard-Brown, Rodney, 71 Huang-ti Nei-ching, 141, 142 Hultgren, Glenn, 103, 106 Hunt, Dave, 57 Huxley, Thomas, 9 hydrotherapy, 35 hypnosis, 100, 136, 151, 175, 198 I Ching, 36, 192 Ideal Academy, 172 idolatry. See under worship imagery, 26, 100, 161 Immigration Act of 1965, 10, 68, 144 immune system, 79, 124, 127, 140, 147, 160, 162, 166, 175 Indiana University Recreational Sports, 56 Indo-Tibetan Program in Contemplative Self-Healing, 39 infections, 98, 130, 133, 148, 153 infertility, 145, 150 influenza, 119 informant pseudonyms, 232n22; Alan, 161; Alejandra, 54; Anne, 210; Arlene, 218; Betty, 91–92, 211; Bob, 91–92, 212; Connie, 145; Deborah, 81; Delva, 218; Jim, 211–212; John, 210; Julia, 216; Kristin, 216; Marcy, 214; Margaret, 86; Marge, 54; Marsha, 218; Mary, 196; Matthews, Dr., 33; Maureen, 11; Molly, 62;

Index Nancy, 212; Rachel, 175; Sharon, 215; Smith, Dr., 206–207, 211–212; Taylor, Dr., 68; Tess, 32 informed consent, 18, 201–212; battery, 203, 204, 211; camouflage, 194–195, 199, 205–212, 216–217; deception, 17, 21, 134, 180, 200, 216, 217, 229; fraud, 17, 21, 134, 200, 216–217, 229; individual standard, 202; material information, 200, 201, 202, 206, 208, 217; negligence, 203; professional-practice standard, 201–202; reasonable-person standard, 201–202, 203; religious information disclosure, 205–212, 216, 228–229; risk disclosure, 133, 134, 136, 138, 203; self-censorship, 17, 21, 199, 200, 206–209, 214–215, 229; unfair business practices, 216, 217. See also decision making; ethics; safety; tort law; vulnerable populations Innate Intelligence, 4, 35, 93–105, 208, 212. See also chiropractic; energy, vital Insight Meditation Society, 209 insomnia, 125, 126, 150 Institute of Integrated Medicines, 116 integrative medicine, 2, 3, 12, 26, 112, 115, 154, 174, 205–206. See also hospitals International Association of Reiki Professionals, 189 International Chiropractors’ Association, 101 International Society for the Study of Subtle Energies and Energy Medicine, 42, 124 Internet: Amazon.com, 59; Beliefnet. com, 161; for distant healing, 32, 184; as health-information source, 1, 32, 161–162, 168, 184, 194, 217, 218; Yahoo, 59, 161. See also media; publishing

309

InterVarsity Christian Fellowship, 71, 103 iridology, 32, 75, 160 irritable bowel syndrome, 150 Isacowitz, Rael, 58 Iyengar, B. K. S., 48 Jackson, Quinton, 85 Jackson, Robert, 222 Jacob’s Ladder, 100 Jacobson, Michael, 70 Jainism, 28, 40, 47 Japanese-Americans, 181 Jaramillo, F., 84 Jehovah’s Witnesses, 203–204 Jentoft, Peggy, 136, 183–184, 185, 186 Jeremiah, David, 140 Jesus (Christ): added to non-Christian religions, 59, 62, 158; Christian doctrine of, 14–15, 44, 107; modeling healing, 157, 179, 181; modeling suffering, 158; as standard, 70; used to critique CAM, 69, 72, 73–74, 102; validating orthodoxy, 45–46, 61, 63, 65, 75, 77–82, 84–85, 87–88, 103–104, 160, 208 Jews, 3, 15, 28, 34, 157–158 John of the Cross, 38 Johnston, Robert, 227 Jois, K. Pattabhi, 48 Jones, Rhonda, 87–88 Jordan, River, 207 Journal of Alternative and Complementary Medicine, 145 Journal of Christian Nursing, 76 Journal of Professional Nursing, 211 Journal of the American Chiropractic Association, 99 Journal of the American Medical Association (JAMA), 12, 123, 127, 133, 153 Journal of the American Osteopathic Association, 29

310

In de x

Kabat-Zinn, Jon, 38, 114, 209 Kadowaki, Kakichi, 158 Kantor, Debra, 212 karate, 26–27, 35; for children, 176; Christian critiques of, 72; Christian use of, 81, 86, 87; Chuck Norris: Karate Commandos, 176; Chun Kuk Do, 62; Karate Kid, 176; safety, 134. See also martial arts; zazen Karate for Christ International, 80, 87 karma, 21, 179, 181, 185, 186, 191 Keating, Joseph, 101 Keene, Patricia, 195 Kendall, Donald, 140, 144, 146 Kennedy, Anthony, 223 Kennedy, Robert, 11, 158 Kent, James Tyler, 32 Khandavalli, Shamsunder, 28 ki: Christian critiques of, 72; Christian relabeling of, 78, 81; defined, 36, 180–181, 213; spiritual energy labeled, 4, 54, 58, 189, 187. See also energy, vital kinesiology, applied, 32, 101, 104, 160 King, Richard, 25 Kircher, Athanasius, 28 Kirlian, Semyon, 5 Kirlian, Valentina, 5 Kirlian photography, 5, 28 Kirschmann, Anne Taylor, 164 Kline, Monte, 79 Kong, Jian, 145 Koontz, Kay, 5–6, 175 Kordich, Jay, 166 Kornfield, Jack, 134 Krieger, Dolores, 136, 190–192, 197 Krishna, 47 Krishnamacharya, Sri Tirumalai, 48, 50 Kropinski, Robert, 133–134 Kuhlman, Kathryn, 159 kundalini, 47, 49, 50, 54, 55, 71, 133, 188, 191. See also energy, vital; yoga

Kunz, Dora, 191, 192 Kushi, Michio, 36–37 labor (childbirth), 119, 122, 150, 151, 156 Lancet, 119 Larimore, Walt, 74 laying on of hands. See under hands Lectio Divina, 38 Lefubre, Leo, 158 Let Us Reason Ministries, 105 life force. See energy, vital Lillard, Harvey, 93 Loizzo, Joseph, 39 lotus, 41, 51, 62, 99 Lust, Benedict, 33 Lyles, Margaret Lee, 214 Lynch, David, 172 Lyon, Ross, 104 MacArthur, John, 57 Maddox, John, 118 Maharishi International University, 41, 88, 134, 225 Maharishi Mahesh Yogi, 41, 134, 170 Main, John, 158 Male, Ronald R., 81 Malkmus, George, 83 mandalas, 192 Mandeville, Marylyn, 62 mantras, 41, 181, 183, 185, 186; Christian critiques of, 72; Christian use of, 60–61, 62, 88, 158; defined, 38, 174; Om (Aum), 45, 47, 52, 56, 61, 62, 174; studies, 114. See also meditation; Transcendental Meditation Mao Tse-tung, 36, 142 Marchand, Murielle, 156, 214 Maria Kannon Zen Center, 26 martial arts, 2, 27, 35–36; aikido, 35, 58, 72, 213; bujutsu, 27; bushido,

Index 27; Christian critiques of, 72, 139; Christianity & Martial Arts Power, 77; Christian Martial Arts, 77; Christian use of, 62, 77, 80, 85, 87, 176; Christian versions of, 80–81, 84; in gyms, 175–176; hapkido, 81; Hwa Rang, 81; judo, 35, 72, 81, 176; jujitsu, 72; kempo, 35; kendo, 72; kickboxing, 35; kung fu, 175; Martial Arts & Yoga, 72; Martial Arts the Christian Way, 84; mixed martial arts (MMA), 85, 87, 176–177; ninjas, 176; Pokémon, 176; practices changing beliefs, 213; Purpose Driven Martial Arts, 80; qi in, 36, 77; religion and, 26–27; in schools, 176; self-defense, 27, 175, 176; tae kwon do, 73, 81, 87, 176, 177; Taoism and, 35–36, 69, 78; Teenage Mutant Ninja Turtles, 176; usage, 176; with other CAM, 57, 191. See also karate; qigong; t’ai chi Martial Arts Ministries, 84 massage: Christian use of, 75, 78, 109; emotionally satisfying, 165–166; informed consent, 211; medical, 175; professionalized, 171; shiatsu, 22, 36, 160; spiritual, 157, 175; studies, 13, 130, 131, 150, 152; Thai, 54; usage, 12–13; with other CAM, 33, 98, 122, 163, 198, 199. See also energy medicine matching law, 137 materialism. See under worldviews Matteo Ricci Foundation, 144 Matteo Ricci School of Acupuncture and Chinese Medicine, 144 Maurer, Edward, 99 Mayo Clinic, 107, 128, 218; on acupuncture, 144, 145, 147–148, 153; on meditation, 7, 127, 175; religion and, 26

311

Mayo Clinic Book of Alternative Medicine, 26, 145, 153 McCoy, Matthew, 205 McDonald, William, 98 McDonald’s, 41 McFarlane, Stewart, 213 McGuire, Meredith, 212 McLuhan, Marshall, 76 McSherry, H. L., 102 Mebane, Sister Mary, 85, 210 media, 41, 76, 167, 175, 184, 206; Associated Press, 59; BBC, 118; CNN, 57; Los Angeles Times, 50; New York American, 50; New York Times, 29, 144, 214; Time, 41, 42; TV/film, 42, 50, 64, 100, 101, 118, 129, 176, 218 Medical Acupuncture for Physicians Program, 145 Medicare, 29, 225 meditation, 2; Buddhist, 7, 10, 25, 27, 37–40, 42, 57, 71, 88, 115, 134, 158, 209, 211; in businesses, 39, 172, 173, 209; centering, 58, 80, 193; chanting, 45, 51, 56, 58, 61, 62, 173, 185; Christian critiques of, 11, 68, 70–71, 72, 86, 139; Christian use of, 59, 86, 211, 214; Christian versions of, 38, 45–46, 60, 62–63, 78, 87–88, 158–159; government and, 221, 223, 224, 225, 226; Hindu, 41–42, 157–158; in hospitals, 39–40, 174–175; informed consent, 206, 209, 211; mu-shin (no-mind), 25, 158; religion and, 26, 174, 175, 223, 224, 225, 226; safety, 133–135; in schools, 174, 177, 224; scientific language, 114, 125, 126, 127, 206, 209; sitting, 25, 38, 39, 41, 62, 88, 100; studies, 7, 13, 114–115; Three-Minute Meditator, 40; Tibetan, 39, 42; usage, 12–13; with other CAM, 6, 36, 57–58, 72, 186, 193, 199, 210, 213, 214; yoga, 45, 46–47,

312

In de x

meditation (Cont.) 59–60, 62–63, 173; zazen, 25, 27, 158. See also mantras; mindfulness; Transcendental Meditation Meehan, Thérèse, 123, 197 Mentgen, Janet, 198 Mercola, Joseph, 29 meridians, 4, 29–30, 32, 35–36, 141– 142, 182, 188, 206; Christian critiques of, 75, 80, 105; not religion, 146–147. See also energy, vital; nadis; qi Meridian Tapping Technique, 29–30 Merton, Thomas, 158 Mesmer, Franz Anton, 28 mesmerism, 4, 8, 28–29, 31, 93, 191 metaphysics, Western, 1, 7, 8, 19, 22, 43, 155, 231n4; CAM, 10, 13, 17, 21, 29–35, 48, 70, 120–122, 180, 188, 191, 198–199; chiropractic, 19–20, 29, 92–95, 97–99, 101, 104, 107, 110; Christian critiques of, 17, 70, 71; Christian use of, 14, 107; defined, 4, 28–29, 112; religion and, 22, 180; scientific language, 6, 21. See also mysticism; New Age; occult; spirituality microcosms, 32, 47, 141, 188 Miles, Patricia, 195 Miller, Arlene, 71, 196–197 mind, 9, 42, 47, 186. See also brain; psychic healing mind-body therapies, 7, 26, 62–63, 131, 206. See also body-mind-spirit mindfulness, 37–40; Buddhism and, 37, 39, 209; Christians and, 71; Full Catastrophe Living (Kabat-Zinn), 38; government and, 225; in hospitals, 39, 174; meditation, 22, 26, 70; religion and, 26, 39, 173; in schools, 172–173, 174, 223; studies, 114; Wherever You Go, There You Are, 38 (Kabat-Zinn); with other CAM, 58, 161. See also meditation

Mindfulness-Based Stress Reduction (MBSR), 39, 173, 209, 225 miracles. See divine healing missions: Buddhist, 25; CAM, 81, 84, 87, 103, 160; Christian, 49, 56, 70, 84; Hindu, 49; Jesuit, 11, 144, 158 modernity: ancientness and, 20, 24, 48, 53, 122, 140–144, 154, 168, 192, 205, 226; chemicals of, 34,166, 168, 169; critiqued, 9, 34, 92, 83–84, 144, 197; embraced, 92, 142, 170, 191; fears of, 166–169. See also detoxification Mohler, Albert, 57, 59 Monica, Laura, 62 monism. See under worldviews Montenegro, Marcia, 57 Mooney, Sharon Fish, 71, 196–197 Moore, J. Stuart, 95, 98–99, 105, 110 Moore, R. Laurence, 96 Moss, Donald, 43 moxibustion, 36, 151 mudra (seal), 54 muscle-response testing, 32 Muslims, 221, 226 mysticism: CAM, 27, 42–43, 69, 81, 181; Christian, 38, 158; Eastern, 36, 38, 49, 50, 105, 146, 158; Western, 31, 115, 176. See also metaphysics, Western; spirituality nadis, 4, 47, 191. See also meridians namaste, 54, 62 Namaste Yoga & Tranquility Center, 54 Narayanananda, Swami, 133 National Academy of Sciences, 129 National Academy of Sports Medicine, 63 National Association for Chiropractic Medicine, 97 National Association of Retail Druggists, 165 National Cancer Institute, 124, 131, 132, 170

Index National Center for Complementary and Alternative Medicine (NCCAM), 131, 218; on acupuncture, 144, 147, 149; on energy, 5; funding, 11–12, 225, 226; on homeopathy, 119; medicine defined by, 29; on meditation, 114, 125; on Reiki, 124, 125; on t’ai chi, 128; on yoga, 125 National Certification Board for Therapeutic Massage and Bodywork, 171 National Certification Commission for Acupuncture and Oriental Medicine, 171 National Chiropractic Malpractice Insurance Company Group, 95, 100 National Expert Meeting on Qi Gong and Tai Chi Consensus Report, 206 National Health Interview Survey, 194 National League for Nursing, 197 Native Americans, 7, 8, 108, 139, 221; therapeutic imperialism and, 226–227 natural remedies: legitimate because from nature, 5, 91, 122, 185; purer than biomedicine, 1, 2, 9, 11, 92, 144, 161, 162, 164; usage, 12 Nature, 117–118 nature, 30, 33, 43, 68; cures, 8, 48 naturopathy, 33; Christian use of, 109, 160, 162–163, 167; Clinical Naturopathy, 33; in hospitals, 175; studies, 13; usage, 13, 120; with other CAM, 101 nausea/vomiting, 132, 148, 150, 151, 153, 154 Navigators, 160 Needle, Dr., 169 Nelson, Leah, 62 neuropathy, 116 neuroscience, 2, 6, 7 New Age: Christians guard against, 14, 16, 58, 65, 68–69, 86, 89–90,

313

110, 140, 212; defined, 68; fear of investigating, 19, 68, 70, 89; labels CAM as illegitimate, 2, 14, 56, 63, 64, 75, 76, 79, 104–105, 108–109, 171; science as opposite of, 19, 20, 68, 93, 106, 228. See also Eastern religions; metaphysics, Western; mysticism; occult; spirituality New Age Journal, 171 New Age Medicine, 104 New Age Movement and the Biblical Worldview, 76 Newport, John, 76 new religious movements, 180, 213 New Thought, 48, 93, 115 New Thought Accreditation Commission, 115 New York University, 191, 197 NIH (National Institutes of Health), 11, 12. 115, 127, 147, 148, 206, 225 nirvana, 37, 187 nocturnal enuresis, 130, 151 North American Nursing Diagnosis Association, 197 Nuremberg Code, 202 Nurses Christian Fellowship, 71 Nurse’s Handbook of Alternative & Complementary Therapies, 120, 126, 135, 205, 210 nutrition, 12, 34–35, 128–130; Breuss Cancer Cure, 34; Budwig protocol, 34, 161; Christian critiques of, 11; Christian use of, 160, 162–163; Gerson therapy, 34, 83, 129–130; Gerson Therapy, 34; Hallelujah Diet, 34, 83; juicing, 34, 83, 160, 162, 163, 166–167; Kelley program, 34, 83; macrobiotics, 36–37, 100, 129–130, 131; metaphysics and, 34–35; organic, 34, 161; raw foods, 34, 163; studies, 127, 128–130; vegan, 28, 129; vegetarian, 8, 13, 28, 129, 162; wheatgrass, 34; whole-food,

314

In d e x

nutrition (Cont.) plant-based, 10, 28, 129, 137. See also cancer treatments; nutritional supplements nutritional supplements, 10, 101, 137; antioxidants, 130, 131; Barley Max, 83; cleanse, 101, 132, 160, 166–168; commercialized, 163, 166–167, 178; cranberries, 130; curcumin, 130; fish oil, 130; flaxseed, 34, 130, 131, 161; ginger, 27; ginseng, 131; government and, 225; GREENSuperFood, 167; liver, calf, 34, 129; omega-3 oils, 130; safety, 34, 130, 131, 132, 133; SaintJohn’s-wort, 130, 131; selenium, 130; soy, 131; studies, 131–132; thyroid, 130; usage, 12; vitamins, 98, 100, 131, 162; zinc, 119–121. See also cancer treatments; detoxification; modernity; nutrition obesity, 128 occult, 7, 231n4; Christian fear of, 68, 159; labels CAM as illegitimate, 71, 72, 73, 75, 76, 79, 88, 105–106, 140. See also metaphysics, Western; mysticism O’Connor, Sandra Day, 223 Office of Alternative Medicine, 11, 225. Ogle, Marguerite, 58 Ohsawa, George (Yukikazu Sakurazawa), 36 O’Mathúna, Dónal, 74 Omoto-kyo, 213 One Christian Ministry, 73, 79–80, 85–86 Options, 34 Origin of Species (Darwin), 9 Osa’s Garden, 162 Oschman, James, 6 Osler, William, 9, 144

osteopathy, 9, 12, 29–30, 70, 92, 160, 225; Osteopathic Medical College Information Book, 29 otitis media, 98 Outstretched in Praise, 61 Outstretched in Worship, 61 Pacific College of Oriental Medicine, 139 pain, 130; arthritis, 124, 125, 127, 149, 151, 153, 175; back, 108, 110, 130, 145, 146, 148–149, 150, 151, 152, 175, 203; breast, 150, 212; chronic, 13, 116, 124, 145, 148, 152; dental, 148; dysmenorrhea, 98, 130, 145, 150, 151; headache, 11, 98, 124, 130, 132, 133, 143, 145, 148, 150, 151; labor, 122, 150; meanings of, 93, 155–156, 218 pain relief: CAM perceived as providing, 69, 105–106, 108, 110, 21, 147–148, 180; motivates Christians to try CAM, 19–20, 86, 90, 92–93, 103, 107, 110–111, 166, 207; pragmatism in, 88, 130, 137, 206, 218. See also placebo effect Palmer, Bartlett Joshua, 94, 95, 102 Palmer College (School) of Chiropractic, 94, 103, 104, 225 Palmer, Daniel David, 93–94, 95, 103, 105 Palmer, Phoebe, 159 Palmer, Walter, 159 palm reading, 93 Paracelsus, 28, 34 Parachin, Victor, 215 paralysis, 133, 148 Passalacqua, Christopher, 100 Patanjali, 47, 216 patient-centered care, 201, 202 Paul, Russill, 59 Pavlik, Sarah, 57 Pelletier, Kenneth, 43

Index pendulums, 32, 168, 185, 198 pentecostals: biomedicine critiques by, 159, 212; CAM critiques by, 71–73, 91, 108; CAM use by, 18, 71, 91, 103, 107, 212–213; defined, 14, 232n20. See also divine healing; evangelicals Pen Ts’ao, 25 People’s Organization of Community Acupuncture, 207–208 Peretti, Frank, 68 personal autonomy. See under ethics Peterson, Eugenie, 50 Pfeifer, Samuel, 72 Pharmaca Integrative Pharmacy, 120 physical culture, 48, 57 physical therapy, 58, 126, 150, 152, 175 Physicians Committee for Responsible Medicine, 129 Physicians Resource Council, 139 Pilates, 52, 57–58, 61, 62, 101 Pilates, Joseph, 57 placebo effect, 114, 116, 117, 119, 123, 151, 152–153, 154 plants, 23, 33, 34, 122, 184. See also herbalism; nutrition pluralism: religious, 15, 16, 17, 31, 43–44, 59, 93, 139, 180, 228; therapeutic, 14, 17, 18, 90, 107, 111, 137, 156, 160, 216, 218, 228. See also beliefs; practices PM Yoga, 65 Pocket Atlas of Chinese Medicine, 146 polarity therapy, 11, 36 politics. See under power Polk, Branda, 61 Post-Graduate School of Homeopathics, 32 Poulin, Fernan, 6 power: empowerment, 177, 181, 187; gender and, 21, 157, 164, 176, 180, 193, 196–197; imbalances, 17, 204, 219; mental, 42–43, 186, 191;

315

physical, 175; political, 10, 48, 227; sexual, 47, 50, 187–188; spiritual, 47, 71, 73, 74–75, 77–78, 174, 175, 183, 186. See also class, social; gender; race/ethnicity Power Healing, 76 Poyen, Charles, 28 practices: changing beliefs, 17, 19, 21, 44, 57, 173, 204, 212, 213–216, 217, 218–219, 228; not religion, 81; religious, 22, 23–24, 46, 60–65, 220, 221; ritual, 2, 27, 28, 53, 60, 181, 185; sacramental, 23, 60, 78, 157. See also beliefs; body; religion; worldviews; worship PraiseMoves, 63–64; PowerMoves Kids, 64; PraiseMoves, 64; PraiseMoves Kids, 64 prana: Christian critiques of, 70; Christian relabeling of, 62, 78; defined, 47; pranayama, 47, 61, 133, 173; spiritual energy labeled, 4, 6, 28, 32, 33, 34, 95, 189, 191–193, 198. See also energy, vital; yoga prayer: CAM with, 13, 62, 93, 160–162, 211, 212; chiropractic and, 93, 94, 100, 102, 106–107; meditation and, 38, 88, 206; school, 222–224; studies, 7, 107, 127, 226; yoga, 53–54, 59–61, 62–63, 64, 65. See also divine healing; hands: praying Pray with Purpose, 38 Prem, Baba, 55 Principles and Practice of Medicine, 9, 144 Protestants: Anglican, 210–211; Assemblies of God, 56, 108; Baptist, 57, 58, 61, 62, 104, 173; Calvinist, 8, 156; cessationist, 8, 14, 71, 73, 103, 162; Charismatic, 10, 14, 71, 159, 232n20; Church of Christ, 162; Episcopal, 60, 159, 215; Holiness, 159; Jesus people, 10; Methodist,

316

In de x

Protestants (Cont.) 61, 88, 159; Presbyterian, 93, 103; priesthood of all believers and, 67, 140, 179, 219; Reformation, 8, 23, 65, 67, 73, 219; Unitarian, 215; United Church of Christ, 156; Unity, 108; Word-oriented, 23–24, 46, 65, 78, 89. See also beliefs; Bible; Christians; clergy; evangelicals; pentecostals psychic healing: Christian critiques of, 11, 71, 88; clairvoyance, 4, 32, 183, 198; crystals, 126; energy, 27, 28, 191, 193; intention, 6, 7, 32, 183, 185, 192, 193, 194; intuition, 4, 32, 54, 115, 136, 183, 186–187, 189, 193, 194, 209, 213; sixth sense, 213; third eye, 183, 184, 189, 196; usage, 34, 185–188, 194, 196, 198, 210 psychology, 12, 33, 42, 115, 191 psychosis, 133, 134, 136, 148 Public Health Service, 202 publishing, 48, 49, 113–114, 195; best-sellers, 29, 38, 41, 49, 50, 68, 81, 129, 131, 158; InterVarsity Press, 104; Lifeway, 61; London Missionary School of Medicine, 82; Paulist Press, 60; Paulist Productions, 60; Society of Saint John the Evangelist, 60; Thomas Nelson, 61; Time Warner’s Faith Words, 45. See also Internet; media Purpose Driven Life (Warren), 81 qi (ch’i), 231n1; Christian critiques of, 69, 74, 105, 140; Christian relabeling of, 77–78, 80; defined, 35–36, 69, 141–142, 144–145, 154; not religion, 128, 146–147, 206; spiritual energy labeled, 4, 32, 33, 34, 54, 58, 95, 144, 160, 163, 189, 191, 198. See also energy, vital; meridians; yin-yang

qigong, 35, 58, 176; Christian critiques of, 139; Christian use of, 214; scientific language, 206; sexuality in, 187; studies, 114–115; usage, 13; with other CAM, 180. See also martial arts Quackwatch, 97 quantum physics, 2, 6–7, 120, 121, 122 Quinn, Janet, 124, 214 race/ethnicity, 13, 15, 26, 176. See also class, social; power Radha, Swami Sivenanda (Sylvia Hellman), 55 Rand, William, 85, 195 Randi, James, 118 randomized controlled trials (RCTs), 113, 114, 150, 151 Raposa, Michael, 213 Raso, Jack, 97 rational choice, 137 Ratzinger, Cardinal Joseph, 11 Rawdon, Larry, 162 Ray of Light (Madonna), 51 reflexology, 35, 87, 160 Reid, Mike, 99 Reiki, 2, 21, 179–190, 193–196, 199; attunements, 85, 181, 184, 185, 186, 187–188; Buddhism and, 11, 180–181, 185, 187, 188; Christian critiques of, 11, 75; Christian use of, 78, 85, 87, 89, 157, 160, 180–182, 214; Christian versions of, 6, 11, 78, 80, 156, 179, 185, 195; defined, 180–182; Essential Reiki, 186; in hospitals, 193–196, 209; informed consent, 194–196, 210–211, 213; initiations, 181, 184, 185; practices changing beliefs, 213–214; praying hands, 182, 185; professionalized, 171; psychic, 186, 187, 188, 210; Reiki Healing Touch and the Way of Jesus, 78; Reiki Level One Manual, 185; religion and, 157,

Index 179–180, 181, 188–190, 195; safety, 136; scientific language, 125–126, 194–196; Secrets of Reiki, 184; sexuality in, 187–188; studies, 115–116, 124; symbols, 78, 85, 181, 183, 185, 186, 188, 213, 214; usage, 13, 194; with other CAM, 54, 191, 198, 210 reincarnation, 37, 46, 57, 185, 186, 191; liberation from 46, 47, 48, 54 relaxation: muscle, 26, 206; religion and, 40, 42, 61; secular language, 86, 127, 174, 195; studies, 124, 127, 150, 152, 226. See also stress religion: CAM and, 1, 3, 13, 220–221; creeds in, 19, 22, 24, 27, 46, 52–53, 100; defined, 3, 19, 22–28, 46, 170, 180, 189, 220, 221; disavowing, 21, 26, 43, 207; disillusionment with, 3, 7, 8, 59, 87, 156–159, 216; doctrines in, 24, 40, 66, 97, 208, 74, 86, 102, 103, 157; dogma in, 53, 96, 101, 158, 173, 179, 188–189; faith in, 75, 81, 82, 84, 87, 103, 107, 108, 157, 159, 173, 179, 192; forgiveness in, 14, 26; functions of, 3, 24, 26–27, 110, 163; government and, 200, 220–227; irreligion and, 200, 223, 224, 226; lived, 17; meanings in, 17, 21, 23, 24, 26, 44, 56, 59, 76, 100; minority, 226; monotheistic, 17, 43, 103, 158, 202, 228, 237n5; negative associations of, 24, 188, 192; panentheistic, 68; pantheistic, 57, 58, 68, 70, 76; privatization of, 227; rules in, 24, 27; science and, 24–25, 43, 49, 154, 170; sin in, 14, 44, 53, 83, 84, 102, 156, 157. See also beliefs; body; compassion; Eastern religions; emotions; enlightenment; metaphysics, Western; New Age; pluralism; practices; sacredness; salvation; spirituality; surveys:

317

religious identity; worship; specific traditions Religious Right, 14 Renaissance, 6 Reston, James, 144 Ricci, Matteo, 144 Rig-Veda, 191 Robaina, Holly, 56–57, 74 Roberts, Oral, 159 Robertshaw, Angela, 136, 184, 188, 213 Rocca, Sabrina, 80 Rogers, Martha, 197 Rondberg, Terry, 97 Roth, Nancy, 60 Ruggie, Mary, 114, 217 Rush, Benjamin, 8 Rutherford, George, 172 Ryan, Thomas, 59 sacredness, 22, 23, 33, 34, 54, 65, 174, 180, 185, 186, 189, 198, 227. See also religion; spirituality safety, 12, 20, 34, 75–76, 112, 130, 131–138, 153, 164 Salladay, Susan, 209 salvation: in Christianity, 14, 70, 86, 88, 94; in Christian yoga, 60, 63; in yoga, 46, 48, 60, 174. See also enlightenment samadhi (bliss), 47, 50, 173 Sanskrit, 38, 51, 62, 87, 158, 181 Saraswati, 41 Satan, 71, 76, 79, 81, 84, 85, 156, 162 Satel, Sally, 196–197 Satyananda, Swami, 158 Saxion, Valerie, 167 Scheel, John, 33 schizophrenia, 150 schools, 217; government and, 21, 200, 222–224; martial arts in, 176, 177; meditation in, 39, 172–173, 177, 225; yoga in, 52, 64, 173–174

318

In d e x

science: as authenticating device, 25, 81, 86; Christian approval of, 68; Christian critiques of, 68, 79; defined, 3, 49, 112; empiricism and, 7, 9, 25, 30, 49, 68, 122, 124, 141–142, 145, 154, 191; popular, 7, 49, 51, 120, 122; religion and, 24–25, 43, 49, 154, 170; as religiously neutral, 2, 19, 20, 68, 104, 105; technology and, 5, 7, 8, 42–43, 68, 140, 144, 156. See also biomedicine; techniques scientific language, 6, 120; anatomy/ physiology, 33, 49, 96–97, 98, 125, 145–146, 147, 171; biology, 49, 114, 115, 117–118, 119, 135; camouflage with, 194–195, 199, 205–209; chemistry/physics, 6, 33, 86, 121, 122, 125, 147, 170, 189; endorphins, 86, 125, 147, 206; enzymes, 34, 167; neuroscience, 2, 6, 7, 29, 49, 94, 96–97,102, 105, 110, 125, 140, 147; quantum physics, 2, 6–7, 120, 121, 122. See also informed consent; science; scientific studies scientific naturalism, 9, 44, 68 scientific studies, 112–113; bias, 114, 130, 150, 151–152, 154; blinding in, 117, 118, 126; citation bias, 116–117; falsification, 125; file-drawer effect, 115; observational, 114; observer bias, 118; outcome-based, 114; poorquality, 114–115, 117, 118, 126, 127, 151–152, 154; publication bias, 115; randomized controlled trials (RCTs), 113, 114, 145, 150, 151; replication, 117, 118, 119, 123, 124; sampling bias, 116; statistics in, 113, 114, 116– 117, 118, 123, 127. See also efficacy; safety; systematic reviews Scientology, 102 Second Vatican Council, 10–11 Secret, The, 101

secularity: CAM associated with, 55, 89; CAM distinguished from, 54; implies legitimacy, 178, 205; as marketing strategy, 50–52, 170–177, 206; professionalization implies, 171, 175, 198; religion and, 2–3, 67; secularization theory and, 227 Sedona, 190 self (Self): Atman, 40, 59; part of universe, 37, 54, 158, 188; union with divine, 46, 51, 55, 59, 186, 187, 210, 215–216. See also God; universe self-determination. See under ethics Seven Storey Mountain (Merton), 158 sexuality, 47–48, 50, 52, 56, 187–188 Shalom Yoga, 62 shamanism, 54, 181 “Shanti Ashtangi” (Madonna), 51 Shelly, Judy, 76 Shen Nung, 25 Shih-chi, 142 Shinto, 72, 8, 180, 213 Shiva, 47, 49, 62 Shukla, Aseem, 53, 55, 215–216 Shulman, Joey, 29 Singleton, Mark, 48 Skillen, Gary, 168 skin diseases, 148 Skyrme, Brenda, 72 Slaughter, Ronald, 97 Smiley, Nina, 40 Smith, Adam, 41 Smith, Linda, 78 Smuts, Jan, 3 Sood, Amit, 7, 127, 151–152 soul: human, 49, 62, 94, 99, 102, 103, 156, 198, 212; of plants, 33 Soyen Shaku (Soen, Shaku), 25, 49 spirit guides, 78, 183, 185, 186, 188, 195, 198, 214 Spirit in Business World Conference, 172

Index spirits: channeling, 8, 29, 31, 89, 93, 183; defined, 4; harmful, 25, 28, 85, 142; human, 99; plant, 28; universal, 40, 47, 180. See also body-mind-spirit; demons; spirituality; universe Spiritual Emergence Network, 133 spiritualism, 8, 29, 93 spirituality: CAM and, 42–43, 48, 49, 56, 87, 95, 100, 174; defined, 4, 24; desire for, 10, 157–158; holistic, 43; is religion, 19, 22, 24, 26–27, 112, 180; not religion, 2, 21, 39, 53, 54, 65, 139, 145, 188–189, 191, 199, 206; safety, 131–136; scientific language, 195, 198, 206–209; universal, 19, 22, 24, 25, 46, 53, 59, 228. See also energy, vital; metaphysics, Western; mysticism; New Age sports, 39, 50, 56, 62–63, 77, 206; combat, 175–176 Ssu-ma Ch’ien, 142 Stanton, Elizabeth Cady, 164 Star Wars, 4, 176 Stein, Diane, 136, 184, 186, 187, 196, 210, 213 Steinecke, Richard, 208 Stewart, Walter, 118 Still, Andrew Taylor, 29 stress: Buddhism and, 37, 38–39; causes of, 37, 79, 160, 170; geopathic, 168; not religion, 38–39, 172–173, 174, 194, 195, 209, 214; relief, 65, 80, 98, 101, 128; studies, 116, 124–125, 126, 226. See also relaxation Stress Reduction Clinic, 38 stroke, 133, 150 Subtle Energies, 124 suffering: Buddhism and, 37, 39, 158–159, 185; Christian valorization of, 60, 155–157; Hinduism and, 41, 46; motivates CAM use, 1, 3, 8, 15,

319

17, 91, 164, 165–166, 177. See also body; compassion; pain Sullivan, Winnifred, 220 Sun Salutation (Surya Namaskara), 48, 51, 53, 60, 62, 63. See also asanas; yoga supernatural, 8, 9, 23, 28, 47–48, 107, 139 superstition, 8, 25, 56, 68, 71, 73, 88, 142 Supreme Court, 9, 217, 221, 222, 223, 224. See also Constitution; court cases surveys: CAM usage, 1–2, 12, 13, 56, 98–99, 133, 143, 164, 175, 194; nutrition, 129; religious identity, 13–14, 24, 102; use of, 18, 107–108, 126, 239n32 Suzuki, D. T., 25 Swamiji (Divine Life Society), 53 Swatmarama, Swami, 133 Swedenborg, Emanuel, 30 Swedenborgianism, 30–31 Syman, Stefanie, 56 systematic reviews, 113; acupuncture, 116–117, 148–154; homeopathy, 118, 119; meditation, 114–115; t’ai chi, 127; Therapeutic Touch, 123; yoga, 114. See also Cochrane Database of Systematic Reviews; scientific studies t’ai chi (T’ai Chi Ch’üan, Taijiquan), 35–36; Christian critiques of, 62, 69, 139; Christian use of, 69, 89; elderly and, 128, 176, 206; religion and, 26, 206; safety, 128; scientific language, 206; studies, 69, 114, 126, 127–128; Taoism and, 36, 69; usage, 13, 23, 36; What Is “Tai Chi”?, 145; with other CAM, 99, 214. See also martial arts Takata, Hawayo, 181 Taoism, 1, 19, 22, 155, 231n1; acupuncture and, 20, 139–140, 141,

320

In de x

Taoism (Cont.) 142, 154, 206, 207; CAM and, 26, 28, 43, 180, 213; Christian critiques of, 69, 72, 86, 139–140; Christian use of, 78; defined, 35–36; martial arts and, 26, 35–36, 69, 78; religion and, 27, 221. See also religion TCM, 35, 36, 142–144, 171, 175, 191, 205. See also acupuncture; herbalism; herbs techniques, 216, 227; coded as medical, 29–31, 68, 91, 105, 128, 147, 193, 194–195, 206; coded as non-religious, 2, 25, 38, 53, 62, 70, 77, 80, 81, 84, 85–86, 174, 176; coded as scientific, 2, 43, 48, 86, 89, 170, 191, 208; religious, 4, 40, 105 Tennant, Agnieszka, 65 Teresa of Avila, 38 Theosophy, 48, 49, 191 therapeutic culture. See pluralism Therapeutic Touch, 2, 21, 179–180, 190–193, 196–199; Accepting Your Power to Heal (Krieger), 191; Buddhism and, 191, 192; defined, 191, 193; Christian critiques of, 11, 71, 76, 81; Christian use of, 80, 81, 87, 157, 160; government funding, 225; Hinduism and, 191, 192; informed consent, 136, 210–211; nurses and, 190, 192–193, 196–197, 199, 209; placebo, 123; practices changing beliefs, 214; professionalized, 171, 198; psychic, 191; religion and, 80, 191, 192, 193; safety, 136; science and, 6, 191, 192; studies, 122–124; Theory and Practice of Therapeutic Touch, 6, 124; Theosophy and, 191; Therapeutic Touch (Krieger), 198; Therapeutic Touch (National League for Nursing), 197; usage, 198

Therapeutic Touch International Association, 197 This Present Darkness (Peretti), 68 Thoreau, Henry David, 49 Tijuana, 34 Tiwari, Subhas, 54–55 Today’s Christian Woman, 57 tort law, 180, 200, 203. See also consumers; ethics; informed consent toxins. See detoxification Traditional Chinese Medicine. See TCM Transcendental Meditation (TM), 10, 41–42, 50; Christian critiques of, 11, 75; Christian use of, 88; government funding, 221, 225; informed consent, 134; safety, 75–76, 133–134; in schools, 172; scientific language, 170; studies, 114–115; TM Book, 170; with other CAM, 31–32, 101, 102 Transcendentalism, 31, 144 Trappists, 158 Tribe, Laurence, 221 Ueshiba, Morihei, 213 Ultimate Fighting Championship, 85, 177 Universal Awakening, 42 Universal Consciousness, 50 universal intelligence, 170, 189. See also Innate Intelligence universe (cosmos): composed of energy, 6–7; divine, 40, 186, 187, 213; one with, 37, 45, 54, 99, 186, 188, 213, 225; source of vital energy, 4, 43, 187. See also God; self Upanishads, 46 Usui, Mikao, 180–181 van de Velde, Jane, 195 Versteeg, Peter, 215 Vishnu, 51 vision problems, 148, 150

Index visualization, 40, 61, 181, 193 Vitale, Anne, 115 vital force, 4, 30, 33, 34, 55, 70, 79, 93, 95, 122. See also energy, vital vitalism, 33, 96, 103 Vivekananda, Swami, 49 vulnerable populations, 18, 229; children, 17, 52, 164, 170, 176, 217, 222; elderly, 17, 36, 52, 128, 176, 206, 217; prisoners, 39, 202; seriously ill, 17, 52, 203, 206, 209; unconscious, 203, 210. See also ethics; informed consent; tort law Walmart, 2, 52, 120, 121 Watchman Fellowship, 104 Weed, Samuel, 93, 103 Weil, Andrew, 163 Weise, Gilbert, 165 Weldon, John, 104 White, Danny, 84 White House Commission on Complementary and Alternative Medicine Policy, 148, 225 White, Judith, 78 WHO (World Health Organization), 116–117, 128, 153, 218 Whole Foods, 123, 132 WholyFit, 62–63 Wigmore, Ann, 34 Williams, Debbie, 38 Williamson, Lola, 157 Williamson, Wendy, 77, 80, 84 Willis, Laurette, 63 Wilson, Cheryl, 162–163 Wilson, Mike, 162–163 Wimber, John, 76 Wing, Janet, 194–195 Winterson, Jeanette, 121 Wirth, Daniel, 124 Wolf, Ava, 194–195 World Chiropractic Alliance, 97, 99, 205

321

World Medical Association, 201 World Parliament of Religions, 25, 49 worldviews: CAM and Christian, 19, 43–44, 62, 67, 90, 104, 228, 234n44; CAM as gateway to holistic, 17, 66, 89, 137, 214, 216, 219 (see also practices: changing beliefs); comprehensive, 25; dualistic, 23, 43–44; holistic, 3–4, 13, 43–44, 96; materialistic, 2, 3, 9, 10, 68, 71, 104, 159; monistic, 4, 43–44, 66, 214 worship: body in, 60; idolatry in, 2, 15–16, 25, 44, 73–75, 79, 82–83, 84, 228; of one God, 15, 24; yoga, 45, 48, 51, 52, 53, 58, 61–63, 64. See also God; practices wushu, 27, 35. See also martial arts Wuthnow, Robert, 219 Wuthnow, Sara, 80 Wyman, Scott, 157 Xie, Zhu-Fan, 116 X-rays, 133, 166, 169 Yahweh Yoga, 60 yin-yang: balance, 22, 128, 135, 144; Christian critiques of, 69, 72, 105, 140; defined, 4; not religion, 128, 145–147; Taoism and, 35–37, 142, 144–145, 154, 192. See also energy, vital; qi YMCA, 2, 216 yoga, 1, 2, 19, 45–66; anjalimudra (praying hands), 54, 88; asanas, 46–48, 49, 50–51, 53, 54, 55, 60, 62, 63, 64, 174, 215, 226; Ashtanga, 216; Autobiography of a Yogi, 49; Buddhism and, 47, 57; Christian critiques of, 11, 52–53, 56–57, 68–69, 71, 72, 74, 86, 91, 102, 139; Christian use of, 55, 89, 214, 215–216, 218; Christian versions of, 45–46, 55, 56–57, 58–66, 77, 80;

322

In de x

yoga (Cont.) commercialized, 45, 48, 51–52, 55; defined, 46–47; exercise and, 52–56, 57, 61, 62–66, 125; Forever Young, Forever Healthy, 50; government and, 223–224, 225–226; hatha, 39, 47–48, 49, 50, 55, 57, 133, 191, 215; Hatha Yoga (Folan), 51; Hatha Yoga (Radha), 55; Hinduism and, 46–49, 50, 51, 52–55, 57, 59, 62, 173–174, 215–216, 223; immortality and, 47–48; informed consent, 209, 214–215; Invitation to Christian Yoga, 60; Jain, 47; Jesus in the Lotus, 59; Kripalu, 59; kundalini, 47, 49, 50, 54, 55, 71, 133, 188, 191; medical, 26, 174–175; namaste, 54, 62; Pilates and, 52, 57–58; postural, 45, 46, 47–48, 55; practices changing beliefs, 55–56, 173, 214–216, 224; pranayama, 47, 61, 133, 173; Prayer of Heart and Body, 59; professionalized, 171; religion and, 26, 46, 49–57, 173–174; safety, 133, 134, 135; samadhi (bliss), 47, 50, 173; in schools, 173–174,

223–224; science and, 48–49, 51; sexuality in, 47, 52, 187; studies, 12, 13, 114, 124–125, 127; Sun Salutation (Surya Namaskara), 48, 51, 53, 60, 62, 63; Tantra, 47, 191; usage, 12–13, 23, 52, 56; with other CAM, 39, 95, 101, 176, 191; Yoga and You, 50; Yoga for Americans, 50; Yoga for Christians, 61; Yoga for Health, 50; Yoga Journal, 51, 52, 215; Yoga Prayer, 60; Yoga Sutras, 47; Yoga the College Way, 53, 133, 174; yoginis, 47; yogis, 42, 47–48, 50 Yoga Alliance, 62, 171 Yoga Ed., 173–174, 223 Yogananda, Paramhansa, 49–50 Yoga Research and Education Center, 171 Youngblood, Lloyd, 79 zazen. See under meditation Zen. See under Buddhism Zen Macrobiotics, 36 Zen Spirit, Christian Spirit, 11 Zlotnik, Jerry, 165 Zoroastrianism, 191

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