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.