Many authors argue that people turn to alternative therapies because they have recognized the limitations of Western medicine and/or are, in general, dissatisfied with allopathic approaches to health care (Fulder 1996)7- Similarly, almost all of the people who participated in this study associated disillusionment with biomedicine with their first experiences of alternative therapies. In Hanna's words: "I found traditional [allopathic] therapy wasn't helping me at all." The dissatisfaction with medicine expressed by these people took many forms. For some a profoundly negative experience with biomedicine led them to look for alternatives. Below, Lindsay and Hanna describe incidents of what they saw as medical negligence, something which led them to turn away from allopathic approaches. In Lindsay's words,

I had a really bad experience with [one doctor]. I had a really bad infection and what he found out was that I was retaining about five hundred CCs of urine. He said that I was probably going to end up living on antibiotics for the rest of my life because every time I turned around I'd get a bladder infection. [That] made me decide.

And Hanna told me,

Well the car accident, the therapy was making it worse. I kept going to my family doctor and saying, 'It's not just in the muscles; I think it's the nerves.' For a year she didn't send me to a neurologist. All I kept having was one x-ray after x-ray and, well, there were no bones injured. She wouldn't believe me until I said there was something drastically wrong behind the left eye. One night I woke up, it felt like I had had a stroke. That's why I've lost a lot of faith in the [medical] system.

For most other informants, however, a sense of dissatisfaction with allopathic medicine was more all-encompassing and tended to be focussed on discontent with medical professionals on the one hand and/or dissatisfaction with medical therapy on the other. Several told me that their sense of dissatisfaction with Western medicine was related to what they saw as arrogant or uncaring attitudes displayed by physicians (Taylor 1984).8 For instance, in relating an encounter with his urologist, Greg said,

His idea was that it was diabetes and he said: 'Sorry to tell you this but there's nothing that I can do for you.' He was like a high-end repair shop, and if he couldn't do the high-end repairs, then I was wasting his time. He gave me three strips of, they reminded me of clarinet reeds actually. He said: 'Just take them home, take them in the bathroom, urinate on them and if they go green you're, no red, no green.' He couldn't remember which colour was diabetes and I'm kinda thinking 'Oh god!' That's maybe where I bottomed out with conventional medicine.

Further, Phripp (19 91) argues that some people seek out alternative therapies in order to have their problem seen as legitimate. Legitimacy is often at issue in cases of environmental illness, chronic fatigue syndrome, or other problems that "do not ... fit accepted [biomedical] diagnostic categories" (Schneirov and Geczik 1996:640). Similarly, another type of discontent voiced by these informants came from having to convince medical professionals that their illnesses were real. For example, Grace told me she felt her doctor did not believe her when she told him about the pain she was experiencing:

My doctor didn't believe that I was still having chronic pain. Because I now suffer from these wonderful things called chronic pain symptoms which [doctors] don't know a whole lot about. So it had to be mental and he sent me to see a therapist. [My naturopath] didn't think I was crazy and that was even more reassuring because I felt that I was valid. The medical profession didn't believe that I was valid, that I was really legitimate.

Dissatisfaction most often arose in connection to allopathic methods of treatment (Northcott 1994).9 In particular, informants raised questions about the suitability and efficacy of allopathic therapy. In addition they voiced concern over the potential iatrogenic effects of medical treatment (Illich 1975). For instance, many informants believed a biomedical approach was not suitable for the kind of problem they had and/or found that allopathic medicine could not help them with their problem. Witness the case of Grace: "One day out of desperation I thought, 'Well I've tried all the other quacks [doctors], I'm going down the tubes. What have I got to lose?' So I called [my friend the naturopath] up and I said: 'I've tried all the other quacks, I might as well try you now.'" Jane sought out alternative therapies when she felt allopathic approaches did not work fast enough:

I ruptured a disk in my back and the conventional methods were muscle relaxers and painkillers and 'Lay on the floor and don't move for three weeks or we'll put you in the hospital in traction.' And it just wasn't quick enough and I thought there had to be other ways. So I started going to chiropractors then and I've been going ever since.

Most common was the belief that allopathic health care was inappropriate to chronic conditions (Pawluch et al. 1994; Sharma 1990, 1992; Wellman 1995). For example, Roger and Lucy turned to alternative therapies in response to chronic health problems for which they found no relief in allopathic medicine. Roger put it this way: "The whole area of managing chronic illness in one's life comes to mind as kind of a departure from a Western medical framework." And Lucy told me this: "The medical field felt that the chronic fatigue had created the liver damage, but when I went to the naturopath they discovered that cortisone has about three pages of counter indications. The medical field, they didn't know what to do."

Finally, several informants' expressions of dissatisfaction were related to concern over side effects and/or invasive medical technology (Campion 1993; Murray and Rubel 1992; Murray and Shepherd 1993; Pawluch et al. 1998b; Sharma 1992; Vincent and Furnham 1996; Wellman 1995). Hanna, for example, found side effects from medication problematic:

Medications just don't agree with me anyway and they made my mind so sluggish that I decided to just come off all the medication they had put me on and I stopped the physio and I worked out my own exercise program and got more into the herbs and vitamins. It took me three years but I got well from there.

Lucy told me she sought out alternative therapies when she developed new health problems as a result of allopathic treatment

I was put on an inhaler. It was a minute dosage of cortisone and they didn't think it would create any problems. I was on it for twenty months and over that period of time the cortisone lowered my resistance and my immune system to such a degree that it was incapable of functioning, so I was diagnosed with chronic fatigue syndrome and over the next five years I went through hell.

Laura turned away from allopathic approaches partially out of fear of side effects and of the invasive nature of medical technology:

It worked for me during my pregnancy and it was a great alternative to having to use medications you really didn't want to take when you're pregnant. And so that continued when I was breast-feeding for the same reasons. It just worked and I had no side effects. It was probably that I had read too much before I got pregnant and in my early pregnancy about how unnecessary some of the procedures were and the potential harm they could cause to be comfortable with them.

As the data presented here show, dissatisfaction with allopathic medicine was certainly something that was concomitant with these informants' decisions to turn to alternative health care. However, discontent with biomed-icine alone does not sufficiently explain why people first use alternative therapies, if for no other reason than disillusionment with allopathic medicine does not necessarily lead to participation in alternative approaches to health and healing and is, in addition, something often expressed by those who have never used alternative therapies. (Sharma 1992). So how then do we explain the individual's use of alternative health care?

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