Alternative Medicine in North America: A Christian Pastoral Response

What is CAM?

CAM can mean different things to different people, incorporates multiple and varied disciplines, and goes by many names. It is important to consider it in historical and cross-cultural perspective (Bivins, 2007; Brown, 2013; Janik, 2014; Sloan, 2006). Most CAM is not new, and actually pre-dates contemporary medicine. Traditional, scientific medicine is only a few centuries old and the majority of the world does not have easy access to it. And what North Americans call alternative medicine is traditional in many other places in the world. Furthermore, medical science is in a constant state of flux; most practitioners recognize that it is not a perfect science.

Preliterate societies made no distinction between religion, medicine, and magic, and in the Middle Ages most medical care was delivered by clergy and/or in monasteries. Rational medicine began with the scientific revolution of the 18th century and dominated much of the Western world until recently. In North America, mass immigration at the turn of the century was accompanied by the introduction of different types of medicine. Homeopathic and naturopathic medicine arose in the late 19th century, probably as reactions to the largely ineffectual and toxic conventional approaches of the day: purging, bleeding, and treatments with heavy metals such as mercury and arsenicals.

In the 20th century, prior to the 1960s, anything other than conventional medicine was rejected by most people. But since then there has been an explosion of interest in CAM. The changing societal perception is reflected in the evolution of appellations; negative words like “quackery” and “questionable” changed to more neutral terms, such as “unorthodox” and “unconventional.” “Alternative,” meaning in place of, evolved to “complementary,” meaning in addition to (conventional medicine). Some terms carry an implicit critique of conventional medicine, such as “holistic” and “allopathic.” The first implies that traditional medicine is somehow incomplete (it also has associations with philosophical monism); the latter is a word used by CAM providers to refer to the use of dissimilar treatments by traditional medicine. The term most in vogue today is “integrative medicine,” which claims to unite all forms of health care into a coherent system. (I will continue to use the term CAM as a convenient catch-all phrase.)

Regulatory bodies have hastened to develop definitions and regulations for the practice of CAM (e.g., Canadian Medical Association, 2015; Public Health Agency of Canada, 2008). The College of Physicians and Surgeons of Ontario (2011) offers the following definitions (derived from the National Center for Complementary and Integrative Health):

Conventional Medicine: Refer to the type of treatment, diagnostic analysis and conceptualization of disease or ailment that is the primary focus of the curricula of university faculties of medicine. It is sometimes referred to as traditional medicine or science-based medicine and is the type of medicine that is generally provided in hospitals and in specialty or primary care practice.

Other categorizations of CAM reflect a less favorable impression. For example, conservative Christian authors Gary Stewart and colleagues (1998, p. 17) use the following divisions:

Complementary therapies: those that deal with lifestyle issues; for example, diet, exercise, stress management.

The sheer diversity of CAM should alert one to the dangers of considering the various therapies a unified group. Some, such as exercise, are merely non-pharmaceutical, well-established therapeutic and preventive medical practices. Others, such as ingestion of the herb Pennyroyal, are potentially dangerous. And others, such as Reiki, have underlying worldviews that are contradictory to both medical knowledge and Christian belief. Regulatory bodies, such as the Canadian Medical Association (2015), recommend that checks and balances be put in place with respect to the marketing, safety, and efficacy of CAM therapies. Furthermore, practitioners should be appropriately licensed.

Even with appropriate regulation, there is still much confusion surrounding CAM. There is also potential harm when CAM is inappropriately used, and conventional medical care denied. Emotional harm is also possible, as in my introductory example of a child being told they have cancer based on the appearance of her eyes. We should neither uncritically adopt nor dismiss all CAM, but evaluate it from scientific and spiritual perspectives. Let us first look at the science behind CAM.

What Is The Evidence For The Effectiveness CAM?

In general there is more evidence for biologically-based therapies or natural products than for other forms of CAM. The well-known gold-standard in summarizing medical research according to strict criteria is the Cochrane (n.d.) Database of Systematic Reviews. A few products have been found by them to have sufficient evidence of efficacy (e.g., cranberry for the prevention of recurrent urinary tract infections, St. John’s Wort for major depression, Omega 3 fatty acids for the prevention of cardiovascular disease), but many conclusions cite “insufficient evidence” to recommend the particular therapy (due to either lack of studies or poor quality studies). Other authors evaluate specific therapies and make conclusions for their effectiveness (e.g., Borins, 2014; O’Mathuna & Larimore, 2001), and there are several reliable websites (e.g., National Institute of Health, 2015; University of Maryland, n.d.) and peer-reviewed journals (e.g., Evidenced-based Complementary and Alternative Medicine https://www.hindawi.com/journals/ecam/; Journal of Evidenced-based Complementary and Alternative Medicine) that offer summaries of CAM research. Of course investigation is ongoing, and just because there is no evidence for a particular therapy today does not preclude there being some tomorrow.

The evidence for specific therapies is not the focus of this paper; however, it is important to note some general concerns regarding CAM research. This research has burgeoned with the increasing popularity of CAM; however, few of the studies use randomized controlled trials, and the language and conclusions they use is often misleading. The National Center for Complementary and Integrative Health, which spearheads much of the research, has been heavily criticized online (e.g., Edzard Ernst, 2016; Science Blogs, 2011; Science-based Medicine, 2015). Historian Candy Gunther Brown (2013, pp. 113–122) notes that most research on CAM is of poor quality, heavily influenced by advocacy groups and marketing biases, often uses observational methods, and is subject to publication and citation biases (data that opposes the desired conclusion is omitted). Further, writers use scientific and/or clinical language as a way to give credibility to a therapy that lacks evidence. Terms such as “used for … ,” “long tradition of … ,” “being studied as a treatment for … ,” and “might help … ” are also misleading as they imply efficacy. Conclusions showing lack of evidence are sometimes reinterpreted (e.g., it is argued that therapeutic touch at least offers comfort) and, if a small effect is found for one therapy, it is applied well beyond what the research indicates (the halo effect). Although she has been criticized for careless scholarship (e.g., Bender, 2014), Brown raises some good points in cautioning how conclusions from CAM research are interpreted and applied.

Behavioral medicine expert Richard Sloan (2006) also criticizes CAM but focuses on specifically Christian-based therapies such as prayer healing. Like Brown, he notes that such research is confounded by methodological issues, lack of precise definitions, and unfounded conclusions (e.g., many outcomes are likely a result of correlation, not causation). Sloan concludes that there is no evidence for the healing power of prayer. Further, he laments the “trivialization of the transcendent,” and even suggests we should separate spirituality and medicine.

Sloan also raises some good points, but perhaps overstates his conclusions. He appears to view medicine and Christianity as non-overlapping magisteria (Gould, 1997); in my opinion this approach precludes dialogue between the two, and ignores the impact that faith has on health. I agree with Brown and Sloan that we need to be cautious in our interpretation of research on CAM; however, if we make the criteria too narrow, we may end up eliminating important information. We need to remain humble that medical science itself does not have all the answers.

In this regard, it is important to recognize the limits of evidence-based medicine, or medicine based on exhaustive randomized controlled trials (e.g., Straus & McAlister, 2000; Tonelli, 2001). (Indeed, there is increasing recognition of the limits of scientific research in general, such as changing knowledge, unresolvable paradoxes, inherent vagueness (e.g., is 42 a large or small number?), and the effect of perspective (e.g., Yanofsky, 2013).) Like CAM, this research is subject to influences of economic and political forces, such as resource limitations. There is also often a large gap between science and clinical practice. Evidenced-based medicine focuses on a very small research question in a specific subject group; it is sometimes difficult to ascertain the clinical relevance of the findings. Best current practice changes according to evolving evidence. Evidence-based medicine also discounts the issue of the individual—empirical evidence is not always applicable to a particular patient in a particular situation. It ignores the importance of clinician experience and intuition, patient narrative and meaning, and the values, morals, and spirituality of both. Finally, the very nature of randomized controlled trials precludes the healing possibilities of the placebo effect, which includes the therapeutic relationship (e.g., Benedetti, 2009; Harrington, 1997; Rankin, 2013). Although the exact nature of this is unknown, it is postulated to relate to the effects of mental activity (e.g., beliefs, emotions, relaxation) on the immune system, mediated by endorphins and dopamine. There are also effects of classical conditioning and the spontaneous remission of many diseases (catalogued by the Spontaneous Remission Bibliography Project of the Institute of Noetic Sciences, 2018).

It is “evident” at this point that CAM is complex in terms of history, definition, and evidence. Before making decisions regarding its use, I suggest we at least be informed about the research behind specific therapies. Furthermore, to add to the complexity, I believe that we should also be informed about the spiritual roots of some CAM therapies.

What are the Spiritual Roots of Some CAM?

There is much misunderstanding about spiritual conceptions that underlie some CAM, and many CAM advocates and marketers have been intentional in downplaying its spiritual dimensions. Because of this, among other factors, North American Christians range in their acceptance of CAM from “it’s all evil” to “it’s all good” to “we can make it good by rebranding it as Christian.” Examples of the last include variations of “Christian yoga,” which may rename poses using Christian terms such as “Holy roller” or “Noah’s arch”; and the “Hallelujah diet,” developed by George Malkmus (2006), who reframed the Gerson diet (a raw food anti-cancer diet purported to transfer plant “vital energy” to the user) by using biblical verses (discussed by Brown, 2013, pp. 67–69).

Brown (2013), in her critique, thinks part of the problem is that people focus more on whether something works than on the reasons it is purported to work. Furthermore, many people incorrectly assume that science is neutral or completely separate from religion (discussed further below) and/or that metaphysical science is better than materialistic science. Sloan (2006) similarly critiques contemporary Christian culture, including the self-help movement, which favors subjectivity over scientific research. Historian Joseph Williams (2013, p. 170), in his research on healing in the Pentecostal tradition, notes that emphasizing the Holy Spirit, conceived of as an impersonal force, allows an easy blending with other forms of metaphysical healing: “metaphysical-like conceptions of divine healing centered on the mind or on the healing power of natural substances peacefully coexisted with dramatic claims of divine intervention.”

For a brief review, metaphysical religion can be defined as any religion that deemphasizes “personal conceptions of the divine,” stresses the “correspondence between supernatural and natural realms,” and underscores the “manipulability of spiritual power” (Williams, 2013, p. 15). New-age spirituality (actually not new, but a repackaging of eastern mysticism and occult practices) is a common example. Such religions claim that the divine is within us and evil is not real. They usually believe in a universal life force or vital/positive energy, and can be categorized as pantheistic, monistic or holistic—“all is one,” “the true you is the ocean.” This contrasts with Christianity, which places a clear distinction between God and creation and emphasizes the Holy Spirit as a personal being, not an impersonal force (e.g., Boyd, 2010, pp. 153–160; Brown, 2013, pp. 10–18, 56–76; Hanegraaff, 1997).

Brown (2013, pp. 91–111) explicates the underlying spiritual/religious origins and beliefs of many CAM practices. Homeopathic, naturopathic, and chiropractic medicine all arose from 19th-century European and American schools of metaphysical thought. The founder of homeopathy and its American popularizer were both Freemasons. Therapists usually admit to being spiritual, claim that disease is caused by a disturbance in vital energy, and follow the “law of similars” (treatments induce symptoms similar to the disease they are treating, but require extreme dilutions to avoid side effects). Naturopathy teaches that cosmic forces from within and without provide healing. For example, in aromatherapy, healing energies from plants are thought to transfer spiritually to the person inhaling the scent of an essential oil. The founder of chiropractic was a spiritualist who emphasized “innate intelligence” and taught the unity of all religions and forms of healing. “Although interpreted as nonreligious, chiropractic is premised on a vitalistic, harmonial philosophy and fulfills many of the same functions as religion … helps explain life’s struggles, cope with present stressors, and anticipate the future with hope” (Brown, 2013, p. 110). Brown points out that contemporary CAM literature usually omits information on spiritual origins and beliefs. Regardless of their religion, I agree with Brown that people need to be adequately informed in order to make wise decisions.

Other CAM therapies are based on Chinese, Hindu, and Buddhist beliefs. Taoism teaches the existence of subtle energies (named “qi” and consisting of five phases and eight opposing principles, such as yin-yang) that flow in meridians in the human body and produce disease if out of balance. Traditional Chinese Medicine, including acupuncture, is thought to unblock the flow of qi. Tai chi’s 13 postures correspond to the five phases of qi, and movement results in the separation of yin and yang, whereas being still leads to balance. Brown (2013, pp. 44–65) notes that many religions are non-creedal, being embodied rather than word-oriented; “the medium is the message.” Yoga is another example of how body postures have meaning. This therapy originated with Hinduism and is based on beliefs in the self as divine (“Namaste” roughly translates as “I bow to the god within you”), connection with vital energy (named “prana”), and reaching higher spiritual realms, often with sexual associations. It includes positions, gestures, and chants that symbolize Hindu beliefs about achieving universal consciousness. Thus the physical and the spiritual cannot be neatly separated. Reiki involves the practitioner moving her hands over the patient’s body in order to manipulate energy fields. It too has sexual aspects at its higher levels and is rooted in Buddhist concepts of universal life energy. Therapeutic touch similarly is based on Buddhism, but also borrows from Hinduism and Freemasonry. Mindfulness, which is increasing in popularity for both physical and mental healing, relates to the Buddhist idea of dispelling of illusions and is the seventh of eight steps on the Buddhist path (Brown, 2013, pp. 22–42).

Brown is fair in noting that not all CAM treatments have religious undertones; for example, some herbs are used simply for their biomedical properties, not for their supposed vital energies. Her primary concern is that people be informed about the spiritual origins and theories of many therapies. Brown is harsh in terms of how readily and uncritically many Christians have adopted CAM, accusing them of idolatry. She quotes historian Harvey Cox in support of the view that many forms of idolatry do not announce themselves as such. “Evangelicals … 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” (Brown, 2013, pp. 227–228). Good fruits do not necessarily outweigh bad roots, and labeling a practice non-Christian or spiritual does not mean it is non-religious; likewise labeling it science does not mean it is non-religious (Brown, 2013, pp. 23, 24, 69–75). Brown expresses concern that people may eventually embrace CAM’s religious concepts even though they initially try CAM for non-religious, health-related reasons. She also critiques conservative evangelical organizations, such as Got Questions Ministries, Focus on the Family, and the Christian Research Institute as being inconsistent, inaccurate, prone to overgeneralization, and separating a practice from its underlying religion (Brown, 2013, pp. 72–90). With respect to the Christian appropriation of non-Christian practices, Brown notes that some rituals, like Easter, have pagan origins but lose that association over time, whereas practices like yoga retain their religious content (Christianity Today, 2013).

Brown discusses how some Christians, Pentecostals in particular, are wary of demonic forces that may be associated with CAM, but she does not emphasize this point. Mennonite pastor Lawrence Burkholder (2003) is less reticent. He claims that the subtle energy (any force that exists outside known space-time and is unknown to science) characteristic of many alternative therapies, such as acupuncture and homeopathy, is “really the action of personal, demonic spirits.” New Testament teaching advises followers of Christ to be on guard against false demonic signs and wonders.

I agree with Brown and Burkholder that everyone who considers using CAM should be aware of the spiritual dimensions of some therapies. However, I suspect the practical reality is much more ambiguous than they suggest (Brown is less dogmatic than Burkholder). As mentioned, definitions are fuzzy and individual practitioners may not even be aware of the spiritual roots of their therapy. Some, but not all, forms of CAM may represent metaphysical religion; some, but not all, subtle energies may be the work of evil spirits. It may be difficult to know the difference between herbs used as medicine and herbs used as vital energy. Not everyone who enjoys the scent of a flower is practicing vitalistic medicine. Many physiotherapists use manipulation techniques similar to those of chiropractors, many chiropractors now advise home exercise, and many fitness classes use stretches similar to those of yoga. Our approach needs to be nuanced. I agree that we should not simply “baptize” CAM therapies with Christian language; however, it is difficult to ascertain at what point and in which situations certain practices lose their religious association. For example, I suspect that many, but not all, chiropractic and mindfulness therapies are disconnected from their spiritual roots. It is also difficult, and perhaps unwise, to prescribe a “dos and don’ts” list; we need to rely on our professional and spiritual intuition in each individual case.

Along with awareness of the spiritual dimensions of CAM, we should be aware of the limits of science and evidence-based medicine, in particular avoiding the religion of scientism. We need to be knowledgeable but remain humble and open-minded. There is much that is unknown. Many scientists, for example, dismiss the possibility of a non-material realm that is evident in Scripture, tradition, and experience. We can also trust in the Holy Spirit who remains with us even if we inadvertently engage in a different religious practice. But we do need to ask why so many Christians are seeking help from therapies that are often based in other religions.

Why is CAM Popular?

A Google search reveals close to 600,000 websites related to CAM. Estimates suggest that 30–60% of North Americans use CAM; usage is higher among women, the elderly, and those with higher income (unsurprising since most CAM is not covered by health insurance). The most commonly used form of CAM is natural dietary supplements (other than vitamins and minerals), and the most common reason for use is overall health and wellness, with other reasons being hope for improvement in disease and symptom relief (pain particularly), fewer side effects than pharmaceuticals, being in control of one’s health, and a desire for holistic care (Ernst & Hung, 2011; NCCIH, 2012). Some types of CAM, such as nutritional supplements and exercise, have good evidence to support their use and in fact are becoming part of conventional medicine. However, the usage of CAM appears out of proportion to its scientific and clinical support. Investigating underlying reasons for the popularity of CAM requires considering social, political, economic, and spiritual factors. I suggest four inter-related explanations: the increasing mistrust in Western medicine; the current culture of consumer demand for control, choice, and “quick fixes”; the marketing strategies of CAM; and spiritual hunger.

First, conventional medicine does not have easy treatments for many complex illnesses, such as cancer, chronic fatigue, and depression. Some illnesses are in fact iatrogenic, and many pharmaceutical treatments have intolerable side effects. Medical care is often fragmented, and the time practitioners spend with patients is limited by economic factors. Some physicians continue to adopt authoritarian roles, but many, because of informed consent issues, appear to lack confidence by using terms such as “might,” “maybe,” and “I don’t know.” This is in contrast to CAM practitioners, who usually present as confident and optimistic (Brown, 2013, pp. 159–163; Christian Research Institute, n.d.). North American Christians, as Brown has shown, are not immune to the influence of authority.

Second, sociological influences in North America have led to a culture of consumerism and entitlement (e.g., Lyon, 1994; Warren, 1997), manifest in trends such as medical tourism (e.g., Barkan, 2017; Cameron, Crooks, Chouinard, Snyder, & Johnston, 2014), and personalized medicine (e.g., Cornetta & Brown, 2013). People want to take control, make their own health-care choices, have it all and have it now. The demand for instant pain relief has led people to seek CAM. This is not all bad, except that many choices are not well-informed ones. As Brown (2013, pp. 219–220) states:

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.

Being unwell is unwanted and there is a tendency toward a panicked “try anything” approach. This is exacerbated by the dissatisfaction with conventional medicine as well as CAM marketing strategies.

North American Christians tend to follow the cultural trend of consumerism. If our health is less than perfect, we demand a “quick fix.” If a treatment does not work perfectly and immediately, we seek another. We would rather take a pill than eat a healthy diet, exercise regularly, and practice spiritual disciplines. We would rather have instant healing through prayer than engage in a relationship—often challenging and time-consuming—with our Creator. Theologians Joel Shuman and Keith Meador (2003), in their aptly titled Heal thyself: Spirituality, medicine and the distortion of Christianity, like Brown, point out the influences of consumerism and individualism with respect to health in North American Evangelical Christians (although they do not focus on CAM). Like Sloan, they criticize empirical research on religious healing, even calling it heresy. Although Christianity teaches responsibility and choice, extreme consumeristic behavior could be viewed as contrary to biblical teaching on humility and selflessness. This is no doubt true of many religions.

Third, CAM promoters have employed excellent marketing strategies. The common use of the misunderstood term “natural” appeals to the uninitiated, and of course implies that conventional medicine is “unnatural.” Endorsement of CAM often simultaneously involves denigration of contemporary society and technology; thus people are told they need cleansing, or healing of negative energies (Brown calls this “purging the toxins of modernity”; 2013, p. 166). There is also an implication that it is harmless. Another common phrase is that of “helping the body heal itself,” even though that is an aim of most conventional medicine. The use of CAM in addition to conventional therapies appeals to the consumer preference for multimodal treatment. Marketing has perhaps been targeted more toward women, both as users and as providers, who have sometimes been neglected in health care; for example, nurses can be empowered by using a treatment such as therapeutic touch that does not require a doctor’s order.

Brown, as discussed above, notes that CAM promoters have neutralized any spiritual connotations of their therapies. They use scientific language, and subtly, or sometimes not, denigrate conventional medicine, especially pharmaceuticals. Appeal to authority and celebrity is also used as a marketing tool. Many alternative therapies that were initially rejected by Christians are now “just another commodity in the secular marketplace” (Brown, 2013, p. 169). Brown’s (2013, pp. 155–178, 200) primary concerns relate to issues of informed consent and consumer protection; she would like CAM providers to be forthright regarding the rationales underlying their practices. Regardless of one’s faith, accurate information is important for decision making.

Finally, CAM appears to be filling a spiritual void in contemporary North America. A number of therapies serve as a gateway to spiritual technologies and worldviews that address needs for meaning, knowledge, and power (Christian Research Institute, n.d.). Brown (2013, pp. 157–159) suggests that some Christians may adopt meditation as a means of filling a gap in their own tradition; others may find therapies that incorporate spirituality (of any kind) preferable to conventional medicine, with its materialistic views and perceived atheistic bias.

The above suggests some categories that may explain the popularity of CAM; the legitimate intermingled with the illegitimate. I agree with Brown that it has often been adopted uncritically, and its spiritual underpinnings ignored by many Christians. The reasons for CAM’s popularity may help us understand how spiritual leaders have failed and how we should respond.

How Should Christian Leaders Respond?

I suggest that the North American Protestant Church has been negligent in three related areas: poor education, poor theology, and neglect of spirituality. (Obviously, there are many Christian leaders, Churches and parachurch organizations that have excelled in one or more of these areas; my implied critique is not exhaustive but meant to be provocative. Also obviously, these issues relate to larger theological disciplines such as theology proper, ecclesiology, suffering and sickness, and Christian spirituality; again my discussion is not exhaustive but suggestive.) These three categories relate to the previously discussed reasons for the popularity of CAM, especially that of spiritual hunger. Understanding areas of neglect may inform an ecclesial and pastoral response.

First, few spiritual care providers provide adequate (if any) teaching with respect to the relationship between science and Christianity in general, and health care in particular. As mentioned earlier, many people assume science is neutral. The topic of objectivity in science is complex, but science is usually recognized to be at least influenced by values and worldviews, following from Kuhn’s famous proclamation that observations are theory-laden (e.g., Liben, 1992; Reiss & Sprenger, 2017; Sullivan, 1989). If people view science and religion as completely separate (or non-overlapping magisteria, as discussed above), they may compartmentalize their lives, viewing decisions around health care, for example, as independent of their faith. I would agree with Brown, as discussed, that in the case of CAM, this is particularly problematic. Organizations such as the American Scientific Affiliation (web site can be found at http://network.asa3.org) are doing a good job educating people about the integration of science and faith, but much more is needed, particularly at congregational and pastoral-care levels. Christian, and indeed all religious, leaders need to teach people how to critically and wisely evaluate and appropriate the secular marketplace.

Some Christians may cite the cliché “all truth is God’s truth” as a reason for uncritically appropriating CAM (Brown, 2013, p. 45). This statement originated with Augustine and was elaborated by Aquinas and Calvin (e.g., Calvin (n.d., 1:12) writes “All truth is from God; and consequently, if wicked men have said anything that is true and just, we ought not to reject it; for it has come from God).” It is often used as an argument for the adoption of knowledge gained from non-Christians. It is correct but incomplete; overused, misinterpreted and misapplied like many clichés. Christians, for example, should examine information through the lens of Christian teaching. The source of truth is important too; as Brown points out, we should consider why a therapy is supposed to work. Some “energies” may in fact emanate from evil spirits. Some apparent “truths” may originate with the father of lies. We need to take a conceptual approach rather than a technical one.

Education is particularly important in the area of health care. The Bible, for example, teaches that our bodies are temples (1 Cor. 6:19, 20) and we are to be wise stewards of the gifts we have been given (Gen. 1:26; Mt 25:14–30). Spiritual care providers need to be knowledgeable about choices people have and provide appropriate education and guidance. Not just the efficacy but the purpose of a therapy should be considered. A Christian might ask, “Does it serve Christian aims (e.g., to glorify God, act as revelation, develop and/or heal his creation, further his kingdom) or foster humanistic/New Age beliefs?” Brown (2013, p. 159) suggests that churches may avoid teaching on CAM for fear of offending supporters who like CAM, but she is perhaps overly cynical in this regard. Regardless, given the popularity of CAM, education is essential.

Second, I believe that many Christian theological concepts have been poorly understood and taught. Brown in her interviews discovered many people who are disillusioned with the Christian Church, especially with respect to the common practice of glorifying pain or praising suffering. “Because Christian clergy have often devalued the body … , 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” (Brown, 2013, p. 156). Brown’s observation echoes the misunderstanding of the relationship between science and faith, discussed above. It also illustrates two almost opposite concepts in Christian belief (admittedly oversimplified): first, the Calvinistic teaching that suffering has a divine purpose may lead people to avoid conventional medical care but secretly seek “natural” treatments, or use prayer alone; second, the charismatic teaching that we should expect health and wellness (prosperity or “name it and claim it” theology) may lead people to embrace any therapy (and “Christianize” it if needed). Many who claim to “just follow the Bible” end up distorting teachings to fit their views, missing the nuances of interpretation. My introductory example of “following a Bible-based diet” is a good illustration of this. The tendency toward simplistic interpretations is likely true in all religions.

It is near impossible to sort out how much and in what manner God’s good creation has been tainted by human irresponsibility, but we always need to be aware of our tendencies toward idolatry as well as the presence and activity of evil spirits in the world. We are to care for our bodies but also recognize that suffering is inevitable (Jn 16:33, Rom. 8:18), though not necessarily God-ordained. (The large topic of the problem of suffering is not the focus of this paper, but Karl Barth’s (1960, p. 366) view is illustrative: sickness “like death itself, is unnatural and disorderly, an element in the rebellion of chaos against God’s creation.”) As mentioned, Christians are often no different from secular North Americans in our desire for a “quick fix.” Our theologies need to reflect the nuances and complexities of seeking health without idolizing it, seeking it without demanding it, and, above all, seeking God’s guidance and presence with us in all states of illness and wellness. In contrast to the self-centeredness of contemporary North American society, Shuman and Meador (2003, pp. 128–135, 94–112), who also note the idolization of the therapeutic in much of Christian culture, suggest that health in Christians arises not from religious activity but within a caring community of fellow believers.

Third, many North American Christian leaders have been negligent in teaching, modeling, and providing opportunities for a deeper spiritual relationship with the triune God. The emphasis on Bible teaching and creeds correlates with a neglect of imagination and experiential and affective aspects of life, and may result in some people seeking holistic approaches and spiritual practices elsewhere.

Like consumerism, this is partly a reflection of societal trends. Iain McGilchrist (2009), in his provocative if overly speculative, book, The Master and his Emissary, reviews research on hemispheric specialization and concludes that right hemispheric processes of emotion and intuition are primary but have long been neglected in the Western world. In the ancient world and the Renaissance period there was better balance between right and left hemispheric functioning. This was lost with the industrial revolution and subsequent scientific myths of truth and unity. With left hemispheric dominance, religion becomes mere utility. He points to the example of the reformational debate about the Eucharist; its metaphorical meaning was lost and it was forced into being “either literal bread and wine or literal body and blood” (p. 316). Our fragmented, mechanistic, indeed empty world has arisen from the unchecked action of a dysfunctional left hemisphere. The prioritizing of focused attention has led to an impoverished view of the world; the animate appears lifeless, and imagination and intuition are denatured. McGilchrist believes language and linearity need to be transcended, and that we need metaphor and imagination in order to truly understand the world.

Many contemporary Christian scholars make similar points, and often lament the negative influence of enlightenment philosophy, such as its emphasis on rationality, divide between reason and faith, and neglect of affective dimensions of faith (e.g., Coakley, 2012; Pearcey, 2004; Vanhoozer, 2007). They desire better integration of spirituality and theology. At the popular piety level, there has been a move toward recovery of spiritual disciplines and contemplative practices, such as Ignatian exercises (e.g., Barton, 2010; Boyd, 2010; Foster, 1998; Willard, 2012). Charismatic Christianity has also led to more openness regarding the work of the Holy Spirit beyond the Word and the Church (e.g., Pinnock, 1992; Yong, 2003). However, other North American Christians appear to be moving in the opposite direction and re-emphasizing restrictive doctrines such as biblical inerrancy, which in turn may result in inadequate and un-nuanced theologies as discussed above (e.g., Piper, 2016; see review by Hübner, 2016).

These suggested responses obviously interact with issues that are larger than and perhaps more important than the embracing of CAM. However, the reasons for the popularity of CAM among Christians can serve as a guide for theological, pastoral, and ecclesial reform. Many CAM therapies are similar to Christian practices with a long tradition. “Practicing the presence of God,” as made famous by Brother Lawrence, and breath prayers (which originated in the sixth century and are also known as prayers of the heart) will have the same health benefits as mindfulness, and fulfill the mandate to “pray without ceasing” (1 Thes. 5:17). At an individual level, pastors and chaplains can offer spiritual “therapies” to suffering people. At a corporate level, along with teaching, churches can devote more time in their services to contemplation and meditation, times of silence, or lectio divina (Latin for divine reading, this involves imaginatively listening to a biblical passage). Perhaps churches need to replace congregational cookouts with congregational calisthenics, bake sales with bike trips. With respect to congregational health, we need more of both prayer and care. In anthropological terms, we need to reenchant the Church.

Conclusion

I noted at the beginning that there is much confusion and misunderstanding surrounding CAM, and this discussion may have compounded rather than clarified the issues! However, part of my point is that life is not black and white, and decisions always need to be made in the context of our religious worldviews and our spiritual relationships. CAM is an area that illustrates this principle well. My conclusions address the individual, the spiritual-care provider, and the Christian Church at large.

First, in order to make wise decisions, I believe it is important for individuals to be knowledgeable about the various types of CAM, its clinical evidence, and its potential spiritual underpinnings. We need to be aware of our susceptibility to consumer mentality, our desire for instant relief of suffering, and the influence of marketing forces. We need to humbly examine both the reasons that CAM (or the specific therapy we are seeking) purportedly works, as well as our reasons for wanting it. This I believe is true for people of all faiths.

Second, pastoral-care providers need to be adequately informed about CAM in order to assist people with decision making. Of course, not all clients/patients want advice or education, but even general information about the relationship between science and faith, or the difference between conceptual and technical approaches, for example, can be helpful. Counselors can gently question people regarding their motivations in seeking a therapy. Regardless of one’s faith, being informed about the relationship between spirituality and CAM (even if fuzzy!) is important for decision making. For example, in regard to my introductory example, we cannot tell people whether to see a chiropractor or not, but we can inform them of its scientific evidence, its spiritual origins, and the likelihood that many contemporary chiropractors do not incorporate spiritual aspects in their practices.

Third, churches need to educate their congregations about the relationship between science or culture and faith, and health care choices specifically. Leaders need to understand theological teachings on sickness and suffering, formulate a consistent response, and teach this as appropriate. They also need to develop practical and compassionate responses to those who are sick. Churches need to consider how they can fill the spiritual needs of a spiritually hungry population.

We need to avoid the extremes of desperately seeking a quick fix from anywhere to alleviate suffering and stoically accepting suffering as the will of God. Christianity is primarily about a relationship with a living God, who neither desires suffering nor promises instant relief from it. As we navigate this difficult path, we can heed the teaching of John, the disciple of light and dark, of truth and lies: “If you hold to my teaching, you are really my disciples. Then you will know the truth, and the truth will set you free” (Jn 8:31, 32); “I am the way and the truth and the life. No one comes to the Father except through me” (Jn 14:6); “But when he, the Spirit of truth, comes, he will guide you into all the truth” (Jn 16:13).