Placebo, “Care Effect,” or Something Else?
There is a new article on Wired Magazine’s website that draws my attention to the difference between real science, scientific writing, and pseudo-science masquerading as science. The article is written by Nathanael Johnson, author of a new book entitled All Natural. I haven’t read it yet, but please don’t hold that against me—it’s not going to be released for another week.
The cover of the book identifies the author as a “skeptic.” Those of you who regularly read my blog know that I am very skeptical of self-identified skeptics. It turns out that many are not skeptics at all. Rather, they have in their minds a long-obsolete notion of what science includes and will do just about anything to denounce and mock anyone who dares disagree. Further, they will do so with all the energy and rage of the most angry religious fundamentalist, so much so that I refer to skeptics as followers of the religion of scientism, a belief in archaic scientific concepts that they feel they must defend.
In the publisher’s description of his book, they say it is “wry, and scrupulously reported.” First, why would a scientific report about anything need to be “wry,” which my dictionary defines as “using or expressing dry, esp. mocking, humor?” Since when is mocking and dry humor a part of scientific study? On the other hand, being wry is a tool in the skeptic’s tool chest, so the publisher’s comment seems to agree with the claim on the cover of the author being a skeptic .
However, the book is supposed to be “scrupulously reported.” Well, we don’t have the book so we can’t say. But we can look at the article and see if what he publishes with his name does qualify as being “scrupulously reported.”
His article begins: “Americans spend $34 billion a year on so-called alternative medicine — botanical pills, acupuncture, energy healing, and the like — despite the fact that few of these techniques are backed by any science.”
Here, Johnson lumps every form of alternative medicine into one group and denounces them all, claiming they are not “backed by any science.” That’s like saying if one fruit tastes bad all fruit tastes bad. This is pure guilt by association. That’s hardly an example of scrupulous reporting. Which ones are backed by science, Mr. Johnson? Which ones are not? Where is the research and experimentation that validates your “scrupulous reporting?”
He writes, “Study after study has rejected the ability of such treatments to cure.” Really? Where are all these studies? What were their protocols? Have they been replicated? There’s nothing indicated. No sources. No footnotes. Just unsubstantiated claims we’re supposed to accept because a skeptic wrote them.
He continues, “For example, a randomized, controlled trial of Chinese herbs on women with ovarian cancer found no effective difference between the herbs and a dummy pill — because there was some improvement with both. A double-blind trial of saw-palmetto pills for men with enlarged prostates produced similar results. What gives?”
Wow. That’s fascinating. Where can I read the original reports, Mr. Johnson? He provides nothing. This Materia Medica of Chinese herbs lists “more than 530 of the most commonly used herbs in the Chinese pharmacopoeia.” And those are just the most commonly used ones. So, Mr. Johnson, which herbs were used in the undocumented test you describe? Why were those herbs chosen? He doesn’t say. How many people were involved in the tests? Nothing is listed. We’re just supposed to accept what the skeptic says.
But let’s assume that this very uninformative article is actually accurate. He presents an interesting question. In two cases, supposedly real (we have no way of knowing) alternative healing methods and imitation alternative healing methods both saw improvement in patients. What does this mean?
Well, first you would need to have a control group where nothing was done. How many people in the control group improved, stayed the same, or didn’t improve? We don’t know. Johnson doesn’t report this. So from a scientific standpoint, his comments are meaningless.
His response to the meaning of these poorly-reported tests: “The obvious answer is the placebo effect.” Uh…no. Your obvious answer is the placebo effect. From your report it’s impossible to tell. What controls were put on the experiments? How long did the experiments take place? For how long after the experiments concluded were the subjects followed and evaluated? Where there any other changes in the subjects’ lives that could have accounted for this? How did the supposed improvement rates compare to a control group of people receiving no treatment?
So no, the obvious answer is not the placebo effect. The placebo effect is merely one possible explanation for superficially reported, undocumented stories (I can’t ethically call them “reports” or “studies” or “experiments” because there’s no evidence they occurred), but it is the one most approved of by people who have their minds made up in advance as to what is possible and what is not: defenders of scientism and pseudo-skeptics.
Care Effect?
Moving beyond the pseudo-skeptical and definitely non-scientific approach made in the first part of the article by Johnson, let’s look at the point he is trying to make.
Johnson cites one research study (again, providing no way to find out exactly what was done, controls that were made, how many people were tested, etc.) where the method of giving care was supposedly tested. Specifically, he claims that if fake care is giving in a warm, friendly, and caring manner it was more effective than if the same fake treatment was given brusquely and without friendliness. How much more effective is it? Well, Johnson doesn’t say. All he reports is that benefits of the fake care “largely disappeared” (whatever that means) when given in that cold manner.
The assumption of the report that Johnson claims to be covering is that it’s not the placebo effect, but a “care effect,” which Johnson describes as, “the idea that the opportunity for patients to feel heard and cared for can improve their health.”
I think most mothers could have told you that!
I do want to add that I actually agree with some of Johnson’s conclusions, albeit not with what I would consider his very sloppy reporting. He writes, “mainstream medicine could stand to learn something important about caring from the alternative forms.” I agree. He continues, “Some $210 billion is wasted annually on overtreatment, according to the Institute of Medicine, while a Medicare study found that overly aggressive treatment kills some 30,000 people a year. As a result, the number of U.S. adults who die from too much medicine is now higher than the number who die for lack of it.” And this is a shocking statistic (if true).
Johnson then falls back into what seems to be a pseudo-skeptical, either-or mindset: “If we’re going to fix our broken health system, we’ll have to solve the problem of overtreatment.” I’d respectfully suggest that if we focus on the problem of undertreatment or overtreatment we’re taking a very narrow and unscientific approach. What we need is to move toward appropriate treatment for each individual. That means it will be less for some and more for others. Johnson just paints with the broad, simplistic solution brush of the pseudo-skeptic. I do hope his book is better than this.
But if it’s not the placebo effect or the care effect (which is described as a result but not analyzed as to the way it works), what other possibility is there?
Love At First Sight?
We’ve all heard of love at first sight. But is it real? My father met my mother at a college party. On their first meeting he said he was going to marry her. She laughed it off. Six months later they were married. How did he know? How did she not know?
I have to admit that my mother was an absolutely gorgeous young woman, and that’s not just because she was my mom, so maybe he was just blown away by her looks:
Aline Rose Weinress Kraig (circa late 1930s)
My Mother
You may not have experienced the love at first sight phenomenon, but most of you have experienced the immediate like or dislike of a person before you even meet that person. Perhaps you think it’s due to the person’s appearance, body language, vocal quality, friends, or something else. But maybe there’s something more?
Every person has an energy field about them. This has been shown with Kirlian photography which illuminates that field and makes it recordable on photographic film. It can be detected and measured with various devices and even can help you alter the field through biofeedback.
Now here’s the reason this is important. Energy, such as this energy field around us, is in motion. It has a frequency. If we examine frequency at audible levels, frequencies that work well together are called harmonious. Those that conflict sound grating and are generally unpleasing to hear. We’re attracted to the harmonious and repelled by the disharmonious.
Okay, bear with me. Things that are harmonious can actually amplify each other. For example, a violin note played near the strings of a piano will cause piano strings that are harmonious with the violin to begin to vibrate. Those in harmony and closest to the note of the violin will sound the loudest. This is known as the law of resonance.
Biofeedback shows that we can change the quantity and quality (i.e., frequency) of our energy fields. If we take the science of sound and the science of biofeedback, it becomes apparent that if we have a strong (i.e., healthy) energetic field it can influence the energy fields of those around us, and by modifying our energy field we will have an effect on the fields of other persons. One way to modify that energy field is through our feelings and attitude.
If you put too much electrical energy through a circuit, it will in some way damage that circuit. It might blow a fuse or circuit breaker or melt a wire. Energy and the physical sources of that energy are intimately linked. Change your physical body and your energy will change. Change your energy and your body will change.
This is a simple formula: care giver’s energy, both in amount and frequency, affects a patient’s energy according to the physical laws of resonance. The change in the patient’s energy affects his or her body. The patient heals.
This goes far beyond the “care effect.” This proposes what could be a testable theory for a viable healing modality.
Unfortunately, such tests will never happen. Drug companies who support medical testing won’t pay for tests. They have no reason to do so as the results have no chance of bringing them money. Governments that support medical testing are composed of politicians who get large amounts of money for their election and re-election campaigns from drug companies. This energetic theory of healing, a theory which is every bit as valid as the placebo effect or care effect, will only be mocked with wry humor by pseudo-skeptics.
Besides, using energy for healing? That sounds like magick. And that’s something a pseudo-skeptics will never accept.
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If you’d like to know more about the concepts and techniques of energy healing, here are some books that will interest you:
Energy SourceBook by Jill Henry
Healing Body, Mind & Spirit by Howard F. Batie
Aura Energy for Health, Healing & Balance by Joe H. Slate
A Chakra & Kundalini Workbook by Jonn Mumford
Chi Gung by L.V. Carnie
Skeptics going after acupuncture don’t seem to realize that there’s solid controlled scientific evidence that it does in fact work better than “sham” or “placebo” acupuncture.
http://ananael.blogspot.com/2012/09/yes-acupuncture-does-work.html
This meta-analysis showed a 7% increase above placebo, which is a larger increase than that found for many anti-depressant drugs – the effectiveness of which these same skeptics have no trouble accepting.
It is true that for some of the other alternative treatments mentioned little scientific evidence has been found. However, skeptics who lump acupuncture in with those merely demonstrate how ignorant they are of the actual current research.
Thanks for your comment, Scott. I was studying acupuncture and acupressure when they were made semi-illegal (they could only be done by an MD) in California. My instructor went on to become one of the top acupuncturists in California. I agree that there are some alternative healing methods that easily do as well as more orthodox methodologies. Some do not. Linking them all together, the “painting with a wide brush” I described in my blog, is a technique used by some pseudo-skeptics to mock anything other than they believe in.
Your point that some drugs have a very limited level of effectiveness is something I’ve found that most people don’t know. If a drug or treatment is just a bit better than a placebo, it will often be approved for sale, making hundreds of millions for the manufacturer while failing a large number of the people for which it is prescribed.
How are the placebo and care effects not magic?
Thank you for your comment, Ian.
There is a difference between something that is magick and something that happens magickally. If I’m thinking about you and you call, that is something happening magickally because I do not know if there is any cause-and-effect associated with your call or if it is just chance.
If I focus on getting you to call me, perhaps performing a spell or ritual, that is magick. I intend something to happen and it happens.
Neither the placebo effect nor the so-called care effect are based on intentionality. They are, therefore, magickal to us, but not the result of magick. Otherwise anything that is vaguely related to something else becomes magick.
Unfortunately, this can quickly turn into a question of semantics more than anything else. The simplest answer to your question is that those two are not intentional.
Hello,
well humans tend to interpret thinks they cannot understand as Magic, this does not mean that it is not real. This age is an age of science, everything must be explained by science. Everything that cannot be explained by science does not exist and is therefore Magic.
by John