Durham E-Theses Looking for alternatives risk, reexivity and complementary Therapies Brooks, Lauren How to cite: Brooks, Lauren (2005) Looking for alternatives risk, reexivity and complementary Therapies, Durham theses, Durham University. Available at Durham E-Theses Online: http://etheses.dur.ac.uk/2790/ Use policy The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that: • a full bibliographic reference is made to the original source • a link is made to the metadata record in Durham E-Theses • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders. Please consult the full Durham E-Theses policy for further details. Academic Support Oce, Durham University, University Oce, Old Elvet, Durham DH1 3HP e-mail: [email protected] Tel: +44 0191 334 6107 http://etheses.dur.ac.uk Lauren Brooks B.A. (Hons), M.A. Looking for Alternatives Risk, Reflexivity and Complementary Therapies The copyright of this thesis rests with the author or the university to which it was submitted. No quotation from it, or information derived from it may be published without the prior written consent of the author or university, and any Information derived from it should be acknowledged. A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy School of Applied Social Sciences Durham University September 2005 O S JUN 2006 Declaration I declare that this thesis is my own work and has not been submitted for the award of a higher degree anywhere else. Copyright Attention is drawn to the fact that copyright of the thesis rests with its author. This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognize that its copyright rests with the author and that no quotation from the thesis and no information derived from it may be published without the prior written consent of the author. This thesis may be made available for consultation within the University Library and may be photocopied or lent to other libraries for the purposes of consultation. Lauren Brooks B,A. (Hons), M.A. Looking for Alternatives: Risk, Reflexivity and Complementary Therapies Abstract This thesis explores individuals' motivations for using complementary and alternative medicines (CAM). More specifically, the thesis explores the relationship between the use of CAM and wider social and cultural changes which have altered individuals' expectations about their health and their understanding of risk and embodiment. The thesis draws on data from 24 in-depth interviews with individuals using a range of complementary and alternative health practices. Building on previous literature in this field this thesis not only explores individuals' initial motivations for using CAM, but also the reasons why they remain engaged with such practices and how their motives change over the course of time. I argue that the use of complementary and alternative medicines should be understood in terms of a career. As individuals progress along the CAM career trajectory their motives for using any given therapy not only change, but they also acquire further justifications and rationalizations for using CAM. One of the main motivations for using complementary therapies, amongst the participants of this study, was because of concerns over the safety of Western medicines, which were associated with potential risks to the health of the body. In contrast, so-called 'natural' remedies or other types of complementary therapies were seen to represent a relatively 'risk-free' alternative. In this sense I argue that complementary therapies are adopted as part of a strategy of risk avoidance and as a means of coping with the anxieties associated with caring for health and body within late modem society. The thesis also explores individuals' use of complementary and alternative medicines for self-care purposes. I argue that such practices should be viewed as a form of resistance to medical control and an attempt to regain control over the self The thesis not only adds to our current understanding of complementary therapies within contemporary society, but also makes a significant contribution to key sociological debates. 11 Acknowledgements There a number of people who I would like to thank, all of whom have been involved in the production of this thesis in some way. Firstly, I would hke to thank Sue Scott for her supervisory expertise. I am enormously grateful for her continual support, encouragement and the invaluable comments she gave throughout the project. I would also especially like to thank all the complementary therapy users and practitioners who agreed to take part in the research, in particular those individuals who went out of their way to help enlist people to take part in the study. I would also like to thank friends and colleagues in the department of Sociology at Durham, who have provided support and encouragement, as well as welcomed distractions, throughout the course of the PhD. Finally, special thanks to my family, and to my husband James, who provided much needed emotional support through the ups and downs of the past three years. Without their love and support I would never have been able to finish my PhD. I therefore dedicate this thesis to them. ni Contents Abstract ii Acknowledgements. Chapter 1: Introduction 1 Introduction 1 The research 3 Structure of the thesis 5 Chapter 2: The (re)eniergence of complementary and alternative medicines 10 Introduction 10 Defining complementary and alternative medicine 11 The marginalization of altemative medicine 17 The growth of complementary medicine 21 Patterns of usage 27 Profile of users 28 Responses to the rise of complementary and altemative medicines 29 Conclusion 34 Chapter 3: Theorizing the consumption of CAM 36 Introduction 36 Motivations for using CAM 38 Health and illness in contemporary society 53 A safer option? Natural healthcare in the age of risk 55 Informed consumers of healthcare 64 Consumer culture, lifestyle and the body 68 Conclusion 75 Chapter 4: Methodology 77 Introduction 77 Background 77 Research design 80 IV Access 82 Interviews 85 Ethical issues 89 Data analysis 93 Reflections 97 Chapter 5: Becoming a CAM user 100 Introduction 100 Theorizing status passage and career 101 The careers of CAM users 103 New users 105 Occasional users 110 Regular users 118 Committed users 121 Vocabularies of motive 130 Conclusion 137 Chapter 6: 'I just don't want to pump my body full of chemicals': Risk, embodiment and the consumption of CAM 140 Introduction 140 Medicine, health and risk 143 Nature, risk and embodiment 147 Reflecting on the risks of orthodox medicines 152 Becoming reflexive 154 Learning to listen to the body 158 Consumption of CAM as risk avoidance 160 Dependence upon orthodox medicines 165 Consumption of orthodox medicines 169 Children, risk and complementary therapies 174 Conclusion 179 Chapter 7: 'I like the control of it': Self-care practices and complementary therapies 183 Introduction 183 Self-treatment and medical dominance 185 Self-care practices and complementary medicines 189 Social networks and the consumption of CAM 193 Sources of information about CAM 198 Lay knowledge and the re-skilling process 202 Individual control and empowerment 208 Repositioning of authority and the new 'experts' 213 The 'dangers' of self-prescribing 219 Conclusion 221 Chapter 8: Conclusion 224 Introduction 224 Becoming a CAM user 225 Strategies of confidence 229 Reclaiming control over the self 234 Discussion 238 Limitations and future research 240 Appendix 1: Participants 245 Appendix 2: Flyer and practitioner letter 248 Appendix 3: Use of over-the-counter CAM products 250 Bibliography 252 VI Introduction Introduction On the 26'*^ August 2005, following an evaluation of the results of 110 trials involving homeopathy and placebo treatments for a range of health problems, Shang et al (2005) published an article in the Lancet concluding that homeopathy is no more than a placebo and any effect is 'all in the mind'. In the same edition of the Lancet a scathing editorial, entitled 'The end of homeopathy', contends that such findings are 'unsurprising'. 'Of greater interest', it is argued, 'is the fact that this debate continues, despite 150 years of unfavourable findings. The more dilute the evidence for homeopathy becomes, the greater seems its popularity' (Lancet, 2005: 690). Some patients, unhappy with their treatment within the impersonal and hurried NHS, may well see in homeopathy 'a holistic altemative to a disease-focused, technology-driven medical model', it says. But they could be endangering their health. This editorial demands that doctors must now recognize the absence of real curative powers in homeopathic medicine: 'Now doctors need to be bold and honest with their patients about homeopathy's lack of benefit, and with themselves about the failings of modem medicine to address patients' needs for personalized care' (ibid: 690). Shang et al's (2005) findings received considerable attention in the media, and most mainstream British newspapers featured articles on the subject, with headlines such as 'Effects of homeopathy 'are all in the mind" (The Independent, 26'*^ August 2005) or 'As a fourth study says it's no better than a placebo, is this the end for homeopathy?' (The Guardian, 26"^ August 2005). The age-old debates about placebo, the efficacy of altemative therapies, and discussion about why poor deluded individuals would want to waste their money by using them, were once again thrown into the limelight. The BBC news online website invited members of the public to comment on the findings of the report and give their opinions about homeopathy in general. The responses presented where mixed.