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Comments on NCCAM's Transition: Mindbody Pioneer Achterberg, AOM Student and an Anonymous Researcher PDF Print E-mail
Written by John Weeks   

3 Voices on NCCAM's Transition: Mind-body Pioneer Achterberg, AOM Student and Anonymous Academic Researcher

Summary:  Here are three additional comments on Integrator dialogue on the selection of the new NCCAM director, Josephine Briggs, MD: mind-body pioneer Jeannie Achterberg, PhD, shares some professional frustration with NCCAM priorities; acupuncture and Oriental medicine student Natalie Schwehr takes me to task for polarizing the discussion; and an anonymous academic medicine-based researcher opines on the wisdom of commenting fully about differences with the status quo since securing NCCAM funds is the anchor for the career. Briggs is actively educating herself. But will those with whom she interviews speak freely, and with deep connection to the clinicians in the field?
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for inclusion in a future Your Comments Forum.

Prior articles in this series:

Oops, They Did It Again: Open Letter to the New NCCAM Director, Josephine Briggs, MD

Your Comments: 12 Voices on NIH Appointing, to Direct NCCAM, a Scientist Inexperienced in CAM

NIH NCCAM Responds to Integrator Open Letter Regarding Briggs Inexperience

Your Comments Forum: Additional Perspectives on the Appointment of NCCAM's Inexperienced Director Josephine Briggs, MD

Jeannie Achterberg, PhD, mindbody research pioneer
1.    Mind-body Research Pioneer Achterberg: "Integrative medicine must be interdisciplinary medicine"

Jeannie Achterberg, PhD, a pioneer in mind-body medicine research, sent me a personal note with a request to not publish. I got back to her and said that hers is a voice that needs to be heard. Achterberg, whose professional involvements includes work with the Kokolulu Cancer Retreats on Hawaii's Big Island, consented.
"John, just a 'thank you' for your recent blog. I just want to support you and vent. 

"I, for one, have been appalled for years at the confiscation of so-called integrative medicine by MD
s, most of whom just leapt upon a bandwagon and act as if they discovered the field. You and I both know of physicians, like Larry Dossey[MD] who have generously and graciously fostered the birth and growth of this work, and view it as a multidisciplinary endeavor.

"Many of us non-physicians who have been in the trenches most of our natural lives, teaching, doing research and clinical work, are simply ignored or thrown a bone of acknowledgment now and then. I developed a mind/body PhD curriculum almost 20 years ago in a psychology program (in a regionally accredited, free standing, experimental school--where else would this have been permitted?)  and have witnessed the graduation of many students who are now competent and productive professionals.  A few had MD degrees prior to entering the program. When I asked [former director Stephen] Straus about funding and scholarships for my students, he replied that it would not be possible. CAM was about medical and nursing education, he said. 

"I gave up. The field will flourish only if integrative medicine becomes interdisciplinary medicine.

"Keep on, keeping on."

Jeannie Achterberg, PhD

2.    Acupuncture student: Doesn't like the us/them dichotomy

Natalie Schwehr is an acupuncture student in the multi-disciplinary
Northwestern Health Sciences University in Minnesota's Twin Cities. She takes me to task for what she views as polarizing language in my column for Integrative Practitioner Online which was entitled The Reductionists are Coming! On the Colonization of the Research Agenda.
"Regarding the appointment of Josephine Briggs as director of the NCCAM, your metaphor of colonialism is problematic and misses a few decades of scholarship and nuanced critical perspective. Suggesting a simplistic dichotomy between 'us' versus the 'overlord' creates unnecessary contentiousness and alienation, flattens diversity and difference, and inhibits potential understanding and mutual interest.

Natalie Schwehr, AOM student
Northwestern Health Sciences University

Comment: Schwehr is correct. Her points - expressed to me privately by others - sometimes make me question my own tactics. Yet I believe that our failure to observe that "colonialism" and "colonization" are appropriate metaphors. (They do not assume malfeasance, only that the colonizer assumes that he/she/it knows what is best for the other.)  The current predicament of a whole person, inter-disciplinary paradigm inside the Pharma-driven, mainly reductive universe of the NIH also, to use Schwehr's words, "flattens diversity and difference, and inhibits potential understanding" if not mutual interest. Then again, it was not mutual interest that created NCCAM in the first place, but rather, a Congressional mandate against which the stomach (and pride) of many in the NIH continue to rebel. Still, Schwehr's points are good ones.

Does financial self-interest limit researcher openness?
3.    Anonymous researcher: "trying to build a career, it's not wise to comment"

I emailed a colleague who is an academic medicine researcher to see if the person had been following the NCCAM discussion and if so, to comment. The writer made clear a desire to not be publicly quoted.
"If you are referring to the discussions about the new director, I do find the conversations interesting and relevant; why they chose this particular new director is beyond me. There are a number of highly qualified academic CAM researchers that would be/were good candidates. As someone who is trying to build a career on NCCAM funding, I don't think it would be wise of me to comment about it in public.

"From what I know, Dr. Straus' reign brought about much progress in research funding going to CAM practitioners which I obviously think is a good thing. Nevertheless, I think that someone that understands 'whole systems' thinking would be an better candidate. But idealists don't win...i.e. Ron Paul and Dennis Kucinich."

Anonymous researcher
Academic Health Center
Comment: The coaxing it took for Achterberg to make her statement publicly (thank you, Dr. Achterberg!) and the anonymity of the third commentator suggests that freedom of expression among researchers, and prospective researchers, may be generally suppressed. If so, Briggs - who to all accounts is actively listening to many voices - may not be hearing what she needs to hear as she makes her rounds. Are her prospective grantees self-censoring to fit what is expected to be Briggs' and NCCAM's favored agenda? Will those with whom she meets be speaking freely?

Self-censorship is a deep, quietly invasive process. I am reminded of a time 20 years ago when I was a free-lancer for a weekly which had a strong-minded civic leader as editor-publisher and a pervasive style and tone. After publishing my 6th or 8th piece, I realized how deeply I had internalized those the publisher-editor's norms. I also realized that the unwritten standards were not only influencing the way I presented my ideas. More significantly, my now internalized world view was shaping both the way I was asking questions and the kinds of questions I was asking. What may feel abrasive to some is that I sense something similar has happened here. Do we need renewal and re-connectivity to the core research questions which will advance what all the clinicians - if not the presently funded body of researchers - have viewed as a new, health oriented, whole practice paradigm of clinical care?

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