A Metadisciplinary Approach to Asian Medicine

Pierce Salguero

Part II in the “Meta Approaches to Asian Medicine” series

This blog first appeared on Medium.com

Hey, we’re different but we can still hang out together!

Interdisciplinarity has failed as a model for collaboration in the study of Asian medicine. Here, I propose the new model of “metadisciplinarity” as a means of bringing people together in more productive and more generative ways.

In my last post, “A Metamodern Approach to Asian Medicine,” I discussed a major communication problem within the study of traditional Asian medicine. I outlined the three major groups that dominate this field: the distinct and occasionally overlapping social groups of practitioners, scientists, and academic scholars. I introduced the epistemes or worldviews each group subscribes to, which I called “traditionalist,” “modernist,” and “postmodernist.” I described the stereotypes the proponents of each episteme have of one another, and the disciplinary rules and norms that are used to maintain and police the boundaries between them. I finished up with a proposal for how we can achieve more fruitful and more constructive co-existence, based on some ideas drawn from the theory of “oscillatory metamodernism,” as recently developed by scholars of aesthetics and religious studies.

While the last post focused on diagnosing the problem and laying out the bigger picture, here I want to explore in specific detail how we can achieve better communication Below, I will argue that our primary model for collaboration — interdisciplinarity — has failed to produce genuine dialogue across the epistemes. I then propose a new model I’m calling “metadisciplinarity” as a means of bringing people together in more productive and more generative ways.

Different types of collaborations

Before discussing the failure of interdisciplinarity, let me first define how I use this term, and related words, so that we’re all on the same page:

To begin with, I use the term disciplinarity to refer to a process of entrainment that involves steeping oneself in and taking on board the primary episteme of a particular discipline — including all of its the methodologies, assumptions, worldview, and truth claims. This is a crucial part of professional formation for traditionalist practitioners, modernist scientists, and postmodernist scholars alike. For each of these groups, cultivating disciplinarity involves internalizing a particular set of knowledge and practices, taking on a new professional identity, and learning to conform to the rules of the game as they pertain to the particular community.

Multidisciplinarity, then, is a form of collaboration in which practitioners or adherents of two or more disciplines with divergent perspectives come together to discuss or address a common problem. The problem is explored from different directions or through different lenses, but synthesis or mutual learning is not expected as an outcome. For example, imagine a conference panel on mindfulness that includes a Buddhism monastic, a neuroscientist, and a historian of religion. An event designed to be multidisciplinary might involve each presenter speaking for 20 minutes, and then the floor being opened up for comments and questions. In this case, the traditional, modern, and postmodern epistemes are given equal voice, but they are not expected to achieve true dialogue. (Multidisciplinarity, like the rest of the terms on this list, can also take the form of a single practitioner, in this case one person who juxtaposes two disciplinary perspectives without blending them together.)

Interdisciplinarity, on the other hand, is when those collaborators have the intention that each participant’s understanding will be enriched and expanded by interacting with the other. An interdisciplinary collaboration ideally should generate integration — some kind of novel approach or perspective that combines or synthesizes the disciplines. For example, if the panelists at the mindfulness panel are all aiming for interdisciplinarity, they will come to the event with the intention to learn from one another in order to find common ground. They would probably also organize the event as a dialogue instead of as a series of lectures or presentations.

A variation on interdisciplinarity is transdisciplinary, where the interdisciplinary collaboration is aiming to somehow transcend the original disciplines altogether — for example, aiming to discover a new field of research, or to bring new stakeholders into the conversation. If the interdisciplinary mindfulness event just described was also intending to inform public healthcare policy, or if it included politicians, healthcare workers, and/or members of the public in the conversation, it could be called transdisciplinary.

The failure of interdisciplinarity

It is important for me to distinguish these different terms in order to clearly state what I see as the problem. In the field of Asian medicine, interdisciplinarity (and, more recently, its variant transdisciplinarity) has been tasked with bridging the gaps between the traditional, the modern, and the postmodern. It has been touted as the tool or method by which these three epistemes will finally be combined together, and their adherents finally reconciled. The much hoped-for end is an “integrative” or “integrated” approach, which will be a synthesis of the most beneficial perspectives of all three and which will unlock all sorts of utopian health outcomes.

This sounds nice, but the problem is that almost every attempt to generate interdisciplinary collaboration of which I am aware has failed to achieve the holy grail of epistemological integration. Sooner or later, these interdisciplinary efforts have (1) failed to produce any collaboration at all, (2) devolved into multidisciplinarity, or (3) come to be dominated by one episteme or another. We’ll go through these scenarios one by one:

1.) Failure to launch

Interdisciplinary collaboration is often doomed to failure right from the beginning by the fact that some or all of the participants in the collaboration refuse outright to participate. While they may pay lip service to interdisciplinary goals, they either explicitly or implicitly refuse to buy into the idea that cross-epistemic conversation is actually worthwhile. This was the scene at the Third International Congress of Traditional Asian Medicine (ICTAM) in Bombay in 1990, described in an essay by Lawrence Cohen that I discussed in the previous post. Sponsored by the International Association for the Study of Traditional Asian Medicine (IASTAM), this conference had the stated purpose of bringing together practitioners and scholars of Asian medicine. Yet, despite the efforts of the organizers, the dividing lines between these two groups proved insurmountable. As Cohen described it, the separation was not only epistemological but also physical. Not seeing enough common ground to even begin the conversation, each group self-segregated into their separate corners of the venue. Ensconced within their own worldviews and paradigms, each group was unable to understand the value of even venturing over to the other side of the building.

Lest you think this is just an isolated example from many years ago, I will point out that such self-isolation continues to play out in many contemporary forums for traditional Asian medicine today. Take a look at any of the major Facebook groups in our field, and tell me which one sees active engagement and dialogue across epistemes!

2.) Bait and switch

Since the 1990s, organizations like IASTAM, their journal Asian Medicine (of which I am the editor in chief), and other smaller-scale efforts (such as my blog site, Asian Medicine Zone and the accompanying FB group) have succeeded in bringing traditionalists, modernists, and postmodernists together into the same space for the purpose of dialogue and exchange. Even when participants have been willing, however, they all too often have been unable to break out from their own disciplines and epistemes. Unwittingly and despite their own best intentions, they often wind up speaking past one another, and the interdisciplinary fantasies soon enough devolve into multidisciplinary realities.

Often, participants in such exchanges may not even realize that this is what is going on. To give an example, I was recently asked to keynote at a conference at a college that was launching an integrative medicine program. The intention of the meeting was to bring scholars and practitioners of complementary and alternative medicine together for mutual edification. My keynote (which was actually an early draft of my previous post on metamodernism) encouraged participants to let loose and enjoy the cognitive dissonance that comes from crossing epistemological boundaries. In the end, however, the conference consisted entirely of talks and panels that were each firmly grounded in one or another episteme. It was a diverse multidisciplinary array of presenters and audience members, to be sure — with lectures from reiki masters, nurse-practitioners, historians of Korean medicine, and many more. But with no structure in place to create dialogue between them, these groups were ships passing in the night. In the concluding plenary session at the end of the day, a spokesperson for the hosting organization proudly congratulated the audience on how much we had all learned from our cross-epistemological collaboration. The audience clapped enthusiastically, wholly unaware of the fact that little to no epistemological cross-fertilization actually had taken place.

3.) One episteme to rule them all

At times, there have been important breakthroughs in our field that appear to have come from successful collaborations between epistemes. Perhaps one of the most high-profile examples is the research done by Tu Youyou, who won a Nobel Prize in 2015 for her work on artemisinin as a novel therapy for malaria. The crucial moment in her discovery came, she says, when she discovered how to extract the compound using a traditional method that was recorded in a fourth-century text by the Chinese physician and alchemist Ge Hong (ca. 283–343 CE).

Tu Youyou (right) in the 1950s. Source: Wikimedia Commons.

At first glance, using an ancient medical text to inform contemporary Nobel-Prize-winning scientific research seems to be a textbook example of the benefits that can come from cross-epistemic dialogue. However, alas, there is actually no interdisciplinarity going on here either. Rather, knowledge from one episteme is simply being absorbed or co-opted by another. In this case, Tu appropriated knowledge associated with the traditional episteme for modernist purposes. Extracting Ge Hong’s traditional method from its original cultural context, she repurposed the technique in order to produce knowledge that could be understood, valued, and utilized within scientific, medical, and public health frameworks.

Please don’t get me wrong: I am not for a moment criticizing Tu’s work, which has been more beneficial to humanity than everything I’ve done in my own life put together. I’m not even criticizing this kind of research strategy. The same basic approach has led to many healthcare interventions — such as Mindfulness-Based Stress Reduction, yoga therapy, medical qigong, and all kinds of other traditional-modern hybrids — that have been therapeutically important in the past 50 years. This kind of approach is extremely useful and should continue; however, my point is that it is not actually an example of epistemological border-crossing. It is one-way translation, not a conversation between equals. It strengthens disciplinarity, not dialogue.

Metadisciplinarity

If we are interested in cross-epistemological dialogue — and, indeed, I recognize that not all of us may be — my proposal is not going to be that we get better at interdisciplinarity. Given our track record, I think interdisciplinary collaborations are largely destined to continue to fail. Rather, I am proposing an altogether new framework for cross-epistemological collaboration that I will call “metadisciplinarity.” If you have read the previous post you will recognize that this new framework draws from the theory of oscillatory metamodernism I discussed there. To use the metaphor from that essay, you could say that metadisciplinarity is a set of specific practices that can help to bring us together in a more productive and generative conversation. They also can help point the way beyond awkwardness and contentiousness, toward the joyous Carnaval-like atmosphere of metamodern oscillation.

In practice, metadisciplinarity involves at least three fundamental shifts in how collaborations across epistemes are oriented:

1.) From integration to polyperspectivalism

Our first order of business is to abandon the goal of integrating the three epistemes, to accept that their synthesis or reconciliation into a larger whole is a pipedream. A metadisciplinary collaboration instead begins with the premise that the traditionalist, modernist, and postmodernist approaches to Asian medicine are incommensurable. We understand that these are not different ways of seeing the same thing, but rather different ways of seeing different things.

Instead of striving for integration, a metadisciplinary collaboration makes space for the simultaneous presence of irreconcilable perspectives co-existing together within a single social frame. (By a “social frame” I mean anywhere where people and their ideas are gathered together, for example, a conference, a journal issue, a website, or a social media feed.) Participants in a metadisciplinary collaboration cultivate the ability to hear the unspeakable being spoken inside of that frame without the need to defend their turf. Participants learn to listen not with a cynical ear that is ready to attack and defend, but with a genuine appreciation — even enthusiasm — for radically alternative viewpoints that emerge through the conversation. We work to abandon the fragile mindset that must translate everything into our own language in order to make it sit more comfortably. We instead work on embodying a cognitive flexibility that welcomes being knocked around by new ideas, that finds creativity in the oscillation between different worldviews, and that experiences excitement or even joy at the chaos and dissonance that can result.

2.) From making truth claims to making meaning

If our social frame has any chance of becoming a tolerant space for that kind of polyperspectivalism, each participant is going to have to agree to refrain from making or defending ontologically strong truth claims. Recognizing that we will never agree across epistemes on what constitutes truth — or even what kinds of evidence are admissible in our quest for truth — we abandon trying to convince each other of any specific positions on it. Releasing ourselves from the burden of arguing over truth claims, we instead focus our energies on working together to explore what is meaningful to the group as a whole. Shifting from truth claims to meaningfulness allows each participant’s viewpoints to be heard not as threats or absurdities, but as valuable contributions to our collective meaning-making project.

Sometimes this can be no more difficult than changing how we turn our phrases. For a practitioner participant to turn to their historian colleague and say “I have direct experience working with qi, and I think my experience can contribute something to our current conversation” is a different statement than if they said “qi is real, and anyone who is sensitive enough can feel it.” The latter makes a black and white assertion from the perspective of one particular episteme, and closes down further dialogue. The former, on the other hand, opens us up a space for sharing, storytelling, and mutual listening.

3.) From disciplinarity to disciplinary transparency

All too often, the participants in cross-epistemic collaborations operate from a set of assumptions that are so well-known and obvious within their home disciplines that they go unspoken. We tend to forget that these assumptions we have internalized are not natural ways of being, but rather are the result of study, memorization, and embodiment through many years of training and practice. These assumptions remain inscrutable for outsiders unless they are made explicit, and they can easily become major obstacles for anyone trying to engage with us on our topics of expertise.

In a metadisciplinary collaboration, each participant in the dialogue therefore commits to being transparent about the disciplinary tools they are deploying at any given moment, and to making their unspoken epistemological assumptions explicitly visible to all participants at all times. The focal point of the collaboration shifts from trying to “solve the problem” or “arrive at the right answer” toward the sharing and refining of a meaningful collection of methods, tools, and insights. Drawing these equally from across the different disciplines and epistemes represented in the collaboration becomes a central concern of the collective meaning-making project.

New possibilities

These three shifts — welcoming polyperspectivalism, focusing on collective meaning-making, and a focus on explaining and sharing disciplinary tools — take us away from policing, defending, and strengthening the epistemic divides that keep us separated from one another, and instead provide a framework for entering into productive dialogue and collaboration across disciplines and across epistemes. But we must resist the impulse to make metadisciplinarity into a new systematization. Remember, oscillatory metamodernism is not about integration, it’s not about organizing everything into some kind of stable hierarchy, and it’s not about splitting the differences between us. Likewise, a metadisciplinary collaboration is not about producing some kind of harmonious stasis. In fact, if a collaboration finds itself in a peaceful stasis, it’s a sign that it’s not metadisciplinary enough! This is not about finding our common ground, but rather finding joy and making meaning in the cacophonous, unstable juxtaposition of incommensurable viewpoints.

Chakra chart attributed to traditional Thai medicine, which was actually invented by Aśokananda (a German yoga teacher) in the 1990s.

To make this more concrete, imagine this scene from a hypothetical conference: An interdisciplinary panel session is put together with three presenters. A practitioner of Thai massage walks the audience through a “traditional treatment to clear the chakras.” A physician presents on how there is no scientific basis whatsoever for the concept of chakras. An academic then presents on how this particular model of chakras has nothing to do with traditional Thai culture, but rather was invented by a guy from Germany in the 1990s. Chaos ensues.

Where do we, the participants in this panel, go from here? Do we cringe and avoid eye-contact? Do we muddle through our presentations and then go our separate ways? Do we publicly duke it out to see whose perspective will win the day? Rather than any of those options — which have become our normal responses to epistemological disagreements in our field — I’m suggesting that we start by explicitly accepting that we will never see eye to eye with our co-panelists. But yet, we still commit to engaging with one another in good faith, at least so long as we are in the shared social frame of the panel session. I’m suggesting we use the allotted time for our panel to create a genuine dialogue where the main focus in not on figuring out which of these viewpoints is right, but rather on figuring out what value there is in one another’s approaches. I’m suggesting we can find joy in experimenting and investigating how we three can make meaning together, while still appreciating the incommensurability of our perspectives.

What would the result of such a collaboration be? Who knows! Metadisciplinarity is fluid, emergent, and unpredictable, and depends entirely on the specific participants gathered together. But, one thing I am certain about is that overcoming the current stalemate in our field depends on whether proponents of the three epistemes can learn to enjoy being jostled together in this way. If you read the previous post, you know that I believe that this kind of opening up to one another is what is needed both in our field and also in the world at large as well.

This is important, so let’s work on it together — no matter which social group or episteme you primarily affiliate with. I’m looking forward to the conversation, and hope that maybe we’ll actually hear each other for the first time.

This the second in a three-part series:

  1. A Metamodern Approach to Asian Medicine
  2. A Metadisciplinary Approach to Asian Medicine
  3. A Metamorphic Approach to Asian Medicine

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.