Philosophical orientation

A person’s philosophical orientation and values towards health (postmodern health values)

are considered the main underlying reasons why people use CAM. A discussion of these two aspects follows and concludes that underlying attitudes, beliefs and values towards health and healing are the best predictors of CAM use.

Philosophical orientation refers to a person’s beliefs, attitudes and values towards health, health care and life (Astin, 1998). Astin (1998) concluded from his U.S nationwide study that a key reason for CAM use is because it is consistent with a person’s philosophical orientation. The majority of CAM users in the U.S choose alternative medicine because it is “more congruent with their own values, beliefs, and philosophical orientations towards

health and life” (Astin, 1998, p. 1548). Having a holistic philosophy of health (belief in the view that body, mind, and spirit are related) was predictive of alternative health care use.

Even prior to Astin’s (1998) study a number of scholars had argued that people who use

alternative health care services do so because they subscribe to a distinctive set of beliefs about health, illness and healing, that is often referred to as an alternative treatment ideology (see Coward, 1989; Furnham & Kirkcaldy, 1996; Goldstein, Sutherland, Jaffe, & Wilson, 1988; Kaptchuk & Eisenberg, 1998; Kelner & Wellman, 1997a, 1997b). Kelner

and Wellman’s (1997b) study found that some CAM users subscribed to ‘an alternative

ideology’ while others chose CAM for more pragmatic reasons such as ‘disenchantment with orthodox medicine’. More recent literature concurs with the ‘philosophical, ideology

and beliefs’ argument (Bishop, Yardley, & Lewith, 2007; Furnham & Lovett, 2001; Lindeman, 2011; Nichter & Thompson, 2006). Furnham and Lovett’s (2001) study on predicting the use of CAM found that attitudes, beliefs, subjective norms (social

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approval/disapproval), perceived control and past behaviour were good predictors of intentions to use CAM. These intentions were significant predictors of actual use.

Studies have suggested that people are “pulled towards” CAM because of an underlying philosophy and “a new set of health beliefs and values in society, entitled the post-modern

philosophy” (O’Callaghan, 2003, p. 28). Postmodern values refers to the shift in values that have signified a transition from the late modern era to postmodernism (O’Callaghan,

2003). A number of postmodern health values have been identified and include: rejection of authority, an increase in consumerism, importance of individual responsibility for health, emphasis on nature and natural remedies, anti-science sentiments and a holistic view of health (Siahpush, 1999a). Several studies have found that subscribing to postmodern values of health were significant predictors of attitudes towards and use of

CAM (O’Callaghan & Jordan, 2003; Siahpush, 1998, 1999a). O’Callaghan and Jordan

(2003) concluded that an emergence of postmodern values of health can partly explain the increased popularity of CAM. Interestingly, Siahpush (1999b) found that CAM users do not reject mainstream medicine and science outright. Many believed there were circumstances when medical science and technology was useful.

These findings suggest that CAM use may reflect a cultural paradigm shift towards health care from an emphasis on curing sickness to creating wellness (Prahalad & Ramaswamy, 2004). In fact Astin et al. (1998) found belonging to the value group ‘cultural creatives’ was a significant predictor of consumer use of CAM as was having higher education.

‘Cultural Creatives’ described by Ray (1997) and Ray and Anderson (2000) are a group of Americans who have a distinct set of values that are argued to be emerging beyond

modernism to become what is called ‘Trans-Modern’. Based on 12 years of survey

research, 100 focus groups and dozens of interviews, Ray and Anderson’s (2000) study presents a complex portrait of this emerging group. The core values this group hold include: concern for environment and social issues; feminism; love of foreigners and the exotic; altruism and interest in self-actualisation, personal growth and spirituality; belief in authenticity, holism and everything natural, believing that body, mind, and spirit is unified. Cultural Creatives who make up approximately 26% of the U.S population are considered the core market for psychotherapy, alternative health care, and natural foods (Ray, 1997; Ray & Anderson, 2000).

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In New Zealand this group could be compared to what Lawson, Todd and Evans (2006)

term ‘Educated Liberals’ who make up 9.4% of the New Zealand population. ‘Educated Liberals’ are progressive and egalitarian who value equality, social justice and the environment along with “creativity, love and inner harmony” (p. 11). Food choices for this

group tend to be healthy and natural with a preference for fresh produce and organic foods. Seventy percent of the Educated Liberals are female between the ages of 35-60 years, highly educated with high household incomes. Interestingly, there has been little growth in this group in New Zealand 2000 (Lawson et al., 2006). Lawson et al. (2006) have observed an overall trend of conservatism and a shift to traditional values, which is opposite to what Ray and Anderson (2000) proclaim is happening in the U.S. Kelner and Wellman (1997b)

argue that there is an increasing number of what they term ‘smart consumers’ who are seeking better health and making informed choices about health care. This ‘smart consumerism’ is thought to reflect the growing interest in CAM and a wider consumer

interest in health and body matters in Western society.