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Integrating science and
religion – implications for
the scientific understanding
of Chinese medicine
Part II: using Ken Wilber’s
Integral Vision as a basis
for the integration of
Chinese medicine and
Western science
Belinda J. Anderson
INTRODUCTION
Part I of this article1
presented an essay review of
Ken WilberÕs book The Marriage of Sense and
Soul: Integrating Science and Religion.34
In Part II
I will use WilberÕs ideas as the basis of an approach
to the integration of Western science (WS) and
Chinese medicine (CM). The term CM is used to
cover all forms of oriental medicine that have de-
veloped from CM.
In the last couple of 100 years we have seen WS
grow into a very powerful force throughout the
world. Following the differentiation of the three
value spheres (arts, morals, and science) with the
rise of modernity, science has grown as the domi-
nant way to establish truth and reality. Science
being heavily reliant on sensory empiricism has
debased other ways of establishing truth and reality
such as spiritual experiences. This has lead to the
almost complete disappearance of the Great Nest of
Being, a belief that all the worldÕs great wisdom
traditions had until this point subscribed to. This
belief is that reality is a rich tapestry of interwoven
levels, reaching from matter to body to mind to soul
to spirit. Each level incorporates and transcends its
lower level. Science does not credit the upper levels
of the Great Nest of Being (soul and spirit) as being
able to determine truth and reality, science instead
R E V I E W
Correspondence to:
Belinda J. Anderson,
PhD, New England School
of Acupuncture, 40 Belmont
Street, Watertown, MA
02472, USA. Tel.: +617 491
3171; E-mail: beaua@
concentric.net
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
looks to matter, body and mind as being the de-
terminants of what we can know to be true. Instead
of transcending and incorporating the lower levels,
soul and spirit are abruptly removed, thereby de-
stroying the notion of the Great Nest of Being.
Wilber using his four-quadrant model and scientific
method (the three strands of knowledge) argues that
valid truth can be gained from sensory empiricism,
mental empiricism and spiritual empiricism. He
proposes that this approach has the potential to
marry science and religion.
CM incorporates all levels of the Great Nest of
Being, both in its theories and practice. With the
widespread adoption of CM in the Western world
and the influence of WS upon China we are wit-
nessing an interesting phase in the evolution of CM.
Much of the soul and spirit aspects of CM have
diminished over the last century due to these trends.
It has been a necessary sacrifice for WS and CM to
co-exist and find some common ground. Wilber
claims that science and religion will never be truly
integrated without the recognition of the value of
the soul/spirit levels of the Great Nest of Being.
Likewise, my thesis in this article in that for CM
and WS to be truly integrated, the soul and spirit
aspects of CM, and spiritual empiricism as a way of
determining truth, must be embraced.
WILBER AND THE INTEGRAL
VISION
Wilber has developed an Integral Vision,33
which
aims to incorporate all levels of the Great Nest of
Being, all four quadrants (see below), and the entire
spectrum of consciousness to heal the fragmenta-
tions of modernity, namely, the dissociation of the
value spheres – arts, morals, and science. I will now
briefly review WilberÕs ideas before venturing into
the integration of WS and CM. This material is
covered in detail in Part I of this article.1
Wilber developed the four-quadrant model as a
way of differentiating between the exterior domains
(those focused upon by science), and the interior
domains (those represented by arts and morals). Put
simply the exterior domains have simple location,
you can put your finger on them, like rocks, houses,
bones, planets, etc. (Wilber refers to these as ITS).
Whereas the interior domains (the I and WE) do not
have simple location, you cannot put your finger on
love, mercy, compassion, morals, ethics, etc. He
divides the interior and exterior domains into indi-
vidual and collective, giving four separate catego-
ries (four quadrants). The individual and collective
exteriors are all in the realm of science, with indi-
vidual exterior represented by studies into the in-
dividual parts of the living world (molecules, cells,
tissues, organs, organisms, etc.), and collective
exteriors represented by the study of systems,
which includes system and information theory, the
Gaia hypothesis, etc. For the interior domains the
individual interior (I) includes mental and psycho-
logical developmental stages right through to
spiritual enlightenment, while the collective interi-
ors (WE) includes socially and culturally deter-
mined systems. A simple example of WilberÕs33
to
distinguish between these is as follows.
If someone had the thought they needed to go to
the grocery store. The individual exterior would be
the brain processes that would be associated with
having that thought. The whole idea of grocery
store and the associated symbols in the mind that
would conjure up are the individual interior.
Someone speaking a different language or in an-
other culture would get very different symbols and
words for the same basic thought. This cultural
backdrop represents the collective interior, our
thoughts are molded by the cultural context. The
social correlates of the cultural backdrop, for ex-
ample, types of technology, forces of production
(horticultural, agrarian, industrial, etc.), concrete
institutions, written codes, and practices, etc., rep-
resent the collective exterior. All these four quad-
rants, intentional, behavioral, cultural and social,
are interwoven and mutually determining.
Modernity in the Western world was associated
with the differentiation of the value spheres; arts,
moral, and science. This allowed each to achieve
independence and individuality and was the pri-
mary force behind the great advances of the modern
world, for example, artistic diversity and expres-
sion, democracy, ethnic and gender equality, and
the rapid and impressive expansion of science and
technology. However, the big three (arts, morals,
and science) did not remain connected in a way that
was mutually empowering. Instead science with its
awe inspiring achievements rose up to dominate the
two other value spheres. Science became scientism
characterized by scientific imperialism and scien-
tific materialism. The modern world, enamored
with the achievements of modern science, accepted
the sensory empirical approach of science as being
superior to other ways of perceiving the world, such
as thoughts, feelings, cultural, and societal inter-
pretations. In effect science viewed the world from
the exterior, focusing on what could be observed
and measured, and the interior modes of knowing
became devalued. What made this domination of
the exteriors over the interiors so convincing and
therefore powerful was the demonstration by sci-
ence that all interiors in fact have exterior corre-
lates. For example, different states of consciousness
and mood states have correlates represented by
Clinical Acupuncture and Oriental Medicine2
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
specific brain processes and chemicals, and hence
depression can be simply reduced to serotonin
levels in the brain.
This domination by scientism reflected that the
once constructively differentiated value spheres,
had now degenerated in their relationship into dis-
sociation. They had lost their mutually positive
interaction, one had risen up and dominated the
other two out of serious consideration in deter-
mining ÔrealityÕ. Essentially what this represented
was the collapse of the Great Nest of Being as
described above. Science with its sensory empirical
approach focused exclusively on the lower levels of
the Great Nest of Being, namely, matter, body and
to a lesser extent mind (in disciplines like mathe-
matics). The upper levels were left to the interests
of the interior domains, especially religious and
spiritual perceptions. The lower levels were seen as
revealing ÔtruthÕ and ÔrealityÕ, thereby demolishing
the validity of soul and spirit in revealing ÔtruthÕ and
ÔrealityÕ.
Several stances arose with the 18th century en-
lightenment to counter this dissociation, and we see
these alive and active today. These stances were
outlined in detail in Part I of this article,1
and so I
will just list them here. They are as follows:
1. Science denies any validity to religion
2. Religion denies any validity to science
3. Science is one of several valid modes of
knowing, and thus can peacefully coexist with
spiritual modes (epistemological pluralism)
4. Science can offer plausibility arguments for the
existence of spirit
5. Science itself is not knowledgeable of the world
but merely an interpretation of the world, and
therefore it has the same validity – no more, no
less – as poetry and the arts (Postmodernism).
In addition to these stances there were also
distinct historical philosophical trends that repre-
sented attempts to redress the dissociation of arts,
morals, and science that modernity brought about.
These, as mentioned in Part I, were Romantic,
Idealist, and Postmodern. The Romantics sought to
heal modernityÕs fragmentation by reembracing the
time prior to the dissociation of the value spheres.
They romanticized such times seeing them as pri-
mal, pristine, and pure, forgetting the atrocities that
also accompanied such periods in history. They
failed in their attempt at integration simply because
there must be differentiation before integration and
they had regressed to pre-differentiation.
The Idealists took the opposite view to the Ro-
mantics who basically embraced the idea of devo-
lution. They believed in evolution as the procession
from nature to humanity to divinity, or from sub-
conscious to self-conscious to superconscious,
where Spirit is fully present at every stage because
spirit is the process itself. Through these ideas the
Idealists came very close to integrating the three
value spheres, however, they failed because they
possessed no yoga, no tried and true method for
reliably reproducing the transpersonal and super-
conscious insights that formed the very core of the
Idealist vision. Their concept of transpersonal
knowledge was dismissed as mere metaphysics,
which in the bad sense of the word means, Ôany
thought system without means of verificationÕ.34
Stance number 5 mentioned above is a hallmark
of the postmodern approach to scientism, which
basically sees science as just another set of Ôpara-
digmsÕ with equal validity as other possible non-
scientific ÔparadigmsÕ. Here we meet the problem
with the word ÔparadigmÕ. This word, as originally
suggested by Thomas Kuhn,15
refers to the experi-
mental approaches (injunctions) that science uses as
models for how to practice science, and the social
structures that keep them in place, like teaching and
rewards. Basically what Kuhn was saying is that
scientific facts are embedded in cultural practices or
paradigms, and as Wilber points out Ôthis does not
deny the objective component of the knowledge; it
denies that the knowledge is merely objective and
innocently empiricalÕ.33
In other words the post-
modern claim, that the world is not an innocent
perception, but is in part a construction, an inter-
pretation, rightly points out that science too, is in
part, a subjective interpretation directly determined
by its paradigms. However, the paradigms of sci-
ence are derived from empirical evidence, which
distinguishes them from the postmodern notion of
Ônew paradigmÕ, which does not require the valida-
tion of evidence. As Wilber points out, removing
this necessity for evidence allowed theoreticism to
flourish fueled by a narcissistic generation who felt
its own beliefs (paradigms) were equally valid as
those based on empirical evidence.34
Furthermore, no Ônew paradigmÕ, be it scientific
or otherwise, is going to reinstate the Great Nest of
Being by validating the interior domains, unless it
uses the eye of contemplation. Here Wilber distin-
guishes between knowledge and understanding that
is gained by sensory empiricism (eye of flesh),
rational knowledge (eye of mind), and spiritual
knowledge (eye of contemplation). Science uses
the eyes of flesh and mind. The eye of contem-
plation (gnosis) transcends the logical, rational and
mental realms and discloses formless mysticism in
openness to the divine. ÔThe deepest of problems
and mysteries directly yields its resolution only to
the eye of contemplationÕ.33
The injunctions of the
eye of contemplation are meditation and contem-
plation. Many Ônew paradigmÕ thinkers, especially
those who espouse the virtues of quantum/relativ-
3Integrating science and religion
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
istic and systems/complexity theories over the
Newtonian–Cartesian worldview, fail to recognize
this very important point. Such new scientific par-
adigms are based solely on knowledge gained by
the eyes of flesh and mind, in no instance does
science embrace the eye of contemplation as a
means for obtaining knowledge.
Wilber argues that the three ways of knowing
(eye of flesh, eye of mind, and eye of contempla-
tion, or empiricism, rationalism, and mysticism) are
all forms of valid knowledge that can be confirmed
by the three strands of knowledge.34
These include
(1) instrumental injunction (the practice, prescribed
experimental methodology), (2) direct apprehen-
sion (experience, data), and (3) communal confir-
mation (checking the results/evidence with others),
as explained in detail in Part I.1
Just as the exper-
imental paradigm in the life sciences might be a
microscope, and that in human sciences a linguistic
interpretation, in the spiritual sciences it would be
meditation or contemplation. Spiritual science is
just as amenable to validation by the three strands
of knowledge, as are empirical and rational sci-
ences. The practices (injunctions), experiences (il-
luminations, data), and confirmation (with a
Master) of the eye of contemplation Ôare all per-
fectly repeatable, verifiable, or falsifiable – all of
which therefore constitute a perfectly valid mode of
knowledge acquisitionÕ.33
CHINESE MEDICINE, THE FOUR
QUADRANTS, AND THE GREAT
NEST OF BEING
CM incorporates both interior and exterior do-
mains, and advocates the existence of all levels of
the Great Nest of Being. It is generally thought of
as being holistic, with some exceptions.31
Birch19
describes CM as non-reductionist, non-dualisitic
and acausal to differentiate it from WS, which has
the opposite characteristics. The practitioner of CM
considers the complete physiological and psycho-
logical picture of the patient. Disease is seen as a
pattern of disharmony involving symptoms, patient
constitution and environmental factors, rather than
being caused by a specific entity, as is the case with
Western medicine. These ideas are expressed suc-
cinctly by Kaptchuk:14
The Chinese method is based on the idea
that no single part can be understood
except in its relation to the whole. A
symptom, therefore, is not traced back to a
cause, but is looked at as a part of a
totality. If a person has a complaint or
symptom, Chinese medicine wants to know
how the symptom fits into the patientÕs
entire being and behavior. Illness is
situated in the context of a personÕs life
and biography. Understanding the overall
pattern, with the symptom as part of it, is
the challenge of Chinese medicine. The
Chinese system is not less logical than the
Western, just less analytical.
Here we see the interweaving of the interior and
exterior domains, all four quadrants are represented
and they are seen as being mutually determining.
This is also seen in the theories of CM. Here I will
limit the discussion to the theories that constitute
the medicine of systematic correspondence,31
which
became more widespread in the Han dynasty, and
includes concepts that are central to the practice of
most current forms of CM. These include the con-
cept of qi and its circulation, yin/yang and five
phase theories. Qi is a difficult word to define in
English, and indeed it has had many different
translations.36
However, examining the general idea
of qi, the so called Ôqi paradigmÕ,5
demonstrates the
undifferentiated nature of CM, and its conceptual
inclusion of the Great Nest of Being. The best
discourse I have found on the qi concept and its
relationship to the Great Nest of Being are the
words of Tu Wei-Ming:14
All modalities of being, from a rock to
heaven, are integral parts of a continuum
(ta hua). Since nothing is outside of this
continuum, the chain of being is never
broken. A linkage will always be found
between any given pair of things in the
universe.
His comments on the difficulty of understanding
qi in the Western world are equally as compelling:
The unusual difficulty of making Qi
intelligible in modern Western philosophy
suggests that the underlying Chinese
metaphysical assumption is significantly
different from the Cartesian dichotomy
between spirit and matter. . .. The continuous
presence in Chinese philosophy of the idea of
Qi as a way of conceptualizing the base
structure and function of the cosmos, despite
the availability of symbolic resources to
make an analytical distinction between spirit
and matter, signifies a conscious refusal to
abandon a mode of thought that synthesizes
spirit and matter as an undifferentiated
whole. . .. The fruitful ambiguity of Qi allows
philosophers to explore realms of being
which are inconceivable to people
constricted by the Cartesian dichotomy.
Clinical Acupuncture and Oriental Medicine4
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
CM also has a well-developed empirical com-
ponent. Observations of the human body, the en-
vironment and their interrelationship were
catalogued, labeled and organized in the theories of
yin/yang and the five phase, and central to both of
these was the concept of Qi. Such sensory empirical
derived information differs from that of WS mainly
because CM observed and deducted from the per-
spective of continuity and interrelationship, while
WS observed and deducted from the perspective of
cause and effect. Furthermore, CM included in its
categories qualities belonging to the interior do-
mains, such as psychological states, and did not
attempt to reduce these to exterior correlates. WS,
on the other hand, seeks to find measurable exterior
correlates of the interior domains (like brain
chemicals as a correlate of psychological state), and
perceives the exterior correlate to be a superior
validation.
CHINESE MEDICINE IN THE WEST
AND ITS INTERPLAY WITH
WESTERN SCIENCE
From this perspective it is not at all surprising that
CM and WS have developed an uncomfortable re-
lationship. The infiltration of WS into CM began in
the early 20th century and developed rapidly after
the communist party resurrected the countryÕs tra-
ditional medical practices as the only practical
means of dealing with the drastic prevailing health
crisis.5
Leading up to this time Western scientific
and technological advances had been enthusiasti-
cally embraced by China, almost to the extinction
of its own traditional medical system. Traditional
Chinese Medicine (TCM) was favored as the best
form of CM practice to meet this challenge, and
hence it's perpetuation and dissemination through-
out communist China and the Western world. In
many respects TCM has incorporated many of the
underlying concepts of biomedicine, and much of
what was not compatible with Western scientific
views was simply not incorporated into TCM.35
However, basic CM theoretical principles of diag-
nosis and treatment (e.g., yin/yang, five phase,
zang/fu, channel theory) remain integral parts of
the practice.
TCM is the predominant form of CM that is
practiced in the Western world, however, it repre-
sents only one form of CM that is currently prac-
ticed worldwide. Birch19
has suggested basically
three different forms of contemporary CM practice.
These he termed traditional, scientific, and inte-
grationist. Traditional includes TCM (although it is
really an amalgamation of traditional and scientific)
and practices that attempt to keep closely to ap-
proaches gleaned directly from the surviving clas-
sical literature. Scientific refers to practices that
have withstood scientific scrutiny and hence in-
clude only those approaches that have been vali-
dated by Western science (for examples see12;30
).
Integrationist, as the name suggests, include ap-
proaches that are based on attempted integrations
between CM and Western medical models (exam-
ples include26;32
). The traditional and integrationist
approaches have retained the undifferentiated, non-
reductionist, non-dual, acausal characteristics of
classical CM (as discussed above). The scientific
approaches are an example of the Western scientific
requirement for validation through the use of sen-
sory empirical analysis (upper right quadrant), and
as such tend to reduce acupuncture, for example, to
a collection of measurable neurological processes.
In looking at these various approaches and their
respective degree of comfort with and acceptability
to WS we see many parallels with WilberÕs five
stances (see above) that exist between religion and
WS. The traditional approaches tend to be disin-
terested in science and its methods of verification,
whereas science tends to classify such approaches
as Ôancient metaphysicsÕ, Ôfolk lawÕ and the like.
Here we see polarization reflective of WilberÕs
stance numbers 1 and 2. Integrationist approaches
are an example of epistemological pluralism
(stance number 3). The validation by WS of some
CM treatment methods is an example of stance
number 4. This is seen most extensively in the
neurological models that are proposed for the
mechanistic basis of acupuncture.29
Stance number
5 as discussed above and extensively in Part I is
Postmodernism, and I think the best example of this
influence with regard to CM and its practice in the
Western world is consumer demand. Modern day
health care consumers, being products of their
postmodern culture, are demanding complimentary
and alternative medicine (CAM),11
seemingly dis-
interested in the relative scientific validity of the
paradigms that each is based upon. It has been
suggested that this trend is a refection of the desire
to find a healthcare alternative that is more con-
gruent with oneÕs own values, beliefs and philo-
sophical orientations towards health and life.2
Parallels with the historically based reactions to
scientism can be seen in the interplay between WS
and CM. The romantic-type reaction is seen on the
part of consumers (patients) and practitioners.
Consumers are often seeking a more personal, tra-
ditional, ancient, even mystical approach to their
healing that also addresses emotional and spiritual
aspects of their health. The disillusionment with
what is often perceived as an increasingly techno-
5Integrating science and religion
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
logical, less personal Western medical system (a
by-product of scientism) is an important driving
force encouraging people to investigate CAM
therapies. Many CM practitioners and students are
also attracted to CM for similar reasons. In a sense
there is a kind of na€ııve belief that ancient/tradi-
tional is better simply because it was developed
before the industrial revolution and the imperialistic
rise of science and technology. Often, as Wilber has
described of the Romantic Movement, there is a
lack of appreciation for what it was really like in
ancient China when CM was all there was. There
are romantic notions of a bygone era.
A parallel with the Idealists is probably best
demonstrated by the successful existence of many
forms of CM (as discussed above) despite the lack
of modern scientific validation. There exists a
critical mass of consumers and practitioners, and a
flourishing education system in many Western
countries.5
Like the Idealist philosophy it appears
that something very real and valuable has been re-
alized and given form. If we see CM as including
all levels of the Great Nest of Being (and all
quadrants), thus incorporating soul, spirit, and
consciousness, than it may be that the incorporation
of CM into the Western world is part of our overall
evolution, in the sense of shifting the balance more
towards the higher levels of the Great Nest. The
downfall of the idealists was that they possessed no
yoga, or no tried and true way of reproducing the
transpersonal and superconscious insights that
formed the very core of their vision. Is such a
scenario in the future of CM? It is a complex
question, in part due to the diversity of different
types of practices that exist with their varying de-
grees of Western scientific influence, and because
CAM therapies have the potential to induce change
to predominant Western scientific paradigms. The
latter is discussed in more detail below. Perhaps the
critical issue is the ability of CM to retain the au-
thenticity and use of its already existing tried and
true yogas, and the capacity of these to be valued
and validated by the modern world.
The Postmodern Movement is also seen in the
attempts to understand how CM works. Perhaps the
best examples are the efforts that have been made to
understand the more esoteric practices included in
CM, such as acupuncture, moxabustion and exer-
cises (Qi Gong and Tai Ji). Many feel that current
Western scientific paradigms, i.e., the molecular
paradigm that dominates biology and medicine, are
incapable of providing a satisfactory understanding
of these therapies.4;5;19;22;24;25;28
So new paradigms
have been proposed to explain possible mecha-
nisms (see below). Many of these new paradigms
are based on newer scientific theories (mainly
from physics) and hence are not examples of what
Wilber referred to as more typical of the general
postmodern trend, which was characterized by un-
substantiated narcissistic theories. However, un-
substantiated (and sometimes narcissistic) theories
and ideas do exist, in part because of the difficulty
of scientifically testing such theories, and as a re-
action against the domination of scientism. As
Wilber points out, Postmodernism was correct in its
conclusion that the world is indeed an interpreta-
tion, but what Wilber was critical of was the further
statement that all interpretations are equally valid.
He reminds us that there is the necessity for some
way of validating various interpretations to distin-
guish between those that are supported by the
Universe and those that are not.
SCIENTIFIC INVESTIGATION OF
CHINESE MEDICINE
The predominant reliance of WS upon sensory
empirical analysis is also reflected in Western
medicine (WM), which using the same approach to
finding ÔtruthÕ, claims to mainly use approaches that
have passed the efficacy test and as such is often
referred to as evidence-based medicine. Conse-
quently the rise in consumer demand for CAM in
the West has been accompanied by an increasing
amount of scientific investigation into these thera-
pies. This research effort can be generally divided
into two categories according to two fundamental
questions: (1) Does it work (efficacy)? and (2)
How does it work (mechanism)? Of all the CAM
modalities, CM has probably received the most
attention in both of these categories, with greater
emphasis being placed on efficacy.29
Much has been written lately about the problems
associated with the Western scientific efficacy
testing of CM.18;29
Fundamental to these problems
is the issue that Wilber raises about the sensory
empirical dominance in WS. In efficacy testing of
CM this is well illustrated by the long-standing use
of the randomized blind trial (RBT) for testing CM
therapies. The RBT is the gold seal of Western
clinical research13
because it is seen as the most
effective way to reduce the influence of con-
founding variables. When applied to CM therapies
such as acupuncture, it often produces a clinical
situation that bears very little resemblance to a
normal clinical interaction between practitioner
and patient. The reductionist approach of science
and its keen ability to separate and isolate variables
is fundamentally in conflict with the very foun-
dations of CM, which as mentioned above is ho-
listic, non-reductionist, acausal, and non-dualisitic.
Clinical Acupuncture and Oriental Medicine6
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
Furthermore the denigration by WS of the left hand
interior quadrants is also in conflict with CM, which
tends to place equal importance upon all quadrants
and their relative contributions to health and heal-
ing. A good example of the manifestation of these
conflicts is the predominant use in these efficacy
trials of symptoms as the basis for diagnosis and
selection of treatment regime, and the almost com-
plete lack of use of pattern and eight principal di-
agnosis, which is the fundamental basis of diagnosis
in most forms of CM. WS has no appreciation for
the mental empirical systems of CM, such as yin/
yang, meridian theory, and zang/fu. Such systems,
like logic and mathematics, are mental constructions
based on and extensions of sensory empirical data,
but with no direct sensory empirical ITS. Essentially
this represents two different ways of viewing
the Universe, two possible interpretations, the
question is validity and a way of assessing this to
the satisfaction of both.
Different issues enter the picture with regard to
investigating mechanism. For the purposes of this
article I am going to focus upon the investigations
into how acupuncture works, as this has received by
far the most attention. CM explains acupuncture
from the perspective of its various theories such as qi,
yin/yang, five phase, zang/fu, and meridian theory.
From this perspective conceptual understanding of
acupuncture and how to use it is quite straightforward
with appropriate training and experience. However,
such theories as mentioned above have no validity in
WS and therefore provide no mechanistic basis for
how acupuncture ÔreallyÕ works. Interestingly, acu-
puncture became of great interest to WS in the 1970s
when it was appreciated that it was very effective for
analgesia and to a lesser extent anesthesia. It repre-
sented a much-needed tool to investigate little un-
derstood pain mechanisms in the body. As such it is
no wonder that today there exists a plethora of re-
search data elucidating the proposed neurological
mechanism of acupuncture29
(and references there-
in). Such investigations have also gone beyond just
the use of acupuncture for pain control. In fact recent
studies8
propose that the use of acupuncture based
upon traditional CM meridian theory is also neuro-
logically based, potentially implying that the nervous
system is THE mechanistic basis of acupuncture. The
one significant characteristic of these studies that
fundamentally undermines such a conclusion is that
most of them used either electrical or strong contin-
uous mechanical needle stimulation. Hence we can-
not necessarily extend the conclusions of such
studies to more usual treatment practice, which most
often does not involve such strong needle stimula-
tion. Furthermore, many of the Japanese styles of CM
use minimal needle stimulation and depth of inser-
tion,6;9
and some styles, such as Toyohari, do not
insert the needle at all. Consequently the nervous
system and perhaps molecular mechanisms in gen-
eral may be an inadequate basis for understanding the
varied systems and uses of acupuncture.
Not surprisingly there have been many other
proposed mechanisms for acupuncture, most of
which are based on non-molecular mechanisms.
Unfortunately most of these hypotheses lack ex-
perimental verification largely because at present
we do not have the technical know how to test
them. One notable exception is the work of Robert
Becker.4
Although much of his research interest
was in the area of regeneration, his conclusions
from such research provided probably the most
conclusive body of research to verify the existence
and regulatory role of non-molecular signals and
processes in biological systems (his predominant
interest was electricity). He extended some of his
theories to acupuncture, and suggested that acu-
puncture may work through electrical processes in
the body in concert with the nervous system. There
have been several studies demonstrating that acu-
puncture points have unique electrical proper-
ties.3;27
Other important contributions to our
understanding of possible non-molecular mecha-
nisms for acupuncture include5;20;24;25;28
Ma-
naka.19;21–23
Many of these investigators state that it
is not possible to understand acupuncture within the
confines of current biological paradigms, and that
ÔmodernÕ biology needs to incorporate the implica-
tions of quantum mechanics and relativity theory.
Even if we take the perspective of 20th century
science and embrace the new theories of physics to
demonstrate that acupuncture operates via some
type of non-molecular mechanism, is this the whole
story? From the perspective of WilberÕs four
quadrants and the Great Nest of Being would we
have included the left hand interior quadrants and
the soul and spiritual levels of the Great Nest?
These are difficult questions to answer because
there is the view that such new theories of science
are connected to spiritual domains.7
However, I feel
this approach to understanding acupuncture and
indeed any form of healing is still incomplete be-
cause it does not include the eye of contemplation,
but only the eyes of flesh and mind.
SPIRITUALITY AND CHINESE
MEDICINE
The existence, nature of, and importance of the soul
and spirit levels of the Great Nest of Being in CM is
controversial, especially in modern day practice.
The importance of religions (like Taoism, Bud-
dhism, and Confusicism) in CM varied throughout
7Integrating science and religion
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
history and between different geographical loca-
tions and styles of practice. Hence generalizations
are almost impossible. However, what most might
agree with intuitively is that soul and spirit do exist
in CM, in varying forms and to varying extents
amongst different practitioners. The same could be
said about WM. What we have very little of is
Western scientific validation of the role and im-
portance of this in health and healing, although this
is definitely starting to change.10
Certainly this seems to have been understood and
appreciated in classical CM. One example of this is
the differentiation of types of practitioners. Jeffery
Yuen describes three types of practitioners: shamans,
teachers and doctors. The shamans or what Kapt-
chuk14
describes as the third level practitioner (or
divine illuminating penetration) healed by predom-
inantly ÔspiritualÕ methods. In the words of Kapt-
chuk:14
The Penetrating Divine Illumination is the
magic of soul meeting soul, Spirit reflecting
Spirit. The instantaneous recognition
necessarily initiates profound treatment. The
immediate responses of the physician in the
clinical encounter – the words, posture,
compassion, belief, and vision – deeply
affect and resonate with the spirit of
another human being. The Divine
Penetrating Illumination is the ultimate
basis of healing. Qi Bo, the medical teacher
in the Nei Jing, admits that his sage teacher
not only was not dependent on normal
diagnostic methods, but also had no use for
routine therapeutic interventions such as
herbs or acupuncture. His teacher, the
symbolic archetypal master that all
physicians aspire toward, both knew and
treated exclusively by the Penetrating
Divine Illumination. The discernment of the
Penetrating Divine Illumination
automatically Ômoves the essence (Jing) and
transforms the QiÕ (Su Wen). Intense
communication and intimate recognition
automatically resonate and affirm the
integrity of a patientÕs Qi and Spirit.
This suggests that historically it was recognized
that certain practitioners could achieve rarefied
skills, which enabled a very different (could we say
spiritual) approach to their art of healing. It is quite
likely that such practitioners also regularly engaged
in some type of spiritual practice such as medita-
tion, Tai Chi, or Qi Gong. Therefore their healing
ability may well have been gained from using what
Wilber calls the three ways of knowing (eye of
flesh, eye of mind, and eye of contemplation, or
empiricism, rationalism, and mysticism).
The exact origins of the theories of CM are
somewhat unknown. The appearance and use of dif-
ferent theories throughout history has been quite well
researched and documented.31
However, how such
knowledge was synthesized is not clearly known. For
example, the existence and location of the acupunc-
ture meridians and points was documented through-
out history, but where this knowledge came from is
somewhat of a mystery. Given the nature of Chinese
culture at these times in history and the strong influ-
ence of religion it is likely that such knowledge was
born from a combination of WilberÕs three ways of
knowing. Theories such as yin/yang and five phase
are clear examples of empiricism and rationalism.
Less sensory empirical theories such as zang/fu and
meridian theory show more clearly the possible role
of the eye of contemplation, or mysticism.
It is no coincidence that WS does not accept CM
medicine theories such as yin/yang, five phase and
zang/fu. Although there has recently been some
Western scientific experimental verification for
some of these ancient theories.8;17
This illustrates
WilberÕs argument that WS cannot accept that the eye
ofcontemplationas just as valid a methodofknowing
as the eyes of flesh and mind (or empiricism and
rationalism). It would appear that the only way that
the ancient theories of CM will be accepted by WS is
if they can pass the sensory empirical validation test.
If this were to happen (and we have reason to believe
it will from recent research along these lines8;16;17
),
then it will leave WS in the uncomfortable position of
having to somehow account for these theories even
though they do not have direct sensory empirical
correlates. For example, you cannot anatomically
define an acupuncture point or meridian, and the
zang/fu bear little resemblance to their Western
counterparts. Or perhaps WS will evolve through the
incorporation of this understanding and develop
further theories that can account for their sensory
empirical measurements of these phenomena. In the
same way that WS can define an emotion as a brain
chemical, an acupuncture point will become an
electrical parameter. The theories may become
plausible from the perspective of the new theories of
physics, with measurability and system theory
models. However, all such understandings are ex-
amples of WilberÕs left hand quadrants, in no case
would the eye of contemplation be necessary for this
type of validation of CM.
THE MARRIAGE OF CHINESE
MEDICINE AND WESTERN
SCIENCE
It is unlikely that the scenario just outlined would
represent any type of real marriage of WS and CM.
Clinical Acupuncture and Oriental Medicine8
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
What we would have is the continuation of an al-
ready stifling trend, what Wilber describes as the
brutal collapse of all higher modes of knowing into
monological empirical science. Converting knowl-
edge and understanding of the theories of CM into
the language of WS, even if it is non-molecular
theories far evolved from Newtonian/Cartesian
thinking, does not evolve our understanding away
from monological empiricism because it does not,
in any way, require the eye of contemplation. It
does not acknowledge that the eye of contemplation
is a valid way of obtaining knowledge (data), and
therefore it does not acknowledge the most likely
source of the theories themselves. It can only result
in a truncation and reduction in the breath and depth
of the knowledge, a devolution.
Wilber proposes that for science and religion to
be truly integrated science must give up its em-
phasis on sensory empiricism, and accept that
mental empiricism (logic, mathematics) and spiri-
tual empiricism (experiential mysticism, spiritual
experiences) are equally valid as ways of estab-
lishing truth. The three strands of knowledge (ex-
plained above) are a scientific method for
determining truth that can be applied to sensory,
mental or spiritual empiricism (or the eyes of flesh,
mind, and contemplation). If this were to be
adopted then it would not be necessary to totally
reduce CM theories to sensory empirical correlates.
They would have their value along with an appre-
ciation and validation of the mentally and spiritu-
ally derived aspects of the theories.
If the existence of acupuncture points and me-
ridians, for example, could be validated from the
experiences of practitioners and patients, who en-
gage in cultivating spiritual awareness, then a new
dimension would be incorporated into our modern
understanding of CM. An understanding that in-
corporated the eye of contemplation, and did not
reduce everything to sensory empirical ITS. It
would honor the most likely source of the theories,
and thereby validate the eye of contemplation as a
valid means for knowledge acquisition. Further-
more it would emphasize the value of spiritual
knowledge and thereby actively encourage spiritual
practice amongst students, practitioners, and pa-
tients. Even WM has to acknowledge that healing is
a mysterious and often unpredictable process. In-
corporating and accepting the spiritual dimension
would enable this to seem a more natural and ex-
pected aspect, one worthy of as much acknowl-
edgement and awe as the tremendous technological
advancements of WS and WM.
Validation of the eye of contemplation would
also allow consciousness to be an accepted and
integral part of both knowledge acquisition and
lived awareness. Wilber reminds us that the most
basic data or direct experience that we have is that
of consciousness, intentionality, and immediate
lived awareness, all else are deductions away from
this primordial data.33
The interior approaches (eye
of mind and eye of contemplation) start with the
immediacy of consciousness, and give birth to
possibilities in the exterior (deductions). It is this
aspect, consciousness and intention, that would
most suffer if CM was reduced to exterior corre-
lates. The practitioner, the patient, their con-
sciousness and intention form the unknown matrix
of CM, the formless mystery, the gnosis.
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1. Anderson B.J. Integrating science and religion –
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2. Astin J.A. Why patients use alternative medicine: results
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4. Becker R.O., Selden G. The body electric. New York:
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5. Birch S.J., Felt R.L. Understanding acupuncture. London:
Churchill Livingstone, 1999.
6. Birch S.J., Ida J. Japanese acupuncture. A clinical guide.
Boston: Paradigm Publications, 1998.
7. Capra F. The Tao of physics. Boston: Shambhala
Publications, 1975.
8. Cho Z.H., Chung S.C., Jones J.P., Park J.B., Park H.J.,
Lee H.J., Wong E.K., Min B.I. New findings of the
correlation between acupoints and corresponding brain
cortices using functional MRI. Proc Natl Acad Sci USA
1998;95(5):2670–2673.
9. Denmai S. Japanese classical acupuncture. Introduction to
meridian therapy. Seattle: Eastland Press, 1990.
10. Dossey L. Do religion and spirituality matter in health? A
response to the recent article in The Lancet. Altern Ther
Health Med 1999;5(3):16–18.
11. Eisenberg D.M., Davis R.B., Ettner S.I., Appel S., Wilkey
S., Van Rompay M., Kessler R.C. Trends in alternative
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scientific approach. New York: Churchill Livingstone,
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13. Hulley S.B., Cummings S.R., Browner W.S., Grady D.,
Hearst N., Newman T.B. Designing clinical research. An
epidemiological approach. New York: Lippincott
Williams and Wilkins, 2001.
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Chinese medicine. Chicago: NTC/Contemporary
Publishing group, 2000.
15. Kuhn T.S. The structure of scientific revolutions.
Chicago: The University Press, 1970.
16. Kwok G., Cohen M., Cosic I. Mapping acupoints using
multi channel device. Australas Phys Eng Sci Med
1998;21(2):68–72.
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17. Langevin H.M., Churchill D.L., Wu J., Badger G.J.,
Yandow J.A., Fox J.R., Krag M.H. Evidence of
connective tissue involvement in acupuncture. FASEB J
2002;16(8):872–874.
18. MacPherson H., Sherman K., Hammerschlag R., Birch S.,
Lao L., Zaslawski C. The clinical evaluation of traditional
East Asian systems of medicine. Clinical Acupuncture
and Oriental Medicine 2002;3(1):16–19.
19. Manaka Y., Itaya K., Birch S. Chasing the dragonÕs tail.
Boston: Paradigm Publications, 1995.
20. Matsumoto K., Birch S. Hara diagnosis: reflections on the
sea. Boston: Paradigm Publications, 1988.
21. Milburn M.P. Emerging relationships between the
paradigm of oriental medicine and the frontiers of
western biological science. Am J Acupuncture
1994;22:145–157.
22. Milburn M.P. Bioelectromagnetics: implications for
oriental medicine and acupuncture. Am J Acupuncture
1995;23(1):53–62.
23. Milburn M.P. The future of healing. Exploring the
parallels of Eastern and Western medicine. Freedom: The
Crossing Press, 2001.
24. Oschman J. A biophysical basis for acupuncture.
Proceedings of the First Symposium of the Society for
Acupuncture Research, Rockville, MD, 1994.
25. Oschman J. Energy medicine. The scientific basis. New
York: Churchill Livingstone, 2000.
26. Requena Y. Terrains and pathology in acupuncture.
Boston: Paradigm Publications, 1986.
27. Rosenblatt S.L. The electrodermal characteristics of
acupuncture points. Am J Acupuncture 1982;10:131–137.
28. Rubik B. Can western science provide a foundation for
acupuncture?. Altern Ther Health Med 1995;1:41–47.
29. Stux G., Hammerschlag R. Clinical acupuncture.
Scientific basis. New York: Springer, 2001.
30. Ulett G.A, Han S. The biology of acupuncture. Saint
Louis: Warren H. Green, 2002.
31. Unschild P.U. Medicine in China. A history of ideas.
Berkeley: University of California Press, 1985.
32. Voll R. Twenty years of electroacupuncture therapy using
low-frequency current pulses. Am J Acupuncture
1975;3(4):291–324.
33. Wilber K. The eye of spirit. Boston: Shambhala
Publications, 1997.
34. Wilber K. The marriage of sense and soul: integrating
science and religion. New York: Random House, 1998.
35. Wiseman N., Ellis A. Fundamentals of Chinese medicine.
Boston: Paradigm Publications, 1995.
36. Wiseman N., Ye F. A practical dictionary of Chinese
medicine. Boston: Paradigm Publications, 1998.
Clinical Acupuncture and Oriental Medicine10
Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.

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Integrating science and religion Part 2

  • 1. Integrating science and religion – implications for the scientific understanding of Chinese medicine Part II: using Ken Wilber’s Integral Vision as a basis for the integration of Chinese medicine and Western science Belinda J. Anderson INTRODUCTION Part I of this article1 presented an essay review of Ken WilberÕs book The Marriage of Sense and Soul: Integrating Science and Religion.34 In Part II I will use WilberÕs ideas as the basis of an approach to the integration of Western science (WS) and Chinese medicine (CM). The term CM is used to cover all forms of oriental medicine that have de- veloped from CM. In the last couple of 100 years we have seen WS grow into a very powerful force throughout the world. Following the differentiation of the three value spheres (arts, morals, and science) with the rise of modernity, science has grown as the domi- nant way to establish truth and reality. Science being heavily reliant on sensory empiricism has debased other ways of establishing truth and reality such as spiritual experiences. This has lead to the almost complete disappearance of the Great Nest of Being, a belief that all the worldÕs great wisdom traditions had until this point subscribed to. This belief is that reality is a rich tapestry of interwoven levels, reaching from matter to body to mind to soul to spirit. Each level incorporates and transcends its lower level. Science does not credit the upper levels of the Great Nest of Being (soul and spirit) as being able to determine truth and reality, science instead R E V I E W Correspondence to: Belinda J. Anderson, PhD, New England School of Acupuncture, 40 Belmont Street, Watertown, MA 02472, USA. Tel.: +617 491 3171; E-mail: beaua@ concentric.net Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 2. looks to matter, body and mind as being the de- terminants of what we can know to be true. Instead of transcending and incorporating the lower levels, soul and spirit are abruptly removed, thereby de- stroying the notion of the Great Nest of Being. Wilber using his four-quadrant model and scientific method (the three strands of knowledge) argues that valid truth can be gained from sensory empiricism, mental empiricism and spiritual empiricism. He proposes that this approach has the potential to marry science and religion. CM incorporates all levels of the Great Nest of Being, both in its theories and practice. With the widespread adoption of CM in the Western world and the influence of WS upon China we are wit- nessing an interesting phase in the evolution of CM. Much of the soul and spirit aspects of CM have diminished over the last century due to these trends. It has been a necessary sacrifice for WS and CM to co-exist and find some common ground. Wilber claims that science and religion will never be truly integrated without the recognition of the value of the soul/spirit levels of the Great Nest of Being. Likewise, my thesis in this article in that for CM and WS to be truly integrated, the soul and spirit aspects of CM, and spiritual empiricism as a way of determining truth, must be embraced. WILBER AND THE INTEGRAL VISION Wilber has developed an Integral Vision,33 which aims to incorporate all levels of the Great Nest of Being, all four quadrants (see below), and the entire spectrum of consciousness to heal the fragmenta- tions of modernity, namely, the dissociation of the value spheres – arts, morals, and science. I will now briefly review WilberÕs ideas before venturing into the integration of WS and CM. This material is covered in detail in Part I of this article.1 Wilber developed the four-quadrant model as a way of differentiating between the exterior domains (those focused upon by science), and the interior domains (those represented by arts and morals). Put simply the exterior domains have simple location, you can put your finger on them, like rocks, houses, bones, planets, etc. (Wilber refers to these as ITS). Whereas the interior domains (the I and WE) do not have simple location, you cannot put your finger on love, mercy, compassion, morals, ethics, etc. He divides the interior and exterior domains into indi- vidual and collective, giving four separate catego- ries (four quadrants). The individual and collective exteriors are all in the realm of science, with indi- vidual exterior represented by studies into the in- dividual parts of the living world (molecules, cells, tissues, organs, organisms, etc.), and collective exteriors represented by the study of systems, which includes system and information theory, the Gaia hypothesis, etc. For the interior domains the individual interior (I) includes mental and psycho- logical developmental stages right through to spiritual enlightenment, while the collective interi- ors (WE) includes socially and culturally deter- mined systems. A simple example of WilberÕs33 to distinguish between these is as follows. If someone had the thought they needed to go to the grocery store. The individual exterior would be the brain processes that would be associated with having that thought. The whole idea of grocery store and the associated symbols in the mind that would conjure up are the individual interior. Someone speaking a different language or in an- other culture would get very different symbols and words for the same basic thought. This cultural backdrop represents the collective interior, our thoughts are molded by the cultural context. The social correlates of the cultural backdrop, for ex- ample, types of technology, forces of production (horticultural, agrarian, industrial, etc.), concrete institutions, written codes, and practices, etc., rep- resent the collective exterior. All these four quad- rants, intentional, behavioral, cultural and social, are interwoven and mutually determining. Modernity in the Western world was associated with the differentiation of the value spheres; arts, moral, and science. This allowed each to achieve independence and individuality and was the pri- mary force behind the great advances of the modern world, for example, artistic diversity and expres- sion, democracy, ethnic and gender equality, and the rapid and impressive expansion of science and technology. However, the big three (arts, morals, and science) did not remain connected in a way that was mutually empowering. Instead science with its awe inspiring achievements rose up to dominate the two other value spheres. Science became scientism characterized by scientific imperialism and scien- tific materialism. The modern world, enamored with the achievements of modern science, accepted the sensory empirical approach of science as being superior to other ways of perceiving the world, such as thoughts, feelings, cultural, and societal inter- pretations. In effect science viewed the world from the exterior, focusing on what could be observed and measured, and the interior modes of knowing became devalued. What made this domination of the exteriors over the interiors so convincing and therefore powerful was the demonstration by sci- ence that all interiors in fact have exterior corre- lates. For example, different states of consciousness and mood states have correlates represented by Clinical Acupuncture and Oriental Medicine2 Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 3. specific brain processes and chemicals, and hence depression can be simply reduced to serotonin levels in the brain. This domination by scientism reflected that the once constructively differentiated value spheres, had now degenerated in their relationship into dis- sociation. They had lost their mutually positive interaction, one had risen up and dominated the other two out of serious consideration in deter- mining ÔrealityÕ. Essentially what this represented was the collapse of the Great Nest of Being as described above. Science with its sensory empirical approach focused exclusively on the lower levels of the Great Nest of Being, namely, matter, body and to a lesser extent mind (in disciplines like mathe- matics). The upper levels were left to the interests of the interior domains, especially religious and spiritual perceptions. The lower levels were seen as revealing ÔtruthÕ and ÔrealityÕ, thereby demolishing the validity of soul and spirit in revealing ÔtruthÕ and ÔrealityÕ. Several stances arose with the 18th century en- lightenment to counter this dissociation, and we see these alive and active today. These stances were outlined in detail in Part I of this article,1 and so I will just list them here. They are as follows: 1. Science denies any validity to religion 2. Religion denies any validity to science 3. Science is one of several valid modes of knowing, and thus can peacefully coexist with spiritual modes (epistemological pluralism) 4. Science can offer plausibility arguments for the existence of spirit 5. Science itself is not knowledgeable of the world but merely an interpretation of the world, and therefore it has the same validity – no more, no less – as poetry and the arts (Postmodernism). In addition to these stances there were also distinct historical philosophical trends that repre- sented attempts to redress the dissociation of arts, morals, and science that modernity brought about. These, as mentioned in Part I, were Romantic, Idealist, and Postmodern. The Romantics sought to heal modernityÕs fragmentation by reembracing the time prior to the dissociation of the value spheres. They romanticized such times seeing them as pri- mal, pristine, and pure, forgetting the atrocities that also accompanied such periods in history. They failed in their attempt at integration simply because there must be differentiation before integration and they had regressed to pre-differentiation. The Idealists took the opposite view to the Ro- mantics who basically embraced the idea of devo- lution. They believed in evolution as the procession from nature to humanity to divinity, or from sub- conscious to self-conscious to superconscious, where Spirit is fully present at every stage because spirit is the process itself. Through these ideas the Idealists came very close to integrating the three value spheres, however, they failed because they possessed no yoga, no tried and true method for reliably reproducing the transpersonal and super- conscious insights that formed the very core of the Idealist vision. Their concept of transpersonal knowledge was dismissed as mere metaphysics, which in the bad sense of the word means, Ôany thought system without means of verificationÕ.34 Stance number 5 mentioned above is a hallmark of the postmodern approach to scientism, which basically sees science as just another set of Ôpara- digmsÕ with equal validity as other possible non- scientific ÔparadigmsÕ. Here we meet the problem with the word ÔparadigmÕ. This word, as originally suggested by Thomas Kuhn,15 refers to the experi- mental approaches (injunctions) that science uses as models for how to practice science, and the social structures that keep them in place, like teaching and rewards. Basically what Kuhn was saying is that scientific facts are embedded in cultural practices or paradigms, and as Wilber points out Ôthis does not deny the objective component of the knowledge; it denies that the knowledge is merely objective and innocently empiricalÕ.33 In other words the post- modern claim, that the world is not an innocent perception, but is in part a construction, an inter- pretation, rightly points out that science too, is in part, a subjective interpretation directly determined by its paradigms. However, the paradigms of sci- ence are derived from empirical evidence, which distinguishes them from the postmodern notion of Ônew paradigmÕ, which does not require the valida- tion of evidence. As Wilber points out, removing this necessity for evidence allowed theoreticism to flourish fueled by a narcissistic generation who felt its own beliefs (paradigms) were equally valid as those based on empirical evidence.34 Furthermore, no Ônew paradigmÕ, be it scientific or otherwise, is going to reinstate the Great Nest of Being by validating the interior domains, unless it uses the eye of contemplation. Here Wilber distin- guishes between knowledge and understanding that is gained by sensory empiricism (eye of flesh), rational knowledge (eye of mind), and spiritual knowledge (eye of contemplation). Science uses the eyes of flesh and mind. The eye of contem- plation (gnosis) transcends the logical, rational and mental realms and discloses formless mysticism in openness to the divine. ÔThe deepest of problems and mysteries directly yields its resolution only to the eye of contemplationÕ.33 The injunctions of the eye of contemplation are meditation and contem- plation. Many Ônew paradigmÕ thinkers, especially those who espouse the virtues of quantum/relativ- 3Integrating science and religion Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 4. istic and systems/complexity theories over the Newtonian–Cartesian worldview, fail to recognize this very important point. Such new scientific par- adigms are based solely on knowledge gained by the eyes of flesh and mind, in no instance does science embrace the eye of contemplation as a means for obtaining knowledge. Wilber argues that the three ways of knowing (eye of flesh, eye of mind, and eye of contempla- tion, or empiricism, rationalism, and mysticism) are all forms of valid knowledge that can be confirmed by the three strands of knowledge.34 These include (1) instrumental injunction (the practice, prescribed experimental methodology), (2) direct apprehen- sion (experience, data), and (3) communal confir- mation (checking the results/evidence with others), as explained in detail in Part I.1 Just as the exper- imental paradigm in the life sciences might be a microscope, and that in human sciences a linguistic interpretation, in the spiritual sciences it would be meditation or contemplation. Spiritual science is just as amenable to validation by the three strands of knowledge, as are empirical and rational sci- ences. The practices (injunctions), experiences (il- luminations, data), and confirmation (with a Master) of the eye of contemplation Ôare all per- fectly repeatable, verifiable, or falsifiable – all of which therefore constitute a perfectly valid mode of knowledge acquisitionÕ.33 CHINESE MEDICINE, THE FOUR QUADRANTS, AND THE GREAT NEST OF BEING CM incorporates both interior and exterior do- mains, and advocates the existence of all levels of the Great Nest of Being. It is generally thought of as being holistic, with some exceptions.31 Birch19 describes CM as non-reductionist, non-dualisitic and acausal to differentiate it from WS, which has the opposite characteristics. The practitioner of CM considers the complete physiological and psycho- logical picture of the patient. Disease is seen as a pattern of disharmony involving symptoms, patient constitution and environmental factors, rather than being caused by a specific entity, as is the case with Western medicine. These ideas are expressed suc- cinctly by Kaptchuk:14 The Chinese method is based on the idea that no single part can be understood except in its relation to the whole. A symptom, therefore, is not traced back to a cause, but is looked at as a part of a totality. If a person has a complaint or symptom, Chinese medicine wants to know how the symptom fits into the patientÕs entire being and behavior. Illness is situated in the context of a personÕs life and biography. Understanding the overall pattern, with the symptom as part of it, is the challenge of Chinese medicine. The Chinese system is not less logical than the Western, just less analytical. Here we see the interweaving of the interior and exterior domains, all four quadrants are represented and they are seen as being mutually determining. This is also seen in the theories of CM. Here I will limit the discussion to the theories that constitute the medicine of systematic correspondence,31 which became more widespread in the Han dynasty, and includes concepts that are central to the practice of most current forms of CM. These include the con- cept of qi and its circulation, yin/yang and five phase theories. Qi is a difficult word to define in English, and indeed it has had many different translations.36 However, examining the general idea of qi, the so called Ôqi paradigmÕ,5 demonstrates the undifferentiated nature of CM, and its conceptual inclusion of the Great Nest of Being. The best discourse I have found on the qi concept and its relationship to the Great Nest of Being are the words of Tu Wei-Ming:14 All modalities of being, from a rock to heaven, are integral parts of a continuum (ta hua). Since nothing is outside of this continuum, the chain of being is never broken. A linkage will always be found between any given pair of things in the universe. His comments on the difficulty of understanding qi in the Western world are equally as compelling: The unusual difficulty of making Qi intelligible in modern Western philosophy suggests that the underlying Chinese metaphysical assumption is significantly different from the Cartesian dichotomy between spirit and matter. . .. The continuous presence in Chinese philosophy of the idea of Qi as a way of conceptualizing the base structure and function of the cosmos, despite the availability of symbolic resources to make an analytical distinction between spirit and matter, signifies a conscious refusal to abandon a mode of thought that synthesizes spirit and matter as an undifferentiated whole. . .. The fruitful ambiguity of Qi allows philosophers to explore realms of being which are inconceivable to people constricted by the Cartesian dichotomy. Clinical Acupuncture and Oriental Medicine4 Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 5. CM also has a well-developed empirical com- ponent. Observations of the human body, the en- vironment and their interrelationship were catalogued, labeled and organized in the theories of yin/yang and the five phase, and central to both of these was the concept of Qi. Such sensory empirical derived information differs from that of WS mainly because CM observed and deducted from the per- spective of continuity and interrelationship, while WS observed and deducted from the perspective of cause and effect. Furthermore, CM included in its categories qualities belonging to the interior do- mains, such as psychological states, and did not attempt to reduce these to exterior correlates. WS, on the other hand, seeks to find measurable exterior correlates of the interior domains (like brain chemicals as a correlate of psychological state), and perceives the exterior correlate to be a superior validation. CHINESE MEDICINE IN THE WEST AND ITS INTERPLAY WITH WESTERN SCIENCE From this perspective it is not at all surprising that CM and WS have developed an uncomfortable re- lationship. The infiltration of WS into CM began in the early 20th century and developed rapidly after the communist party resurrected the countryÕs tra- ditional medical practices as the only practical means of dealing with the drastic prevailing health crisis.5 Leading up to this time Western scientific and technological advances had been enthusiasti- cally embraced by China, almost to the extinction of its own traditional medical system. Traditional Chinese Medicine (TCM) was favored as the best form of CM practice to meet this challenge, and hence it's perpetuation and dissemination through- out communist China and the Western world. In many respects TCM has incorporated many of the underlying concepts of biomedicine, and much of what was not compatible with Western scientific views was simply not incorporated into TCM.35 However, basic CM theoretical principles of diag- nosis and treatment (e.g., yin/yang, five phase, zang/fu, channel theory) remain integral parts of the practice. TCM is the predominant form of CM that is practiced in the Western world, however, it repre- sents only one form of CM that is currently prac- ticed worldwide. Birch19 has suggested basically three different forms of contemporary CM practice. These he termed traditional, scientific, and inte- grationist. Traditional includes TCM (although it is really an amalgamation of traditional and scientific) and practices that attempt to keep closely to ap- proaches gleaned directly from the surviving clas- sical literature. Scientific refers to practices that have withstood scientific scrutiny and hence in- clude only those approaches that have been vali- dated by Western science (for examples see12;30 ). Integrationist, as the name suggests, include ap- proaches that are based on attempted integrations between CM and Western medical models (exam- ples include26;32 ). The traditional and integrationist approaches have retained the undifferentiated, non- reductionist, non-dual, acausal characteristics of classical CM (as discussed above). The scientific approaches are an example of the Western scientific requirement for validation through the use of sen- sory empirical analysis (upper right quadrant), and as such tend to reduce acupuncture, for example, to a collection of measurable neurological processes. In looking at these various approaches and their respective degree of comfort with and acceptability to WS we see many parallels with WilberÕs five stances (see above) that exist between religion and WS. The traditional approaches tend to be disin- terested in science and its methods of verification, whereas science tends to classify such approaches as Ôancient metaphysicsÕ, Ôfolk lawÕ and the like. Here we see polarization reflective of WilberÕs stance numbers 1 and 2. Integrationist approaches are an example of epistemological pluralism (stance number 3). The validation by WS of some CM treatment methods is an example of stance number 4. This is seen most extensively in the neurological models that are proposed for the mechanistic basis of acupuncture.29 Stance number 5 as discussed above and extensively in Part I is Postmodernism, and I think the best example of this influence with regard to CM and its practice in the Western world is consumer demand. Modern day health care consumers, being products of their postmodern culture, are demanding complimentary and alternative medicine (CAM),11 seemingly dis- interested in the relative scientific validity of the paradigms that each is based upon. It has been suggested that this trend is a refection of the desire to find a healthcare alternative that is more con- gruent with oneÕs own values, beliefs and philo- sophical orientations towards health and life.2 Parallels with the historically based reactions to scientism can be seen in the interplay between WS and CM. The romantic-type reaction is seen on the part of consumers (patients) and practitioners. Consumers are often seeking a more personal, tra- ditional, ancient, even mystical approach to their healing that also addresses emotional and spiritual aspects of their health. The disillusionment with what is often perceived as an increasingly techno- 5Integrating science and religion Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 6. logical, less personal Western medical system (a by-product of scientism) is an important driving force encouraging people to investigate CAM therapies. Many CM practitioners and students are also attracted to CM for similar reasons. In a sense there is a kind of na€ııve belief that ancient/tradi- tional is better simply because it was developed before the industrial revolution and the imperialistic rise of science and technology. Often, as Wilber has described of the Romantic Movement, there is a lack of appreciation for what it was really like in ancient China when CM was all there was. There are romantic notions of a bygone era. A parallel with the Idealists is probably best demonstrated by the successful existence of many forms of CM (as discussed above) despite the lack of modern scientific validation. There exists a critical mass of consumers and practitioners, and a flourishing education system in many Western countries.5 Like the Idealist philosophy it appears that something very real and valuable has been re- alized and given form. If we see CM as including all levels of the Great Nest of Being (and all quadrants), thus incorporating soul, spirit, and consciousness, than it may be that the incorporation of CM into the Western world is part of our overall evolution, in the sense of shifting the balance more towards the higher levels of the Great Nest. The downfall of the idealists was that they possessed no yoga, or no tried and true way of reproducing the transpersonal and superconscious insights that formed the very core of their vision. Is such a scenario in the future of CM? It is a complex question, in part due to the diversity of different types of practices that exist with their varying de- grees of Western scientific influence, and because CAM therapies have the potential to induce change to predominant Western scientific paradigms. The latter is discussed in more detail below. Perhaps the critical issue is the ability of CM to retain the au- thenticity and use of its already existing tried and true yogas, and the capacity of these to be valued and validated by the modern world. The Postmodern Movement is also seen in the attempts to understand how CM works. Perhaps the best examples are the efforts that have been made to understand the more esoteric practices included in CM, such as acupuncture, moxabustion and exer- cises (Qi Gong and Tai Ji). Many feel that current Western scientific paradigms, i.e., the molecular paradigm that dominates biology and medicine, are incapable of providing a satisfactory understanding of these therapies.4;5;19;22;24;25;28 So new paradigms have been proposed to explain possible mecha- nisms (see below). Many of these new paradigms are based on newer scientific theories (mainly from physics) and hence are not examples of what Wilber referred to as more typical of the general postmodern trend, which was characterized by un- substantiated narcissistic theories. However, un- substantiated (and sometimes narcissistic) theories and ideas do exist, in part because of the difficulty of scientifically testing such theories, and as a re- action against the domination of scientism. As Wilber points out, Postmodernism was correct in its conclusion that the world is indeed an interpreta- tion, but what Wilber was critical of was the further statement that all interpretations are equally valid. He reminds us that there is the necessity for some way of validating various interpretations to distin- guish between those that are supported by the Universe and those that are not. SCIENTIFIC INVESTIGATION OF CHINESE MEDICINE The predominant reliance of WS upon sensory empirical analysis is also reflected in Western medicine (WM), which using the same approach to finding ÔtruthÕ, claims to mainly use approaches that have passed the efficacy test and as such is often referred to as evidence-based medicine. Conse- quently the rise in consumer demand for CAM in the West has been accompanied by an increasing amount of scientific investigation into these thera- pies. This research effort can be generally divided into two categories according to two fundamental questions: (1) Does it work (efficacy)? and (2) How does it work (mechanism)? Of all the CAM modalities, CM has probably received the most attention in both of these categories, with greater emphasis being placed on efficacy.29 Much has been written lately about the problems associated with the Western scientific efficacy testing of CM.18;29 Fundamental to these problems is the issue that Wilber raises about the sensory empirical dominance in WS. In efficacy testing of CM this is well illustrated by the long-standing use of the randomized blind trial (RBT) for testing CM therapies. The RBT is the gold seal of Western clinical research13 because it is seen as the most effective way to reduce the influence of con- founding variables. When applied to CM therapies such as acupuncture, it often produces a clinical situation that bears very little resemblance to a normal clinical interaction between practitioner and patient. The reductionist approach of science and its keen ability to separate and isolate variables is fundamentally in conflict with the very foun- dations of CM, which as mentioned above is ho- listic, non-reductionist, acausal, and non-dualisitic. Clinical Acupuncture and Oriental Medicine6 Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 7. Furthermore the denigration by WS of the left hand interior quadrants is also in conflict with CM, which tends to place equal importance upon all quadrants and their relative contributions to health and heal- ing. A good example of the manifestation of these conflicts is the predominant use in these efficacy trials of symptoms as the basis for diagnosis and selection of treatment regime, and the almost com- plete lack of use of pattern and eight principal di- agnosis, which is the fundamental basis of diagnosis in most forms of CM. WS has no appreciation for the mental empirical systems of CM, such as yin/ yang, meridian theory, and zang/fu. Such systems, like logic and mathematics, are mental constructions based on and extensions of sensory empirical data, but with no direct sensory empirical ITS. Essentially this represents two different ways of viewing the Universe, two possible interpretations, the question is validity and a way of assessing this to the satisfaction of both. Different issues enter the picture with regard to investigating mechanism. For the purposes of this article I am going to focus upon the investigations into how acupuncture works, as this has received by far the most attention. CM explains acupuncture from the perspective of its various theories such as qi, yin/yang, five phase, zang/fu, and meridian theory. From this perspective conceptual understanding of acupuncture and how to use it is quite straightforward with appropriate training and experience. However, such theories as mentioned above have no validity in WS and therefore provide no mechanistic basis for how acupuncture ÔreallyÕ works. Interestingly, acu- puncture became of great interest to WS in the 1970s when it was appreciated that it was very effective for analgesia and to a lesser extent anesthesia. It repre- sented a much-needed tool to investigate little un- derstood pain mechanisms in the body. As such it is no wonder that today there exists a plethora of re- search data elucidating the proposed neurological mechanism of acupuncture29 (and references there- in). Such investigations have also gone beyond just the use of acupuncture for pain control. In fact recent studies8 propose that the use of acupuncture based upon traditional CM meridian theory is also neuro- logically based, potentially implying that the nervous system is THE mechanistic basis of acupuncture. The one significant characteristic of these studies that fundamentally undermines such a conclusion is that most of them used either electrical or strong contin- uous mechanical needle stimulation. Hence we can- not necessarily extend the conclusions of such studies to more usual treatment practice, which most often does not involve such strong needle stimula- tion. Furthermore, many of the Japanese styles of CM use minimal needle stimulation and depth of inser- tion,6;9 and some styles, such as Toyohari, do not insert the needle at all. Consequently the nervous system and perhaps molecular mechanisms in gen- eral may be an inadequate basis for understanding the varied systems and uses of acupuncture. Not surprisingly there have been many other proposed mechanisms for acupuncture, most of which are based on non-molecular mechanisms. Unfortunately most of these hypotheses lack ex- perimental verification largely because at present we do not have the technical know how to test them. One notable exception is the work of Robert Becker.4 Although much of his research interest was in the area of regeneration, his conclusions from such research provided probably the most conclusive body of research to verify the existence and regulatory role of non-molecular signals and processes in biological systems (his predominant interest was electricity). He extended some of his theories to acupuncture, and suggested that acu- puncture may work through electrical processes in the body in concert with the nervous system. There have been several studies demonstrating that acu- puncture points have unique electrical proper- ties.3;27 Other important contributions to our understanding of possible non-molecular mecha- nisms for acupuncture include5;20;24;25;28 Ma- naka.19;21–23 Many of these investigators state that it is not possible to understand acupuncture within the confines of current biological paradigms, and that ÔmodernÕ biology needs to incorporate the implica- tions of quantum mechanics and relativity theory. Even if we take the perspective of 20th century science and embrace the new theories of physics to demonstrate that acupuncture operates via some type of non-molecular mechanism, is this the whole story? From the perspective of WilberÕs four quadrants and the Great Nest of Being would we have included the left hand interior quadrants and the soul and spiritual levels of the Great Nest? These are difficult questions to answer because there is the view that such new theories of science are connected to spiritual domains.7 However, I feel this approach to understanding acupuncture and indeed any form of healing is still incomplete be- cause it does not include the eye of contemplation, but only the eyes of flesh and mind. SPIRITUALITY AND CHINESE MEDICINE The existence, nature of, and importance of the soul and spirit levels of the Great Nest of Being in CM is controversial, especially in modern day practice. The importance of religions (like Taoism, Bud- dhism, and Confusicism) in CM varied throughout 7Integrating science and religion Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 8. history and between different geographical loca- tions and styles of practice. Hence generalizations are almost impossible. However, what most might agree with intuitively is that soul and spirit do exist in CM, in varying forms and to varying extents amongst different practitioners. The same could be said about WM. What we have very little of is Western scientific validation of the role and im- portance of this in health and healing, although this is definitely starting to change.10 Certainly this seems to have been understood and appreciated in classical CM. One example of this is the differentiation of types of practitioners. Jeffery Yuen describes three types of practitioners: shamans, teachers and doctors. The shamans or what Kapt- chuk14 describes as the third level practitioner (or divine illuminating penetration) healed by predom- inantly ÔspiritualÕ methods. In the words of Kapt- chuk:14 The Penetrating Divine Illumination is the magic of soul meeting soul, Spirit reflecting Spirit. The instantaneous recognition necessarily initiates profound treatment. The immediate responses of the physician in the clinical encounter – the words, posture, compassion, belief, and vision – deeply affect and resonate with the spirit of another human being. The Divine Penetrating Illumination is the ultimate basis of healing. Qi Bo, the medical teacher in the Nei Jing, admits that his sage teacher not only was not dependent on normal diagnostic methods, but also had no use for routine therapeutic interventions such as herbs or acupuncture. His teacher, the symbolic archetypal master that all physicians aspire toward, both knew and treated exclusively by the Penetrating Divine Illumination. The discernment of the Penetrating Divine Illumination automatically Ômoves the essence (Jing) and transforms the QiÕ (Su Wen). Intense communication and intimate recognition automatically resonate and affirm the integrity of a patientÕs Qi and Spirit. This suggests that historically it was recognized that certain practitioners could achieve rarefied skills, which enabled a very different (could we say spiritual) approach to their art of healing. It is quite likely that such practitioners also regularly engaged in some type of spiritual practice such as medita- tion, Tai Chi, or Qi Gong. Therefore their healing ability may well have been gained from using what Wilber calls the three ways of knowing (eye of flesh, eye of mind, and eye of contemplation, or empiricism, rationalism, and mysticism). The exact origins of the theories of CM are somewhat unknown. The appearance and use of dif- ferent theories throughout history has been quite well researched and documented.31 However, how such knowledge was synthesized is not clearly known. For example, the existence and location of the acupunc- ture meridians and points was documented through- out history, but where this knowledge came from is somewhat of a mystery. Given the nature of Chinese culture at these times in history and the strong influ- ence of religion it is likely that such knowledge was born from a combination of WilberÕs three ways of knowing. Theories such as yin/yang and five phase are clear examples of empiricism and rationalism. Less sensory empirical theories such as zang/fu and meridian theory show more clearly the possible role of the eye of contemplation, or mysticism. It is no coincidence that WS does not accept CM medicine theories such as yin/yang, five phase and zang/fu. Although there has recently been some Western scientific experimental verification for some of these ancient theories.8;17 This illustrates WilberÕs argument that WS cannot accept that the eye ofcontemplationas just as valid a methodofknowing as the eyes of flesh and mind (or empiricism and rationalism). It would appear that the only way that the ancient theories of CM will be accepted by WS is if they can pass the sensory empirical validation test. If this were to happen (and we have reason to believe it will from recent research along these lines8;16;17 ), then it will leave WS in the uncomfortable position of having to somehow account for these theories even though they do not have direct sensory empirical correlates. For example, you cannot anatomically define an acupuncture point or meridian, and the zang/fu bear little resemblance to their Western counterparts. Or perhaps WS will evolve through the incorporation of this understanding and develop further theories that can account for their sensory empirical measurements of these phenomena. In the same way that WS can define an emotion as a brain chemical, an acupuncture point will become an electrical parameter. The theories may become plausible from the perspective of the new theories of physics, with measurability and system theory models. However, all such understandings are ex- amples of WilberÕs left hand quadrants, in no case would the eye of contemplation be necessary for this type of validation of CM. THE MARRIAGE OF CHINESE MEDICINE AND WESTERN SCIENCE It is unlikely that the scenario just outlined would represent any type of real marriage of WS and CM. Clinical Acupuncture and Oriental Medicine8 Clinical Acupuncture and Oriental Medicine (2003) 4, 1–10 c 2003 Elsevier Science Ltd. All rights reserved.
  • 9. What we would have is the continuation of an al- ready stifling trend, what Wilber describes as the brutal collapse of all higher modes of knowing into monological empirical science. Converting knowl- edge and understanding of the theories of CM into the language of WS, even if it is non-molecular theories far evolved from Newtonian/Cartesian thinking, does not evolve our understanding away from monological empiricism because it does not, in any way, require the eye of contemplation. It does not acknowledge that the eye of contemplation is a valid way of obtaining knowledge (data), and therefore it does not acknowledge the most likely source of the theories themselves. It can only result in a truncation and reduction in the breath and depth of the knowledge, a devolution. Wilber proposes that for science and religion to be truly integrated science must give up its em- phasis on sensory empiricism, and accept that mental empiricism (logic, mathematics) and spiri- tual empiricism (experiential mysticism, spiritual experiences) are equally valid as ways of estab- lishing truth. The three strands of knowledge (ex- plained above) are a scientific method for determining truth that can be applied to sensory, mental or spiritual empiricism (or the eyes of flesh, mind, and contemplation). If this were to be adopted then it would not be necessary to totally reduce CM theories to sensory empirical correlates. They would have their value along with an appre- ciation and validation of the mentally and spiritu- ally derived aspects of the theories. If the existence of acupuncture points and me- ridians, for example, could be validated from the experiences of practitioners and patients, who en- gage in cultivating spiritual awareness, then a new dimension would be incorporated into our modern understanding of CM. An understanding that in- corporated the eye of contemplation, and did not reduce everything to sensory empirical ITS. It would honor the most likely source of the theories, and thereby validate the eye of contemplation as a valid means for knowledge acquisition. Further- more it would emphasize the value of spiritual knowledge and thereby actively encourage spiritual practice amongst students, practitioners, and pa- tients. Even WM has to acknowledge that healing is a mysterious and often unpredictable process. In- corporating and accepting the spiritual dimension would enable this to seem a more natural and ex- pected aspect, one worthy of as much acknowl- edgement and awe as the tremendous technological advancements of WS and WM. Validation of the eye of contemplation would also allow consciousness to be an accepted and integral part of both knowledge acquisition and lived awareness. Wilber reminds us that the most basic data or direct experience that we have is that of consciousness, intentionality, and immediate lived awareness, all else are deductions away from this primordial data.33 The interior approaches (eye of mind and eye of contemplation) start with the immediacy of consciousness, and give birth to possibilities in the exterior (deductions). It is this aspect, consciousness and intention, that would most suffer if CM was reduced to exterior corre- lates. 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