When the new and pioneering College of Naturopathic Medicine (CNM) opened the doors to its very first students of Naturopathy 25 years ago, the world – and the world of natural health – was a very different place. Here, CNM’s Director of Education, BOBBY QURESHI reflects on just how much has changed in that time and looks forward to what we can expect in the next 25 years …

Since CNM’s inception 25 years ago, the field of Naturopathy has evolved considerably. But what – specifically – has changed over this time, and are all these changes for the greater good of the patient/client/natural health consumer?

From my own experience within this profession (one that I am so proud to be a part of), I want to give you a glimpse into what I have observed over the years and also share what I believe the future of Naturopathy will look like. So, let’s dive in …

WHAT HAS GROWN IN THE LAST 25 YEARS?

Naturopathy is a philosophy of healthcare that many would traditionally describe as both an art and science. Out of these two pillars, it is certainly the ‘science’ element that has transformed during the last couple of decades.

Evidence- based medicine has become the dominant paradigm within the field of conventional medicine which places great emphasis on the findings from “best available current research”. This model, I have noticed, has gradually become more accepted by many naturopaths, with practitioners seeking a deeper understanding of how a nutrient, herb or other natural remedy may work in the body. This has certainly filtered through into naturopathic training, where students are given an insight into what we now call ‘mechanisms of action’.

However, the inclusion of an evidence-based approach presents many challenges. The type of research generally regarded as the ‘highest quality’ within this framework is typically very isolated. And it also does not take into account that naturopathy has always placed a strong emphasis on treating patients individually; ‘standardised protocols’ simply do not work when we are trying to address the real underlying cause of a patient’s symptoms. For example, 10 individuals with eczema will have different underlying causes, and so the approach needed to resolve each case of eczema will differ.

As discussed widely by the highly regarded Dr Aseem Malhotra, another problem with this model is that many studies are now funded only because they are likely to be profitable. For example, drug companies will often fund research into drugs they are looking to have approved. Even more alarming is learning that the drug regulating agencies are often largely funded by these companies too: for example, in the UK, 86% of the Medicines and Healthcare products Regulatory Agency (MHRA)’s budget is derived from the pharmaceutical industry.

I have certainly observed how easy it is for naturopaths to shift into a more ‘prescriptive’ approach when applying the evidence-based medicine model. This can very easily result in what we might call ‘green allopathy’!

So, we have to ask ourselves, is this model truly fit for naturopathic practice?

Technology has advanced drastically over the last 25 years too – with so many fantastic opportunities for the field of naturopathic medicine.

It has provided the opportunity to study naturopathy online from any corner of the globe, learn from the world’s leading practitioners and even enable practitioners to host clinic consultations online. Technology has most certainly expanded the reach of naturopathy, and I myself am now working remotely with many patients from around the world, which is quite amazing. Thank goodness for Zoom!

One area of technology that is continuing to grow by the day is comprehensive (‘functional’) testing. This is certainly a way of gaining a deeper understanding into the functioning of a patient’s body.

We now have comprehensive stool tests that reveal insights into the functioning of the digestive system, genetic testing that reveals a body’s genetic strengths and weaknesses, comprehensive hormonal testing to understand how the orchestra of the body’s hormones is working together, and so much more.

I have found that, when used properly, some testing can greatly benefit the decision-making process around certain clinic cases. But with this area being so new and ever-evolving, there is a risk of test results not being used in an optimal way. For example, we may have a stool test revealing an overgrowth of bacteria within the small intestine, causing bloating. But we still need to be asking ourselves: why are the bacteria overgrown there in the first place? Unfortunately, I see so many naturopaths making this mistake and neglecting to dig a little deeper in the more traditional ways.

One area that has excited me greatly in more recent years is the emergence of  medicinal mushrooms usage in the West. (I may have to hold back my unbridled excitement on this one!) Mushrooms such as Shiitake, Reishi, Lion’s Mane and Turkey Tail have, for hundreds if not thousands of years, been a key feature within the medical systems of many Asian countries, and with our understanding of how these amazing fungi work growing every day, it is no surprise to see their popularity increasing in Western countries.

Higher quality supplements are continuing to be developed and are becoming more accessible, which ultimately provides much greater benefits for patients. I remember when I first learnt about probiotic supplements, there were only a couple of brands on the market and they all used the same bacterial strains. Fast forward to today and we now have probiotic formulae targeted at just about every area of concern, e.g., the skin, gut, reproductive tract, mouth, and so much more!

WHAT HAS DISAPPEARED OR BECOME LESS POPULAR IN THE LAST 25 YEARS?

Well, thankfully, urine therapy is no longer a feature in a typical naturopath’s clinic! We have certainly made progress in some areas. Jokes aside, there are areas which have declined in use and, sadly, most are probably at a loss to the profession.

The shift to focusing on ‘evidence’ to support the application of certain natural interventions has resulted in the decline of some therapeutic modalities that simply do not fit within the methodology demanded by the evidence-based medicine model. Modalities such as Bach flowers, Bush flowers and Kinesiology seem to be less popular as a result, which is a great shame for patients who would be served very well by these approaches which we might consider ‘energetic’.

I often ask students in my CNM lectures: should we dismiss a modality just because a research study does not show ‘evidence’ that it works, despite the results experienced by so many patients? I talk from my own experience, and also that of so many other naturopaths who use these modalities with great success, when I say that these natural approaches mentioned can produce the most profound responses.

My own favourite of the ‘energetic’ medicines are the Bach flowers, which are emotional remedies that can provide a sense of balance when someone is feeling emotionally ‘imbalanced’. For example, if feeling resentful, impatient, overwhelmed, anxious or struggling with grief, Bach flowers can work a treat! (See our article on page 46 for more about the Bach flower system and how it works).

For many naturopaths, acceptance within a conventional medical setting is important.

Whilst for some, this journey can be successful, for others, this search for acceptance and respect can result in practitioners becoming less aligned with fundamental

naturopathic principles, ultimately resulting in patients not being given a truly holistic, cause-focused and individualised approach to care.

SO, WHAT CAN WE EXPECT IN THE NEXT 25 YEARS?

The future of naturopathy looks extremely bright. With the rates of chronic disease continuing to rise every year, the general public becoming more aware of the limitations within current conventional healthcare models, and the increased interest in people taking responsibility for their health, more people are likely to keep seeking naturopathic support.

In a world that has become increasingly digitalised and disconnected, the value of a naturopathic consultation is likely to be given greater emphasis. I am realising more and more just how therapeutic the consultation process itself is, before I even give my patient their naturopathic plan. What does that tell you? Equally, in this modern world where so many people are ‘out of touch’ with each other, I imagine ‘hands-on’ therapies will also become more popular.

I also expect to see energetic practices come back more strongly as the pendulum always swings. At CNM we have spent years updating our naturopathic training to the point where we now have a beautiful balance between applying traditional naturopathic concepts and energetic modalities, whilst drawing upon new knowledge that can help inform the clinical decision-making process.

It is the fundamental principles of naturopathy that we must not forget, because it is this ‘art’ that makes naturopathic medicine so unique and effective. And, of course, over the next 25 years, I look forward to welcoming more students who want to truly make a positive difference to people’s lives and who decide to come and study naturopathic medicine with us at CNM.