The Therapeutic Order

“What is good to take for sleep?”

“How about night sweats?”

People often ask questions like these and expect simple answers. Turns out, the answer is simple in a sense, but it’s not usually what they expect! Furthermore, it’s not possible to answer these kinds of questions quickly – a lot of investigation is needed first to get it right.

As a naturopathic doctor in Washington state and consultant elsewhere, my thought processes are guided by a set of principles called the Therapeutic Order. This means I begin by recommending the most basic and gentle of therapies first to establish the foundation of health. Check out my post Foundational Basics for more on this level of support. Once this baseline is dialed in, I move up the Therapeutic Order to implement additional interventions.

The second step is to stimulate the body’s self-healing mechanisms. This is where I commonly use constitutional homeopathy, acupressure and tailored yoga poses. For example, if someone is waking at 4am nightly I may recommend a routine before bed with acupressure points at their lung meridian as 4am is “lung time” in Chinese Medicine. I’d ask a lot of questions to understand them as a whole person and pick out the best homeopathic remedy. Are they hard on themselves, getting frequent headaches that are worse sunlight and experiencing a low thirst? This could suggest a Natrum muriaticum case, for instance.

Often I see remarkable changes at this point in the game such as improved sleep and mood – an overall sense of feeling more like ones self. However, to help accelerate the process and nourish the physical body, the next level of the Therapeutic Order looks to strengthen weakened or damaged organ systems. Botanical medicine and nutrient supplementation are used here with an eye on addressing the underlying root-cause. Maybe the person who wakes at 4am has had longstanding stress and their hypothalamic-pituitary-adrenal axis (HPA-axis) needs an adaptogenic herb, B vitamins and magnesium to restore balance.

Ensuring structural integrity with interventions like chiropractic care, massage or physical therapy are implemented at this point. The fifth step of the Therapeutic order is using natural medicine in a manner that’s directed at symptoms and diagnoses directly (versus the root-cause focus as in step three above).

Finally, steps six and seven of the therapeutic order involve using pharmaceuticals to halt progression of disease and invasive therapies, like surgery, to suppress disease. Sometimes these interventions buy us time to work on the earlier steps, or they save lives.

Any therapy – from chamomile to chemotherapy – can be considered “naturopathic” depending on the context in which it’s used. The Therapeutic Order offers a map for ensuring proper timing and implementation of tools from various medical disciplines.