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Spirituality and Chinese Medicine
By Mary Kay Ryan Two radically divergent points of view seem to have come to the fore regarding the subject of spirituality and Chinese medicine. One passionately denounces the exclusion of spirituality from Chinese medicine while the other, much more recent trend, is diligently rooting out the spiritual from Chinese medicine in the pursuit of something called "modern secular TCM." Euro-Americans are vulnerable to the confusion over the place of spirituality in medicine for a variety of reasons. We ourselves are the products of a few hundred years of battling over the place of spirituality in society and medicine at large. "Separation of Church and State" has wider ramifications than just governmental ones for us and we are likely to get nervous when spirituality seems to be mandatory in any way. In addition, the post-60's legacy of cultural diversity leaves many of us reluctant to embrace any particular religious system and even more unwilling to force our religious convictions on others. Post-'70s TCM practitioners, however, are often highly influenced by "New Age" thinking which includes a panoply of eclectic spiritual views, many of them held up to be "Eastern" in some way. These contradictory trends have left us feeling like eternally searching religious nomads alternately eschewing and embracing this or that spiritual outlook. Another problem with discerning the place of spirituality in our medicine has been the tendency to avoid any clear definition of the concept. In late 1970s and early 1980s Euro-American acupuncture, spirituality became collapsed with emotionality. This made good historical sense given the backdrop of a larger social critique being leveled at biomedicine for its almost total exclusion of psycho-emotional aspects of illness and health. Furthermore, psychology became for a while in the late '60s and early '70s, a kind of secular religion in which the universality of human emotions were naively taken as givens. The relationship of emotionality to spirituality, however, is a problematic one and the two certainly cannot be blithely assumed to be one and the same. Ascertaining a more exact definition of the "spiritual" is probably advisable before deciding how or if it is to be a part of the medicine we do. Spirituality and religious institutions pose questions and offer answers about a variety of human experiences. Now all spiritual systems address all of these questions equally. These questions are highly interrelated and have clear ramifications to medicine. Roughly speaking and without being exhaustive, these questions include:
How do these ideas relate to medical concerns? Clearly they encompass issues of birth and death; connections to things larger than oneself and the efficacy thereof; the reasons and causes for suffering; the way one judges the quality of life; the ways one can influence life; application to deities for assistance in misfortune and ill health and so on. In short, they all address the most basic question about life and death, health and illness: "Why me, why now?" The questions for us are whether or not issues of spirituality will be included in the medicine we do, and how? We could emulate the most backward trends in biomedicine and ignore them entirely, ending up with a medicine that completely "somatizes" the experience of health and disease. We could "emotionalize" spirituality and in that way include something of the human psychological life in medicine. We could "Sinacize" and give only Asian style answers to them. Thus we could imply that one must become Buddhist or Taoist or a "believer in qi gong" to be healthy. This might satisfy those few of us who may have adapted Chinese or other Asian cultures entirely, but is likely to leave many of our patients (and some of us) with their own spiritual traditions with another medicine that cannot encompass the mundane life of the body and the transcendent life of the spirit. I would suggest that the most productive course of action is to "historicise and universalize" these questions instead. This would consist of examining how Chinese and other traditional medical systems have addressed and incorporated spiritual ideas and practices into medicine in the past. Ayurveda, Tibh unani, Tibetan medicine, a variety of African and Native American systems, as well as folk systems from around the world have done a better job of thinking about these issues than we are probably currently doing either in Chinese or modern biomedicine. Outfitted with a variety of approaches and an understanding of the universality of the questions being asked, we can then ask the following:
The exclusion of spirituality from biomedicine was relentless in the latter half of the 19th century in Europe and especially the United States. To undo this and to insure that the same will not happen in Chinese medicine as it strives to be accepted worldwide, our rediscovery and reinvention of spirituality in medicine will likely have to be as persistent.
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