Common Factor Mechanisms in Clinical Practice and Their Relationship with Outcome.

UNLABELLED: This study investigates three common factor mechanisms that could affect outcome in clinical practice: response expectancy, the affective expectation model and motivational concordance. Clients attending a gestalt therapy clinic (30 clients), a sophrology (therapeutic technique) clinic (33 clients) and a homeopathy clinic (31 clients) completed measures of expectancy and the Positive Affect and Negative Affect Schedule (PANAS) before their first session. After 1 month, they completed PANAS and measures of intrinsic motivation, perceived effort and empowerment. Expectancy was not associated with better outcome and was no different between treatments. Although some of the 54 clients who endorsed highest expectations showed substantial improvement, others did not: 19 had no change or deteriorated in positive affect, and 18 had the same result for negative affect. Intrinsic motivation independently predicted changes in negative affect (ß = -0.23). Intrinsic motivation (ß = 0.24), effort (ß = 0.23) and empowerment (ß = 0.20) independently predicted positive affect change. Expectancy (ß = -0.17) negatively affected changes in positive affect. Clients found gestalt and sophrology to be more intrinsically motivating, empowering and effortful compared with homeopathy. Greater improvement in mood was found for sophrology and gestalt than for homeopathy clients. These findings are inconsistent with response expectancy as a common factor mechanism in clinical practice. The results support motivational concordance (outcome influenced by the intrinsic enjoyment of the therapy) and the affective expectation model (high expectations can lead for some clients to worse outcome). When expectancy correlates with outcome in some other studies, this may be due to confound between expectancy and intrinsic enjoyment. KEY PRACTITIONER MESSAGE: Common factors play an important role in outcome. Intrinsic enjoyment of a therapeutic treatment is associated with better outcome. Active engagement with a therapeutic treatment improves outcome. Unrealistic expectations about a therapeutic treatment can have a negative impact on outcome.

To feel what others feel: two episodes from 18th century medicine.

In the late 18th century two medical fashions--Mesmerism in France and the Perkins 'tractor' in the USA and England--appealed to the principle that a single universal force acts on all of us and is responsible for health and illness. This principle served both fashions well, as it made it all the easier for those who came within their force fields to experience the sort of sensations that other subscribers to the fashion also seemed to feel. The first research on what is now known as the placebo effect was in connection with these two movements. The propensity to feel what we suppose or imagine that others like us feel remains even now one of the channels of the placebo effect.

Chronic pelvic pain.

Though there are myriad etiologies of CPP, common therapeutic targets include inflammation, somatic dysfunction, and psychological disturbances. Inflammation may be addressed not only with dietary changes including nutritional and botanical supplements but also with mind-body therapies. Somatic dysfunction may respond to manipulative therapies provided by osteopaths, naturopaths, chiropractors, and some physical therapists. Therapists may also offer visceral, craniosacral, myofascial, and other whole-body therapies, as can highly trained massage therapists and bodyworkers. Mental health care may be key in many cases. Integrative medicine heralds the return to a sense of the human being's intrinsic capacity for healing, incorporating the vitalism of many of the therapies' origins (traditional Chinese medicine, indigenous medicine, ayurveda, osteopathy, chiropractic, etc) with the gains made by a more reductionistic tradition. Given the complexity and wide variation of etiologies and symptoms of CPP, using an integrative approach may offer expanded therapeutic solutions. We must expand our capacity to listen to each patient-with ears, eyes, mind, heart, and hands. Each treatment plan may then be tailored to the unique history and perspective that lie within the individual. Doing so requires the essential elements of time, skill, and love.

Vida, saúde, doença e cura: encontros e desencontros entre Hahnemann e Nietzsche / Life, health , illness and healing: matches and mismatches between hahnemann and nietzsche

Este artigo tem como objeto os pensamentos vitalistas de Hahnemann e Nietzsche analisados a partir dos conceitos de vida, saúde, doença e cura. Buscou-se traçar correspondências e explicitar as diferenças dos pensamentos envolvidos, tendo como objetivo avaliar as hipóteses de os vitalismos desses autores serem semelhantes e se poderia ser possível afirmar que a busca da "grande saúde" equivaleria à meta do tratamento homeopático. Conclui-se pela semelhança dos vitalismos e pela ampliação do ideal de cura homeopático através da busca da "grande saúde", pois contempla a liberdade de espírito ao mesmo tempo em que se compromete com a ampliação da normatividade vital do ser humano.

This article having as object the vitalist studies by Hahnemann and Nietzsche. It aimed analyzing the concepts life, health and disease in the thoughts of these authors, drawing connections and explaining the differences of thoughts involved. The study sought to assess the idea that Hahnemann's vitalism resembles Nietzsche's, and whether it is possible to say that the pursuit of "big health" would the goal of homeopathic treatment to address the "freedom of spirit" in achieving the expansion of the vital normativeness.

O poder sobre a vida: os corpos regidos pela prática biomédica versus corpos de intensidades / The power over life: bodies governed by biomedical practice versus intensity bodies

Neste artigo, discuto a questão da materialidade organicista do corpo contra um corpo de intensidades. De acordo com Separavich e Canesqui (2010), os estudos de Marcel Mauss (2003 [1934]) e Margaret Mead (2000 [1935]) "revelou que, embora se possa atribuir uma materialidade universal ao corpo, definições, disposições corporais e seus significados são múltiplos. Como resultado dessa heterogeneidade nas formas de conceber corpo, as concepções do que seja saúde e doença também múltiplas tradições" (p. 251). De acordo com Cecil G. Helman (1994) para "os membros de todas as sociedades, o corpo humano é mais do que um simples organismo físico oscilando entre a saúde e a doença. É também o foco de um conjunto de crenças sobre seu significado social e psicológico, estrutura e funcionamento. A expressão 'imagem corporal' é usada para descrever todas as maneiras pelas quais um indivíduo conceitua e experimenta seu próprio corpo, consciente ou inconscientemente" (p. 30), variando com cada sociedade e momento histórico em que se definem: incluem crenças sobre a forma e o tamanho ideal do corpo, crenças sobre sua estrutura e crenças sobre suas funções. Pretendo refletir sobre o corpo, trazendo alguns elementos históricos para chamar a atenção para a ocorrência de certas condições ­ conhecimento médico e outros aspectos sócio-históricos ­ entrelaçada com a produção de práticas e intervenções médicas, no corpo, assim como no governo da vida, com a intenção de chamar a atenção para as práticas médicas integrativas que são a partir de uma visão do corpo de intensidades.

In this article, I discuss the issue of the organicist materiality of the body versus a body of intensities. According to Separavich and Canesqui (2010), the studies of Marcel Mauss (2003 [1934]) and Margaret Mead (2000 [1935]) "revealed that, although a universal materiality can be attributed to the body, definitions, bodily dispositions and their meanings are manifold. As a result of this heterogeneity in the ways of conceiving the body, the conceptions of what health and disease are also have multiple traditions" (p. 251). According to Cecil G. Helman (1994) for "the members of all societies, the human body is more than a simple physical organism oscillating between health and disease. It is also the focus of a set of beliefs about its social and psychological meaning, structure and functioning. The expression 'body image' is used to describe all the ways in which an individual conceptualizes and experiences his own body, consciously or unconsciously" (p. 30), varying with each society and historical moment in which they are defined: they include beliefs about ideal body shape and size, beliefs about its internal structure, and beliefs about its functions. I intend to reflect on the body, bringing some historical elements to draw attention to the occurrence of certain conditions - medical knowledge and other socio-historical aspects - intertwined with the production of medical practices and interventions, in the body, as well as in the government of life, with the intention of drawing attention to integrative medical practices that are based on a vision of the body of intensities.

Tone as a health concept: An analysis.

STUDY DESIGN: Concept analysis. INTRODUCTION: This paper is a report on the analysis of the concept of tone in chiropractic. PURPOSE: The purpose of this paper is to clarify the concept of tone as originally understood by Daniel David Palmer from 1895 to 1914 and to monitor its evolution over time. METHODS: Data was sourced from Palmer's original work, published between 1895 and 1914. A literature search from 1980 to 2016 was also performed on the online databases CINHAL, PubMed and Scopus with key terms including 'tone', 'chiropractic', 'Palmer', 'vitalism', 'health', 'homeostasis', 'holism' and 'wellness'. Finally hand-searches were conducted through chiropractic books and professional literature from 1906 to 1980 for any references to 'tone'. Rodgers' evolutionary method of analysis was used to categorise the data in relation to the surrogates, attributes, references, antecedents and consequences of tone. RESULTS: A total of 49 references were found: five from publications by Palmer; three from the database searches, and; the remaining 41 from professional books, trade journals and websites. MAJOR CONCLUSIONS: There is no clear interpretation of tone in the contemporary chiropractic literature. Tone is closely aligned with functional neurology and can be understood as an interface between the metaphysical and the biomedical. Using the concept of tone as a foundation for practice could strengthen the identity of the chiropractic profession.

Homeopathy: natural mind-body healing.

1. Homeopathy is an accepted form of health care in many countries worldwide. 2. Homeopathy is deeply healing, yet does so without causing side effects, tolerance, or addiction problems. 3. Homeopathic remedies are available over the counter in health food stores and some pharmacies. 4. Homeopathy is distinct from herbal medicine and does not interact with conventional treatments.

Complementary and alternative therapies in occupational health. Part One.

Occupational health nurses have the opportunity to work effectively with employees in the area of complementary and alternative health care. The above Sidebar summarizes important points related to the occupational health nurse's role in this rapidly growing aspect of health care delivery.

Hormesis, epitaxy, the structure of liquid water, and the science of homeopathy.

According to the western medical establishment, homeopathy is both "unscientific" and "implausible". A short overview of its history and the methods it uses, however, easily reveals that homeopathy is a true science, fully grounded on the scientific method and on principles, such as, among others, the Arndt-Schultz law, hormesis, and epitaxy, whose plausibility has been clearly and definitely demonstrated in a number of scientific publications and reports. Through a review of the scientific literature, an explanation of the basic principles of homeopathy is proposed based on arguments and evidence of mainstream science to demonstrate that, in spite of the claims of conventional medicine, homeopathy is both scientific and plausible and that there is no reasonable justification for its rejection by the western medical establishment. Hopefully, this hurdle will be overcome by opening academic institutions to homeopathy to enlarge the horizons of medical practice, recover the value of the human relationship with the patient, and through all this, offer the sick a real alternative and the concrete perspective of an improved quality of life.

Magic of signs: a non-local interpretation of homeopathy.

Among homeopaths the common idea about a working hypothesis for homeopathic effects seems to be that, during the potentization process, 'information' or 'energy' is being preserved or even enhanced in homeopathic remedies. The organism is said to be able to pick up this information, which in turn will stimulate the organism into a self-healing response. According to this view the decisive element of homeopathic therapy is the remedy which locally contains and conveys this information. I question this view for empirical and theoretical reasons. Empirical research has shown a repetitive pattern, in fundamental and clinical research alike: there are many anomalies in high-dilution research and clinical homeopathic trials which will set any observing researcher thinking. But no single paradigm has proved stable enough in order to produce repeatable results independent of the researcher. I conclude that the database is too weak and contradictory to substantiate a local interpretation of homeopathy, in which the remedy is endowed with causal-informational content irrespective of the circumstances. I propose a non-local interpretation to understand the anomalies along the lines of Jung's notion of synchronicity and make some predictions following this analysis.

The complex 'whole': exploring homoeopathic and spiritual considerations.

Unlike the biomedical model, holistic health care takes a much broader view of what constitutes health and the responsibility for helping restore an individual's health. Homoeopathy addresses the physical, mental and emotional aspects of the whole individual, while alternative practices such as yoga, hypnotherapy and meditation can be described as 'functional' spiritual practices which demonstrate the taking of personal responsibility for health care to the individual.

La electrodinámica cuántica y la homeopatía / The quantum electrodynamics and the homeopathy

Existen principalmente dos posiciones médicas que parecen opuestas entre sí en el enfoque de la enfermedad, una de las cuales sostiene que el origen de las enfermedades del ser humano reside en las perturbaciones que el alma/mente produce sobre éste, mientras que la otra privilegia tan sólo las alteraciones de la estructura molecular del cuerpo en función de la genética y su expresión. Los autores pretenden demostrar que únicamente una combinación de ambos puntos de vista puede ser capaz de explicar las distintas enfermedades observadas por distintos autores. Son conocidas las bases científicas del punto de vista organicista y aquí pretendemos, con los conocimientos actuales de la electrodinámica cuántica, suministrar un modelo que permita describir los posibles mecanismos a través de los cuales el alma/mente cogobierna al cuerpo conjuntamente con los genes, siendo ambos los responsables de las así llamadas "enfermedades" del ser humano. El vínculo entre el alma/mente y la materia resultaría ser la materia virtual descubierta por la electrodinámica cuántica. Describimos algunos de los así posibles mecanismos mediante los cuales las partículas virtuales acoplan el alma/mente con la materia molecular. Teniendo en cuenta la naturaleza de estos mecanismos, logramos definir científicamente a la fuerza vital, lo que a su vez permite discriminar a los distintos factores que intervienen en el origen y desarrollo de las enfermedades. Entre los factores cuya naturaleza puede aclararse de esta manera se encuentra la naturaleza de los miasmas; también permite entender como el remedio homeopático interviene en una enfermedad