Herbal medicine is one of the oldest forms of healing. In fact, herbs are often called the “people’s medicine” because they offer a convenient and affordable source of medicine, and in some parts of the world, may be the only medicines available to people. With the growing use of and interest in natural alternatives to pharmaceuticals, there is a consequent need for healthcare consumers to have more information about the healthcare practitioner who specializes solely in the medicinal use of herbs. Herbalists who work in clinical settings are a little known piece of our ever-evolving healthcare system. In this article, I will provide a background on herbalists philosophy and training, as well as how they function in a clinical setting. This article is designed to help the wider consumer better understand not only when to see an herbalist, but how to go about choosing one. You can also tune in to the January 22nd edition of Andres Vergara and Michele Collins’ internet radio show, Holistic Healing with Chinese Medicine, to learn more about how herbalists use Chinese medicine as a clinical system to use herbs to treat complex health issues.
Distinguishing Characteristics about Herbalists
Most herbalists are grounded in a belief in the body’s innate healing capacity and use herbs to stimulate the body’s vital life force (referred to as Qi in Chinese medicine). Simply put, most herbalists (with the possible exception of those trained in a strictly western medical model) seek to understand and treat the underlying health issues, rather than to use herbs to eliminate specific symptoms.
Clinical herbalists are typically trained in a traditional system, such as traditional Ayurvedic medicine or traditional Chinese medicine. For both of these systems, herbs are a very important therapeutic tool, however, herbs are one of many tools these systems use. These healing traditions serve as the analytic framework or system that helps an herbalist determine the nature of the health concern and how to go about addressing it through the therapeutic use of food and herbs. Many herbalists gravitate to one of these (typically eastern) traditions, in large part due to the absence of a wholistic framework in the west for understanding the subtle emotional and physical indicators that lead to chronic disease and illness. There are wholistic, intact systems in the United States, mainly in regions such as Appalachia or among Native Americans. However, because these systems are not widely practiced or taught outside of these communities (although this is starting to change), many herbalists either learned that tradition from a family member, sought out individual teachers in these regional traditions, or became trained in a system such as Chinese medicine.
These traditional systems are all wholistic, nature-based systems that focus on restoring balance to the overall organism, rather than on the elimination of physical symptoms. Physical and emotional symptoms are seen as the signposts and clues that help to understand, as well as to differentiate, the root cause of the imbalance, which, in turn, provides invaluable information on how to heal it. Because the body is seen as a microcosm of what is occurring in the macrocosm of nature, nature is seen as a key resource for understanding not only what causes health imbalances, but also points the observer to specific plants, animal, insect, and mineral substances that can be used to restore harmony.
What Does a Clinical Herbalist Do?
Many people do not know what to expect when they go to see an herbalist or may not know when to consult one. Herbalists not only have an in-depth knowledge of plants, but also have concrete experience using them, as well as monitoring their success in a clinical setting (usually both with themselves and with clients). Herbalists can select for you the most appropriate combination of herbs and monitor and adjust that formulation as you continue to change and heal. Given the confusion that can arise from the wide array of herbal products on the market today, trained herbalists can help you to understand which products to use and under which circumstances they will be the most effective. Much of information published about herbs in the popular press does not reference people with concrete clinical experience who know how herbs work in the messy, complex clinical world, making herbalists a valuable resource to navigate the ever-growing range of available products.
A key role of a clinical herbalist is their ability to apply the knowledge of whatever tradition they use to differentiate the cause of a particular health issue. For example, health issues such as a headache or insomnia do not typically have one origin in traditional systems, but multiple potential causes, that must be understood in the context of the individual. A practitioner, through the case history, as well as through additional tools such as tongue and pulse diagnosis, can differentiate the cause, and thus create the most effective herbal formula, based on that differentiation. Successful treatment is contingent on understanding and addressing the true underlying cause. Treatment is extremely individualized based on a person’s constellation of symptoms and physical constitution, and includes not only herbal formulations, but food and lifestyle recommendations, as well. This can explain why some people find relief when self-prescribing an over-the-counter herbal remedy for something such as menopausal health concerns, and some find no relief. These products speak to a generalized understanding of a health issue, but can not address the way that specific constellation of symptoms, nor the way they express themselves in a specific individual’s constitution.
Because clinical herbalists are trained and have experience in the art of formulation, they know how to combine herbs to maximize their effectiveness. Many herbal products, and indeed, much of the research and practical literature about herbs in the US focuses on the use of single herbs for health issues, like St. John’s Wort for depression, chamomile for an upset stomach, or valerian for insomnia. A clinical herbalist rarely uses single herbs, especially to treat complex health issues. Interestingly enough, data from around the world on the safety of herbs supports this practice by showing us that herbs used in combination are found to be safer than herbs used singularly. This is because herbs in a formula work synergistically. Herbs are combined in a way that counterbalances any potential side effects certain herbs may have when used individually. In fact, using a single herb for health issues (especially chronic and complex issues) is not often sufficient in and of itself as there usually are underlying factors contributing to it that often need complex mechanisms to address it fully, as well as successfully. Although, as any good herbalist knows, there are always exceptions to every rule.
Training and Regulation of Herbalists
There is currently no licensure for herbalists at the state or national level in the US, nor is there an accepted, standardized course of study for herbalists. In part, this is due to the vast differences in both the traditional systems herbalists use in their individual practices, as well as the vast differences in the way herbalists are currently trained. Certain traditions do offer licensure for their practitioners. For example Chinese herbal medical practitioners, who in the United States are typically also licensed acupuncturists, can receive a Diplomat of Chinese Herbology from the National Commission for the Certification of Acupuncturists (Dipl CH).
What can be very confusing for people is that, in addition to these tradition specific recognitions, there is also a distinct community of herbalists (myself included) who receive their training outside the recognized schools within those specific traditions. This is because there are distinct training opportunities for those who do not identify by the tradition they use (i.e. traditional Chinese medicine), but by their use of herbs as medicine. It is important to keep in mind, however, that not all of the herbal medicine training programs teach practitioners a traditional analytic system such as Chinese medicine. This is a very key issue to consider when choosing an herbalist. That healing tradition, whether it be a Native American tradition or a West African one, is the practitioner’s reference point that allows them to assess if what they are doing is working, and if not why, as well as how to modify the treatment strategy accordingly.
Herbalism is a unique profession in that you still have practitioners who may have gained their formal knowledge, not always through formal schooling and a degree program, but from apprenticeships or one-on-one study with individual teachers. I have met some truly gifted herbalists who have no formal training or degree and who learned primarily through self study and apprenticeships. Because there is no standardized course of study, a graduate degree in herbal studies or designation such as “master herbalist” does not guarantee that a practitioner is a competent clinician, has mastered the use of a diagnostic system such as traditional Chinese medicine, or has even met a baseline level of knowledge. This can make it difficult for consumers to assess an herbalist’s qualifications and skill level.
In many ways in the herbal profession in the US, you are recognized by the person or people with whom you have studied. Many of these teachers were part of the “Herbal Renaissance”, as it is sometimes referred, of the 60s and 70s and were instrumental in helping bring the knowledge of systems such as Chinese and Ayurvedic herbalism to the United States. Knowing with whom an herbalist studied can give you many pieces of information such as an herbalist’s philosophy, their analytic system or framework, and even their approach to dosage. This, however, is usually meaningless for people outside the herbal community, as it is its own special language.
Because of the variety of healing systems herbalists use, the most important considerations are that they were well-trained in the characteristics and uses of herbs, in how to apply them through the use of their diagnostic system and can apply the principles of that system in a complex clinical setting. If in doubt, always ask an herbalist about their training and background. A good herbalist should be clear about their scope of practice and be willing to answer your questions.
Quality Control of Herbalists Within the United States
There is a group, the American Herbalists Guild (AHG), founded in 1989, that is the sole organization in the United States that represents and advocates for practitioners who use herbs medicinally. The AHG deliberately includes practitioners from a diverse variety of traditions, such as Native American and traditional Chinese medicine. The AHG has a peer-reviewed professional membership application process. Eligible practitioners are those who have been trained either through formal schooling or through apprenticeships and who have had a clinical practice for a minimum of 2 years. If accepted as a professional member, the practitioner is then able to use the designation Registered Herbalist (RH AHG).
However (to confuse matters further), there are many talented, gifted herbalists who have chosen not to become professional members of the AHG. So, while AHG can help to distinguish an herbalist’s level of skill, it does not mean that an herbalist who does not have this designation is not equally qualified. If you have questions or concerns, it is important to ask a practitioner to clarify their position about such issues as what diagnostic system they use, how they were trained, and whether or not they are involved in the AHG. The community of herbalists I have had the privilege of interacting with over the years have been a fiercely intelligent, independent, and creative group of individuals who deeply value and revere herbs and plants and their healing capacity, be it through internal ingestion of them or simply sitting and meditating with them. This makes a trip to an herbalist a very worthwhile endeavor and quite worth the process of finding one.
