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Taking the Case of Homeopathy Juliet Louise

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Taking the Case of Homeopathy Juliet Louise PRACTITIONER BASED INQUIRY: TAKING THE CASE OF HOMEOPATHY JULIET LOUISE SMITH A thesis submitted in partial fulfilment of the requirements of Bournemouth University for the degree of Doctor of Philosophy Bournemouth University January 2012 This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and due acknowledgement must always be made of the use of any material contained in, or derived from, this thesis. ABSTRACT JULIET L SMITH PRACTITIONER BASED INQUIRY: TAKING THE CASE OF HOMEOPATHY After twenty years of practising and teaching homeopathy, I am concerned that research into treatment by professional homeopaths has become stifled by evidence based medicine discourse. Homeopathy’s distinguishing features are obscured by erroneous assumptions that a homeopathic prescription is subject to the same biochemical pathways as pharmacological medication. Homeopaths are urged by external parties to ‘prove homeopathy works’ on biomedical terms. This reflexive inquiry is an attempt to redress the balance. From postmodern and pragmatic perspectives I reflexively engage with professional experiences (Smith, 2009) as a means of articulating practitioner based knowledge (Freshwater and Rolfe, 2001, Rolfe et al., 2001). The subjectivity of the practitioner researcher is transformed from a research problem into an opportunity to critically examine practitioner experience (Lees and Freshwater, 2008). The research process is a focus for the inquiry itself, with the intention of creating an open text that invites participation from the reader (Denzin and Lincoln, 1994). I ‘take the case’ of my own practice and its wider context, and enact a synergy of homeopathic practice and research methodologies. The thesis is organised around the eight principles of homeopathy. Case vignettes and homeopathy’s visual iconography (Cherry, 2008) are used to integrate clinical experience into the thesis. Multiple analytical strategies evolved, including discourse analysis, action research, narrative analysis and writing as inquiry. These are not applied to pre-existing professional experiential data (Lees, 2005), but engaging with these strategies has shaped data creation and the inquiry itself. Use of multiple methods is not an attempt to triangulate, rather the dissonance between them is essential to achieving competing and multiple perspectives on professional experience. There is no intention to present a discrete set of findings. The inquiry is framed through the inquiry process, creating an innovative approach to practitioner based inquiry as a collage of reflexive, experiential interpretations and interactions with professional practice. I redefine evidence as being the inquiry process itself and the practitioner as integral to knowledge creation and application in practice. The open dialogic text invites practitioners to adapt this model of practitioner based research in their own practices. The self-critical iterative dialogue gives voice to the practitioner researcher in discourses that are congruent with homeopathic practice. I make original contributions to knowledge by examining homeopathic practice from different theoretical and experiential perspectives, including observations on the connections between homeopathy’s enduring popularity and how the patients’ own belief systems about health and illness are still influenced by the old humoural system of medicine. 4 CONTENTS ABSTRACT ....................................................................................................................................3 CONTENTS....................................................................................................................................5 LIST OF TABLES AND ILLUSTRATIONS .................................................................................. 12 ACKNOWLEDGEMENTS ........................................................................................................... 13 AUTHOR’S DECLARATION ....................................................................................................... 14 1 INTRODUCTION ................................................................................................................. 15 1.1 Welcome ................................................................................................................................ 15 1.2 Homeopathic practice ............................................................................................................ 15 1.3 Research into the use of homeopathic remedies .................................................................. 16 1.4 Identifying the problem .......................................................................................................... 17 1.5 Locating this inquiry ............................................................................................................... 18 1.6 Key theoretical perspectives ................................................................................................. 18 1.7 Aims and objectives of the inquiry ......................................................................................... 20 1.8 Structure of the thesis............................................................................................................ 20 1.9 Orientation to the thesis......................................................................................................... 21 PART ONE: TOWARDS PRACTITIONER BASED INQUIRY IN HOMEOPATHY ..................... 23 2 AUTOBIOGRAPHY OF THE INQUIRY ................................................................................ 24 2.1 The intention .......................................................................................................................... 24 2.2 Backwards and forwards in time ........................................................................................... 24 2.3 Reflective pause before moving on to ways of seeing this inquiry ........................................ 30 3 WAYS OF SEEING THIS INQUIRY ...................................................................................... 31 3.1 Case vignette ......................................................................................................................... 31 3.2 Introduction ............................................................................................................................ 31 3.3 How am I looking at practice? ............................................................................................... 32 3.3.1 The constitutive role of practice ................................................................................. 32 3.2.2 Practitioner research ................................................................................................. 33 3.4 Designing the thesis .............................................................................................................. 38 3.4.1 Visualising the inquiry process ................................................................................. 38 3.4.2 Fragmentation and core narrative............................................................................. 41 3.4.3 Many voices .............................................................................................................. 42 3.4.4 Participatory dialogue ............................................................................................... 43 3.5 Reflective pause before moving on to the context of the inquiry .......................................... 44 5 4 CONTEXT .............................................................................................................................. 45 4.1 Introduction ........................................................................................................................... 45 4.2 Conceptualising health .......................................................................................................... 45 4.3 Locating homeopathy within CAM ........................................................................................ 46 4.4 Dominance of biomedicine discourse ................................................................................... 47 4.5 Integrated healthcare ............................................................................................................ 49 4.6 Introduction to the homeopathy professions ......................................................................... 51 4.7 Introduction to homeopathic knowledge ............................................................................... 55 4.8 Who consults homeopaths? Problems of terminology .......................................................... 57 4.9 Developing CAM research culture ........................................................................................ 58 4.10 Introduction to homeopathy research .................................................................................. 60 4.11 Reviewing the experimental evidence ................................................................................. 61 4.12 Reviewing observational studies .......................................................................................... 63 4.13 Evidence based rhetoric ...................................................................................................... 64 4.14 What are the problems with evidence based discourse? .................................................... 66 4.15
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