Manifesto for a New Medicine

James Gordon has long been recognized as one of alternative medicine’s foremost spokespersons. A graduate of Harvard College and Harvard Medical School, Dr. Gordon worked for ten years at the National Institute of Mental Health, where he developed the first alternative program for runaway teenagers. Now Clinical Professor of Psychiatry and Community and Family Medicine at the Georgetown University School of Medicine, he also serves as Chairman of the Advisory Council to the National Institutes of Health Office of Alternative Medicine, and is Director of the Center for Mind-Body Medicine in Washington, D.C.

Over the past 15 years, Gordon has developed the first comprehensive medical school program in mind-body medicine, conducted a private practice in which he utilizes a wide range of approaches including acupuncture, homeopathy, spinal manipulation, nutrition, and various forms of mind-body medicine, and appeared countless times in virtually all major media (CNN, Newsweek,Washington Post and New York Times among them) as an articulate and knowledgeable representative of the alternative medicine community.

Dr. Gordon?s new book, Manifesto for a New Medicine: Your Guide to Healing Partnerships and the Wise Use of Alternative Therapies (Addison-Wesley) is a dramatically written, highly informative, and at times deeply moving story of his work as a holistic physician and teacher. Perhaps more than any other book, it demonstrates what a truly holistic medicine looks like, and how it can be made available to those who have not yet experienced its benefits.

In this interview with Dr. Daniel Redwood (whose first Pathways interview was with James Gordon ten years ago), Gordon speaks of the dramatic advances in public acceptance of alternative medicine in the past decade, discusses how he first became involved with alternatives, and offers inspiring stories of healing from his practice. He also describes outreach programs in which natural healing approaches have been brought into the D.C. public schools.

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James Gordon Interview

Daniel Redwood: What is different now than it was ten or twenty years ago when you are interviewed about alternative medicine?

James Gordon: Twenty years ago, or ten, or in some instances even five years ago, people acted as if I were an anthropologist bringing news back from some strange tribe about their customs. Now when people talk to me, the questions are: How do I use this in my daily life? How do I integrate it? What do I do about my conventional doctor? It?s as if I?d gone from being an anthropologist to being a friendly family doctor and adviser.

DR: Alternative medicine has penetrated much more deeply into the culture during this time.

JG: It?s very much a part of the culture. First of all, people are much more sophisticated about it. It?s not, “How can you possibly think of using herbs?” On the skeptical side, it?s “Are you sure the herbs are safe?” and on the more informed side, “Exactly which herb do you think would work better?” and “Why do you use Chinese herbs rather than western herbs?” So it?s a whole other level of sophistication. People understand that this is being used and they want to learn how to use these approaches most intelligently.

I think the issue that?s still there with many people, and this is partly why I wrote the book, is people thinking, “Well, this stuff sounds great, but is there any evidence for it all?” I was being interviewed the other day by a very intelligent college professor, who said, “Well, of course, there?s no evidence for any of this.” I said, “Wait a minute, there are hundreds and hundreds of studies on many of the modalities, and many of those studies are very good.” Part of what I?m trying to do is to make that evidence available in a way that people can read it, understand it, and put it in context with stories about people very much like themselves who got better.

DR: Which of the alternative modalities would you say have the strongest documentation at this time?

JG: I think there?s a tremendous amount of documentation for most of what we call the mind-body approach. For hypnosis, imagery, biofeedback, attitudinal change, relaxation therapies, and meditation, there?s very strong evidence. I think there is very good evidence for some herbal therapies. We understand what the constituents are, we understand the pharmacology of the constituents, and we understand that there are clinical studies on a number of them that are just about as good as the clinical studies on drugs.

There certainly is good evidence for chiropractic and low back pain, both clinical and epidemiological studies, the worker?s comp studies. I don?t think the studies are as good yet for some of the other uses of chiropractic, but there are some studies. We have some idea of the physiology, and the same thing is true with acupuncture. In some areas there are wonderful studies on acupuncture. We know a lot about the physiology of acupuncture. We know that the points have a different electrical potential, we know how they affect neurotransmitters, and the physiology of breathing and immunology. So there?s a tremendous amount of evidence that?s gathering. It?s not as if we have evidence on the use of acupuncture to treat every condition, but we know that it makes real physiological change, we know what some of those changes are, and we have some clinical evidence.

DR: What about homeopathy?

JG: Homeopathy has become a kind of lightning rod, because from our western point of view it seems so improbable. We really don?t know what the mechanism is; people are just guessing at this point. And yet, there are perhaps 20 studies, double-blind, controlled, sometimes crossover studies, on the use of homeopathy.

DR: The Scottish physician David Reilly recently had an excellent paper on homeopathy published in Lancet, which demonstrated clear benefit from homeopathic treatment. He said afterward that based on his study, you had to conclude that either homeopathy works or clinical trials don?t.

JG: That?s a very good point.

DR: How were you first attracted to alternative forms of healing?

JG: I was first attracted because I was made uncomfortable by conventional psychiatric treatment. I was working with psychotic people, who seemed not to be sick in the way that people with gall bladder disease or people with heart disease or cancer are sick, yet they were treated as if they were physically ill. They were put in pajamas, and given large doses of medication. I didn?t understand it. It seemed like they had certain difficulties; they were sometimes harder to understand or more erratic than most so-called normal people, but they certainly didn?t seem sick.

So I began to question the whole medical model. That is, that there was a specific disease entity that people had, and a specific kind of pharmacological or surgical treatment for them. I began to question whether for these psychotic people, if we regarded their experience as essentially a human experience, if we created a healing environment in which they would be fully respected, could change the nature of their illness? So I was questioning the whole notion of fixed diagnostic categories.

DR: How did that play out?

JG: Quite remarkably. I was given the opportunity when I was chief resident in psychiatry at Albert Einstein in New York, to create a ward in which psychotic people could come and not have to take medication, in which they could go through their psychosis. It was an extremely popular ward, both with the patients and with the residents and doctors who wanted to come work there.

The most dramatic instances were among people who were psychotic for the first time. These were people with acute schizophrenia, who were able to go into their psychoses, to go down into their madness, often to regress to earlier stages of their lives, and then to grow up again. That happened in several instances it was very powerful.

DR: To turn the breakdown into a breakthrough.

JG: That?s right. Exactly. With people who had been psychotic for a long time, it was harder. It had become a very fixed pattern in their lives. But even with those people, they were able to express themselves more freely and able to feel more relaxed. One young guy remarked, “Everywhere else I?m crazy, but here I?m sane.” He became a member of our community and he was able to function. So it was a very powerful experiment.

When I came to the National Institute of Mental Health after my residency, I was still quite interested in working with very troubled and troubling people. I was working with runaway and homeless kids, and runaway houses that worked with those kids, trying to see, again within the context of a place that respected their experience, if their experience could change.

I began to think about what we could do by changing our attitude toward people and changing the setting in which we treated them, creating a real therapeutic community. But I also started wondering about biology, and whether there was a way to work with biology to promote transformation. I thought medication and electroshock therapy simply suppressed the symptoms, and what I was interested in was seeing if this process of transformation, this kind of breakthrough that you mentioned, could happen on a biological basis. So I was open to the possibility of looking at other kinds of alternative therapies.

DR: Did your experience at Einstein at that special ward turn out to be one unique and wonderful episode, or was it something that grew and developed in other settings?

JG: Later, when we were working with the runaway kids, it was based on the same kind of principle. The counselors who had created these programs initially were very much on the same wavelength as I was. They were not psychiatrists or mental health professionals, some were ministers, some were draft resisters, some were hippies, they were just people who wanted to create an environment that was friendly to these kids. They saw themselves as big brothers and sisters to the kids. It didn?t occur to them to think in diagnostic terms. It didn?t occur to them to see these kids as having a disease. They were very puzzled and troubled by how disturbing some of the kids were, and how upset some of them were. It was my job to help them to understand the inner experience of these kids, and to create a setting where the kids could go through that experience, in which they would be dealt with as people and not as patients.

DR: It sounds like even back then you were playing a bridging role between the alternative culture and the establishment.

JG: That?s right. I feel that has been my role at least since that time.

DR: What forms is that taking now?

JG: I have all these establishment credentials: Harvard College, Harvard Medical School, residency in psychiatry, ten years at the National Institute of Mental Health. What I?m trying to do is use the credentials, and my experience as somebody who has the capacity to take a hard critical look at these therapies, and to say, “Let?s take this look, but let?s do it in an open-minded way. Let?s open ourselves to the experience of some of these approaches, and let?s look at the actual scientific literature that backs them up.”

So as somebody who has worked with some of these alternative therapies for 25 years at least, I am now saying to the medical establishment and to what I hope is a mass of people in this country, that here?s how we might think of looking at these approaches. You have to keep an open mind. I am somebody who has been there, and I am hopefully a reliable observer. So here, look through my eyes, and then having looked through my eyes and my experience, take a look for yourselves. Here?s the information. Don?t necessarily believe me. See what I?ve learned, and then check it out for yourself.

I?m doing that as I go around giving lectures at medical schools and hospitals. I?m doing it with the book, reaching out to non-medical people, and I?m also doing it at the National Institutes of Health. Part of my role is to present to NIH what is going on, to try to make it available to them.

DR: When you were offered the position as chair of the Program Advisory Committee for the NIH Office of Alternative Medicine (OAM), did you have any hesitation about taking that job? And how is it going?

JG: I didn?t have any hesitation at all, because the job is to advise the office. What I am bringing to that advice is 25 years of experience in the field, 25 years of working with these approaches, of meeting the people, knowing the people who are pioneers, of knowing people who are practitioners of indigenous healing systems, and learning from them. I see my role as trying to make my experience available to NIH as it formulates policy. So I feel very good about being a kind of messenger as well as an adviser.

DR: What are some of the projects that the OAM is currently involved with that you find the most exciting or of the greatest potential value?

JG: Speaking for myself rather than for the OAM Advisory Council, I think the one that?s absolutely crucial is providing a database, so that all the information about alternative medicine will be easily available to anyone in this country who wants to have it. The information about what?s being done, what?s working. To say here are all the studies, here is what has been learned.

DR: Does that database not currently exist anywhere else?

JG: It does not exist. Obviously anybody with a computer can begin to tap into it, but to gather all the information from the databases all around the world is very difficult.

DR: At what stage is this project now?

JG: The very early stages. It?s a massive project and we?re just at the beginning. Another part of that project is to gather fact sheets together, to answer or at least provide references for the most commonly asked questions. The greatest number of calls we receive are about alternative therapies for cancer. In my own office I must get a dozen calls a week. The OAM gets far more calls, of course.

DR: How do you deal with the people who call?

JG: The OAM is putting together a fact sheet about what is known, and that?s taking some time. In my own office, I talk to them about what the options are. Sometimes I refer them to Ralph Moss in New York City, who?s got an up-to-the-minute database with which for $250 he can give people information about specific therapies that are being used around the country for specific cancers. In most cases there are no controlled studies at all, so we give them what is available.

I tell them to read Michael Lerner?s book, Choices in Healing. And then I sit down and talk with them. I can?t meet with everyone because I don?t have time. For those patients I do meet with, I talk about what the possibilities are. I tell them to check out the information, so that we can then go over it together.

DR: Your role as a healer goes beyond direct application of therapies into an educational function.

JG: Yes. And that?s the focus of the book too, education. I think the role of the healer is at least fifty percent guide and teacher, and probably far more. I am there to help teach people how to understand themselves, to become more aware of what?s going on in their lives. To see how to use what they?re learning to help themselves, and how to look beyond wherever they are to what may be most useful to help them go where they want to go. Whether that?s in terms of looking at alternatives for cancer, or in terms of looking at alternatives for their work situation, I think these are absolutely crucial functions for a physician to have.

DR: You have some deeply moving stories in your book about patients you?ve worked with. The book begins with a Washington, D.C. attorney you call David. Could you briefly tell us that story?

JG: I started the book with that story because David in some ways represents all of us. He is a man who is very conventional, a man who wants to trust his physicians. He has serious rheumatoid arthritis. I said he represents everybody, but actually he represents the