The use of non-medical healthcare - generally complementary and alternative medicine (CAM) - by low-income rural residents of Victoria, Australia, CAM-practitioner services provision to poorer clients, and the cultural meanings and significance for health-consumer agency, of these practices

© 2015 Dr. Tass Frances M HolmesOverview: This anthropological and qualitative research focuses on the use of non-biomedical therapies (frequently designated ‘Complementary and Alternative Medicine’ (CAM)), by low-income residents of a rural Victorian (Australian) community, and provision of healing services to poorer clients by CAM-practitioners. Incorporating ethnographic fieldwork, participant observation and in-depth interviews, it describes the cultural, political and spiritual meanings and significance non-biomedical healing activities held for research participants. Background: Demographics of poverty prevent many Australians, including rural residents, from affording private-sector healthcare, particularly CAM-practitioner services, which attract no Medicare rebates, and are less available than conventional or allied care. Various CAM systems retain distinct differences from biomedicine, in philosophical or paradigmatic understandings of wellbeing, and in their practices, and much CAM remains marginal, effectively construed as irrelevant to health. Informed CAM use by consumers continues often to be portrayed as a social deviance, through normative ideas, policy structures, and dominant medical and pharmaceutical interests, which exert high-level control over health behaviours, calling upon increasingly legalised ‘duty-of-care’ models. Findings: In contrast, respondent narratives highlight popular unconventional beliefs, common among community members, such as recognition of ‘psychic’ aspects of healing, and politicised feelings of dissent regarding mainstream biomedical assumptions. Holistic health maintenance is not understood as solely about symptomatic ‘treatment’ and practitioner interventions. Preventative and socio-cultural approaches, including self-care and community participation and belonging, may constitute the backbone of health promotion and effective ‘cure’. Also, CAM’s marginal categorisation seemingly nurtures a counter-cultural activism; CAM choice is often associated with alternative beliefs. Participants described folk-medicine, indigenous healing, and CAM in general, as mediating for them an improved health-consumer agency and rejection of biomedical determinism. Stories of spiritual and emotional healing suggest these are attributed equal importance to physical wellbeing. Many CAM consumers and practitioners are women, who adopt spiritually-oriented, holistic or ‘natural’ means of contributing to family health or enhancing identity and belonging. CAM creates a potentially powerful site of resistance, social transgression, activism and health agency, including with respect to major biomedical ‘clinical’ areas of cancer, childbirth and mental illness. Summary: While exploring the background of rural poverty, and theoretical understandings of CAM’s marginal standing, this thesis prioritises description of participants’ experiences of using diverse CAM, including professionalised services (integrative medicine, homeopathy, naturopathy, Chinese medicine, nutrition) – increasingly promoted as necessary by practitioner associations and regulatory bodies – and informal, folk-cultural practices (folk herbalism, psychic healing, narrative therapy, touch-based treatments), representing significant cultural or spiritual/intellectual property, and relatively accessible for those with compromised finances. Conclusion: Low-income rural consumers are overly familiar with circumstances of poverty (perhaps especially sole-parent families), and have insufficient access to non-biomedical treatment options. Additionally, CAM-practitioners’ ability to assist poorer clients is compromised within a competitive marketplace that offers no public subsidisation. Despite this, efforts of the rural research participants to build supportive networks and provide economical health treatments for themselves and others, reflects overall a determined retention of traditional explanations of wellbeing and healing, and a spiritually-based and community-focused value system that views healing as part of an experiential life journey

The Analysis of Event-Related Potentials

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