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Can a Collaborative Action Research approach to my Educational Enquiry help to express, define and validate my standards of professional practice?

Reverend Je Kan Adler-Collins, Director, Laurel Farm Clinic of Complementary Medicine

April 1997

“ We are still novices in the art of thinking, Great discoveries in ourselves and in the cosmos at large will depend on the invention of new forms of thinking, You are, what you think” Henrick Skolimowski 1994(p169)

Historically, the field of training in Complementary Medicine has been surrounded by controversy. This educational inquiry will focus on the lack of clear understanding of the nature of professional standards or practice in complementary medicine and the complex process of validating the standards I use in my work as a complementary therapist. Through studying my own practice as a Director of a School of Complementary Medicine, a Registered Nurse, practising therapist and researcher I intend to offer some insights on the way an action research approach into Complementary Medicine could help to define and validate standards of practice. I hope to overcome the problem highlighted by Johannessen (1994).

“ Another problem in research on unconventional Medicine seems to be that many unconventional practitioners have no training in research and there for have difficulties performing research of adequate standards” Johannessen 1994. COST European Commission

I will place my enquiry in its National and European context and justify my use of an action research approach before presenting my self-study.

Nationally. Setting The Scene

“Government policy permits a doctor registered with the General Medical Council (GMC) to use or prescribe therapies” (BHSS letter UNP/13 of 2.9.1985).

The Government statement of 3rd December 1991 confirmed a Registered Medical Practitioner’s right to delegate treatment of patients to specialists, including complementary therapists. Such treatment can be paid for by either the Health Authorities or fund holding GP’s.

The GMC’s rules for doctors published in Professional Conduct and Discipline: Fitness to Practice dated February 1991 (paragraphs 42 and 43) allow a doctor to delegate to persons trained to perform specialist functions, treatment or procedures provided that he (doctor) retains ultimate responsibility for the management of the patient.

In 1994 the Government, through the Department of Employment, commissioned a project in which National Occupational Standards for health and social care would be developed. West Yorkshire Health Authority have published Guidelines (1995) for employment of Complementary Therapists in the NHS. There are, however, as yet no National Standards of Training, Curriculum, Assessment or validation of therapy and the British Complementary Medical Association Executive Committee (BCMA) is still seeking trust status.

Europe. Setting the scene

The European Alliance had developments on several fronts relating to Complementary Medicine, its direction and training standards. The European Parliamentary Document, reference A3029194 part B, was issued by the Committee of Environment, Public Health and Consumer Protection. This shows that health Practitioners (Heilpraktiker) for example are treated differently in different countries.

Six countries out of the European twelve either tolerate the profession or recognise it officially. The approach in the United Kingdom and Ireland is based on Common Law dating back nearly four hundred years. Since 1970 Denmark has permitted people who are not doctors to practice non-conventional medicines subject to certain conditions. Germany recognised the profession of Heilpraktiker in 1939, since 1981 the Netherlands has not prosecuted Complementary Health Practitioners and a bill to recognise them as an independent profession is currently being drafted. In Spain, finally, the Supreme Court has ceased to convict practitioners who are not doctors.

Each country wishes to protect its citizens and the European Community is faced with a paradoxical situation in which a health practitioner who is recognised as competent and practices in one country, may be prosecuted in another community country for practising illegal medicine. This situation conflicts with the principles in the Treaty of Rome in particular with concerning the free movement of persons and the freedom of establishment (Title 111 Articles 52, 56 of the Treaty of Rome).

The Commission states that proof of therapeutic efficacy cannot be obtained by generally accepted scientific methods. The Commission requires a guarantee relating to training and suggests that legislation must be enacted on teaching by specifying the content and establishing who is competent to teach and goes further to suggest that the teaching structure should be to university standard qualifications or a high level diploma. Such study should take place in university facilities or private institutions licensed and subsidised by national authorities. These should lead towards a state recognised diploma. ( European Parliamentary Document A3029194 Part B.)

In 1990 this Committee presented a Proposal for a European Directive aimed at widening the scopes of European Directive 65/65/EEC and 75/31/EEC by including Homeopathic medical products. This proposal accumulated in Directive 92/73/EEC. The European Parliament was consulted and was called upon by the Commission, by a large majority, to implement all the appropriate measures to ensure the harmonisation and the status of Complementary Medicine.

The Issues of Training & Standards

Complementary Medicine has to address the issues of training and standards and all the sub issues of accreditation, validation and research protocols. There is ample evidence that the classical Medical model of Research, with its use of control groups for testing the efficacy of different medicines appears inappropriate when the intentions of therapists and the feelings of patients are to be taken into account (C.O.S.T Action B, Unconventional Medicine, First Annual report, European Commission 1995).

Because of the value-laden nature of Education, the issue of defining the standards of professional practice in any form of education depends on defining, communicating and legitimating the values-based criteria of assessment. Day (1995) has made the following suggestion for the nursing curriculum:

“ The work of the Care sector Consortium could complement the work of the UKCC (United Kingdom Central Council) & ENB (English National Board) to inform the setting of standards and educational training in Nursing Midwifery and Health visiting.” And continues;

“ Perhaps it is nor surprising then that curriculum developers are now examining NVQ approaches to identify the best principles of practise and how these might be applied to the Nursing Curriculum”

I intend to proceed with addressing these issues by using an action research approach to answer the question:

What standards of practice do I use in accounting for my work as a Nurse practitioner, Priest and teacher Director of the Laurel Farm Clinic of Complementary Medicine?

My choice of an action research approach to my educational enquiry is partly addressed by Cohen and Manion;

Action Research .... "Essentially an ‘on the spot procedure’ designed to deal with a concrete problem located in the immediate situation. This means that the step by step process is constantly monitored (ideally that is over varying periods of time and by a variety of mechanisms, questionnaires, diaries, interviews and case studies for example). So that the ensuing feedback may be translated into modifications, adjustments and directional changes, redefinition’s as necessary so as to bring about lasting benefit of the ongoing process itself". (Cohen and Manion 1989 .. 223)

The choice of action research was largely determined by the nature of my question. Because the question involved a self-study of my own practice I needed an approach which might enable to answer such a question. The only research approach which appears to embrace the ‘I’ of the researcher as part of both the object and subject of an enquiry is action research. There are several different schools of action research (Noffke 1997) and as Hughes (1996) has argued it is important to understand the theoretical antecedents of the approach used. As my intention was to describe and explain my own educational development in the course of my enquiry into my standards of practice, I looked at Whitehead’s (1993) living theory approach and felt some affinity for this approach because it focused on the individual creating their own explanations for their own practice in enquiries of the kind, “how do I live my values more fully in my practice?’.

I did not feel it appropriate to adopt the critical theory approach of Kemmis and Carr (1983) as at this point in my enquiry I am not engaging with social justice issues. I also did not choose the hermeneutic approach following the work of Gadamer of Elliott (1994) because I wanted to go further than interpretation and to put myself and my practice at the heart of my enquiry. The action research approach I decided to work on was developed by Andre Dolbec and Lorraine Savoie-Zajc (1996), at the University of Quebec in their work on collaborative inquiry with school principals to implement a continuous learning culture. My choice of this collaborative approach was influenced by the collaborative nature of my enquiry. Professor Dolbec was on a Sabbatical year with the Action Research in Educational Theory Group in the School of Education at Bath. Andre is a gestalt therapist as well as being a Professor of Education at Quebec University. He was interested the use of case study. Curzon (1993) Tells of the advantages and disadvantages of this method;

“The sensitive use of case studies is said to improve students skills in the detection and rejection of irrelevance, in the consideration of the possible results of a decision, in the evaluation of alternative procedures, and, perhaps above all, in the perception of the importance of facts.”

Curzon (1993 p298)

I elected to use this method and by so doing I could take Lewin’s theory of tension (1939 ) and modify it to create a neutral, safe zone where both the Andre and I would be safe to explore the concepts of this inquiry without violating the other in the quest for our knowledge. I respectfully suggest that Lewin’s theory of tension , of A dominating B or B dominating A, can be modified by creating a neutral zone of “safe communication” Where both A and B can examine the issues or facts and take on board what they are able to integrate into their own truth and understanding.

By working collaboratively with me in helping to understand how standards of complementary medicine could be expressed, defined, communicated and legitimated. Andre agreed to undergo a course of treatment and for both of us to write up the process and present it back to the Action Research in Educational Theory group for critical analysis or validation.

This process of validation involves the application of such criteria as the comprehensibility of the account, the relationship between claims and evidence, the explication of the values base of the enquiry and the authenticity of the account (McNiff, Lomax & Whitehead 1996). In our collaborative enquiry we agreed to keep diaries of our reflections on our experiences of the sessions. We agreed that Andre’s confidentiality would be protected in the sense that nothing would be published about his experiences without his permission. This conforms with the BERA Ethical Guidelines.

Before I offer you an account of how I began to make explicit my standards of practice I should perhaps say a few words about the main spiritual values which are at the core of my being and actions. I am a priest of Japanese Shingon Mikkyo Buddhist Order with the given name Je Kan. I was given my name by my fellow priests and it stems from Ji bo Kannon ,an archetypal nurturing healing Mother. This energy represents unconditional loving and the ability to lovingly heal all with out judgement or conditions, through the transition of your own understanding of your own issues. Your I, truly transcends to the collective We of community. The teachings of Mikkyo are over 2000 years old. It is the study of esoteric Buddhism through Gyo (Discipline) understanding and love.

Here is apictures of Ji bo Kannon.

Whilst this is not the appropriate place to tell the story of my development from Warrior to Priest (Adler-Collins 1996) the story does provide some insights into the nature of my commitment to the spiritual values of the archetypal nurturing, healing Mother, two of whose qualities are trust and making safe all forms of communication. It also explains why I identify with Bataille’s (1987) search:

‘I have subordinated all else to the search for a standpoint that brings out the fundamental unity of the human spirit.’ (p.8)

and his view that the human spirit can express a passionate

‘assenting to life up to the point of death.’ (p.11)

MY ACTION PLAN: TO REVEAL, JUSTIFY AND VALIDATE MY STANDARDS OF PRACTICE.

My action plan is to create, maintain and understand a safe healing space and to construct a valid account of my professional practice as a ‘healer’. This is how I intend to do it.

1. Creating my safe healing space.

My healing space or treatment room will be as clean and inviting as I can make it with soft and gentle colours. The room will be warm, well ventilated and welcoming with soft lights, pleasant smells of oils and incense and candles as a symbol of the light that we work with in the process of healing.

2. Maintaining and holding my safe healing space.

I will take responsible for my clients whilst they are in my care or healing space I will work at maintaining the safe space and this will require that my own mental and spiritual disciplines are in place. I work at ensuring that I am focused in the moment. This, for me, is achieved by the discipline of Meditation and prayer The client will visit issues of pain and negativity in his/her life, it is these issues that are causing the dis-ease. I value my insights which permit me to see these issues without being invasive or abusive but at the same time strong enough to allow the process to take place. This often means that I am exposed to negative energies which are released from the client in the form of emotional releases or even negative thoughts. My own issues from my own autobiography (Adler-Collins 1996) are often reflected back to me during a course of treatment and I work at responding to these in a way which is helpful to the client.

3. Understanding my healing space.

I now want to take a ‘risk’ in Winter’s (1989) sense that the action researcher reveals himself or herself in a vulnerable way. In what follows I simple want to communicate that I understand my healing space in term of positive and negative energies, Prayer, love and compassion. For me, my work as a healer is all about energies that are in the body, some are positive and some are negative. It is the negative energies that are in thoughts and emotions that can cause dis-ease. During the therapy the client will often shed the negative energy and this needs to be naturalised. I am responsible for this and the disciplines of energetic defence are my responsibility.

There is a process which I have evolved , I work at transcending the negative energy and making it “safe” I do this through the process of Prayer, expressing love, compassion and understanding, listening with out judgement and using incense and essential oils . This is a practice used by many religions when dealing with negative energy, thought patterning, addictive behaviour or “ bad spirits”. It may sound strange to talk about bad spirits in an educational paper, but this is part of my ‘risk’, and shamanic healing Mikkyo Priests, of which I am one, work with the belief that there are energies (which we do not understand) that are negative in there own right. They believe, as I do, that these energies attach themselves to vulnerable people and feed off the life force of the individual. Western Medicine does not tend to accept the validity of this idea. However, all major religions of the world acknowledge this process and train their priests to deal with it. My practice is based on a combination of my training and my intuitive recognition of these energies and the use of flower essences, crystal healing, accupressure and aromatherapy to explore them and to make myself and my clients safe. If I do not there is a possible danger that I could take on, or absorb, the negative energy of the clients and, in turn, become ill

Let me explain how I do this.

I have taken the work of Dr Edward Bach who pioneered a system of using flower essence to support the emotional body through a process of self growth or disease. Dr Bach found 38 flower essences to which he attached certain emotional values. I have taken this work and repeated all his experiments over the last 10years and I have worked with finding out and developing more flower essence to assist in understanding the emotions I have found in myself.

To the results of my research I have attached values to what I perceive the properties of the flowers etc to be . I measure the bodies energy and how it inter reacts to a flower essence in a positive or negative way on a ten point scale. It is entirely subjective, grounded in my intuitive responses to the individual and I am making no claim to its efficacy of treatment or the validity and reliability of the measures at this point in the healing process. However, I use this system to express my own insights about what will help the individual to express their emotional issues and address them safety . These insights are recorded below in relation to a particular flower essence.

ACTION

The reflections of both Andre and myself on the four sessions are provided in Appendices (1 & 2). One of the difficulties I experienced in constructing my account was how to integrate data from the diary entries in a way which could provide evidence in my communication of my standards of practice. I will discuss this further in the section on evaluation. At this point I simply present Andre’s diary entries in Appendix 2 as evidence that we met on 12,19,26 Feb. 5,11,18 March, 29 April. 13 May, 3, 10 17 June, 1 July.

In the second session I also carried out the procedure I described above with the flower essences

HOW CAN I EVALUATE MY ACTIONS THROUGH COLLABORATION IN A WAY WHICH REVEALS MY STANDARDS OF PRACTICE?

All I wish to do at this point is to indicate ways in which this kind of collaborative enquiry has the potential to express, define and validate my standards of practice. Given the preliminary nature of this enquiry and its limitations of length I will draw on the data from the diaries to see to what extent I can communicate the nature of three (*) of the following standards of practice.

1) Creating a safe healing space*

2) Maintaining a safe healing space

3) Understanding a safe healing space

4) Expressing love in the healing process

5) Expressing compassion in the healing process*

6) Expressing understanding in the healing process

7) Enabling the other to understand their own healing process*

How can I show my standard of practice of creating a safe healing space?

In taking my enquiry forward I intend to develop multi-media forms of presentations to enable me more fully to describe and explain the spiritual, aesthetic and ethical qualities in my standards of practice. In this preliminary phase of my enquiry I am drawing on the diary entries of my collaborator to show how my standard of practice of creating a safe healing space has been experienced and understood.

Andre 5 March

During all that time, there was music in the background. I recognized some Indian music from the U.S. desert where I travelled in the past. I could not recognize the language but the incantations. It was good and in perfect harmony with Je Kan's pressures. He massaged my feet and I appreciated the from the pressures he was applying through my bones. The fatigue that had accumulated there came to the surface and he helped to let it disappear. He then asked me to turn on my back to work my head. He came to sit behind me and told me to concentrate on the warmth I was about to experience. I closed my eyes and started to feel his warmth through his hands. They were not touching me but were at about an inch from my face.. I just received the warmth. My notion of time disappeared and started to feel peaceful. I was like a battery being charged. I felt very good and was aware that he was present to my experience. I let go. He started to massage my head and shoulders and stopped at the end of the tape. He got up to put another tape: I recognized monks singing their Gregorian chants. He then left the room, leaving me alone, in peace with myself. He

would wake me up later and tell me that I had rested for an hour. The treatment was over, I looked at my watch, it was one o'clock.

How can I show my standard of practice in expressing compassion in the healing process.

In my professional judgement as a ‘healer’ the way individuals can express their spiritual energy is often influenced by their past experiences. Sometimes these are so painful that they influence the health of the body. The links between some forms of heart-disease and stress for example are a case in point. In working with the emotions associated with such pain I feel and express compassion for those I work with, as both a personal and a professional response. In the diary entry which follows, Andre is expressing the grief he feels for the loss of relationship with his son. As I know the ‘Nurturing Mother’ qualities of Ji bo Cannon, I express my compassion in a way which permits Andre to share his loss with me.

Andre 29 February

I just realised at that moment that I did not use my diary to write down my feelings or emotions. I told him that, up to now, I only used my diary write down my thoughts about what I am doing with him and about what I learn around action research. His answer was: "This is it, isn't it? Your difficulty to go to your feelings and the fact that you always stay at the cognitive level".

Wham! I was caught right there. It is true that I did not write my "tats d'mes" in this diary. Why not? As if it was not the proper place, as if I could not articulate them, as if the fact of writing them down might not help me to grasp them a bit more clearly...........

I am like many of my students. I am using my head all the time

and do not see with my heart. I am full of feelings in relationship to my son. It is his birthday today February 29th. I miss him so much. He has disappeared. I am sad and angry at him for what he has done. I lost control on my father-child dream. He jumped out of it and I can't do anything. Most of the time now, I am in touch with this pain that does not go away. I can't leave it behind, it keeps coming back. I am sure that my stomach problem is related to it. At the same time, I am afraid. What if it was not an ulcer. Why does it still hurt? Why can't they get that pain out of me? I am waiting for someone (the doctor) to liberate me from it. I feel unable to do it myself and feel very childish. I am expecting others to take care of me and I feel very passive.

How can I show my standard of practice of enabling the other to understand their own healing process?

Whilst expressing my own professional skills in the exercise of my intuitive judgement about the nature of the relationships between the physical and emotional which is affecting the person, my aim is to enable the other to understand their own healing process, and hence to find their own way of healthier living. In the following extract Andre is showing in his insight about ‘letting go’, and ‘accepting experience’ that he is working towards ways of integrating his cognitive and emotional experiences. Most importantly for the development of his understanding he is forming a question, ‘How can I connect them?’. This question recognises the importance he is now giving to connecting his logic of living with his logic of conceptualisation.

I use my logic to conceptualize while, on the other hand, I have experiences in which I have emotions that are not integrated. How can I connect them?

Andre February 29 , 1996

I shared with him what happened when I took the flower essences at home last Saturday. I felt an immense sadness that came from nowhere. He did not seem astonished at all. It seemed natural for him to hear that and he told me that he had noticed a lot of sadness in my life the first time he had met me. He then told me that I had to let go, to grieve. The grieving process will help me to alleviate my tensions. His comment made sense. My son is always there, in my background. I keep him there and refuse to let him go. Grief.

I asked him how he had found my pain in the 7th vertebra. It seemed so evident to him. He felt that the energy was blocked in that area. It is at that crossing that the energies generated by my left and right brains are connecting. There does not seem to be any integration. It made sense. On the one hand, I use my logic to conceptualize while, on the other hand, I have experiences in which I have emotions that are not integrated. How can I connect them? The more I am looking for an answer to this question, the more difficult it is to solve my dilemma because I monopolize my brain to solve the puzzle, which accentuates the problem. I need to accept my experience without trying to change it, without judging that it is less useful than my thoughts.

Submission to the Validation Group

My initial question was, Can a collaborative action research approach to my educational enquiry help to express, define and validate my standards of practice?

I have now answered the question to my satisfaction in the sense that I have produced an account of my practice which is comprehensible to me. It enables me to more fully understand what I am doing. It is also in a form which can be submitted for public validation and opens up my practice as a ‘healer’ to professional accountability.

I would appreciate it if in your criticisms you would include a response to the following questions:

a) Have I produced a comprehensible account of my practice?

b) Have I started to communicate my linguistic meanings of my values/standards?

c) Have I begun to show the meanings of my standards of practice in relation to:

i) Creating a safe healing space*

ii) Maintaining a safe healing space

iii) Understanding a safe healing space

iv) Expressing love in the healing process

v) Eexpressing compassion in the healing process*

vi) Expressing understanding in the healing process

vii) Enabling the other to understand their own healing process* ?

d) Have I also shown an educational researchers’ regard for using evidence in relation to knowledge claims?

I have included three Appendices from my data archive for those who might be interested in further extracts from Andre’s Diary, in my reflections on the sessions themselves and in some of my notes on further reading when I was exploring the background of research into complementary medicine.


APPENDIX 1

Je Kan’s Reflections on the four sessions

First Appointment.

Andre arrived on time and we had a cup of coffee and a chat prior to going to the therapy room. Andre looked “grey” and showed signs of long term stress in his body language. He sat with his arms crossed and his legs crossed and was very direct with his eye contact. I became very aware of Andre’s ability to analyse. Everything that was said was absorbed , weighted and catalogued I could feel his mental process as he applied his mental body to the spoken word. It also became very clear to me that his main process was one of thinking and there was an obvious lack of feeling. By lack of feeling, I mean that he was firmly placed in his head, not his heart.

With this observation, my role was to plan a strategy in order to create an environment where Andre would feel safe to, perhaps, start the process of examining the feelings through love of self rather than the process of cognitive reason. First sessions are vital, they set the ground rules and define the boundaries between therapist and client. In order to do this I spent considerable time explaining the systems and values I attached to the therapy and observed Andre’s responses to the theory. He questioned me at length and challenged me on several points which was both challenging and stimulating for me. The object of this session was to engage Andre’s mental body and, to a slight degree, challenge his truths and concepts while at the same time creating a safe neutral zone of communication. This safe zone of communication is an extension of Kurt Lewin’s tension theory (1939). Lewin tells of how communication is where individual A will talk with individual B and one or the other will either dominate at the expense of the other. I believe that if we can create a neutral zone where each arrives at the table with his/her own issues ,understandings and truths. They place these values in the neutral zone where each party has agreed to honour and respect the values of the other and thus, each can examine the issues on the table, touching lightly perhaps, even picking up a point that they feel comfortable with and incorporating it into their own truth. Under this system there is no transfer of value laden inference with the natural zone. Most conversations are value laden . These values can create tensions and conflicts which are detrimental to the healing process. Non safe communication does not recognise the integrity of others or the power that words can convey. It is often the case that you can recover from a physical injury quicker than you can recover from the damage done by a cruel word. It often remains buried in the emotional body , festering and colouring your perceptions. I had the feeling that Andre was ready in his mind to start the therapy or the hands on. What I realised at that time is that he had not realised that he already started the therapy .

A detailed medical case history was taken and an issue concerning the stomach was highlighted. In my concept of Medicine, which is based on Eastern Medicine and the Meridian Lines of the body, the stomach is an area which is closely linked with emotions. During listening to Andre, it became clearer that the first problem identified, being that of his functioning in the Mental body, was symptomatic of a dysfunctional emotional process. By this I mean that Andre’s dis-ease in and with his emotional process was making him physically ill. This was not a psychosomatic process but the body’s response to emotional issues which had been locked up with in him for a long time. With no outlet for these issues, the body would choose the weakest point. Through observing his body language and facial expressions I was able to see beyond the mask, or public face, and could identify the coiled tension that Andre was carrying. My concern about the suitability of this process, as a public domain paper, was growing for Andre had provided evidence that he had deep emotional issues of a very private and painful nature which needed to be addressed and what had started out as a cognitive process for us both had changed and become very real in terms of this was now becoming a relationship between client and therapist not peer student in an educational process. By this I do not mean to imply that no educational process took place, quite the opposite, for we were each learning from each other as we gently explored the journey together. I felt it to be inappropriate to start hands on treatment at this stage and advised Andre of this and I explained that we now had our safe zone and the next step would be to address the emotional body through the Medium of Flower essences in the next session.

Session 2.

The aim of this session was to provide Andre with a scaffolding system which would allow him safe access to his emotional body. In the event of an individual being hurt or experiencing painful situations, which we all do, often the perceived pain is such that we retreat from the emotional body where we feel exposed and vulnerable and this is often accompanied by feelings of lack of control. We cannot control the feelings that others cause in us and we do not like the pain these feelings cause. In our retreat we look for a place that we can feel safe in, this is often the Mental body. The Mental body is a place where we can have a degree of control over what and how we think and view the illusion of our reality. We can create an environment which allows us the illusion of control and safety. We can in effect control the amount of exposure we have to the Emotional body and the feelings of others by placing a series of filters in our Mental body which allows us to interact with the outside world under our own terms and conditions and under our own Mental control. It is often the case that individuals who do this and make it an art form, have very sharp minds for they exercise the Mental body and can, without very much effort, use this powerful tool to “feel” others. They, in effect ,examine the feelings of others through a mental process that would not or, could not, do on themselves.

Andre was a case where he used his Mental body to examine feelings rather than use his emotions and heart to feel the feelings. There was a very distinct gap between the Emotional and Mental bodies. The result was physical dis-ease. I, as a therapist, can only recognise in others what has been or occurred in my own life. It is part of my truth that we can not really see others as they really are, we can only see reflections of ourselves through our own experiences . Some of these issues we may have transcended others are still active filters to our own perception of reality as we see. It is therefore a rule of mine that I will not and do not have the right to interfere with the process of another individual. Their truth is not my truth. So how do I help Andre through safe communication to address the issues that he had given his consent to work with? I will address the Spiritual body in session 3.

Session 3

As part of the support to session 2, Andre was required to write a reflective log of his feelings and emotions while taking the essences . This allowed Andre to make safe the feelings and energies by using the reflective log to analyse his feelings. This log is private and is only shared with the therapist if the client chooses to do so. At the beginning of session 3, I checked to see if Andre had any issues he wished to discuss and addressed with them prior to commencing A Buddhist Healing service.

Part of my truth is that the Spiritual body is where soul connects with the Mental, Emotional and Physical bodies. It is also my belief that, through faith and belief, you can act as a connection to others and enable them to draw on the vibration you are holding as a vessel in service and use that energy for self healing. The Japanese Shingon Mikkyo sect of Buddhism, as part of my training, selected me to be taught a form of sacred healing. A service was carried out for Andre. I was unable to ascertain the effect, if any, on Andre except to say that he was very thoughtful and quiet after the service.

The 4 session

In the first session we addressed Andre’s Mental Body, the second his Emotional body and the aim of the 3rd was to address his Spiritual body. The aim of the 4th session was to address the Physical body. The physical body is producing cells all the time and it my belief that the physical properties of the cell are controlled by an energetic blueprint which is obtained by the Chakra system. The Chakra system is an Eastern concept which believes that our Physical bodies have a series of energy centres. These energy centres have a vibration, colour and frequency and are responsible for the physical harmony of our bodies. The Chakra system connects to the Meridian system which is the energetic pathways of the body not dissimilar to the nervous system. These systems, in turn, relate and connect to the Spiritual, Mental and Emotional bodies.

If there is disease in any of these bodies this is duly reflected in the blueprint by which the cells are built. So you have a physical system of matter, e.g. cells, and an energetic system which are the blueprint for these cells. Dis-ease in any of the bodies can result in faulty blueprints and the cells which the body create are of a different frequency to the healthy cell. The body quickly recognises this and the body defence mechanisms come into play by attacking the new different vibration cells. These cells in turn respond to the attack by reproducing faster than healthy cells which then result is a cycle of dis-ease progressing to disease. The idea of my therapy is to reverse that process. We had addressed the Mental Body and made it safe, we had addressed the Emotional body and made it safe, we now had to address the Physical body and make it safe.

The way to do this is, I believe, through safe touch or therapeutic touch. This is where the body is gently massaged, all stress point are covered and the meridian line checked along with pressure points. All areas of tension are mapped and recorded and the physical profile is logged.

Several issues were found in Andre’s physical body during the course of the treatment, they were identified and treated and the session finished of with a Reiki healing treatment which put Andre to sleep for over an hour.

All the elements of Andre’s bodies had now been evaluated and the support systems activated for Andre to start his journey of self healing. For my part I had completed the safest form of treatment that I knew through my own truth. My role would now be of critical friend and evaluator. His treatment plan would now consist of massages with essential oils and listening on my part. To give love and hope and positive confirmation to his progress and be there should he need the support or sounding board for his understanding.

Like most best laid plans things did not go to plan, I broke my finger building a statue and was unable to massage Andre and he continued his treatment from my wife. This introduced him to a different form of energy in the form of female energy, its softness and lovingness. I was able to see that the process started by Andre was carried on as we continued. In my judgement his physical problems started to quickly resolve themselves and his colour became healthy. However, the issue of how to judge the effectiveness of my influence on Andre or other clients, needs further research.

In our collaborative enquiry, Andre had agreed to write a reflective diary, parts of which I could use for this study. We had agreed his right of confidentiality over his writing. He evaluated his progress and applied his own values to his understanding in the following way. Whilst these extracts are included in Appendix 1, I only wish to draw attention to particular evaluations which have direct bearing into my enquiry into the standards of judgement I use in my practice. My intention is to make particular claims about the nature of this enquiry and of its potential to answer my question through further research, before I present the report to the validation group and then offer my evaluations of their criticism.

(5200 words)

In action research, as in much qualitative research there are issues (Denzin & Lincoln 1994) concerning representation and legitimation. Where I make a claim in relation to my interpretation of transcript data I have numbered the lines in each of the four sessions and refer to my claims about this evidence in terms such as 4,1-5 which means session 4, lines 1-5.

Andre Dolbec's Diary

(Je Kan, I have translated my diary. I have also indicated the

dates of the meetings to help you use it in your initial paper.)

Monday, February 12, 1996

Tonight I went to Je Kan's farm in Carlingcott, near Bath. I was

invited there by him in the afternoon meeting at the university.

We were served a superb dinner. Helma and her mother prepared a

soup with a taste I had never experienced before and that was

excellent. The lamb bred on the farm was also excellent. The

ambiance was relaxed and my wife and I felt at home. Through the

conversation with Jack and Je Kan, I was brought to thinking that

the holistic medicine approach could help me deal with my ulcer.

Jack suggested that I could help Je Kan to validate his approach

and to be better recognized by the academic world.

We came to an agreement: I will be the guinea-pig in a process

that will start next week. I am excited and I am looking forward

for the next meeting while, at the same time, I am a bit fearful

in face of the unknown. This process can only do me good. It

will allow me to continue the process already initiated back home

in body work. We will see. I have decided to write my evolution

in this diary and discuss my perceptions.

Monday, February 19, 1996

I arrive at Je Kan's farm at 11 o'Clock. After his welcome and a

chat with Helma, his wife, and himself at the kitchen table

around a coffee, I go upstairs for the first treatment. Je Kan

does not know how to proceed to do this enquiry, a self-study of

a sort, while answering Jack Whitehead's expectations. We both

decide to use a diary. I will write down the perceptions and

sensations experienced during and after each treatment and Je Kan

will do the same and he will try to make clear his intervention

goals. At the end, we will put our data together.

Je Kan then explains to me the theoretical ground behind what he

is doing. I feel fully confident in his science and am a bit

surprised by all the explanations that he gives me. I suppose

he wants me to feel confident that he knows where he is going.

He talks for 30 minutes about the different ways to know how

other people feel. There are four different ways to read

others: pulse, temperature of the body, a third one that I do

not remember and the energy field. He will work on the energy

that he will try to balance through some mixture of flower

essences that he made himself. I am surprised by the procedure.

It looks like alchemy. I simply have to touch the caps of

flower essences bottles with my left finger. During that time,

he touches my right hand and feels my response to the energy

fields created by the different bottles. That helps him to

identify seven of them where he says he reads some negative

current.

He then writes down each essence chosen and explains what they

mean. The feelings they are attached to are connected to my

experience. It feels strange that he is able to describe my

experience with these essences. I feel so much secure that I

could talk about my personal life. It does not seem necessary

since he seems to understand so much of it already. Then,

trying to remember what he felt with each essence, he puts a few

drops of these seven mixtures in another bottle and then fills

it with water. That will constitute his first intervention.

Three drops of this three times a day.

I was disappointed that it was over. No Aromatherapy nor a

massage. That will come later, next week, he said. We debrief

this first treatment and I tell him that I did not need all the

theoretical explanations beforehand. I understand why he did it

though. There is a big leap of faith needed and I have to

believe that he has some power that I do not know. How can he

feel such an energy field? It is as if he was in contact with

another reality. He feels the different chakras. Is it

possible for me to have access to a similar experience without

having to convert to Buddhism. I feel a bit anxious because I

do not understand his experience, neither do I have access to

his perception of me, to what he says that happens within me.

When I leave him, I feel willing to continue. A whole world is

opening. I feel dependant on his "wisdom" and feel challenged.

I am looking forward to understanding more.

February 29, 1996

After a long trip due to traffic congestion this morning, I

arrive at Je Kan's house at 11:20 am. After a few coffees and a

good discussion on action research where we share our views, he

explains to me that today he will work at the spiritual level.

The spiritual dimension is helpful to get at the energy level, he

tells me. What he will do is to go with his wife and I into his

Temple and there, he will pray in Japanese in order to ask God to

bring us energy. He tells me to write in my diary any thoughts

or feelings that might originate from this experience or any

other that could be linked with the flower essence therapy. I

just realized at that moment that I did not use my diary to write

down my feelings or emotions. I told him that, up to now, I only

used my diary write down my thoughts about what I am doing with

him and about what I learn around action research. His answer

was: "This is it, isn't it? Your difficulty to go to your

feelings and the fact that you always stay at the cognitive

level".

Wham! I was caught right there. It is true that I did not write

my "‘tats d'‘mes" in this diary. Why not? As if it was not the

proper place, as if I could not articulate them, as if the fact

of writing them down might not help me to grasp them a bit more

clearly.

The experience in the Temple was very good. I felt a lot of

peace just sitting there, my eyes closed, listening to his

Japanese incantations and feeling the resonance of the bowl he

was banging with a stick. He explained to me later that he tried

to get the bowl resonate to his prayers. When it does, he has

the right pitch.

The exercise lasted 30 minutes. Before the end of the ceremony,

he came close to me and touched me with a stone through which he

was transmitting his vibrations to me. It was to me to get what

I needed, he later told me. I felt very open to the process. It

was as if something was happening when I was open to it. In

these circumstances, I lose my head and sense energy waves. I

feel that there is a whole world very close that I do not

perceive. I have the feeling that he can open this world for me.

No, I think that I can open it myself with his help.

I am like many of my students. I am using my head all the time

and do not see with my heart. I am full of feelings in

relationship to my son. It is his birthday today February 29th.

I miss him so much. He has disappeared. I am sad and angry at

him for what he has done. I lost control on my father-child

dream. He jumped out of it and I can't do anything. Most of the

time now, I am in touch with this pain that does not go away. I

can't leave it behind, it keeps coming back. I am sure that my

stomach problem is related to it. At the same time, I am afraid.

What if it was not an ulcer. Why does it still hurt? Why can't

they get that pain out of me? I am waiting for someone (the

doctor) to liberate me from it. I feel unable to do it myself

and feel very childish. I am expecting others to take care of me

and I feel very passive.

Isn't it the same with Je Kan? When I take these flower essence

drops, I always wonder how I can get better as a result. It is

as if I was in the middle of magic, surrounded by mystery and I

am a bit uneasy about it. I will see Je Kan next Monday for the

third treatment. I am open to it. It is supposed to be a

massage. I was a bit disappointed today that it was only

spiritual. I am looking forward to being touched and to feel a

warm contact on my body. Again, my child is here. As if I was a

three years old, wanting to be cared for.

Tuesday, March 5, 1996

I am at the keyboard after a long morning in bed and a good walk

after breakfast. I feel good in my body. I do not have a lot of

energy and I delay the task of writing in my diary. It is as if

I wanted to run away.

Yesterday, I went to Bath for my weekly treatment with Je Kan.

When I arrived, he was in the Temple with two students of his.

The trip went well and I arrived on time: 11 o'C.lock. The

two lady students were sewing dresses and kimonos for the Feast

to be held there on March 27. The Temple will be consecrated at

this date. One of them offered me some tea and it is with my

cup that I followed Je Kan to the treatment room. It was time

for my first massage.

I walked upstairs on my own to get undressed and take place on

the massage table. I put blankets over me and waited for Je Kan

to come. It took some time because he waited for my signal to

join me. When he entered the room, he removed his toga and sat

on a bench, near me to explain what he intended to do. The

massage would be "soft" and its aim would be to help my energy

to move in my body. It would be similar to a Tai-Chi dance. He

would use rose oil because, according to him, it is very light

and good for a first treatment. To my question: "Will you work

my tummy?", he answered: "No, we never work where the pain is

directly experienced... Through your feet and the massage, I

will work on your vulnerability points."

I realized that I was trusting him very much to take care of me.

I laid down, put my head on its side and waited. He put oil in

his hands, removed the blanket on my back and started to massage

me. It felt good. Big pushed from top to bottom. His hand

were massaging my skin. I felt "worked on" and I felt good. It

did not take him a minute before he reached my 7th vertebra. He

started to push on it and I felt like an explosion of pain right

there. At the same time, I was experiencing some kind of a

relief. It was as if he just had located a weak point that I

had not located myself. I had not realized all the tension that

was there. I realized that my neck and my shoulders where

hurting for many weeks. I had never stopped to experience the

pain. I could understand the noise from the cartilages being

pressed. To the pain was my desire to see him continue in the

hope that he would take my ache away.

He then put a stone on the vertebra and covered it with his

hand. I felt an instant warmth. He put another one on the back

of my spine and it felt like a burn. From where was that heat

coming from? There was no stove nor hot water in the room. He

worked on my spine for a while moving slowly with one stone in

the middle of one hand, while putting pressure on the sick

vertebra with the other. It felt as if he was passing an

electricity current between his two hands. After a while, he

left my back and started to work on my feet.

During all that time, there was music in the background. I

recognized some Indian music from the U.S. desert where I

travelled in the past. I could not recognize the language but

the incantations. It was good and in perfect harmony with Je

Kan's pressures. He massaged my feet and I appreciated the

sensations from the pressures he was applying through my bones.

The fatigue that had accumulated there came to the surface and

he helped to let it disappear. He then asked me to turn on my

back to work my head. He came to sit behind me and told me to

concentrate on the warmth I was about to experience. I closed

my eyes and started to feel his warmth through his hands. They

were not touching me but were at about an inch from my face.. I

just received the warmth. My notion of time disappeared and

started to feel peaceful. I was like a battery being charged.

I felt very good and was aware that he was present to me

experience. I let go. He started massage my head and shoulders

and stopped at the end of the tape. He got up to put another

tape: I recognized monks singing their Gregorian chants. He

then left the room, leaving me alone, in peace with myself. He

would wake me up a later and tell me that I had rest for an

hour. The treatment was over, I looked at my watch, it was one

o'Clock.

I met him and his wife for lunch. I felt so peaceful that I was

not in any hurry to go back to the university to work. I waited

for him to come with me and we left at three.

While driving, we discussed and I shared with him what happened

when I took the flower essences at home last Saturday. I felt

an immense sadness that came from nowhere. He did not seem

astonished at all. It seemed natural for him to hear that and

he told me that he had noticed a lot of sadness in my life the

first time he had met me. He then told me that I had to let go,

to grieve. The grieving process will help me to alleviate my

tensions. His comments made sense. My son is always there, in

my background. I keep him there and refuse to let him go.

Grief.

I asked him how he had found my pain in the 7th vertebra. It

seemed so evident to him. He felt that the energy was blocked

in that area. It is at that crossing that the energies

generated by my left and right brains are connecting. There

does not seem to be any integration. It made sense. On the one

hand, I use my logic to conceptualize while, on the other hand,

I have experiences in which I have emotions that are not

integrated. How can I connect them? The more I am looking for

an answer to this question, the more difficult it is to solve my

dilemma because I monopolize my brain to solve the puzzle, which

accentuates the problem. I need to accept my experience without

trying to change it, without judging that it is less useful than

my thoughts.

Monday, March 11, 1996

Before my treatment today, I had a long discussion with Je Kan

about his research. Then we go to the treatment room upstairs.

It is not a strange experience anymore. I lie down on the

massage table while talking with him. I sense some tension in

my body. He tells me that my legs are so tensed that they stay

up even when he tries to let them down. It is as if I needed

tension to maintain my equilibrium. If I do not "push" myself,

I feel uneasy. The same learnings that I have made in the past

are coming back. The massage helps me to relax a bit. I stay

in the room, by myself for half an hour and then join Je Kan and

Helma downstairs. I am invited to join them to the Temple for

another religious ceremony for another patient. Since I am not

the focus of attention this time, I decide to open my eyes and

to observe what happens. The experience is different. I did

not feel it from within but as outside. When I look at the

lady that was there to be healed, I notice her face which is

very red. She seems so calm and relaxed compared with what she

looked before the prayer.

Where is my religious life? Je Kan's is in it all the time. I

remember when I was young. It is not as present as it was

anymore.

It has taken all that time to get relaxed. The tension comes

and go in my body, like a wave in my legs, in my jaw.

That evening, there is a dinner invitation at the Farm and my

wife and I accompany the university action research group to Je

Kan and Helma's gathering. The tension is back. I take more

room then the last time. I feel pushed by the tension inside

me. I don't feel in balance and try to recapture it by

discussing intellectually. At times, I see that I push others

too much. I am not sure if it is too much and need to ask

others what that think. It seems O.K. to my wife. It is

difficult for me to sense the boundaries when I am in that

state. Tonight, it felt as if everybody was far away and could

not make contact. I realize that if nobody establish the

boundary, it is to me to do it.

When the guests leave, I debrief the evening with Je Kan, Helma

and Christiane. I was not alone to have felt to tension in the

room. I feel better. I like to be confirmed in my sensations.

The next day, I share my observations of Je Kan and Helma with

Christiane my wife. It helps me to become aware of my own life,

of our couple life. I realize the tension between my

professional life and my personal life. The danger to be drawn

into the professional side appears to me. There are so many

people around me now that do not have time to be with

themselves. They work all the time, they forget about their

heart and their body. I recognize myself in them. I have to

clarify my priorities.

Monday, March 18, 1996

When I arrive at Je Kan's Clinic today, he is busy fixing the

computers. My treatment starts around 12:45. When we walk

towards the treatment room, he asks me if I have noticed any

changes since the beginning of the treatments. I answer that I

am less worried by my stomach and that I feel more relaxed. I

also share my awareness that my relationship with Christiane is

becoming stronger. He nods his head and tells me that he

noticed. He then asks me if I understand what he does in his

interventions. I am aware that he works my energy level, that

he tries to harmonize the different trends..He confirms my

perception and tells me that he works at the four levels. He

tells me that, contrary to what I was doing before, I now

recognize my pain; I am not ignoring and bypassing it as I used

to, my body has some space to get rid of the symptoms. I don't

need them to catch my attention. He tells me that people often

use their sickness and the symptoms because they need them.

Do my need change? I often feel the need to move, to act, to

become agitated. I often experience the impulse to move, to

push. I feel it with Christiane and start to make sense of the

feedback she has been given me for the last two years. It is

amazing how I could not make sense of what she was saying

before.

I realize that the ache disappears. I don't fell any pain in my

left side. Only from time to time.

Monday April 29, 1996

After one month, I went back to Carlingcott today. Since the

last time, the Temple has been consecrated and Helma has been

ordained a priest in the Buddhist religion. I spend a few hours

discussing with Je Kan about ways to develop his school of

holistic medicine.

Around one o'Clock, his wife Helma invites me to follow her to

the treatment room to renew my flower essences. She follows the

same process that Je Kan had done two months earlier. I

identify ten essences. A true cocktail, according to her. Many

seem to be opposites. She reads in my choices the emotions of

grief and resentment. It brought back my frustration with my

son. It made sense that I had picked up those essences. I

recognize my anger towards him as well as my nostalgia of the

past.

Monday, May 13, 1996

Since the last session, I have taken these new flower essences

drops. It seems that I experience sadness more often since I

take them. I do not have as much enthusiasm to work as before.

I spend more time to do things. I do not feel the need to run

as much as before. I had the feeling that everything could

wait.

Last week, Je Kan hurt his finger and cannot give massages

anymore. Today, Helma was the one that gave me the treatment.

The experience is different. She is softer. She does not seem

to follow a technique. I sense her contact. It seems more than

a therapeutic touch, she is a presence to me. I relaxed under

her care and almost felt asleep. After the treatment, we share

our common experience in our lives regarding the family

triangles. In the last weeks, Christiane's daughter visited us

and I felt a lot of tension inside myself. I am aware that I

created a lot of it too that I dumped on them. I realize that I

often make decisions for the others around me, for Christiane

especially, that I often plan her life without consulting her.

Monday, June 3, 1996

I went to Je Kan's clinic today. He seemed very busy because of

the computers that broke down last week. The computer

technicians are there to fix the problem. I give them a hand

and leave for the university to come back later to pick him up.

I received no treatment today. In the action research seminar,

Je Kan becomes angry at Terry's presentation. I also intervene

to share my confusion about the process.

Monday, June 10, 1996

I arrived early at the farm: 10:45 am. The atmosphere is

relaxed.

Je Kan gives me a massage. I fall asleep twice. I feel in

security. His hands are warm, I stay in the here and now, my

stress melts, I let it go, I relax. When he starts to massage

my back, he goes directly where I have experienced a back

problem in the last few days. He pressed my lower back vertebra

and after massaging it, the pain goes away. The Gregorian

chants music goes back and forth in my experience. Je Kan

leaves me there to relax and I stay quiet until the music is

over. I feel a lot better.

Monday, June 17, 1996

Today, I arrived at Je Kan's place with a hard copy of my diary.

It is the end of our self-study and we have to make sense of all

the data. I started by reading my diary and identifying the

passages that are related to our common experience. Then, we

tried to clarify what Jack Whitehead might want us to do and how

it could be used by Je Kan in his course work. Since we had no

idea, I read my diary out loud and Je Kan took notes while I was

sharing my experience.

He seemed touched by my experience as read from my diary. He

shared his emotion with me when I finished. He could see my

progress, the awareness I had made throughout the therapy as

well as my fragility as I was working through my problems. I

became aware, as I was reading that I had moved from a position

of dependance to a position of independence, of self-regulation.

I feel a lot more autonomous then I was when I started to work

with him. I feel in control my life. I am in charge of it. I

stopped concentrating on the symptoms located in my body and

became more aware of their cause that was in my heart, my

emotions.

I became aware that as the time was passing, I did not keep

writing about my emotions. I have been through many cycles of

awareness of my feelings and then forgot about them until the

pain would come back to remind me of my priorities. It is so

easy to go back to what I do best: to stay in my head. It is so

easy for me to stay at that level.

Monday, July 1, 1996

Today Je Kan gave me a copy of his paper where he describes what

he has done and how he has seen me change. I recognized myself

when he wrote about me. The treatment seems to have worked as

he was expecting.

When I look back at my stomach problem, I think that it is under

control. I am not afraid of my body anymore and feel more

confident. I have started to integrate my feelings and my

sensations with my thinking and I feel in equilibrium more often

than in the past. The experiment is over. I have received a

lot of love and tender care both from Je Kan and Helma. I wish

I will be able to come back next summer to work with them to

participate in their learning community.

APPENDIX 3

The literature search around this question provided 120 books

and articles relating to research and complementary medicine. Sources were:-

The British National Biography;

Ulrich’s International Periodicals Directory;

Educational Resource Information Centre (ERIC) of the United States of America;

Society for Research into Higher Education (SRHE);

Compuserve;

Internet.

CRITICAL REVIEW - on selected material relevant to project.

Aldridge, D Pietroni, P (1987) Research trials in general practice towards a focus on clinical practice. Family Practice; 4(4):311-5.

With current moves towards an emphasis on the "whole" patient rather than fragmenting the person into organ systems, research methods need to be developed which reflect that emphasis and direct us in our endeavour as clinicians. It is possible to have a descriptive science of human behaviours which can be based upon clinical consultations. In this way the clinician is required to act as a clinical anthropologist as well as a clinical epidemiologist.

Anthony, H. (1986 Feb) Post script: a further critique of current trials methodology. Implications for research into orthodox and complementary therapies.

Comp Med Res: 11):48-54.

There is considerable volume of evidence of individual differences in susceptibility to disease, in the progress of disease, and in response to treatment. There are therefore strong cases both for questioning the validity and applicability of the result of clinical trials which assume homogeneity of response without evidence and fail to look for interactions; and for developing modifications of methodology which take the differences into account. If the differences were all truly idiosyncratic, there would be no hope of progress. Luckily, there is evidence of individual characteristics which determine, or mark, such differences in response, raising the hope of defining the patterns of characteristics which are associated with better response to particular treatments and eventually with improved prospects of predicting the most appropriate treatment for individual patients.

The lynch-pin of any improved methodology lies in the ability to recognise and define these characteristics so that they can be used: all other advances depend on this. Initial steps must be a review of the literature on all the non-specific physiological, psychological, and other individual characteristics which contribute to, or mark, differences in individual responses to treatment (excluding factors directly related to the specific disease), collaborative studies to find out what assessments of this type are actually used in everyday clinical practise, and further careful observation. I suspect that we might be surprised by the wealth and range of factors unearthed.

Crichton, N.J. (May 1990) The importance of statistics in research design. Comp Med Res: 4(2): 42-50)

This paper aims to identify the importance of statistical considerations in the planning and design stages of an experimental study. Points are illustrated with examples from published studies on complementary therapies. The need to identify the objective of the study clearly and specifically is stressed, a variety of types of design are discussed and the reason for careful calculation of sample size are explained.

Lannoye.P. Explanatory Statement on the status of complementary medicine. Paper A3-0291-94 part B .EEC Commission Brussels.

This paper is a comprehensive report on the status of Complementary Medicine in Europe; it brings together a series of European papers and makes recommendations for the harmonisation of training standards within Complementary Medicine within member states. It champions a higher education platform for the education of therapists across borders. The report calls for the licensing of centres of excellence and their working towards state approved qualification. It is critical of the different member states and actually contrary to the Treaty of Rome, which calls for cross transference across borders of skills within EEC member countries. An important point of this report; being a qualified doctor does not mean that you automatically have the right to be a complementary therapist. It implies that further training is required. A point to note is that they are looking for a training period of 4-5 years at higher education or university level.

British Complementary Medical Association. Internal document. Amendments to the motion for a resolution to Lannoye’s report.

This paper calls into question the use of the words alternative and complementary, it plays the semantics of words which however do bare great relevance. Alternative medicine is practiced without the use or input of a qualified doctor. Complementary Medicine is exactly that; it complements the care already being given by a qualified doctor. The document in itself is a document that is self interesting, this is hardly surprising because the BCMA represents 25,000 practitioners.

It lays out those interests for Lannoye and in certain areas tells Lannoye what the U.K. position is. The disturbing thing about this document is that it is taking the view point that the BCMA has the right to view this platform as its own. One of the interesting factors of the report, however, is that it does appear to accept most of the Lannoye report including element I, which refers to the training of complementary therapists at a higher educational level leading to a state award. This is quite surprising really as for most of the therapists within the BCMA have very poor qualifications. The implementation of the Lannoye report is going to cause the sector as a whole tremendous difficulty if it goes its own way. The BCMA makes no reference of how the Lannoye report will impact upon their training schools.

James, I. (1986 Feb) The appropriate use of conventional research methodology. Comp Med Res. 1(1): 7-11.

A clinical trial may be defined as a scientifically designed experiment to compare treatments in groups of patients by controlling or equalising all variables except the administration of the therapy itself.

The main purpose of a clinical trial is to eliminate bias. Experience has shown that clinical impressions of the efficacy of treatment can be misleading. The dangers of having ineffective medicines or treatments available are that they may be hazardous; really effective treatment may be denied the patient, and time and resources may be wasted. I am not sure whether it is wise to refer to treatments as standard or complementary. I hope to see the day when they are described simply as effective or ineffective.

Reason, P. (Apr-Jun 1987) Methods of Assessment. Holistic Med 2(2): 103-7.

The author is critical of the BMA’s report basing its assessment of both orthodox and alternative therapies on scientific method. Science is a product of western thinking, and is a powerful tool for enquiry, but it is by no means ‘free from overriding social values and political bias’.

He criticises the BMA also for being fundamentally unscientific in not making proper use of the accumulated information on the various alternative therapies. The report should have undertaken a holistically critical assessment of the whole of the data available, instead of dismissing the empirical evidence of alternative therapies as not fitting into existing orthodox medical theories. Instead of this limited view of enquiry based on western materialist philosophy, and realised on the clinical trial, the author proposes five principles which might facilitate more creative enquiry into alternative practice.

Hylandt. Experimental Learning, Competence and Critical Practice in Higher Education. Studies in Higher Education Vol.19 No.2 1994.

The expanding influence of competence based education (CBE) through the activities of the National Council for Vocational Qualifications (NCVQ) now extends to all levels of the systems including the work of higher education institutions. The NCVQ approach is, however, ill equipped to deal with education and training beyond the level of basic skills, and is largely irrelevant to the sort of learning that goes on in higher education. A critique of the NCVQ model of CBE is presented and in place of the behaviourist obsession with performance outcomes, models of learning and development drawn from the cognitive and experimental traditions are recommended for higher education. Educators in this sphere need to maintain an attachment to critical practice and the humanistic traditions in order to resist the narrow utilitarian models of practice presented by CBE strategies.

Hylandt’s presentation is an intriguing document which provokes a great deal of thought in the reader; in basic terms he accuses NCVQ of expanding above and beyond its initial remit. On a personal note I have found myself agreeing with many of the stated points and in essence he is presenting the case that NCVQ and the formation of NVQs with the Government bandwagon are not actually carrying out the role for which they were initially perceived, and Hylandt puts forward the case that this extension of role if not challenged, could be detrimental to education in general and higher education in particular.

Storey, O’Kell and Day. Utilising National Occupational Standards as a complement to Nursing Curricula. NHS Executive Internal Document 1995.

This document examines