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Why People Continue to use SCAMs

Rodin's The Thinker
I remain curious as to why people use, and continue to use, useless pseudo-medicines. I read the literature, but I find the papers unsatisfactory. They seem incomplete, and I suspect there are as many reasons people choose a pseudo-medicine as those use them.

There are numerous surveys on what SCAMs people use. Designing and offering these surveys to every possible medical condition is a growth industry: the old, the young, cancer patients, AIDS patients. All need be asked which SCAM they use. It seems to be a ready way to get a quick entry in your CV, but which SCAM is used does not speak to the why a particular SCAM is being used. Why try acupunctures, say, instead of reflexology?

There are numerous reasons suggested for why people partake of SCAMS as a general concept: dissatisfaction with standard medical care is a common one but is not always supported in the literature. Gullibility, ignorance, and stupidity are often credited, none of them are particularly valid. Dr. Novella covered the topic in 2012. There is some data to suggest that which SCAM and why is a moving target, changing over time.

The problem with surveys is that the answer given depends in part on how the question is phrased. And as I get older the more I suspect that free will and conscious, rational thought are an illusion at worst and rare phenomena at best. Sure, I can make trivial choices, deciding to hit a 7 or 6 iron on number 5 at Rose City, depending on wind and tee location. That is, I hope, a rational decision based on current conditions. And I can still snap hook the ball into water that should never seriously come into play.

But so much of what I think burbles up from some subconscious mental process. After I come to a decision or have an opinion, I devise an after-the-fact conscious justification for my position. I hear myself making up the reasons on the fly, half-wondering who made the decision in the first place.

This is most acutely true in ID and happens more and more as my career progresses. As I hear a case presentation from the resident the probable diagnosis pops into my head. Since I have to teach the resident why I think it is a particular diagnosis, I explain my reasoning, but I am often aware that it is all after-the-fact hand waving. I do not really know why I thought it was a liver abscess that is causing the fever.

Just where these ideas come from is unknown, and a little creepy since it is not the conscious me who is doing the work. It is part of the reason why, along with free will, I suspect consciousness is a minor and unimportant aspect of the human condition. So much seems to go on in my brain over which I have no control.

Most of the brain’s work is done while the brain’s owner is ostensibly thinking about something else, so sometimes you have to deliberately find something else to think and talk about.
~ Neal Stephenson, Cryptonomicon

Declared motivations for behavior are just one big post hoc ergo propter hoc fallacy. So when people offer explanations for why they participate in a particular SCAM, I am skeptical. I suspect it is all an after-the-fact rationalization. People’s motivations are black boxes and I suspect most do not have a good understanding as to why they use SCAM or do anything else.

Still, it doesn’t stop one from making broad generalizations. I find it interesting how various biases lead to erroneous conclusions about the way the world works. As I have mentioned before, our brains have evolved to survive reality, not to understand it.

In part what separates those who subscribe to the notion of science-based medicine and those who practice pseudo-medicine are explicit criteria for accepting evidence of therapeutic efficacy combined with an understanding of all the logical fallacies to which we are prone.

The most compelling evidence are randomized, placebo controlled, double-blind studies. The least compelling is personal experience and testimonial. I do not consider making stuff up as evidence, a standard not always shared. For most people the order is reversed, and so often it is the story of the friend’s cousin who had their disease cured with some pseudo-medicine, and what do you have to say to THAT, Mr. Smarty Pants Skeptic?

I take Feynmans quote to heart:

The first principle is that you must not fool yourself – and you are the easiest person to fool.

Those who practice pseudo-medicine have to ignore it. And there are many ways in which we can be fooled in to continuing a pseudo-medicine after, for whatever reason, we have decided to give it a try.

It has been suggested that illusions of causality (are) at the heart of pseudoscience including pseudo-medical interventions. After reviewing

how superstitious beliefs of all types are still happily alive and promoted in our Western societies

the authors state, or understate,

it is not easy to counteract the power and credibility of pseudoscience.

One cognitive bias is that with people will credit control of events even though they are not responsible for the event. The classic examples are gamblers and athletes with their useless rituals. Interestingly, the more a person is involved in an activity, the stronger their illusion of control. Health and illness tend to provide an opportunity for deep involvement. Few issues are as important as personal health and offer more risk for being fooled.

…people (and, arguably, other animals as well) trying to obtain a desired outcome that occurs independently of their behavior tend to believe that they are causing the outcome.

And people often credit causality of two events even when there is no credible connection between the events. We love to find causality where none exists.

Medical conditions are particularly prone to cognitive errors. Diseases and their symptoms wax and wane spontaneously and more severe illness tends to lessen overtime (regression to the mean). People usually seek care when symptoms are at their worst and so will get better no matter the intervention, effective or not. However, the bias will be to credit the intervention for the resolution.

I see this all the time in my practice. A patient with no good diagnosis for a treatable infection gets better on antibiotics. Is it that they got better and were on antibiotics (true-true and unrelated is the medical shorthand) or they got better because they were on antibiotics. I tend towards the former but it is very hard to convince doctors and patients that the latter is not true. I wonder how much inappropriate antibiotic prescribing is due to illusions of causality rather than pleasing the patient and time constraints, which are the usual explanations.

The hypothesis, ‘the illusion of efficacy of an intervention is an important factor regarding why people believe worthless therapies are effective,’ was studied. In a computer simulation:

Participants were asked to imagine being a medical doctor who was using a new medicine, Batatrim (i.e., target cause), which might cure painful crises produced by a fictitious disease called Lindsay Syndrome. Then, participants were exposed to the records of 100 fictitious patients suffering from these crises, one per trial. In each trial, participants saw three panels. In the upper one, participants were told whether the patient had taken the medicine (cause present or absent). In the second panel, participants were asked whether they believed that the patient would feel better. Responses to this question were given by clicking on one of two buttons, ‘Yes’ or ‘No’. The purpose of this question was to keep participants’ attention. The third and lower panel of each trial appeared immediately after participants gave their response. It showed whether the fictitious patient was feeling better (i.e., effect present or absent). In Group High p(C), 80 out of the 100 patients had followed the treatment and 20 had not. In Group Low p(C), 20 patients had followed the treatment and 80 had not. In both cases, 80% of the patients who took the medicine, and 80% of those who did not, reported feeling better.

So no matter the intervention, patients improved 80% of the time.

There were then asked

To what extent do you think that Batatrim is the cause of the healings from the crises in the patients you have seen?’ (Causal question), and ‘To what extent do you think that Batatrim has been effective in healing the crises of the patients you have seen?’ (Effectiveness question)

Those who were in the Group High were more likely to judge the Batatrim effective, which is probably how people assess therapies in real life, even though the results were random.

Interestingly, they were less likely to rate Batatrim as causing the improvement, even in the Group High. Thinking in terms of causality is not how people assess therapies in real life.

So they suggest that thinking in causal rather than in effectiveness terms, may help decrease the illusion of efficacy. Understanding potential causality, prior plausibility, is difficult. Most people have no reason to understand the biomedical sciences in the depth that would allow them to understand why homeopathy or acupuncture is a crock. So when they take useless nostrums and improve they probably think in terms of efficacy of the treatment rather than causality and credit the useless nostrum.

Not really a surprise as a result, except for the potential beneficial effect of getting people to think causally about an intervention. When a person knows they improved after, say, acupuncture, they always look at you (me) like you are dense when you suggest they did not get better from the acupuncture. Of course they got better from the intervention. Duh.

Quite possibly, the effectiveness question is the one that is most frequently used by lay people when inquiring about the efficacy of medical treatments, and pseudoscientific claims in general, but it should be noted that it is probably a misleading question. Stating that a treatment is not effective when all the people who we know that have followed it feel better makes no much sense. However, if we were asked whether the treatment is the real cause of the recovery of those patients, we would have to look for alternative potential causes (even hidden causes). This process forces participants to consider all the evidence available, something that they do not always do and that other questions may not require.

This study, even as a simulation, helps add to the understanding not only as to why people continue to use a given useless therapy, but perhaps one way to counter their use, although the authors do note that it is easier said than done:

Although a good knowledge of scientific methods is always desirable, one problem of such a strategy is that it requires, first, to convince people that science is something they should pursue (something quite difficult in pseudoscience circles of influence), and second, perhaps even more difficult, to convince people to use control conditions, to reduce the frequency with which they attempt to obtain the desired event, so that they can learn that it occurs equally often when they do nothing.

But wait. There’s more. The use of pseudo-medicines is more nuanced than illusion of causality.

I expect therapies to do something, not only the primary effect, but to have side effects. It turns out that doing nothing is an important factor in people thinking a useless therapy is effective.

In PLOS One was the recent article “The Lack of Side Effects of an Ineffective Treatment Facilitates the Development of a Belief in Its Effectiveness.”

They suggest:

While most would agree that people frequently resort to those treatments they believe are more effective, we propose that the reverse also holds: frequent use of a treatment, because of the lack of side effects or other considerations, fuels the belief that it is effective, even when it is not.

They use the ultimate in nothing, homeopathy, as an example, noting that use of the nostrum results in the causal illusion, which is increased when the process being treated has a high spontaneous resolution rate.

They note:

Basic research suggests that the more often a patient takes a completely useless medicine, the more likely she will develop a belief in its effectiveness. This is particularly true when the desired outcome (the healing) takes place frequently.

No one had looked at the consequences of medication side effects have in determining the belief that a useless therapy has efficacy. Their

prediction is that, because a lack of side effects encourages the use of the treatment with high probability, it facilitates the illusory belief that the treatment is working.

The used a computer simulation, a variation of the prior study. Students were asked to again treat a dangerous disease called “Lindsay Syndrome” with a drug called Batatrim. I am starting to think we should call all useless drugs Batatrim, but it would be too obscure a meme. Participants were divided into two groups:

The high-cost group was informed that Batatrim would produce a severe and permanent skin rash as a side effect in every patient who takes it.

and a low cost group whose patients had no complications from the Batatrim. Subjects were then shown the records of 50 consecutive patients with the disease and asked as to whether they would treat.

Whether or not the patient got better was determined randomly, but 70% of the time the fictitious patient improved.

After the treatment was decided and the computer randomly assigned the results, the subjects had feedback:

In the no-cost group, the outcome was displayed as a picture of a healthy face and the message, “The patient has recovered from the crisis”, whereas the outcome absence was displayed as a picture of an ill face (greenish, covered in sweat) identical to the one presented in the top panel of the computer screen, and the statement, “The patient has not recovered from the crisis.” … By contrast, the high-cost group was shown pictures and messages conveying not only the disease outcome, but also the side effects of Batatrim when it was used. Thus, whenever the medicine was given, the picture of the patient showed a skin rash, and the statement also included the words “…and has severe side effects.” Likewise, whenever the medicine was not given, the words “…and has no side effects” were added to the message.

At the end the subjects were asked to rate the perceived effectiveness of Batatrim. When there were no side effects reported subjects were much more likely to give the medication AND were much more likely to rate the drug as effective.

In this study, we have shown that knowing a medicine produces side effects prevented the overestimation of its effectiveness that is typically observed when the percentage of spontaneous remissions is high. We demonstrated that the mechanism by which this effect works rests on the lower frequency of the treatment usage exhibited by those participants who were aware of the medicine’s side effects.

To my mind, having no side effects is equal to saying that the therapy has no effects. But in the world of pseudo-medicines, having no effects and no side effects work together to fool the patient, by way of the causal illusion, that there is efficacy.

Having no side effects promotes use of the medication and for a process that has a high spontaneous resolution rate, promotes reinforcement of the causal illusion. Since the therapy is harmless, you use it more often and see it ‘work’ more often.

The solution? Perhaps it is actually education and awareness of how to think, at least in adolescents. For many adults it is probably too late.

We found that training a group of adolescents in the rational manner of making inferences about cause-outcome relationships decreased their illusory perceptions of causality in a subsequent non-contingent situation. Moreover, including a control condition in the positive contingency scenario allowed us to conclude that the lower causal ratings observed in the experimental group could not be solely explained by a general increase in suspicion in this group. Rather, the group specifically made more realistic judgments in the null contingency condition while preserving an accurate view of the positive contingency condition.

Whether this kind of educational interaction will result in long-term changes after the initial interaction is unknown and I would be skeptical. I suspect that rational thought is not the default cognitive mode. This is certainly the case for me. I always have to will myself to think rationally about topics. The causal illusion is powerful especially when combined with all the other cognitive biases simultaneously in action and the apparently natural resistance to changing one’s mind even as realty changes around you.

A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines. With consistency a great soul has simply nothing to do. He may as well concern himself with his shadow on the wall. Speak what you think now in hard words, and to-morrow speak what to-morrow thinks in hard words again, though it contradict every thing you said to-day.

Still, it gives one hope, and that despite my lobbying to make Sysiphus the logo for SfSBM, the concept at the heart of the science-based medicine blog, accurate information, is fundamentally the correct one.

Posted in: Basic Science, Critical Thinking

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303 thoughts on “Why People Continue to use SCAMs

  1. Stephen H says:

    Blame the corpus callosum (http://contingenciesblog.blogspot.com.au/2005/03/are-there-rational-grounds-for_30.html ).

    I actually heard the suggestion that it was responsible for “miracles” on a radio program recently, but can’t find that reference – searching online for “corpus callosum miracle” just tells me that lots of parents thank their favourite god for their child’s “escape from agenesis of corpus callosum”.

  2. goodnightirene says:

    I got over the SCAM’s rather quickly with no intervention. I attribute this to an excellent basic science education–mostly the history of science as presented throughout my study of Anthropology. I had wonderful professors who stressed critical thinking and greatly valued the essay test over the (snort) much derided true/false or multi-choice versions.

    But perhaps this is just an illusory perception–I just THINK I rejected pseudoscience because of my education. I wonder how many in my class are touting the wonders of acupuncture?

    1. Windriven says:

      I always loved essay tests because I was always interested in concepts but also too lazy to remember exact dates, arcane formulae*, etc. Often times multiple guess and true/false tests use relatively useless minutiae to infer broader understanding whereas with essay tests there is nowhere to hide. You understand the issue or you don’t.

      “*Never memorize what you can look up in a book” – some physicist whose name I can’t recall ;-)

      1. WilliamLawrenceUtridge says:

        Einstein :)

        In defence of the multiple choice test, in some cases the purpose of the class is to force you to learn the basic list of facts that underpin a more sophisticated understanding of the topic. So in my anatomy and physiology class, multiple choice exams were actually an excellent and appropriate test, because without knowing where the biceps brachii is, you can’t understand its action (and more importantly, can’t have a meaningful conversation with someone about how to manipulate it). When all you want students to do is to read the textbook, which has tremendous inherent value, there’s no need for an essay after the fact. I used to defend tests against detractors because they really only existed to make and ensure people actually read the damned book. In days of yore, when learning was based purely on face-to-face discussion and transmission of knowledge, there were no tests beyond perhaps oral exams.

        Also, I rocked MC tests, I could pass many MC tests purely on the basis of question structure and in the rare case where they gave you a sample set of questions and responses found in the final, my memory was good enough that I could pick the correct response without even reading it.

        Man, I really liked being a student.

        1. Windriven says:

          “Also, I rocked MC tests, I could pass many MC tests purely on the basis of question structure”

          Yeah, but so could lots of others. I liked essay tests because they separated the wheat from the chaff.

          Your point is well taken that some subjects do require rote memorization. In the fields that I studied that was less common.

          1. WilliamLawrenceUtridge says:

            But to get to the point where it’s worth spending time to separate the wheat from the chaff, one must first acquite a certain basic foundation of factual knowledge. Even Einstein must have had to learn the basic facts of the photoelectric effect and mathematics to reach the point where he could completely upend physics. Yes, don’t bother memorizing the specific energy levels of quantum states – but know that they exist, their aproximate magnitudes and behaviours, things that can all be adequately tested using multiple choice. And this was reflected in my classes – as I progressed through the years of my degrees, the classes were smaller and the tests were more prose than tick box.

            People rag on modern education for being too much rote memory and whatnot, and I think this sometimes misses the point – in many cases the important thing is whether you can stick out four years of rote memorization. Because the reality is, most graduates aren’t going to work in their discipline, so what is needed is a demonstration of your ability to persist in the face of boring work.

            1. Windriven says:

              “most graduates aren’t going to work in their discipline, so what is needed is a demonstration of your ability to persist in the face of boring work.”

              Now there’s a heartening thought as I head to the Idaho panhandle for a vacation hiking in the mountains. If I was at the beginning of my career, I’d be sure to bring a straight razor with me.

              1. WilliamLawrenceUtridge says:

                “…because you’re going to end up doing boring work” is basically synonymous with being an adult :)

                Still, I’d rather have a boring job and an entertaining commute and weekend in the modern world than have to fight off lions and scavenge for carrion, ignorant of everything over the next set of hills as a hunter-gatherer.

              2. Windriven says:

                Echoing Nancy below, I’ve been lucky enough to avoid that particular false dichotomy :-)

            2. n brownlee says:

              Yeah. I flunked.

              1. n brownlee says:

                ” I’d rather have a boring job and an entertaining commute and weekend in the modern world than have to fight off lions and scavenge for carrion, ignorant of everything over the next set of hills as a hunter-gatherer.”

                Jeez, on what planet is THAT the choice?

              2. mouse says:

                “Jeez, on what planet is THAT the choice?”

                Wasn’t that Vulcan in the original Star Trek?

              3. WilliamLawrenceUtridge says:

                Meh, it’s mostly caricature, but it’s also a deliberate selection of two extremes. It’s a rhetorically deliberate false dichotomy.

        2. irenegoodnight says:

          “Also, I rocked MC tests, I could pass many MC tests purely on the basis of question structure and in the rare case where they gave you a sample set of questions and responses found in the final, my memory was good enough that I could pick the correct response without even reading it.”

          That is exactly the problem with MC tests.

          To be clear, all types of tests were part of my program, but all mid-terms and finals were essay and I agree with you on the value of getting the basics down as a platform for further development. The other advantage of the essay is that it demonstrates thinking and writing skills as well. One could easily ace a series of MC tests and not be able to write a coherent sentence–I saw that a lot when I was a TA.

          1. WilliamLawrenceUtridge says:

            I go back again to the purpose of the test; for basic memory stuff, MC is perfectly fine. And if the purpose of the course is not to teach how to compose a sentence, then your grammatical abilities should matter not at all.

            I’ve a soft spot for MC tests, since they supported my magna cum laude graduation certificates.

      2. irenegoodnight says:

        Great minds….

        Your view of the essay test was shared by my professors (and me), but I was a “mature” student (30!) and the incoming classes moaned on and on about them. I considered it an opportunity to show what I KNEW, rather than what I didn’t know.

      3. Stephen H says:

        Windriven, I suggest you should tell us the author’s name. It’s important to the history of physics and books of quotations!

        1. Windriven says:

          Man, I just can’t come up with it. German guy. Crazy hair. Never bought into quantum mechanics 100%.

  3. Sabio Lantz says:

    Fascinating write up — thanks.

    I totally agree with your bubbly-will theory. And like you, not the self-righteous kind that sees everyone else as mindless, but because I have repeatedly seen it in myself thus agree with a modicum retrofit free will theory.

    I have practiced SCAM and now practice orthodox medicine (OM). I would say that most of my patients now, as back then share a disturbingly large amount in common. Instead of asking why did my former patients (or myself) seek out SCAM, we could also ask now, why do my present patients seek out OM. I think one of your paragraphs hit on it: recommendations of those around them that they trust. Most my present pt’s weigh such evidence (anecdotal) much heavier than the abstract evidential stuff. Most my pt’s weigh their information on trust: trust their family, trust their doctor and such — most know next to nothing about the science.

    All the other factors you delineate also feed the persistence of SCAM, but the decision making most of use do is deceptively shallow. But shallow is often the best choice when trying to survive a world, rather than understand it. Yet, unfortunately, the shallow choice is also the worse. The heuristic comes with problems — but not enough problems from stopping us from overpopulating our planet.

    1. Windriven says:

      “I totally agree with your bubbly-will theory.”

      For excellent explorations of this read Gerald Edelman, MD and his theory of neuronal group selection or Daniel Dennett. a philosopher and cognitive scientist at Tufts. Dennett’s grandly titled Consciousness Explained is a somewhat dated but still quite relevant exposition. Edelman’s Wider than the Sky lays out the rough outlines of TNGS in non-specialist language.

      1. Sabio Lantz says:

        @Winddriven:
        I’ve already read two or these and a few others. It is a theory I have held for a long time. No more reading needed. But thanx for the huge reading list — like I need one.

        BTW, are you Mark Crislip? I see you responding to many comments.
        Odd, because this blog has no possibility of following by e-mail. I just happened back here.

        I suggest you turn on the ability for commentors to “follow by email” so that dialogue is possible.

        1. WilliamLawrenceUtridge says:

          Dr. Crislip posts under his own name, and infrequently. He has a multimedia empire to manage.

        2. Windriven says:

          Ha! Not only not Dr. Crislip, not Dr. Anybody; never even took a college level biology class. I prefer my science to have hard mathematical certainty: PV=nRT. Always (more or less). Medicine is more like Acey-Deucey-One-eyed-Jack (a type of poker with too many wild cards). The rules are there but the referee is drunk.

  4. KayMarie says:

    So that is why most of the sCAM are so quick to posit that their treatment has no side effects. I always wondered about why that seemed to be such a powerful marketing ploy.

    But then if you reject evolution, you reject how many of our body systems are just theme and variation where the same parts get replicated with diverging functions or that the same handy part already there got re-purposed a few different times as different things evolved. So you may think that each thing is it’s own unique thing in the body and so each treatment should have one and only one effect and if it has a side effect it can’t be doing the right thing in the right place.

    I do think they also play very well on the psychosocial dynamic in ways that encourage following the feelings and “surviving reality” aspects of our brains rather than the critical thought areas. Some of what you must do if you believe in the uncertainty of your treatment (what the data says) does tend to be a cross-purpose with the things that seem to make people feel less ill and more well.

    My other thoughts is the nostalgia effect. Especially in the “back to nature” aspect of a lot of this. Somehow there was an Eden-like time where there was no illness and everyone lived to 120 and died peacefully in their sleep and if we can just get back to that time.

    Add to that the belief that modern life must be bad for our health in ways other than we sit too much and have way more access to food than is good for anyone. One of my favorite tropes is that X disease was not named (or at least doesn’t have the modern name) until (date where modern life destroyed are imagined idyllic perfect heath) so that disease never effected anyone in all of history until (fill in the easily identifiable bad guy fad of the moment) was inflicted upon us unawares.

    Sure science has unintended consequences, but all disease only erupted after (fill in evil corporation) began selling (fill in evil compound) is all too common. Some of this probably also fits with the anti-vax thing. It’s new, we were never sick before, why did they do this to us!!! ARRRRRRRRRRRRGH11! response.

    As to which ones, I think a lot of that is more my friend went to a (fill in the quack) and got better than some deep analysis. I don’t know that many people pick doctors by some deep analysis either, it is either what’s close or who a friend went to.

    My last thought is one element of a lot of the treatments is 30 minutes to an hour devoted to relaxation without your cell phone or other stressers intruding. We probably all do need a little more intensive down time, and I think it is fair to say many if not most of us won’t do that unless we pay someone to make us do it.

    1. Windriven says:

      “my friend went to a (fill in the quack) and got better than some deep analysis.”

      Deep analysis is not the default mode for most people. As George Carlin once observed: “Think of how stupid the average person is and realize half of us are stupider than that.”

      Work. Eat. Watch Xxxday Night Football. If Saturday, bang significant other. Repeat.
      Bread and circuses, that’s the ticket.

  5. Windriven says:

    “I always have to will myself to think rationally about topics.”

    Here I think you captured the issue rather well. Rational thought is both an understanding of logic and reason, and the discipline to apply those principles relentlessly. The first is difficult enough to teach, the second comes largely from within. I’m not sure that is teachable lest the lessons begin very young.

    “I remain curious as to why people use, and continue to use, useless pseudo-medicines.”

    I no longer care. My interests now are how best to make affordable, science based medicine available to those who want it, minimizing governmental support for the various idiocies masquerading as adjectival forms of medicine, and maximizing governmental authority to compel participation in critical public health measures (read: vaccinate your irksome spawn).

  6. Egstra says:

    “. . . people often credit causality of two events even when there is no credible connection between the events. We love to find causality where none exists.”

    I had to laugh at this. A goof friend and I have spent many hours, walking on the track and discussing just which variable has exacerbated our arthritis. “Was it the weather,” we ask? “Was it the salt in the pizza?”

    We both know, however, that arthritis is highly variable and it probably wasn’t any one thing that made it better or worse in that moment.

    1. Sean Duggan says:

      Ee… my wife has been diagnosed with preliminary indications of MS, including occasional facial numbness and we’ve given up on trying to find a trigger. It seems to be eating most of the team, but the type of food and amount seems completely inconsistent. And I have a sneaking suspicion that she just might be more likely to notice facial numbness at a time when she’s actively using her mouth and face to consume food.

      1. mouse says:

        I’m sorry to hear about the diagnoses Sean Duggan. I remembered that you mentioned your wife’s symptoms quite awhile ago. I was hoping that it was just a passing thing.

        I don’t want to be intrusive, since I only know you via this board. But I did want to say my thoughts are with you guys.

        1. Sean Duggan says:

          Why thank you. So far, we’re still sort of in limbo. Things haven’t gotten worse. They haven’t gotten better. Frankly, I’m starting to wonder if they haven’t just forgotten us… the last time the doctor scheduled a test was a good half a year ago.

          1. mouse says:

            Don’t know if you’ve found the same, but I’ve found that doctors assume your symptoms have disappeared or aren’t bothersome unless you make an appointment and tell them otherwise. If your wife isn’t comfortable or you all have questions/concerns I wouldn’t hesitate to make an appointment and see what can be done to address the situation.

            Hope it goes well.

  7. Mikeb says:

    I was never attracted to SCAMs. Don’t know why. Most I’ve ever indulged is St. John’s Wort for “depression” and glucosamine for arthritis pain. When I read the debukings I just stopped using them. Now I just drink hard cider.

    I just naturally hate mysticism and bullcrap of all sorts, always have. Wish I could bottle it and sell it to Natural News.

    1. WilliamLawrenceUtridge says:

      Don’t you hate “I’m not religious, I’m spiritual”? Shut up you damned hippie, at best that means you like trees, at worst it means you believe in a human-centric universe ordered by a being you merely don’t call “God” but is otherwise essentially identical.

      Damned hippies.

      1. mouse says:

        Just as an aside. I’ve always thought of spiritual as relating to the human spirit and how it may best thrive or starve in spite of adversity (or in plentiful times for that matter) and how that relates to art, music, communication, etc. Somewhat secular humanist approach, perhaps. I don’t read much about religion,atheism or inbetween.

        I’ve never thought of it as a religious or mystical thing, more just as a word describing a mental/emotional/physical characteristic that can be harnessed or harmed.

        I’m alway bemused when people think of it as mystical. Perhaps I am just lacking the word that people use in the place of my version of spirit.

        But then again, I think ice cream, blues and the scent of grass are good for the soul…so what do I know.

        1. WilliamLawrenceUtridge says:

          Many of the disagreements in this area probably source to definitions. I wouldn’t call what you define as “spiritual” as “spiritual”, most of it I classify as “entertainment” (not meant pejoratively – I think it’s fantastic that we live in a society where we have the leisure and access to so much entertainment and opportunities for socialization. The ability to tell and consume so many stories, so many narratives, so many different lives, and in so many different mediums be they prose, television, or even clothing and accessories, is amazing and deeply satisfying to me). So really what I object to is what you seem to call “mystical”, which I would treat as synonymous with my personal definition of “spiritual”.

          My hatred of “hippies”, my catch-all deliberately exaggeratedly pejorative term, really comes down to people who naively think that the world would be a better place if we just “got along” and were less materialistic. Brilliant idea, have you thought about the execution? My suggestions generally involve ensuring a predictable world where diseases are controlled, food supplies are adequate and the struggle for daily existence is minimal. And my solutions involve a large, technical government infrastructure and a lot of companies…both of which seem to be objected to by “hippies”. You are never going to solve the world’s problems by demanding or expecting people to consume less, but you can solve some of them through a significant investment in industries that promote efficiency and technical solutions to currently-intractable problems.

          And what’s with the drum circles? Gah!

          Of course, my own solutions aren’t really solutions, I just like to complain.

          1. mouse says:

            I suspect you know different hippie than me. Most the ones I know are liberals who are for better infrastructure, social programs and universal health care. They are concerned about corporations due to the influence of money in politics that seems to lead us away from the above goals. Shrug, maybe it’s regional.

            1. WilliamLawrenceUtridge says:

              Any hippies I know are either special-pleaded out of being hippies, or don’t actually exist. They’re my placeholder for anyone who complains about the evils of corporations on their laptop, connected to a wireless network, drinking coffee, while wearing clothes.

              I try not to be racist, so all the hatred of outgroups that humans carry instead gets poured onto imaginary hippies. Then lit on fire. They burn really well too, because they’re made out of straw.

              1. mouse says:

                Poor imaginary hippies. My sister once observed that I look like a depressed, goth, crunchy granola hippie. That was, of course, more of a fashion statement than a personal philosophy. One, which, I sadly can’t carry off at my present age (Black hair and lipstick especially).

                I’m not sure what’s wrong with complaining about the evils of corporations on a computer, though. Should I confine my concerns about the Koch brothers or predatory lending to snail mail or are you criticizing an overly black/white bias against corporations?

              2. WilliamLawrenceUtridge says:

                I have a soft spot for goths, being a poser-goth in my youth, so I forgive you your hippieness.

                Also, I’m having a hard time reconciling the images…you had a skirt made of wheat that you dyed black?

                My complaint is based on the fact that Apple somehow gets a pass, despite being a corporation. And a kinda shitty one too, whose products are extremely expensive and almost deliberately less functional in their minimalist design. But all computers are made by corporations, nearly all coffee is produced and imported by corporations (even the fair trade ones are still corporations, and still result in some externalities and inevitably bad practices), the wireless network is generated by a corporation-produced electronic device and is probably found in a corporate location, and the clothes were manufactured at some point by a company. There are some dodges (buy used clothes, use your own wireless network) but there’s no real way to home-brew the PC used to connect to the ‘net to complain about corporations.

                Corporations are a necessary evil, and demand reasonable regulation, not banning or vilification. That’s the kind of simplistic solutions that protest-attending hippies* present.

                *My caricature straw-hippie version, not real hippies, the kind I use to funnel all of my irrational need to hate into.

              3. WilliamLawrenceUtridge says:

                To clarify a bit more, since I think I lost my point mid-rant, my objection is to complaining about corporations as a block when using tools designed and built by a corporation.

                And further – what I really object to are large-scale street protests that seem more designed to entertain, give the sense of doing something, be sufficiently dramatic to be cathartic and allow violent outlets to a minority of participants than to allow actual change. Marching, throwing rocks and wearing bandannas may seem like a solution, but it’s ultimately a meaningless (and again, cathartic) gesture that is easily ignored. Its purpose seems to be the sensation of accomplishment, the drama of the moment that gives the illusion of useful activity, meanwhile actually changing very little and ignoring the realities of actual political change – grassroots activism, door knocking, mail-outs, consistent dialogue, networking, and the painful, frustrating, backsliding drag of activism that greys the hair and wrinkles the brow.

                So say I, who has only ever been inconvenienced by street protests, never participated in on (and whom, upon reading about the background of the protests, the activities contained therein, and what the protesters are actually protesting against, became disgusted with the whole thing).

          2. Missmolly says:

            I’m just going to put it out there and wait for the pitchforks: drum circles are FREAKING AWESOME!
            Being in the middle of a heap of people making music together is an amazing experience. Like being part of an orchestra, and you can still experience it even if you’re not a remarkable musician.
            My partner and I sometimes run drum circles at our local park- we meet all sorts of random people from the area that we would never otherwise have met, and hang out together having fun for an hour. Even if the music sounds crap, it’s a great way to build community! Thankfully we live in an affluent conservative suburb, so hippies rarely show up to ruin out buzz :)

            1. WilliamLawrenceUtridge says:

              I’m probably the only one willing to wield a pitchfork, but I have one out now. Down with drum circles, us hard working middle class stiffs are trying to sleep! Damned hippies.

              1. Missmolly says:

                Ooh, I’m probably stinking out da internets with my all-natural crystal non-functioning deodorant :) but let’s be fair, even drum circles aren’t as arse-clenchingly irritating as harmonic chanting…

              2. WilliamLawrenceUtridge says:

                Ha, I used to use crystal deodorant. It tasted funny.

                Once, in the King’s Chamber of the Great Pyramid, a group of people who looked like they were Indigenous South Americans, linked hands and chanted/hummed. The acoustics of the King’s Chamber are pretty amazing, so it resonated impressively. They soon left, I’m assuming because I killed their buzz. It was pretty funny.

              3. Windriven says:

                “Ha, I used to use crystal deodorant. It tasted funny.”

                You were doing it wrong, William.

              4. WilliamLawrenceUtridge says:

                Oh snap, that was actually pretty good :)

            2. Windriven says:

              I thought drum circles were something oil companies cut in wheat or corn fields.

              1. Missmolly says:

                Actually, they’re made by aliens. Aliens sent for the sole purpose of causing WLU to froth at the mouth :)

              2. WilliamLawrenceUtridge says:

                Don’t mock my mouth froth, it’s useful when I run out of milk foam in my coffee!

                I kid, I also don’t drink coffee. Makes my pee smell funny.

        2. n brownlee says:

          ” I think ice cream, blues and the scent of grass are good for the soul…so what do I know.”

          Well, they are.

        3. Thor says:

          I’m totally with you on the blues, mouse.
          Regarding “spiritual”, it seems that the word can have so many meanings that it is rendered essentially useless. It’s purely a fluff-word. When asked what the word means any number of answers can be given. But, we already have words for what spiritual seems to be implying or signifying. Plus, spiritual has so many connotations, interpretations.
          In essence, though, the word has the root “spirit”, which signifies, refers to, implies a facet of a human being other than mind and body. That’s the real meaning: having to do with spirit. And spirit signifies an energy, like our endeared life-force, like that entity which survives death, a soul, etc. Spirituality definitely has religious meaning. Maybe not organized religion, but nonetheless.
          If spiritual means various qualities and attributes of human nature, of the mind, then why not use the specific words we already have for these?
          Spirituality is an almost haughty word implying virtue. It easily gets in the way of precise and fruitful communication.

          1. mouse says:

            Thor “And spirit signifies an energy, like our endeared life-force, like that entity which survives death, a soul, etc. ‘

            Yup. You’re not telling me that something from e.e. cummings didn’t survive death, are you? Because – http://www.poets.org/poetsorg/poem/my-father-moved-through-dooms-love#

            And of course it has a religious connection, because we humans invented religion in an attempt to control and direct the spirit, poor Michelangelo and his ceiling.

            Look, just because something is symbolic doesn’t mean it’s not real, The mind is entirely symbolic, but we don’t argue that it’s not real.

            On the other hand, I do have a terrible time finding the appropriate words somedays, maybe I’m just having an aphasic moment, cause I can’t think of a better word for what I’m talking about.

            1. WilliamLawrenceUtridge says:

              But when people mean spirit in terms of survival after death, they generally mean consciousness. Sure, one can say one’s spirit survives in one’s children, or one’s art, or one’s impact on society, but what people generally really mean when they talk about a spirit or soul is the bit of you that thinks and remembers. Sure, cummings may impact people years after her death, but I think if you told that to a dying person, they’d probably think it was a cheat or a sop. We don’t want to survive in our children, we want to survive as that amorphous network of meanings and experiences that we define as “me”.

              Sadly, we don’t.

              1. mouse says:

                WLU “But when people mean spirit in terms of survival after death, they generally mean consciousness. Sure, one can say one’s spirit survives in one’s children, or one’s art, or one’s impact on society, but what people generally really mean when they talk about a spirit or soul is the bit of you that thinks and remembers. Sure, cummings may impact people years after her death, but I think if you told that to a dying person, they’d probably think it was a cheat or a sop. ”

                If you told me that I’d have a similar impact after my death to e.e. cummings on my deathbed, in a reliable way (clearly one couldn’t really know that,) I say f*&k yeah!

                The fact that some people have a different idea about what spirit is matters little to me. Some people believe that Thomas Kincaid creates art. I’m not going to stop being inspired by art because they are deluded. I don’t know why I would stop being spiritual because some folks think it means something to do with an afterlife.

                But I may start saying “I’m not religious. I’m spiritual!” more often, just to get skeptic’s goat. (Every depressed, goth, hippie should have a goat.)

            2. Thor says:

              I hear you, but I agree with WLU. You are taking quite a liberal approach to the use of the word spiritual. You’re using it in an admittedly broad, symbolic way which is not the usual, or common usage. It’s a certain poetic liberty, vague, amorphous, interpretive.
              Sometimes people do this with God and religion. Kind of a “no true Scotsman” variation. “Oh, you mean by God that entity that created the universe and answers prayers? That’s not my God. My God is the universal life-force, nature”. Or, “Oh, you need religion for God. I’m a deist, so religion isn’t even a factor for me”. And, “I don’t believe in religion or God. Those are moronic. I’m more of a spiritual person. There’s something about us that is more than just body and mind”.

              1. mouse says:

                “It’s a certain poetic liberty, vague, amorphous, interpretive.”

                poetic, liberty and interpretive I was going for, even amorphous is okay, but vague…that’s clearly due to my lack of communication skills.

      2. deconstructed says:

        Wow, why so bitter? I think all experience is mystical, and challenge anyone to prove otherwise. Yes, the universe unfolds according to physical laws. Yes, ‘medical cures’ not based on evidence are quackery. That doesn’t make the process of experiencing of that unfolding any less mysterious and fascinating.

        I find that pure reductionism is more or less isomorphic to depression.

        1. Windriven says:

          “I find that pure reductionism is more or less isomorphic to depression.”

          ‘K. I don’t. I wouldn’t even characterize it as pure reductionism. The entire field of chaos theory confronts the irreducible. I find beauty and fascination and unending wonder without need of ‘spirituality’ or ‘mysticism.’

          1. deconstructed says:

            I’d call “beauty and fascination and unending wonder” pretty much the same thing I mean by “mystical”, so we’re quibbling semantics.

            1. Harriet Hall says:

              Reductionist science has enabled us to learn things that increase our appreciation of the beauty and fascination and unending wonder of the world. Every atom in your body was forged inside a star. Every lungful of the air you breathe contains a molecule of air that was once in the lungs of Julius Caesar. How could you not find that awe-inspiring? How could you possibly know about it without reductionist science?

              1. irenegoodnight says:

                That is a beautiful sentiment HH–I’m going to memorize it. It’s the best woo-rebuttal I’ve heard yet! Many thanks.

            2. WilliamLawrenceUtridge says:

              My original point was that this conversation inevitably hinges on semantic, more precisely, the use of idiosyncratic and unexplicated definitions :)

              Your use of “mystical” doubtless bears zero resemblance to mine, or windy’s, or Dr. Hall’s, or Mouse’s.

              1. WilliamLawrenceUtridge says:

                Sorry, not belittling or singling out deconstructed’s statements, I mean that all of our definitions are probably divergent in large or small part.

              2. mouse says:

                True, it’s semantics. But I think it’s the fun kinda semantics that reveals something about people’s incredibly diverse inner lives, rather than the dictionary thumping kinda semantics that is pretty boring.

              3. WilliamLawrenceUtridge says:

                Meh, I love dictionaries too.

                Yes, the dialogue is interesting, if you have an interesting interlocutor. The exploration of meaning, nuance, agreement and disagreement, particularly finding out the finest shades of disagreement, is incredibly interesting. That is perhaps one area where I can find flow, a really good discussion. The greatest reward is when you really lay out and examine in a neutral manner your mutual presuppositions and definitions to find out what is actually meant by nearly every word. Far more rewarding than simply saying “you’re wrong about spiritualism”.

              4. mouse says:

                WLU “Meh, I love dictionaries too.”

                I like dictionaries.(Love would be strong for me. I much prefer thesauruses) I like thumping. It’s the thumping of dictionaries I find boring.

                I agree on the rest if your comment. Although flow for me…not so much, interesting and rewarding, though.

              5. Windriven says:

                @mouse

                ” I like thumping.”

                Have you thought about joining Missmolly’s drum circle?

        2. Thor says:

          Why call it mystical with, like the word spiritual, all that it implies—a hidden world of metaphysical happenings, a realm beyond human understanding, God, or godly arenas of existence? The challenge is to “prove” that all experience isn’t mystical? Wow. That’s ass-backward. I’m sure you know that one doesn’t prove a negative, and that it’s up to you, who is making the claim, to prove that ALL experience is, in fact, “mystical”. Just because the experience of the universe is mysterious and fascinating, doesn’t mean that it’s mystical. Why throw in that extra word. You are using a less religious form of the God of the Gaps idea.

        3. WilliamLawrenceUtridge says:

          I’m not bitter, I just think the insertion of unnecessary entities is irritating, sloppy, and is a poor justification for a lot of bad thinking and specious rationalization. If you want to label a positive experience as “spiritual”, it adds an unnecessary word that is imprecisely defined that you are using as a sloppy cover for the actual adjective you mean. Probe deeply enough, as “why did you find it spiritual”, you find the real reason for the positivity of the experience.

          I find reductionism comforting. The idea that I find certain experiences positive because of my existence as a primate is comforting to me, because if nothing else it shows me a path to experiencing it more frequently or with a greater intensity. I love the speculation that fills the void of a gap in reductionism, but what I love even more is having that gap filled.

          What’s mystical about experience? Every indication is that we’re a meat sack carrying around firing neurons. Adding an overlay because you don’t like the image may help you, but that doesn’t make it true. And it doesn’t help me. The fact that your experience is due to firing neurons creating a mini model of the universe doesn’t make your experience any less real to you than claiming it’s due to the “soul”.

      3. stanmrak says:

        WLU, it’s clear from your answer that you have no idea what being “spiritual” means.

        1. KayMarie says:

          Well there is what spiritual probably should mean or what it can mean in the right hands.

          Then there is what far too many people mean when they say they are spiritual which often gets you into those that worship nature or those that worship themselves when they aren’t one of those who just want to mix and match the beliefs of various religious without having to be beholden to whichever ones they find annoying at the time.

        2. WilliamLawrenceUtridge says:

          It’s clear from your answers that you have no idea what good evidence is.

          Also, if you provided your own definition of “spiritual”, I could assess whether I meet or even desire such an experience. Your claim of me having “no idea” is as cognitively and semantically empty as all of your statements. Which doesn’t surprise me, deep thoughts or even thoughtfulness are obviously not a strength of yours.

        3. R. Miller says:

          This response is kind of adorable. A huge part of the “spiritual” movement has been do distance itself from organized religious belief, as in the often stated “I’m spiritual, but not religious!” and attempt to cast a wide umbrella that allegedly accommodates many philosophies. Yet so often we find ourselves back at square one, with the ‘enlightened’ spiritual gurus looking down on other peoples’ personal beliefs and guiding principles while belittling anyone who doesn’t keep rank within the guru’s specific and limiting schools of thought. It really exemplifies how NewAge simply became Religion 2.0.

        4. weing says:

          “WLU, it’s clear from your answer that you have no idea what being “spiritual” means.”

          He’s not the only one. I’ve always inserted “x” for when people use the word. Then through simple algebra or calculus, I could figure out what the unknown is. No luck. The best I can come up with is that it’s some kind of a pretense.

  8. Peter S says:

    Marketing, in my opinion. People who are suffering but for whom real medicine doesn’t have good answers and who haven’t been helped by drugs are vulnerable to anti-establishment messages, particularly when delivered by people who promise to get at the “root cause” of your symptoms, to treat you as an “individual,” to provide treatments that the establishment eschews because there is no money in them, and so forth. And as mentioned tropes such as natural and no side effects resonate with people too.

  9. Prisby says:

    The bloggers on this site are doctors and deal with medicine every day. I’m not a doctor. Here are some my thoughts and experiences.

    Why do people believe in SCAMs? Most people just don’t know. I’ll admit I used to be fairly ignorant and I am well educated with a strong background in math and science.

    How often does a typical adult see their physician? Do most physicians actively present details to their patients about chiropractic, homeopathy, healing crystals, supplements, reiki, miracle weight-loss pills, male enhancement, and etc.? On one side of the battle is an annual physical with almost zero information on SCAMs. On the other side is Oprah or Dr. Oz five times per week, news articles on evil pharmas not letting people use experimental or debunked drugs, Smiling Bob, Jenny McCarthy, and so many more.

    It’s direct bombardment with bad information vs. the requirement to actively seek good information. One requires no work while the other requires work. One side can say almost anything they want while the other side has to use facts. Is there a better source than SBM? I haven’t found one. How many hits per day does this site get?

    I’ve used Excel spreadsheets to show the math on what a 200C dilution really is. The number of decimals is so immense that Excel can’t calculate it past 153C! Despite the numbers, I couldn’t convince some highly intelligent people that homeopathic dilutions are nothing. Popping multiple homeopathic sleeping pills while showing the back of the box (thanks Randi) prompts threats to call an ambulance and makes people wonder about MY sanity. I don’t do that anymore and I don’t do it for the wrong reasons.

    I dislike manipulating people (that may be a lie) into changing their perceptions on SCAMs, but the SCAM providers themselves are sometimes the best resources. I have found the chiropractor.com website section “History of Chiropractic” is a great defense against the “you’re not a chiropractor and you don’t know what you’re saying” attacks and is perfect for helping people understand what chiropractic really is. If someone reads that section and still believes in chiropractic is medicine. . .

    Too many people don’t have a clue and so many don’t want to have a clue. It’s a frustrating battle, but one that needs to be fought.

  10. deconstructed says:

    Overall I agree with the gist of what you’ve written, but I find the survey on types of CAM you linked to pretty annoying because it’s lumping meditation and yoga in with homeopathy, and I think that’s pretty bold and unwarranted. Yoga’s not going to cure cancer, but it’s clearly good for you for all kinds of reasons. Meditation isn’t going to cure psychosis, but you know what? It’s had a much more beneficial effect on my happiness and the way I process anxiety than I ever got through years of MD psychiatrists and polydrug regimens. Beyond that, there’s enough hard data at this point to conclude that consistent meditative practices alter the way the brain works. Is that really a controversial idea?

    1. WilliamLawrenceUtridge says:

      Yoga is exercise and perhaps relaxation, meditation is relaxation (I think Dr. Novella wrote a post a while back discussing the dearth of studies comparing simple relaxation to meditation), but the problem is it’s treated as if it were a mystical (ahaha) experience and panacea. Perhaps you don’t, but many proponents do. Meditation may even induce psychosis for that matter.

      Treating yoga and meditation as what they are, or what they are comparable to, is reasonable, but you kinda underscore Dr. Crislip’s point – the answers depend on the question, and often the questions are asked badly.

      1. deconstructed says:

        Sure. I agree. But you have to understand that I’m coming from a perspective of having been significantly damaged by psych drugs that were prescribed in reckless combinations (for which there were no RCTs, let alone RCTs of these drug combinations in children, which I was at the time.) So, there’s a lot of harmful things done in the name of conventional medicine, and needless to say those experiences bias the way I read blogs like this. I like science. I am not anti drug.

        All that stuff left me in a real mess, and after seeing a dozen of more MDs over the years, “more drugs” was the only answer they had. That didn’t help me. The things that have helped me, are largely things being called scams in this article.

        I’m not alone, either. Far from it.

        1. WilliamLawrenceUtridge says:

          Sure, but the lack of evidence for some uses and combinations of drugs for some conditions doesn’t excuse making unsupported claims for meditation. I’m glad it worked for you. I hope it has the potential to replace drugs for many people. But until there is good evidence of this fact, making broad claims about it doesn’t mean it’s true. A common standard for all things.

          But hey, if you are currently drug-free, avoid prison and pay taxes, I have absolutely zero issue with you doing something you like. Hopefully science will one day study it and validate your experience as a broadly-applicable solution, because more options are always a good thing.

    2. Thor says:

      Meditation and yoga (stretching), like nutrition and exercise, are prime examples of how simple, basic, and beneficial human activity get co-opted into CAM. They then get turned into quasi-religious activity. Claims made for them both simply have no bounds (why isn’t it enough that meditation stills the chatter of the mind so that other aspects of consciousness can be noticed?). It can’t be helped that they are lumped with all things CAM. They are stuffed into the pseudo-science tool-kit
      grab-bag. They’ve become magical tools for attaining “spirituality” (New Age religion).

      1. Missmolly says:

        And hell, if you can’t attain spirituality by staring into your own sweaty crotch through a twisted graveyard of unnaturally positioned joints and muscles* for 45 minutes, how CAN you attain it?
        *your yoga mileage may vary

      2. Andrey Pavlov says:

        Meditation and yoga (stretching), like nutrition and exercise, are prime examples of how simple, basic, and beneficial human activity get co-opted into CAM. They then get turned into quasi-religious activity

        Indeed. This is basically what I and others have said in the past – the the CAM is often in the intent and the marketing. Yoga is great. I don’t do enough of it these days*. But when you start claiming it re-aligns your chakras or cures Alzheimer’s then it is quackery. Or food stuffs; if you eat spinach salad that is food. If you eat a 5kg bag of spinach every day because you believe it will help prevent or cure some disease, then it is a medicine; same if you buy a pill that concentrates 5kg of spinach into a single tablet; and if the claim is that it will “boost your immune system” or cure some disease, then it is quackery.

        *It can also be much more than just stretching. I do movement yoga and it is one heck of a workout!

        1. Thor says:

          I didn’t mean to be flippant. (I started doing yoga at 15!) Of course, yoga is more than just stretching.
          Let’s call it an exercise system, incorporating breathing exercises and even meditation.
          Let’s put aside the “spiritual” baggage that usually comes with it like a conjoined twin.

  11. NotADoc says:

    I live in a city that may well have more CAM practitioners per capita than any other city in the U.S. Everyone, from the little Hispanic abuela down the block to the flowing-haired, kale-eating trust funder has an acupuncturist. It’s pretty much expected that you will go to a crystal healer/homeopath/naturopath for ANY ailment, and failure to do so is a sign of great irresponsibility and probably even moral turpitude.

    Much of this goes hand-in-hand with other New Age ideas, particularly the one about “creating your own reality”: you have brought illness or injury into your life for a reason, and have lessons to learn from it. Conversely, living your life in the approved manner inoculates you against illness, poverty, and above-mentioned moral turpitude. Beautiful combination of magical thinking and blaming the victim.

    Add in mistrust of GMOs, cell phone towers, gluten, and worst of all, Big Pharma, and the person offering ancient healing modalities starts to look pretty good. If all you have to do to cure illness is to think better thoughts and delve into past-life issues, what’s to lose?

    1. Thor says:

      Sounds like we live in the same city. Hint: somewhere in northern CA.

      1. NotADoc says:

        How about northern NM?

        1. Thor says:

          You win!

  12. Windriven says:

    There seems to be a Luddite impulse in much of the population and it manifests itself in various ways. In Nigeria we see Boko Haram – Western Education is Forbidden – and its embrace of an Islam so repressive as to have crossed the line into sociopathy. In the industrial West we see embrace of the naturalistic fantasy even among the well educated. I suspect that it is all rooted in a fear of the unknown.

    Proton beam therapy sounds like something out of StarTrek, acupuncture is an ancient (not really) treatment provided by wizened old Chinese. You miss with a proton beam, scary sh!t might happen. You miss with an acupuncture needle, no big deal as has been proven in a number of RCTs :-)

    Fear begets all sorts of dumb behavior.

  13. Peter S says:

    This is one of the best lists I have ever seen — it’s from the site of a California MD, Jeremy Kaslow.

    Rapid Weight Reduction Program
    CVAC
    ACG – Nutritional Cardiograph
    Advanced Diagnosis
    ASYRA Testing
    Allergy Testing
    Anodyne
    BioPuncture (Microdose Biomodulation)
    Blood Vessel Elasticity (DPA)
    Body Impedance Assessment (BIA)
    Breast Thermography
    Electro Interstitial Scan (EIS)
    EPT
    Food Testing
    Free Radical Assessment (ODT)
    Heart Rate Variability (HRV)
    JMT
    Low Level Lasers (LLLT)
    Metabolic Tests
    Neural Therapy
    NeuroEmotional Release
    Nutritional Counselling
    Photon Directed Action (PDA)
    Physical Therapy
    Toxic Ionic Metals (IMT)
    UltraLite Weight Loss
    Fees
    Meridian Energy Assessment (MEA)
    Activated Oxygen
    Inhaled Ionized Oxygen (IIOT)
    Lasers – Class IV Therapeutic
    Microdose Bio-Modulation
    Pulsed Electromagnetic Fields
    UVBI
    ROS – Revelar
    Ozonotherapy
    Prolozone

  14. whoa says:

    “The most compelling evidence are randomized, placebo controlled, double-blind studies. The least compelling is personal experience and testimonial. ”

    Don’t trust your experiences, or other peoples’ experiences. Most of all don’t trust your mind!

    Only trust RCTs paid for by Big Drug.

    1. Mark Crislip says:

      I take Feynmans quote to heart:

      The first principle is that you must not fool yourself – and you are the easiest person to fool.

      Those who practice pseudo-medicine have to ignore it

    2. Thor says:

      “Don’t trust your experiences, or other peoples’ experiences. Most of all don’t trust your mind!”

      You should try this idea sometime. You just might find that a new world of reality opens up for you. Perhaps a liberating feeling will come over you, as well. It will be refreshing. Your cognition may even become enhanced. Give it a go.

      I remember that Seinfeld episode when George decided that whatever his usual thinking was, he would do the opposite because his mind always led him to make wrong decisions.

    3. JD says:

      Don’t trust your experiences, or other peoples’ experiences. Most of all don’t trust your mind!

      You have missed one of the main points of the post. These are all subjective and have an impressive ability to distort reality. Are you really advocating for trust of anecdotes and testimonials over rigorously obtained evidence? All because pharmaceutical companies just happen to perform RCTs? I really can’t follow the logic here.

      1. whoa says:

        If I try something and it obviously works, then I trust my own experience. If I repeat the experiment many times, and the same thing always works, then I don’t have to wait for big expensive RCTs, which most likely will never be done.

        If very large numbers of people try something and are sure that it works, then I might try it and see if it also works for me.

        If we have no trust whatsoever in our own experiences or the experiences of others, then we have to wait for the big RCTs, which may never happen.

        This applies to decisions in all areas of life, not just medicine. We must trust our own judgment, and the judgment of people we respect. We also consider the opinions of large numbers of people.

        Yes, each of use can be wrong, and everyone we know can be wrong, and millions of people can be wrong.

        We can’t afford to do our own RCTs and we usually can’t wait for someone else to do them. So we make our own imperfect decisions — about health and everything else.

        Expensive RCTs won’t get done unless some big organization or corporation decides they are worthwhile or profitable. And they can often be wrong or misinterpreted.

        But “skeptics” can always trash each and every alternative medical idea because it has no RCTs to prove it works.

        1. Harriet Hall says:

          “If I try something and it obviously works, then I trust my own experience. If I repeat the experiment many times, and the same thing always works”

          That may be good enough for most practical purposes, but you should understand that you may still be wrong. See http://www.sciencebasedmedicine.org/why-we-need-science-i-saw-it-with-my-own-eyes-is-not-enough/
          If you don’t understand this principle, you don’t understand science.

          1. whoa says:

            I understand science Harriet. I also understand that big expensive RCTs are not something I can wait decades for. Most of the RCTs that might interest me will never be done.

            I have to make decisions every day, about health, relationships, career, finances, etc. etc. Big Science can’t help me with most of them, I have to use my poor little brain. And yes, it can be wrong. No decision is perfect, no human brain is infallible.

            But the paternalistic don’t-trust-yourself “skeptic” movement is just appalling to me.

            I have been through a doctoral program and I understand the scientific method and all that. I also have some understanding of human nature. In that four years I saw more paternalism and authoritarianism than any other place I have been.

            Yes people are always saying and doing stupid things, but in my opinion it is NOT because our minds are feeble and deceptive and can’t be trusted. It’s because life is difficult and decisions are hard, and the Truth just can’t be known. So people do they best they can.

            You “skeptics” think the big answers are there, confirmed by RCTs, or else about to be confirmed by RCTs. All we have to do is blindly trust Big Science.

            1. Andrey Pavlov says:

              I have been through a doctoral program and I understand the scientific method and all that.

              There is at least one lie in there. Probably one and a half. Sorry whoa, but no matter how much you claim to understand science, what you write and how you think about topics make it crystal clear that you haven’t the foggiest. Including how you keep focusing on “big expensive RCT’s” like they are the only form of evidence. They aren’t. And they aren’t the only way we will think something worthwhile. There have been no RCT’s on whether smoking causes lung cancer. Yet we still somehow know it does and act accordingly. In fact, we here are very much against the idea that an RCT is the only form of evidence. So much so that Dr. Gorski (I believe) coined the term “methodolatry” to indicate when people perversely think only RCTs are worthwhile evidence. So stop going after that straw man. (not that you will, of course)

              Yes people are always saying and doing stupid things, but in my opinion it is NOT because our minds are feeble and deceptive and can’t be trusted. It’s because life is difficult and decisions are hard, and the Truth just can’t be known. So people do they best they can.

              Wait a second, what’s the difference? You’ve said nothing different to anything we’ve said. You can say that the human mind is spectacularly brilliant and that the universe is just mind bogglingly complex and difficult to understand, and you’d be correct. Or you could say that the human mind is not evolved to understand reality and it isn’t quite capable of fully understanding the complexity of the universe and that would also be correct. It is all relative. Either way, compared to what we are trying to accomplish the human mind is feeble and can’t be trusted. You’ve done nothing but use different language to say the exact same thing. Either our minds are great and the universe is more difficult still. Or our minds are simply not great in comparison to the universe. It’s all relative and it just depends on which perspective you’d rather take. Given that the universe is what it is, and we aren’t about to change it, it seems more rational to approach the shortcomings of our brains in trying to improve how we deal with and understand complex issues, don’tcha think?

              ou “skeptics” think the big answers are there, confirmed by RCTs, or else about to be confirmed by RCTs. All we have to do is blindly trust Big Science

              Funny that considering that we here have coined the term “methodolatry” as I mentioned above, which means that we recognize that we can’t get and don’t need RCTs to answer every question out there. There are plenty of other means of evidence that can support a claim. And considering that Big Science also includes the “science” and science involved in investigating claims like those of CAM and we are highly critical of them, it can hardly be said we blindly trust “Big Science.” We advocate for a deep understanding of science (something you were woefully uneducated in during your doctoral degree) so as to be able to critically analyze and all all evidence and claims no matter the source.

              But, once again, you’ll just completely ignore this and continue on in your own fantasy world where you think you actually do have an understanding of how science works and somehow magically know better than actual scientists and physicians and just keep on trucking along with your tanker full of napalm lighting up vast fields of straw men.

              1. Windriven says:

                Wonderfully done, Andrey.

                “something you were woefully uneducated in during your doctoral degree”

                To be fair, she never said her having been through a doctoral program resulted in a doctorate – there is all that nasty thesis and its defense part. And she never said her education was in science. If she has a degree it could be in Italian Literature of the Renaissance or naturopathy or chiroquacktic.

            2. Harriet Hall says:

              Others have adequately answered your comment, but I’d like to add something. If you have good reason to think something works, I agree that it might be reasonable to try it rather than to wait decades for an RCT. But what constitutes good reason? There are no good reasons for homeopathy. Testimonials are unreliable. If you choose an untested remedy at random, it is overwhelmingly more likely not to work than to work. A good reason would have to be compatible with the body of current scientific knowledge; it would have to have prior plausibility. Some herbal remedies might fit the bill; but much of CAM does not. So how do you decide what to try?

              If you have tried something repeatedly and have gotten better each time, it is reasonable to keep doing it, but not to claim that you know “it works.” Only scientific testing can rule out “post hoc ergo propter hoc” errors.

              1. whoa says:

                Ok Harriet, I more or less agree with that. It sounds different from what you said before. It seemed like you were saying we should always wait for RCTs.

                I think MDs should pay attention to what patients are saying on the internet, and notice if something is working for large numbers of people. Don’t just assume patient reports are always nonsense.

              2. Harriet Hall says:

                Sure, we should pay attention if large numbers of people are reporting something. But that doesn’t mean we should assume they are right. It means it might be worth studying to find out if they are right. Assuming they are not reporting something we know is ridiculous, like cures from homeopathy. If you don’t think large numbers of people can be wrong, just think of astrology or dowsing.

              3. WilliamLawrenceUtridge says:

                You should always wait for RCTs when making recommendations for others. If you want to waste your time and money on something stupid, that’s your own business. Few editors or commentors here would argue four outright outlawing of SCAMs, what is generally asked for is that SCAMs not be paid for out of tax dollars, that there be options for private insurance plans that do not involve SCAMs, that there be no research funding for the more absurd and improbable SCAMs, and that the imprimatur of state agencies not be granted before proof demonstrates effectiveness. SCAMs and real medicine should be on an even playing field, and if this were the case then most SCAMs, then they would be derided as unproven nonsense rather than justified by being “ancient” or “natural” or some other nonsense.

                Don’t just assume patient reports are always nonsense.

                Doctors don’t. That’s how viagra went from being a heart drug to a penis drug. But when the method of action doesn’t make sense and when there are no objective signs that can be read, then sometimes it is better to note that patients often fool themselves rather than wasting resources investigating. Homeopathy for instance, and chiropractic for anything but musculoskeletal pain.

              4. Windriven says:

                “pay attention to what patients are saying on the internet , and notice if something is working for large numbers of people. ”

                A PhD in experimental psychology wrote that? Without irony?

                You are either kidding me or you are kidding yourself.

              5. Calli Arcale says:

                If you have tried something repeatedly and have gotten better each time, it is reasonable to keep doing it, but not to claim that you know “it works.”

                THIS.

                I get these dreadful headaches every now and again. They’re horrible; if gnawing off a foot would cure them permanently, I’d totally do it. But it won’t, so I don’t. I used to think that my husband’s backrubs helped, because he’d give me a really awesome massage, I’d go to bed, and the next day I’d be on the mend. (They’d been diagnosed as tension headaches; I now believe they’re migraines.) Then I had one when he was on a business trip, and the duration was pretty much the same as when I had him around to rub my back. And then later I had one when he was around to rub my back, and it actually lasted longer. I started paying more attention, and as pleasant and wonderful as the backrubs were, they really had no effect on the progress of the headache. It just has to run its course each time. And frustratingly, the same has been true of everything else I’ve tried. Pain relievers make it a little more bearable, but that’s about it. I’m not quite ready to try the more serious migraine medications; I saw how groggy they made my mom, so I doubt they’ll leave me any more functional anyway. If they get worse, I’ll consider it.

                So you can try something for years and perceive an effect only to later discover that the two things had nothing to do with each other. *shrugs* It happens, and there’s not really a good way around it in an N of 1 situation.

              6. Iqbal says:

                Harriet Hall

                ” But what constitutes good reason? There are no good reasons for homeopathy. Testimonials are unreliable. If you choose an untested remedy at random, it is overwhelmingly more likely not to work than to work.”

                My wife has been a binge eater. Many of these eating sessions lead to upset stomach with frequent visits to the toilet.
                Before marriage, she used modern medicine. The many visits to toilet would vanish as she would end up with constipation. This was accepted consequence of the” tablet” and the situation would last for about a week.

                After 27 years and marriage, in the similar situation, she was offered homeopathic medicine. This time, from upset stomach, she came to normal stomach, without the intervening stage of constipation. This has continued to play out for the past 28 years now.

                Earlier, the intervening stage of constipation was normal situation. Today she believes, it was a difficult trade off than the numerous visits to the toilet.

                Would she ever go back to “modern medicine” with this experience? She now promotes homeopathy in her family.

              7. WilliamLawrenceUtridge says:

                Seems like the solution is “don’t binge eat”, not “use homeopathy”.

              8. KayMarie says:

                Seems like the solution is “don’t binge eat”, not “use homeopathy”.

                Add some, maybe she was using the inappropriate pill at the inappropriate time at the inappropriate dose. Modern medication is not magical like alt med treatments claim they are. They can’t diagnose you, know if they are the right medication, or adjust their dose magically.

                Also was there a “don’t take anything” test. Which is an important control before “oh this worked better than that”. Maybe this, or that, is the same as didn’t take anything at all.

            3. WilliamLawrenceUtridge says:

              I understand science Harriet. I also understand that big expensive RCTs are not something I can wait decades for. Most of the RCTs that might interest me will never be done.

              Your claims above clearly demonstrate you don’t understand science, because you claim anecdote as adequate to broadly generalize.

              I have to make decisions every day, about health, relationships, career, finances, etc. etc. Big Science can’t help me with most of them, I have to use my poor little brain. And yes, it can be wrong. No decision is perfect, no human brain is infallible.

              Quite the opposite actually, the human brain is incredibly fallible and that’s the problem, that’s the reason we need the structures and strictures of science. The human brain can’t even be relied upon to remember your meals from the previous week, or even critical incidents from your childhood (read The Invisible Gorilla if you trust your memory) or even critical incidents from your marriage; the mind reconstructs these memories, it does not store them.

              Further, of the things you list that science can’t help you with, only one, perhaps two (health and relationships) are amenable to scientific inquiry. If you think or are trying to apply science to the others, you’re once again doing it wrong and don’t understand the point.

              But the paternalistic don’t-trust-yourself “skeptic” movement is just appalling to me.

              It sounds like it’s because you don’t understand it. You don’t understand the skeptical “movement”, and you don’t understand why skeptics place so much emphasis on science over other types of learning. Consistently science discovers that you really can’t trust yourself, that your perceptions, memories, reasoning and actions are fundamentally untrustworthy due to systematic distortions built in to the human neural structure. Evolution prepares you to live just long enough to breed – little else. It doesn’t prepare you to think.

              I have been through a doctoral program and I understand the scientific method and all that. I also have some understanding of human nature. In that four years I saw more paternalism and authoritarianism than any other place I have been.

              Didn’t do well in your doctoral program then?

              It’s funny, because despite your protestations that you understand the scientific method, your comments continue to indicate that while perhaps you may be able to explain the steps in the method, you don’t understand the “why” of each step. Otherwise you wouldn’t keep talking about how trustworthy your experiences are.

              Yes people are always saying and doing stupid things, but in my opinion it is NOT because our minds are feeble and deceptive and can’t be trusted. It’s because life is difficult and decisions are hard, and the Truth just can’t be known. So people do they best they can.

              I’ve highlighted the part where you’ve gone wrong. There is a massive amount of evidence coming out of cognitive psychology that indicates the mind is blatantly, insidiously and continuously deceptive. Not for things like gravity, and in particular not for things like human relationships (though even there, trusting your mind is not a guarantee of happiness), but for health, for diet, for the microscopic and macroscopic, for the EM band outside of our perceptual range, for carbon dioxide gas, for anything with a delayed impact, for all of that, the mind is just terrible at determining causality, and if you think otherwise, you are wrong.

              You “skeptics” think the big answers are there, confirmed by RCTs, or else about to be confirmed by RCTs. All we have to do is blindly trust Big Science.

              Ha! Added to your list of things you don’t understand is apparently skepticism itself. Skeptics realize that the Big Questions aren’t within science’s domain, beyond the ability to recognize where spurious and specious answers have been thrown up by society and gurus. Skeptics trust science to answer empirical questions like “is this dangerous” and “why is this person tired”, and are quite comfortable with science coming back to say “hmmmm…not sure”. Science and skeptics merely take the step of suspending judgement or regarding explanations as tentative in the meantime. It’s quacks and gurus and scam artists who try to project certainty into that void.

              1. whoa says:

                “Didn’t do well in your doctoral program then?”

                I got an A on every test except for one B. I passed the oral exam on the first try, and got out of that hell in just 4 years.

              2. whoa says:

                “There is a massive amount of evidence coming out of cognitive psychology that indicates the mind is blatantly, insidiously and continuously deceptive. ”

                Oh yes, I am very familiar with that massive amount of “evidence,” having done my PhD in cognitive psychology. I know exactly how full of BS most of that “people-are-stupid” research really is. The underlying motivation is to prove that the average idiot needs help from the paternalistic educated elite to set them straight.

                Our brains are optimized for survival, first of all, and then for social relationships. Social relationships are unfathomably complex and require fast and accurate processing, which occurs mostly subconsciously.

                People, in general, are “smart,” much smarter than they even realize. Even you, WilliamLawrence, although you appear to be such an arrogant mindless idiot, have a brilliant subconscious mind. We all do.

              3. weing says:

                “Oh yes, I am very familiar with that massive amount of “evidence,” having done my PhD in cognitive psychology. I know exactly how full of BS most of that “people-are-stupid” research really is. The underlying motivation is to prove that the average idiot needs help from the paternalistic educated elite to set them straight.”
                Now you are giving an argument from authority. Yourself. And you do sound paternalistic too.

                I thought you said your PhD was in experimental psychology. Now, you say it was cognitive psychology. Which is it?
                How do you know what the underlying motivation of this research is? Was that your motivation and you are projecting it onto everyone else?

              4. WilliamLawrenceUtridge says:

                I know exactly how full of BS most of that “people-are-stupid” research really is.

                Huh, sounds like once again you didn’t actually understand the material. Cognitive psychology doesn’t say “people are stupid”, cognitive psychology says that the brain comes pre-installed with a multitude of cognitive biases and faulty heuristics that make rational reasoning difficult. I would say further that most of the research isn’t aimed at “paternalist elitism”, it’s aimed at pointing out these biases that all of us have, and either setting up systems such that the effects of biases are minimized, or educating people about them so they can accommodate for them. For instance, informing people of the bystander effect, standard in all intro psych classes, reduces the impact of the bystander effect. It’s not because psychology profs are elitist douchebags lording their superiority over impressionable students that these examples are found in first-year classes, it’s because the simple act of describing the bias reduces its impact. Cracked is actually a pretty good website for doing this in a humorous way, and it’s very far from elitist – but I would venture it is extremely successful as well. That’d be a fun study!

                Sounds like the one who wants to be an elitist douchebag is you, pointing out how superior you are to the rest of us with your knowledge of not only these fallacies, but why you are above these fallacies, why they aren’t as smart as you, and why the rest of us are just dupe and sheeple. You’ve got one part of “elitist douchebag” down pat though, so good job. Actually, make that both parts.

                You come across as a douchebag is what I’m saying.

                Also, if you actually studied cognitive psychology, it didn’t seem to take.

                People, in general, are “smart,” much smarter than they even realize. Even you, WilliamLawrence, although you appear to be such an arrogant mindless idiot, have a brilliant subconscious mind. We all do.

                Really? So that’s why I consistently ignore my wife’s directions despite her driving far more than I do? That’s why I consistently misread social cues from people I’m unfamiliar with? That’s why I am virtually incapable of remembering fundamental episodes of my life? That’s why when I fact-check many of my facts before I post, it turns out they’re wrong in subtle and blatant ways?

                The subconscious mind isn’t brilliant, it’s sub-optimal. Being optimized for survival means being sub-optimal for many, many other things – among them, surviving in massive, faceless nation-states, understanding molecular interactions, grasping deep time and understanding how the anthropic principle is a fallacy rather than a fact.

                I’m not an arrogant idiot, I’m a self-doubting, self-questioning reader who realizes his subconscious is not brilliant and who has this fact confirmed on a daily basis.*

                You, whoa, may have grasped experimental psychology (allegedly, you may also simply be a liar), but if you think the subconscious mind is brilliant, you don’t seem to have grasped cognitive psychology.

                *Which, given confirmation bias, is to be expected.

              5. JD says:

                The underlying motivation is to prove that the average idiot needs help from the paternalistic educated elite to set them straight.

                Sounds like someone fell out of the ivory tower and is now spitefully throwing some stones back up at the windows.

                I direct your attention to the following re these “paternalistic educated elites:”

                https://www.youtube.com/watch?v=TPMS6tGOACo

        2. JD says:

          But “skeptics” can always trash each and every alternative medical idea because it has no RCTs to prove it works.

          You’re ignoring well-conducted observational research. Skeptics don’t trash CAM simply because there are no RCTs, we question because these therapies have generally not even exceeded the lowest rung of evidence. And in many cases, there is absolutely no underlying biological rationale. I don’t reject homeopathy because RCTs haven’t shown efficacy, I reject homeopathy because it is nonsense that is not supported by our physical understanding of reality.

          Overall, it’s important to recognize that every form of evidence has limitations. For observational research, RCTs, and systematic reviews/meta-analyses, these are well-known. This is why real world research is not conducted in a vacuum and each of these offers something. But, if we have to rely on limited studies, as we often do to determine whether a drug or therapeutic should be approved for use, it damn well should be an rigorously conducted RCT. And it’s not like you are the first person to think that RCTs aren’t perfect and need to be followed up, that is why we do comparative effectiveness research using claims data etc.

          We can’t afford to do our own RCTs and we usually can’t wait for someone else to do them. So we make our own imperfect decisions — about health and everything else.

          I don’t know about you, but I would at least defer to those who have studied the underlying physiology or biological mechanism, as opposed to someone with a university of google degree. Thus, I contest that it doesn’t have to be so imperfect

          1. Iqbal says:

            JD

            ” I don’t reject homeopathy because RCTs haven’t shown efficacy, I reject homeopathy because it is nonsense that is not supported by our physical understanding of reality.”

            Some interesting reading for you. This is also one of the many reasons why people shift to alternative(?) medicine.

            http://businesstoday.intoday.in/story/india-best-ceo-automobiles-rajiv-bajaj-leadership/1/201398.html

        3. Andrey Pavlov says:

          If I try something and it obviously works, then I trust my own experience. If I repeat the experiment many times, and the same thing always works, then I don’t have to wait for big expensive RCTs, which most likely will never be done.

          Well then you’ve obviously missed the entire point of this post and the lessons from 400 years of doing science.

          This applies to decisions in all areas of life, not just medicine. We must trust our own judgment, and the judgment of people we respect. We also consider the opinions of large numbers of people.

          Keep reinforcing that you haven’t the slightest inkling of what science is all about and how easily you can (and do) fool yourself and others. You do realize that given the 7ish billion people on the earth there are a lot of people who have opinions that are completely and utterly ludicrous, right? You know like Harold Camping and the thousands of people who believed the world was going to end… including one woman who killed her children and herself because she was so thoroughly convinced of it. How do you differentiate those opinions and judgments from the ones you should listen to? Based on who you “trust and respect”? Well, people trusted and respected Harold Camping. Oh, but it’s obvious you say? Well it is only obvious when the ideas happen to align with what you already believe to be the case. So how can you be sure you aren’t wrong to begin with? Unless you are never wrong, of course.

          And so you see that all your fluff means nothing – it is just a way of spinning your wheels to justify whatever belief you already have and want to keep.

          But of course, I don’t actually expect you to see that. Because I am not someone you respect and trust. Because what I am saying does not align with what you already believe.

          We can’t afford to do our own RCTs and we usually can’t wait for someone else to do them.

          O rly? Emily Rosa is published in the NEJM and she was 8 when she did an RCT at home. So sorry, but that excuse has no legs either

        4. WilliamLawrenceUtridge says:

          If I try something and it obviously works, then I trust my own experience. If I repeat the experiment many times, and the same thing always works, then I don’t have to wait for big expensive RCTs, which most likely will never be done.

          Wow, you once again really missed the point of Dr. Crislip’s post. For a highly liable condition, repeated use of a placebo increases the apparent explanatory and causative value the mind in a systematically deceiving way. For thousands of years people swore by bloodletting and purgatives because their experience told them that they worked. It was only when the bled were compared to the unbled that reality was revealed. Your mind systematically and consistently distorts your perceptions and memories to be self-confirming, not consistently honest. Do you consistently track how long it takes for a symptom to disappear, both when taking your whatever and when not? Or do you eyeball it? I get cold sores, and even for me – a skeptic – I was surprised when I ultimately compared my different approaches to taking care of them (ointments and unguents) to simply leaving them alone. Turns out – no difference in healing time.

          If very large numbers of people try something and are sure that it works, then I might try it and see if it also works for me.

          Again, bloodletting, purgatives, and to this we can add modern examples of multivitamins, B12 shots, enemas, gluten-free diets, etc. Large numbers of people are easily deceived, which is why anecdotes, no matter how many you amass, are never convincing. In example, if you consistently try to use apple juice to treat cancer, using anecdotes of surviving patients will convince you apple juice cures cancer – but that’s because you can find hundreds of survivors simply by the nature of the survival rate of cancer. It is only by amassing data on how many people died and thus can’t provide an anecdote do you realize that apple juice doesn’t treat cancer.

          If we have no trust whatsoever in our own experiences or the experiences of others, then we have to wait for the big RCTs, which may never happen.

          Well fortunately the funding of RCTs isn’t performed randomly – the big diseases and killers are funded preferentially over the smaller ones, so most people can be safely guided to healthy lifestyle choices.

          Also, one would note that if you trust the experience of others, inevitably the “others” will include the one person whose uncle, or grandma, or brother, smoked two packs a day and knocked back a 40-ouncer of whiskey every week and lived until 99, because the mind preferentially remembers the unusual.

          You are missing the point of science, and Dr. Crislip’s post.

          This applies to decisions in all areas of life, not just medicine. We must trust our own judgment, and the judgment of people we respect. We also consider the opinions of large numbers of people.

          Sometimes valid, not so for health. The experience of millions of people would indicate matter and energy are different, there is no quantum foam, and solid matter is not composed of mostly empty space. It takes science to demonstrate the truth of things. Sure, trust personal experience for some things – movies, restaurants, book recommendations, etc. – but not for health, life, longevity, human flight or travel to the stars. Not all opinions are equal.

          We can’t afford to do our own RCTs and we usually can’t wait for someone else to do them. So we make our own imperfect decisions — about health and everything else.

          And sometimes that’s valid – do I have a pear or an apple? And sometimes it’s not – do I have a pear or a churro? And in the past you have agitated for trusting health decisions to exactly the wrong people, quacks and charlatans and patients. That’s not the path to an imperfect decision, that’s the path to an early grave or a waste of money.

          Expensive RCTs won’t get done unless some big organization or corporation decides they are worthwhile or profitable. And they can often be wrong or misinterpreted.

          Yes, that’s how the grant evaluation system for the NIH works, because how else should you decide who gets funding? And yes, science is imperfect and doesn’t lead to the right decision immediately in all cases – but it’s the only game in town, all other options for empirical facts are nearly worthless.

          But “skeptics” can always trash each and every alternative medical idea because it has no RCTs to prove it works.

          Oh, no, that’s the straw man that quacks like to pull out. Skeptics trash alternative medicine mostly because quacks demand the right to charge for their services and for public support in the absence of evidence, a clear double-standard, often leading to blatant hypocrisies like criticizing Big Pharma for making a profit while treating Stan Burzynski like some kind of saint.

          Skeptics also trash alternative medicine because so much of it is so incredibly irrational and contradicts so much of what we know about biology and physiology that it’s laughable; quacks are often so ignorant and indoctrinated they don’t even understand how incredibly unlikely their claims are. Put another way, skeptics dislike CAM because it’s just stupid, closer to the imaginary games of childhood than the true nature of reality.

          1. mho says:

            OT Re cold sores, have you used valacyclovir? It isn’t CAM and it will stop an outbreak from blistering.

            1. WilliamLawrenceUtridge says:

              Only works if you can feel it during the prodromal stage. I can’t. I’ve tried it (once) but it’s expensive and usually the only indication I have of an oncoming cold sore is a fluid-filled blister on my lip.

              1. mho says:

                Ah. I didn’t realize that some people don’t feel them until the blister appears.
                Darn.

              2. WilliamLawrenceUtridge says:

                Yup. Believe me, I am also unhappy about it :)

        5. weing says:

          “If I try something and it obviously works, then I trust my own experience. If I repeat the experiment many times, and the same thing always works, then I don’t have to wait for big expensive RCTs, which most likely will never be done.”

          First of all that is not an experiment. You are really just playing with yourself. It might be enjoyable for you but it does not bear fruit.

          1. Thor says:

            I always enjoy it when you chime in with your quips, saying so much with only one or two lines. Good stuff!

        6. Chemmomo says:

          whoa “If I try something and it obviously works, then I trust my own experience. If I repeat the experiment many times, and the same thing always works, then I don’t have to wait for big expensive RCTs,.”

          A suggestion:

          Try not doing it, and see if that works.

        7. Andrés says:

          Well, I am going to completely agree with whoa on this point. Nothing unexpected of course. I don’t wait until RCTs are scheduled/finished in order to act either. All of you implying that because of that she doesn’t understand Science is a complete non sequitur. It may be it may be not. It has nothing to do with taking action on incomplete information. Although I hope she isn’t talking about homeopathy because RCTs has already been done showing its emptiness.

          weing said:

          You are really just playing with yourself. It might be enjoyable for you but it does not bear fruit.

          Are you sure? I think that even with useless interventions for common viral infections avoiding antibiotics (certainly useless in that case) as a side effect is a positive outcome. Of course the alternative should be doing nothing but it does not seem to be often the case.

          Chemmomo said:

          A suggestion:

          Try not doing it, and see if that works.

          Of course discontinuation/rechallenge is a not appreciated enough technique to tentatively judge an intervention impact with a very limited population size of 1.

          1. weing says:

            “I don’t wait until RCTs are scheduled/finished in order to act either.”
            That’s OK. You are not a scientist or a doctor so you can be as irresponsible with your life as you want to.

            “I think that even with useless interventions for common viral infections avoiding antibiotics (certainly useless in that case) as a side effect is a positive outcome. Of course the alternative should be doing nothing but it does not seem to be often the case.”

            Show me the RCTs showing the usefulness of using antibiotics for viral infections, and I might prescribe them. Your complaint appears to be that doctors aren’t always following the science. BTW. How do you know the alternative should be doing nothing in this case but acting on incomplete information in your case? It seems you agree with the science-based approach when it agrees with your biases but you are willing to discard it when it doesn’t.

          2. Andrés says:

            weing said:

            Show me the RCTs showing the usefulness of using antibiotics for viral infections, and I might prescribe them.

            I don’t know over there but here people can buy antibiotics like amoxicillin without prescription. I am quite sure that both self medication and some over-prescription by MDs (and patients not liking the wait and see) drive antibiotic use higher than it should be.

            weing said:

            How do you know the alternative should be doing nothing in this case but acting on incomplete information in your case?

            I am talking about judging homeopathy effectiveness. I know (on-line) an somewhat intelligent woman doing homeopathy even on their children. I say somewhat intelligent because she admits it is highly unlikely it is anything else than placebo but that it covers her drive to act. In my case I have checked the high antihistamine and antipyretic effect of vitamin C in high doses. I am as sure as I can be that both are real effects due to the oblige discontinuation to sleep and afterwards rechallenge getting consistently the same effect. What I have no means of discerning is if it has a viricidal effect or not. At this point it is a credibility issue. As far as I have been able to check both late Drs. Klenner and Cathcart predicted the results I get. I will continue to act as if they are correct while waiting for their hypothesis to be falsified.

            weing said:

            It seems you agree with the science-based approach when it agrees with your biases but you are willing to discard it when it doesn’t.

            I want more Science not less. I will change course if needed when it arrives. Vitamin D RCTs results are coming. Vitamin C Phase II trial on sepsis seems to be approaching since Phase I one has just been published.

            Meanwhile I will keep the risk/benefit analysis to drive my decisions. Of course low/no side effects interventions are preferable but I don’t dodge some more dubious (at least from the current common wisdom perspective) ones if I think they are of value to those near me. I am perfectly aware that even endobiotic doesn’t mean safe as Seth Roberts’ death seems to attest. I go first though. That’s the responsible thing to do in my eyes.

            1. Andrey Pavlov says:

              I want more Science not less. I will change course if needed when it arrives.

              Bullshit. You’ve established quite well that you’ve got your ideas and you’ve even already inappropriately shifted the burden of evidence such that you will never have to change your course. Sure you want more science, but you want it only to continue to pursue what you’ve already concluded you like and you don’t know how to integrate and actually understand what the science is telling you. Otherwise you wouldn’t be continuing to conflate Vit C in critically ill septic patients with Vit C for people with the sniffles.

              Of course low/no side effects interventions are preferable but I don’t dodge some more dubious (at least from the current common wisdom perspective) ones if I think they are of value to those near me.

              And yet again proving you don’t actually care about the science and are doing it wrong. You have no idea how to valuate such things and are merely going with what “feels” valuable to you. And then you demand evidence against your position based on cherry picking the flimsiest of evidence to support what you already value based on nothing more than feeling. And conflate all sorts of data and keep moving goalposts so that you can always believe that Vit C (or whatever other stuff you happen to like) is likely to be helpful in something other than scurvy.

              Which is fine. You are perfectly welcome to do that. But you just don’t get to pretend that you are doing anything remotely scientific around these parts.

              Oh, and the fact that you can say:

              Well, I am going to completely agree with whoa on this point. Nothing unexpected of course. I don’t wait until RCTs are scheduled/finished in order to act either. All of you implying that because of that she doesn’t understand Science is a complete non sequitur.

              means you really, really aren’t paying attention in addition to being patently unscientific. Whoa is a complete and total scientific illiterate. You may as well have said you agree with Mercola or Mike Adams.

            2. Andrés says:

              Dr. Pavlov said:

              Otherwise you wouldn’t be continuing to conflate Vit C in critically ill septic patients with Vit C for people with the sniffles.

              Well, I see highly unlikely that late Dr. Klenner was just partly right or wrong. Since he concluded that vitamin C was an efficient antiviral, efficient antitoxin and a good adjuvant as antibacterial (but not antifungal) from all of his clinical experience using mainly intravenously delivered vitamin C I would find very informative any experiment falsifying any piece of it.

              Dr. Pavlov said:

              You may as well have said you agree with Mercola or Mike Adams.

              Well, I have read whoa’s comments only on two posts so if I have missed something delusional or unscientific from him/her please let me know. Deciding to act on incomplete information has nothing to do with it.

              1. Andrey Pavlov says:

                Well, I see highly unlikely that late Dr. Klenner was just partly right or wrong.

                Well at least you;ve identified your problem. Though you continue to ignore the serious problems with his data and the very fact that even without those problems it is still unconvincing data. You don’t seem to realize that even if absolutely everything Klenner said and wrote was above reproach (it isn’t) that it still would not establish anything that needed to be disproven. And you ignore the fact that it has, indeed, been disproven! All the studies on Vit C and viral infections has shown… nada. Noise in the data at best. Same goes for all other infections not in acutely critically ill septic patients.

                Klenner’s work is at best nothing more than a hypothesis generator. It absolutely does not establish anything that needs to be disproven. The fact that you still are utterly oblivious to this is unequivocal evidence that you don’t appreciate how science is done and that you are interested in nothing more than proving your conclusions to be true. And I have shown why Klenner’s work was fatally flawed. He even admitted it in his own paper you referenced to me. And you simply brushed it aside as if it were inconsequential.

                And seriously, Andres. You are linking me to a site that contains multiple references from whale.to, orthomed.com, angelfire.com, and the completely debunked Pauling studies and you expect anyone here to take you seriously?

                Let me be clear – you are referencing whale.to and orthomolecular medicine websites as if they are evidence to support your assertions and the basis of arguing that they need to be disproven.

                At this point, after all this effort and time, and you still reference such incredibly fetid garbage you’ve managed to relegate yourself to nothing more than mockery and plain dismissal from me. Your attempts at trying to be scientific and find out answers to medical questions is a joke and you should stop wasting your time and potentially harming others with your inanity. Either start doing it right or do everyone a favor and stop entirely. Or at least shut up about it and take whatever the hell you want to take for yourself. You are an adult and are perfectly free to make stupid decisions based on stupid references. But you are also an adult who is fair game for mockery and criticism when you put forth such painfully asinine arguments.

              2. Andrés says:

                Dr. Pavlov said:

                All the studies on Vit C and viral infections has shown… nada.

                Intravenously delivered vitamin C has shown lower mortality on guinea pigs as I have already pointed out. Perhaps intravenously delivered vitamin C has the same effect if Dr. Klenner observations were accurate enough as I have already commented upon. Oral delivered vitamin C in doses of 8g/day at most has shown to lower symptoms duration time as I have already pointed out.

                Dr. Pavlov said:

                And I have shown why Klenner’s work was fatally flawed.

                and before:

                AND…. can’t even really do that since they admit later on in the paper that the tests they used to confirm that there was actually measles and not something else could not be trusted which they only learned 6 months later.

                Non sequitur. Late Dr. Klenner diagnosed measles on his daughters without any test:

                Our first act, then, was to have our own little daughters play with children known to be in the ‘contageous phase.’ When the syndrome of fever, redness of the eyes and throat, catarrh, spasmodic bronchial cough and Koplik spots had developed and the children were obviously sick, vitamin C was started.

                Dr. Pavlov said:

                And seriously, Andres. You are linking me to a site that contains multiple references from whale.to, orthomed.com, angelfire.com, and the completely debunked Pauling studies and you expect anyone here to take you seriously?

                Dr. Hemilä keeps a variety of links where those papers are still available. They weren’t first published there but on medical journals though. And Dr. Pavlov said:

                At this point, after all this effort and time, and you still reference such incredibly fetid garbage you’ve managed to relegate yourself to nothing more than mockery and plain dismissal from me.

                Are Dr. Hemilä and me guilty by association? Well, your choice.

                Of course I think that gram doses of intravenously delivered vitamin C should be studied first on critically ill patients, septic or not.

            3. Calli Arcale says:

              “I don’t know over there but here people can buy antibiotics like amoxicillin without prescription. ”

              In the US, you cannot buy antibiotics without a prescription unless you are buying them for livestock. I have heard of people avoiding doctor’s bills by going to the local aquarium supply store and buying tetracycline meant for pet fish. It’s of course a rather erratic approach to dosing, since you’re buying something where the dose is given per gallon of fishtank and the patient is meant to be absorbing it via the gills and the quality/safety standards are heck of a lot lower than for human medicines, but, well, it’s a way to get antibiotics I guess.

    4. KayMarie says:

      Generally I prefer RCT done by independent researchers but if a company is going to profit from the research makes sense they pay the bill.

      Unless you want a big government program where companies funnel in most of their profits and the gov’t hires out the work to those that won’t profit directly from it.

      Although the question is which would come up with a better mix of new drug discoveries, the free market or bureaucrats. Each is biased, but in different ways.

      Once you learn all the many and varied ways your direct experience of reality differs from the actual reality it does become clear how one should limit one’s conclusions based only on subjective experience, especially ones where you generalize the conclusions to more than just that one experience.

      Especially when your experience tells you two different things depending if you trust your eyes that say coin one is much bigger than coin two (in the usual optical illusion of circles surrounded by circles) or you trust your fingers that will actually know both coins are exactly the same size and move to pick them up with identical movements.

      Which experience is real? Which do you trust? If we blind and randomize the experiment to find out does that mean you trust it much much less than if we did something clearly full of biases?

    5. Egstra says:

      “Don’t trust your experiences, or other peoples’ experiences”

      My mother smoked 4+ packs of cigarettes a day for some 60 years. She lived to be 96
      My uncle smoked 3 packs a day for nearly 50 years. He died at 93.

      Obviously, smoking is good for you.

    6. WilliamLawrenceUtridge says:

      Don’t trust your experiences, or other peoples’ experiences. Most of all don’t trust your mind!

      Yes, that’s the point – experience deceives. If science were easy, we would have figured the earth orbited the sun rather than vice-versa thousands of years ago, not hundreds. The mind is actually quite bad at understanding reality, which is why it requires rigorous rules and regular reminders.

      Only trust RCTs paid for by Big Drug.

      Nope, straw man. Trust the convergence of data from multiple sources that point to a consistent signal that rises clearly from the noise the better your tests and measures get, and as replication and extension continue to confirm your belief has a truth value.

      Also, Big Pharma are not the only funders of RCTs. The NIH funds hundreds of millions of dollars worth every year, and that’s only in the US.

  15. CHotel says:

    Am I the only one that looked up the Rose City scorecard to see how long the 5th hole was, to be suprised it was only 157? I am, aren’t I.

    Evil looking hole though, that’s a lot of water left and it goes tight to the green.

    1. Windriven says:

      My game always starts badly before I gradually fade away. This may owe to the fact that a round of golf is only slightly less appealing than a picnic in a rainstorm with both of my ex-wives and their attorneys.

      Here I am teeing off at the 11th hole at Rose City.

  16. Kevin F. Quinn says:

    Great article, made me think. I particularly like, “our brains have evolved to survive reality, not to understand it”. That helps with appreciating human behaviour elsewhere; in particular I’m thinking of religious belief and the cognitive dissonance that goes with it.

    Aside; for fun – re. “Responses to this question were given by clicking on one of two bottoms, ‘Yes’ or ‘No’” – we need to make this a thing. Web forms should have bottoms to click, the world would be a better place for it :)

  17. Sabio Lantz says:

    To site administrator !,

    I suggest you turn on the ability for commentors to “follow by email” so that dialogue is possible.

    1. Windriven says:

      I second that motion Paul, though with trepidation. The site has become big and complex enough that changes sometimes have unintended consequences.

      By the way, good work fixing the latency problem with comments.

  18. Kagehi says:

    Huh.. I currently work in a grocery store and, in my experience SCAM adherence is a combination of a) the inability of people to self diagnose, b) the inability to the standard medical industry to be perfect and “find the problem” on the first attempt (which is just idiotic, since the SCAM people never find a solution, at all, usually, never mind on a first attempt), c) the temporary placebo effect – where by trying something new causes temporary relief of symptoms, until the next time they have a twinge of pain, or some other issue, and go seeking out a “cure” for that too, and finally d) an information feedback loop, where by other SCAM users advise anyone and everyone that will listen about the glorious effects of the latest SCAM, and, worse, the media, or at least people like Dr. Oz, and most of the crappy low information magazines out there, all promote the next “big thing” in SCAMs.

    This leads to, for example, the experts saying that we don’t actually, it turns out, know what taking more vitamins that actually needed will do to you, except in a few cases, where we know for a fact that its damned dangerous, even as, at this point, I am surprised you can still buy bottled water, never mind anything else, which doesn’t contain “anti-oxidants”, among other things (the researcher who came up with this theory has since concluded that while they *may* have the effect of reducing oxidation based genetic damage, they also, in doing so, cause genetic repair systems to go offline, which can, in turn, actually lead to more errors, not less. Animals genetically engineered to not make their own, while its unknown what other effects this has, many of which may be negative, where shown to live some 25% longer than their “normal” cousins, or those who had the ability removed, but where then provided with anti-oxidants in their diet.)

    In any case, one rule still applies, with a small modification from the original phrasing – when the factual information doesn’t create an immediate and obvious benefit, and given a lack of understanding of what constitutes good information, as a result, people will seek out and accept bad information as a replacement.

  19. Andre D Paris (@AndreDParis) says:

    Couldn’t we all just use tactics outlined in Professor Boghossian’s work? To help people think more critically and rationally? I’m just not ready to throw in the hat, I know Scooby Doo was probably what helped me in my youth, but other’s just have to change their thinking slightly to think clearly.

  20. Pete A says:

    Most sCAM is not claimed to have no side effects, most claims are that it has no medically harmful side effects. Homeopaths and reiki practitioners, for instance, carefully explain to their clients: improvements indicate that the treatment is working; setbacks (worsening of symptoms) are a frequently-experienced part of the natural healing process, but these indicate that the treatment is working at a deep level on the long-term underlying causative issues.

    If a hay fever sufferer experiences a severe asthma attack while receiving sCAM treatment for it, they will likely be informed that this is part of their wonderful natural healing process. They are very unlikely be told by their practitioner to seek expert medical advice and stop using sCAM because it doesn’t cure asthma and/or hay fever. sCAM partitioners assume that a client doesn’t return because the client has recovered; they don’t keep records for the clients that died due to the practitioner’s despicable medical incompetence and flagrant disregard for medical ethics.

    1. WilliamLawrenceUtridge says:

      Yep, you’ve basically described how CAM is completely unfalsifiable. Any and all outcomes are evidence that it works.

  21. Z-one says:

    Wow, Dr. Crislip, you have hit multiple nails on the head with this post. Bravo!

    I admit to not having read all of the responses, so I hope my contribution is not redundant or irrelevant at this point.

    The only thing I think I can add is that most SCAM users, woo-dabblers, alternative-minded folk, etc, have a HUGE emotional investment in believing that they are “ahead of the curve” when in comes to personal health and medicine. They think that “mainstream medicine” has failed them and that SCAM has, does, or may someday provide a better, safer, more natural or holistic — and certainly a BETTER — option.

    I’ve been there, done that, and found those options wanting — in MAJOR ways. I have lost friends, ended relationships, and otherwise changed my behavior as I have questioned and challenged “the world according to SCAM.” Such is life. Keep up the good work!

  22. nicole says:

    I guess that are a lot of reasons people turn to SCAMs. To the above comments, I’d add a couple things: first, people want to feel that they are doing something. My sister (a scientist) often jokes that whenever she gets a cold, her science training goes out the window. She knows that time is really the only cure, but it feels helpful to be doing something. For her, that is usually limited to things that aren’t really SCAM like drinking extra orange juice, even though she knows that it doesn’t really cure the common cold. But I can imagine how many people fall prey to homeopathy or some other SCAM, get over their cold, and then tell themselves it was of course shorter in duration because of the SCAM!

    Second, I think being in intense physical pain can cut off one’s ability to think rationally. That might explain why many people with back pain or headaches invest in SCAMs. A tiny bit of (coincidental) improvement after the SCAM gives them “proof” that the scam is working and hope that the pain will eventually go away.

    I read this blog frequently, but this is the first time I’ve commented. Thank you for such an excellent site!

  23. whoa says:

    “she never said her having been through a doctoral program resulted in a doctorate – there is all that nasty thesis and its defense part. And she never said her education was in science. If she has a degree it could be in Italian Literature of the Renaissance or naturopathy or chiroquacktic”

    I did the nasty thesis and the nasty defense, at a respected university. I studied experimental psychology. I guess I can prove this by answering questions about the PhD process, or about experimental psychology or statistics, or whatever you can think of to ask. But I can’t promise to know the answer to any possible question, just reasonable ones that a PhD in experimental psychology should be expected to know.

    1. Windriven says:

      Touchy, touchy. I guess what is said about those drawn to the study of psychology might have some merit. I was demi-semi defending you … Or at least casting about for excuses for you.

      That said, if you were awarded a doctorate in a science from a decent university, you should sue them for fraud. Or perhaps the rest of us should.

      1. WilliamLawrenceUtridge says:

        I guess what is said about those drawn to the study of psychology might have some merit.

        What, half those drawn to study psychology are really nice people who want to help and the other half are nuts and desperately trying to fix themselves? That saying? Then there’s the half who just couldn’t decide on a major so they took the easy way out.

        And let’s not forget the half that are bad at math and can’t hack the stats courses.

        1. Windriven says:

          Right you are. I’d forgotten the half who are really nice people drawn to the discipline so as to help others. I should be ashamed. But I’m not. I should probably see someone…

        2. whoa says:

          Since you don’t know much about anything, you don’t know that cognitive experimental psychology has nothing to do with being a shrink.

          1. Windriven says:

            You really are waaaay too touchy. Lighten up.

          2. WilliamLawrenceUtridge says:

            Since you don’t know much about anything, you don’t know that cognitive experimental psychology has nothing to do with being a shrink.

            Nothing except having to take an undergraduate psychology degree (or in the rare case of transferring in, a few prequalifiers analogous to undergraduate psychology).

            1. whoa says:

              You don’t even know what psychology is. Psychologists were never therapists until some time in the latter 20th century. Only psychiatrists were therapists. Psychology was always an experimental science, and one of the first to make extensive use of statistics.

              Clinical psychology became one subdivision of psychology. Psychotherapists are usually either psychiatrists, clinical psychologists, or social workers.

              It is just plain ignorant to equate psychology and psychotherapy.

              1. WilliamLawrenceUtridge says:

                Do you have to have some sort of background and understanding of psychology to acquire the professional designation of “psychologist”, “clinical psychologist” or “licensed psychologist”? Is psychotherapy a course available for undergraduate and graduate students? What faculty is that generally found in at most universities? Do most people who enter clinical psychology programs come from an undergraduate background in psychology?

                You’re basically making my point by the way. You claimed that “Since you don’t know much about anything, you don’t know that cognitive experimental psychology has nothing to do with being a shrink“, I pointed out that they come from a common scholarly background and fall within the same faculty, a point you agree with when you say “Clinical psychology became one subdivision of psychology. Allow me to point out that just as clinical psychology is one subdivision of “psychology”, so is experimental cognitive psychology.

                Unless you mean by “shrink” exclusively psychiatrists, who have a medical degree – but for the purposes of our conversation I’m going to say that “shrink” in the mind of the general public is a category that encompasses both psychologists and psychiatrists.

                None of which has anything to do with the original entry into the comments of this post – your massive pharmanoic defence of the desire to ignore any studies or evidence you don’t like that show drugs are effective and SCAMs are not.

                Keep your eye on the prize, don’t get drawn into pointless and equivocal tangents there champ.

        3. whoa says:

          “And let’s not forget the half that are bad at math and can’t hack the stats courses.”

          Experimental psychology happens to be one field where you have to be good at statistics. Which I am.

          1. Windriven says:

            Then why are you so woefully deficient in reason and logic? It is reasonable to expect someone with an advanced degree in a more-or-less scientific area to think with clarity.

            I will say again, and now I’m not joking around, when you manage to go through roughly 20 years of education and are awarded a terminal degree yet still think in a disorganized and incoherent way, something is remarkably wrong. It is one thing to learn facts and processes, quite another to learn to reason in a logical and disciplined way. One cannot be considered an educated person without both.

            1. whoa says:

              Anything will seem incoherent if you are too stupid to understand it.

              1. WilliamLawrenceUtridge says:

                I will merely note that nobody here has been particularly convinced for the duration of your appearance here. Not since your first appearance as an apologist for CAM and shouter of Pharma in a crowded hospital, and not now.

                So it’s possible your brilliance has been beyond everyone else’s ability to comprehend, or perhaps there is a more parsimonious explanation.

          2. weing says:

            So which is it. Experimental or Cognitive psychology that you have a degree in?

            1. whoa says:

              Which are you, a physician or an MD?

              1. WilliamLawrenceUtridge says:

                That’s a dodge, not an answer.

          3. WilliamLawrenceUtridge says:

            Too bad we’re not debating statistics, because your grasp of cognitive biases seems abysmal.

  24. Bryan says:

    Of course, everything that has been proven to work already did work before any RCT proved that it did. That’s probably one reason why people chase wild geese. 

    And personal experience, however unreliable, isn’t always wrong. People who ate copious amounts of liver regularly would unknowingly have ameliorated if not cured their pernicious anemia long before Minot and Murphy published their lifesaving liver diet in 1926. Bloodletting will have benefitted people with polycythemia vera for centuries, as it still does today. 

    So, pointing out to people that RCTs are lacking and that post hoc ergo propter hoc is a fallacy won’t keep them from using unproven remedies they feel work for them.

    1. simba says:

      I agree with you, Bryan. I think also people forget the sheer number of cures that turned out not to be. I mean, we remember people with polycythemia who benefited from bloodletting, and forget that it was used for everything, and mostly just killed people faster. For every one pre-scientific doctor/’wise woman’/local know-it-all lord treating, say, cholera with fluids and rest, there were hundreds treating with bloodletting until the diarrhoea stopped (in other words dehydrating the patient deliberately), magic underwear, blistering, burning, heavy metals, high doses of poisons, running-with-bread, bizarre rituals etc.

      Because the stories about, say, people using digitalis for heart troubles are exceptional, they get passed on. We then forget that they are exceptional, and forget that it was much more likely that you’d be given the nearest heart-shaped-leaf for your heart troubles, something that would have a nice visible effect like blistering or vomiting or bleeding, and a hefty dose of digitalis to get rid of your down’s syndrome child. I come from a tradition where people used to, still do, consult the local wise herbalist to get whatever concoction they pulled off the shelf. More often than not you were amusing the patient until the disease finally got them. Poisonous substances or ones that tasted or smelled awful, or sounded suitably exotic, were preferred.

      We forget just how haphazard those approaches turned out to be, and forget why we don’t use them any more. Even the most intelligent people are simply not designed to figure out effective treatments by themselves- if they were science would never have been needed.

    2. weing says:

      “And personal experience, however unreliable, isn’t always wrong.”
      Definitely. Don’t forget rhino horn powder.

  25. weing says:

    There is another possibility too. My calculus teacher broadened my mind when he asked whether we really thought that we could only get an A by studying hard? When we answered in the affirmative, he pointed out that some of us have sisters.

    1. WilliamLawrenceUtridge says:

      Am I the only one confused by this comment?

      1. n brownlee says:

        I don’t get it, either. Was he asking for set-ups?

      2. weing says:

        I don’t know why it appeared here. It was supposed to follow your comment.

        “And let’s not forget the half that are bad at math and can’t hack the stats courses.”

        1. n brownlee says:

          Oh… yeah… me an’ Barbie think math is HARD!

  26. whoa says:

    “Also, if you actually studied cognitive psychology, it didn’t seem to take.”

    No, it didn’t “take.” I was not easily brainwashed into the cognitive psychology mob.

    1. Windriven says:

      Your thesis advisor must be proud. Incompetent, but proud.

      1. whoa says:

        Well you are showing off your deep ignorance again. A whole committee has to decide if a candidate will pass, not just their advisor.

        1. WilliamLawrenceUtridge says:

          Correct me if I’m wrong, but the thesis advisor is the one who prepares you to defend your thesis and generally supervises your day-to-day work, are they not? So…while your statement is factually correct, so is Windriven’s. Right?

          1. whoa says:

            “Correct me if I’m wrong, but the thesis advisor is the one who prepares you to defend your thesis and generally supervises your day-to-day work, are they not?”

            Of course you are wrong, as usual. No one prepares anyone to defend their thesis — it isn’t elementary school. No one supervises a graduate student’s day-to-day work. If someone is supposedly smart enough to get a PhD they are expected to figure things out.

            1. Andrey Pavlov says:

              @Whoa:

              You really have literally not a clue what you are talking about and just enjoy seeing your words show up on the internet, dontcha?

              Of course there is a thesis advisor that prepares a candidate for defending his or her thesis. That is how it works. You don’t have the foggiest of how anything in science or education actually works… and it shows so painfully obviously I actually cringe for every time you spew forth your mind numbingly idiotic thoughts.

            2. Egstra says:

              “Of course you are wrong, as usual. No one prepares anyone to defend their thesis — it isn’t elementary school. No one supervises a graduate student’s day-to-day work.”

              Oh, my … I wonder why I was meeting with tht woman every week.

              1. KayMarie says:

                Well, I have seem some different ways graduate programs are designed and different way thesis advisers run research labs.

                I have seen departments where they need more teaching assistants than they have professors to have people complete research projects with, so there is a bit more cut throat if you fail you fail and we actually need half of to fail, usually at the testing stage before you really start in har on the work leading to the thesis defense. The let everyone in and make the procedure grueling enough that people can’t finish.

                Often in those departments there are some professors who are very committed to having their students pass and do actively mentor them, others just go with the whoever flunks isn’t macho enough to make it through.

                The other thing that happens is some professors need the cheap labor so are not at all interested in allowing you to finish in a timely fashion so also are loathe to really mentor you through the process. The longer they can delay your final defense the longer they have you to do their scut work.

                Not all professors are complete asses,although sometimes the academic environment seems to tolerate that, but then so do some corporations. But there are enough of them that there are probably people with a view of graduate school base on surviving indifferent or actively hostile thesis advisers.

                So I can believe someone was told that this isn’t elementary school and you are on your own and you won’t get the support and mentoring that some professors and some departments actually encourage.

                It may also depend if your thesis adviser has funding for their research. Any well-run lab that regularly gets grants tends to have regular lab meetings an other mentoring opportunities to ensure the work that needs to be done to satisfy the granting agency is being done. May depend on the granting agency, but do what you want when you want and if you fail you fail and if you pass without any input from anyone ever, well that is just ducky usually means you’re lab is likely to not meet the milestones, etc that help keep the lab funded.

                Now in softer sciences or parts of the university where people are not expected to generate revenue for the school, maybe there is more leeway to have most if not all of your students fail from lack of mentoring. Unfortunately are your students doing well often isn’t the major thing that they look for on the promotions and tenure committee. However, successful graduate students do tend to help produce the products that are counted, so some mentoring usually is in the professors own self interest.

                And there are those who need to believe they never had any help from anyone of any kind, ever. They alone are strong enough to not need any of the usual mentoring the rest of us mere humans seem to require.

              2. WilliamLawrenceUtridge says:

                Egastra, the error was mine. I said “day-to-day” with the implication of a thesis advisor being someone you could meet with or even just drop in to talk to about advice or guidance on a set of experiments, data analysis, or even just someone to bounce theories off of. I should have said “regularly but possibly irregularly with a large degree of variation between the amount of contact a graduate student would have with their thesis advisor, depending on the program, the degree, the student, the supervisor, the faculty oversight requriements, the weather, the seismological conditions, unexpected flooding, pandemic illness, meteor strikes, car maintenance, pet food supplies, internet status vis-a-vis up or down, and what’s on cable for that particular week.” But then I’d probably be criticized for not discussing the impact of Netflix to impact on our free time.

                Whoa is nothing if not pedantically precise which allows him or her to be correct in matters of minute fact while being wildly wrong when it comes to a larger picture.

            3. Sawyer says:

              I’m usually supportive of a person’s right to maintain their anonymity on this blog, but Jesus tap-dancing Christ, what the hell university did you study at?

              What you are describing has not been the norm, in any field, at any respected institution of higher learning, ever. If you had zero interaction with an adviser you should be extremely disappointed with your school for depriving you of a key component to your education. The “100% independent” approach can work very well for an undergraduate education. It doesn’t work for graduate research. I’m afraid your misunderstanding of science is a testament to its failure.

              1. AJB says:

                Maybe it’s one of those Universities that sends you the PhD of your choice (and a nice certificate, suitable for framing) once your check clears.

              2. whoa says:

                Well I am anonymous here whether you approve or not.

                I disagreed with my advisor on some important aspects of the research topic I had decided on. I thought it was a great topic, and I had plenty of ideas. I started the program when I was over 40 so I was not an innocent young graduate student just waiting to have my ideas and opinions handed to me.

                So I worked very very hard, knowing my advisor would not be a source of inspiriation, or even someone I could talk over my ideas with.

                I did everything right, so no one could possibly fail my research. And I had already gotten almost straight As in the courses, so they knew I wasn’t dumb.

                I knew some graduate students there whose advisors held their hands through the process. Others were somewhere in between.

                Being a doctoral student is unpredictable and you really never know how it will go. Most probably become ABDs (all but dissertation).

                I was not going to be an ABD no matter what. I knew I had good ideas and I understood statistics.

                No I did not get brainwashed into mainstream materialist science. All my professors were devout atheists and political progressives, and I am neither.

                On the first day of my first year of the program, my advisor stated “This is what we believe in my lab …” and I thought “Oh this is going to be a LONG four years.”

                I think she was surprised that I had my own thoughts, that I had not come there to have thoughts poured into me. But she did not try to force me to stop thinking, I guess once she realized I was going to think no matter what.

              3. WilliamLawrenceUtridge says:

                Are you a persecuted minority, or just a dick?

                So I worked very very hard, knowing my advisor would not be a source of inspiriation, or even someone I could talk over my ideas with.

                So…it sounds like you developed your ideas and then didn’t bother discussing them with your thesis advisor? Whom, despite their apparent political affiliations and religious beliefs, always secure grounds to evaluate their professional competence, presumably knew the field well enough to teach it at a graduate level.

                Wow, I can’t imagine why your graduate experience left you bitter. You must be an utter delight to work with.

                I think she was surprised that I had my own thoughts, that I had not come there to have thoughts poured into me. But she did not try to force me to stop thinking, I guess once she realized I was going to think no matter what.

                Did your dissertation ever get published? Is the resulting journal article heavily-cited?

                I’m sure we’ll hear “yes” and “yes”, but you can’t ever link to it because of your valuable privacy. What a shame we can’t fact check, so all we’re left with is your word (and your persecution complex, and your belief that SCAMs have value).

                Yeah, I call bullshit.

        2. Windriven says:

          Had your thesis advisor been competent you would have never gotten to the committee. It is one thing to have insights that differ from the mainstream of your field. It is quote another to reject the broad sweep of science and to embrace intuition over careful research.

          I don’t know where you went to school or what you studied or what credentials you’ve been granted. I do know that your contributions here have been inconsequential.

          1. weing says:

            I suspect she has a PhD from the university of google.

          2. whoa says:

            I don’t embrace intuition over careful research. I said that we can’t wait for big expensive RCTs to decide every question.

            And I said that human beings are not all complete fools that can’t ever trust their own perceptions and experiences. The research that supposedly shows that is largely elitist paternalistic bs.

            1. AdamG says:

              Can you cite a single example of this supposedly ‘elitist paternalistic’ research?

              1. whoa says:

                Lots of stuff by kahneman tversky at Stanford.

                They spent many long years trying to show how people are illogical and inferior to computers or to educated “smart” people who are aware of the typical defects.

                Some of their experiments had very obvious problems. But the whole people-are-stupid research area suffers from underlying misconceptions, imo.

                K & T called things illogical that are actually adaptive heuristics that work much better than “logic” for real life.

                We don’t see any computer swith common sense. And “smart” people who are overly logical can be lacking in common sense also.

                And I am saying this as someone who tends to be overly logical.

              2. AdamG says:

                Apparently you didn’t learn the definition of ‘citation’ during your graduate career.

                “Some of their experiments had very obvious problems.”

                OK, pick one. that’s all I ask. Cite a specific paper that is highly referenced by proponents of “people-are-stupid research” and tell us what these specific obvious problems are.

                That shouldn’t be too hard for a Ph.D., right? It’s basically a required skill for entry. If the whole field is ‘largely bs’ like you claim you should have lots to choose from.

                By the way, could you provide us with your working definition of “common sense?”

              3. Andrey Pavlov says:

                And I am saying this as someone who tends to be overly logical.

                Thanks for that whoa. Nothing tops off a nice day in clinic with a truly hearty belly laugh!

              4. WilliamLawrenceUtridge says:

                You’re greviously misunderstanding our opinions and the context of that research regards this website. Again, the idea is not that people are stupid. The idea is that there are a multitude of cognitive heuristics that work extremely well at not getting eaten, or finding food in a mosaic environment, or deciding who to trust within a group of families. The idea is that these heuristics are not well adapted to modern life and decision-making. People make decisions about medical care on the basis of how much they like their doctor rather than how good their doctor is at their job. That works great when you’re figuring out if your impala steak today will get you ground nuts during a future drought – you’re basing your decision on the trustworthiness of a person. But in a highly technical field where competence is not determined by trustworthiness, such a heuristic will misfire and you get charismatic faith healers who attract, and kill, hundreds, rifling through their bank accounts in the process. You get Stan Burzynski who defines an in-group and an out-group, and forces you to choose sides – a great tactic when you have to fight another band of proto-humans for territory or an elephant carcass, but a terrible way to decide if piss extracts cure cancer.

                Even your own comments illustrate your point – you apparently decided on the basis of your thesis advisor’s religious and political affiliations that you didn’t need her help. That’s in-group/out-group thinking, not the logical thinking you are apparently so good at. And speaking of logic, what’s your logic for believing in a divine creator who personally gives a crap about you?

                People can be very good at the systematic deductive and inductive resoning and hypothesis testing required by scientific research and terrible at picking a mate or a ripe pineapple, because these are very different ways of thinking and reacting. In fact, most of the skeptical movement and science based medicine could be interpreted as an objection to the use of cognitive processes that work extremely well in social situations in situations that require non-social analysis.

                In other words, you’ve missed the point.

            2. simba says:

              Seconded- establish how you know it’s wrong, not just that you dislike it.

              I love how people with psychogenic illnesses are “neurotic” and “just need a hobby”, yet it’s totally the preponderance of evidence that is elitist and paternalistic, for telling us our brains aren’t perfect.

              Whoa doesn’t like people telling him/her their brain isn’t perfect so that’s paternalistic and elitist. But patronizing/dismissing people in pain or with mental illnesses is perfectly fine.

              Whoa- you don’t get to just decide research or evidence is wrong because you don’t agree with it. Provide citations, point out the flaws, and show us good research evidence that you’re right.

              1. whoa says:

                I think people can have mental illnes, but I think it very often has a physical cause.

                So it is very ironic when you tell people their physical symptoms are psychological, and their psychological symptoms are physical.

              2. simba says:

                Irrelevant. You were patronising people with psychogenic illness, or mental illness (and please note psychogenic illness may be caused by stress.)

                Unless of course you rescind your earlier comments, where you implied those with mental illness or somatoform disorders were “hypochondriacs”, with amplified “mild symptoms.. who are “neurotic and unhappy”, could reason the pain away, and whom you tried to distance (a “universe of distance”, in fact) from those with “physical symptoms.”

                The point people here are arguing is that our brains are not designed to show us that xyz treatment will cure us (please note: this is not the same as saying our brains are ‘all complete fools’). They are not accurate or objective enough to figure out what ‘works’, consistently and well, which is why we have developed studies.

                You appear, and correct me if I’m wrong, to be arguing that the brain is accurate enough to figure out in most cases if something ‘works’ without needing to resort to studies, that our subjective perceptions and experiences are enough to allow us to do this. To me that seems obviously false, so maybe your position is a different one to the one you’re conveying?

                If you’re arguing that for self-limiting conditions sometimes you’re as well off trying things and if they work, even if it’s only the placebo effect, there’s no harm done- that I can get behind.

              3. WilliamLawrenceUtridge says:

                I think people can have mental illnes, but I think it very often has a physical cause.

                So it is very ironic when you tell people their physical symptoms are psychological, and their psychological symptoms are physical.

                Straw man – few to none here believe that. I, at least, and I venture others, would say that symptoms can have physical and psychogenic causes, and mental illness can also have physical and psychogenic causes. The actual cause for each patient must be assessed individually. And when someone suggests, for instance, that their symptoms are caused by wholly novel forms of life or some other cause which requires a complete revolution of an entire field of science, we set the bar higher. I fail to see how this is unreasonable.

            3. MadisonMD says:

              I said that we can’t wait for big expensive RCTs to decide every question.

              One major point hammered home on SBM is that RCT is not required to decide every question. e.g. appendectomy for appendicitis, antibiotics for meningitis, surgery for localized cancer, tourniquets for bleeding. So you have no disagreement here. (Is this another straw man you are knocking down?)

              However, neither does the absence of a RCT license you and others to just make stuff up. Moreover, you will have to acknowledge that perceptions can be mistaken. I mean, how would you explain the apparent effectiveness of Perkin’s tractors? That is only one amongst many many many examples. Thus, whether an intervention is acceptable without RCT or not depends on the specific case.

              Moreover, there is a distinction between you personally choosing a harmless intervention that you believe to be effective based on your experience, and a doctor or other medical source recommending it to all based on his/her personal experience.

    2. WilliamLawrenceUtridge says:

      No, it didn’t “take.” I was not easily brainwashed into the cognitive psychology mob.

      Let me guess – cognitive psychology, based on a different set of rules of evidence, wasn’t scientific enough for you?

      It’s a real shame though, how their results might actually apply to humans in a real and meaningful way, versus all those rat brains you’ve cauterized, sliced, preserved, stained and otherwise been mean to.

  27. IvandaVGV says:

    To the question of “Why?”:

    As someone above commented, I wanted to feel like I was doing *something*.

    After 2.5+ years of numerous tests, specialists, and ineffective treatments, I am no closer to a diagnosis or real relief for my sudden-onset and now chronic whole-body pain, excessive sleepiness/fatigue, low-grade fever, and cognitive issues. This has been life changing, and I haven’t been able to finish my doctorate (no, not in psychology, but another liberal art, geography, so take it easy on me) or work a real job in over 2 years. I am too young to feel this old!

    I like to think I fall firmly on the side of Science and Skepticism. Historically , I have not been easily lured by the trendy, the flashy, or the sensational in any category, let alone medicine. My understanding of quantitative and qualitative statistics is enough to help me be a fairly well-informed consumer of statistics.

    My tests show enough evidence that something is physiologically wrong with me that I haven’t had to endure too much of the “it’s all in your head” treatment — although the little I’ve had was plenty. The tests do not, however, help identify the problem. So I’ve been kicked to the curb over time by 3 rheumatologists who told me there was nothing more they could do for me, and who, I believe, simply got frustrated that I didn’t fit into a tidy, pre-defined, diagnostic box. They are human, too, after all, and MDs seem to be a self-selected group of plenty healthy egos. They are trained to “fix”, and when they can’t figure out what to fix, I’m left with such non-diagnoses as “undifferentiated connective tissue disease” or “idiopathic” something-or-another.

    Rheumatologist #4 is still trying, but in the mean time, the best medical science can do for me in 2014 is manage my quality of life with drugs that date back millennia and come with heavy prices to pay in terms of my independence (e.g., can no longer safely drive) and risk of addiction. That’s right, our currently endorsed pain and energy management techniques date back much farther than the combustion engine, and I can get on quite a soapbox about how ridiculous it is that we haven’t implemented wide-spread advances in that technology either.

    So, do I feel like I’ve been let down by the current state of medical science? Um…yeah. Ask yourself if you would, too.

    Do I feel like I am “ahead” of medical science? In a sense, yes. Not at all in the “I know better what’s good for my body than a bunch of MDs” way, but rather, in the “medical science hasn’t caught up with the identification or treatment of this disease/syndrome/illness” way.

    Do I know that RCTs take time, money, replication, the proper alignment of the stars (that’s a joke, son) to get published, read, and validated? And even then more years of research, development, and oversight before getting a new test or medicine to us masses? Yep, I get it. I respect it. I believe in it — that’s also kind of a joke as I’ve read a fair amount of the fact-vs-belief literature in my research into the human responses to climate change.

    I’ve scoured the respected, peer-reviewed medical journals to the extent that I have access. I actively bring suggestions to my current, little team of docs. I listen and implement their suggestions. However, there just isn’t much out there in terms of new research. The lack of attention and money put towards research into pain and rare diseases is, IMHO, shameful.

    The uncertainty of every aspect of my future at all time scales (e.g., hour-to-hour, year-to-year) seems to be front and center for me more so than for most folks. So if I get a few sessions of acupuncture, or restorative yoga, or mindful meditation, or Feldenkrais, or whatever, the experience is generally a more positive one than sitting around thinking about how much it sucks that pain and fatigue have changed my life, challenged my relationships, and limited my body and brain.

    As usual, I’ve buried the lead. I can’t stop you or your readers from painting everyone who ever give sCAMs a try with the same brush. I can’t stop you or your readers from thinking that I am weak for needing to stay in the game somehow when I’ve gotten to the end of the official rule book. I can’t make you or your readers throw out some empathy for folks in similarly, unenviable positions. But you asked, and I answered.

    I truly hope you and your readers never experience something like this. We aren’t all necessarily mindless, gullible sheep. Sometimes, we need the illusion of control or the placebo effect however briefly. Sometimes, we just need another third-party human being to give a damn for a little while — even if we have to pay them to care.

    I appreciate what is being done with this site. It’s important work. If you ever feel like throwing some energy toward something else that really will change lives, advocating for quality research into measuring, identifying, and relieving pain could sure use more of your help.

    Cheers,
    Liz

    1. whoa says:

      Liz,

      I believe that the atlas joint, where the top vertebra meets the skull, may be responsible for the kind of symptoms you are having.

      Chiropractors and physical therapists may not consider this, although some might.

      Just consider it, and see if you can determine whether the curves of your spine, especially upper cervical, seem to be correct.

      1. WilliamLawrenceUtridge says:

        Oh Jesus Christ. So based on a brief description of someone’s symptoms, you now feel perfectly safe to diagnose someone and forward them to a chiropractor? You’re an asshole.

        “Hi Liz, I just want you to know that I, a stranger on the internet, think I know enough about your case from a single sentence to forward you to someone who might just tear an artery in your neck. Don’t trust anyone else because they think people are stupid, meanwhile I feel perfectly safe diagnosing you over the internet. And don’t worry, I’m much smarter than you, so that’s how I know what your nonspecific symptoms mean.”

        1. whoa says:

          Her life is being destroyed, with no help at all from mainstream medicine. I know a lot about physical therapy, and suggesting this to her cannot hurt.

          I doubt any mainstream MD would ever ask a patient like this if they ever were in a car accident, or had general anaesthesia. This kind of pain syndrome can result from atlast joint problems.

          Most chiropractors probably don’t even check for this.

          It can’t hurt and it could save her life.

          1. KayMarie says:

            Most general medical histories I’ve been asked for include all your surgeries (so would have info about anesthesia exposure) and pretty much every time I show up in pain there is a question about any potential things I did that may have been a cause of injury.

            Maybe there are bad doctor who refuse to take medical history, but I wouldn’t call them Mainstream. They are outside the Mainstream in the direction of just being bad at their job.

            Maybe they don’t say this pain is only because you had general anesthesia when you were four for a surgery (like is in all my medical histories for all of my doctors I have ever seen), but they usually do have in the medical history if you have ever had surgery or any major injuries.

          2. WilliamLawrenceUtridge says:

            Her life is being destroyed, with no help at all from mainstream medicine. I know a lot about physical therapy, and suggesting this to her cannot hurt.

            Do you know as much about physical therapy as you do about cognitive psychology? And apparently you don’t know that much since you point to chiropractors as a useful profession. And it very much can hurt since cervical artery dissection is a rare but present risk. Not to mention chiropractors are notorious for insisting their patients come in for “wellness treatments”, three times a week for the rest of their lives.

            I doubt any mainstream MD would ever ask a patient like this if they ever were in a car accident, or had general anaesthesia. This kind of pain syndrome can result from atlast joint problems.

            It’s amazing that you are so comfortable saying this without ever having even met Liz.

            Most chiropractors probably don’t even check for this.

            Most chiropractors oppose vaccination and sell useless supplements. As a profession they are a net drain on the health of the world.

            It can’t hurt and it could save her life.

            Or it could kill her through a torn vertebral artery. Or she may simply not want your advice. Or the chiropractor may convince her to discontinue all mainstream treatments in favor of manipulations.

            Making health recommendations makes you an asshole.

        2. whoa says:

          Maybe it would be better if we try harder to convince Liz she is imagining the pain, maybe to get sympathy or to avoid work. Maybe we should emphasize that she is wasting time and money trying yoga and other non-mainstream treatments.

          Maybe we should try harder to convince her to just accept the pain and be glad there are addictive drugs that can dull it.

          Maybe she should be more patient and wait for the RCTs that will eventually tell us what can cause this kind of pain.

          If I recommend something based only on anecdotal evidence, it could be wrong. She might end up trying something that is harmless and costs nothing.

          1. simba says:

            Whoa- you seem to be arguing against points that no-one here has made. If there is someone else who you regularly argue with who makes those points, try to remember that it’s not us.

            For example- no-one here has ever questioned the *reality* of people’s pain, just whether it has a psychological or ‘physical’ origin. You are the one who has decided that any pain that isn’t physical isn’t actually real. I realise that’s a position that plenty of people hold, because of the enormous prejudice against those with mental health issues, but no-one here has expressed that belief except for you.

            Treatments are not recommended against because they are ‘non-mainstream’, just if they don’t have good evidence for safety and efficacy.

            Similarly, people do not use treatments which don’t work because they’re ‘stupid’. The placebo effect is a natural result of the way the human mind works, and has nothing to do with being ‘stupid’. The weird strawman you’re arguing against (your “maybe it would be better…” post) doesn’t actually represent what people here believe or are arguing.

            Go back and read what people are actually saying: literally everyone has said variations on ‘try what you want, especially if it’s safe, but doctors shouldn’t recommend things based on anecdotes without making that absolutely clear, because to do otherwise is misleading to the patient. And we usually can’t figure out what works based on just anecdotes.’

          2. WilliamLawrenceUtridge says:

            Maybe it would be better if we try harder to convince Liz she is imagining the pain, maybe to get sympathy or to avoid work. Maybe we should emphasize that she is wasting time and money trying yoga and other non-mainstream treatments.

            Liz accepts that she is in pain for no reason anyone has been able to discern. Such recognition, rather than lurching from one false cure to another, is courageous and I am glad she has recognized this fact, frustrating as i tmust be. Even if she claimed it were due to chronic Lyme disease or some other nonsense, I would not claim her pain wasn’t real, only that there is no good evidence supporting it being due to a tick bite. Yoga I would say is merely exercise, but exercise is excellent for the body.

            Maybe we should try harder to convince her to just accept the pain and be glad there are addictive drugs that can dull it

            Liz has obviously accepted the pain and the sub-standard treatmetns for it. It’s a frustrating reality, what I wouldn’t do is try to convince her to pursue unreal options instead.

            Maybe she should be more patient and wait for the RCTs that will eventually tell us what can cause this kind of pain.

            Perhaps it will, perhaps nothing can treat her condition because it is idiosyncratic to her. Condescending with unlikely treatments because you are “so knowledegable about physiotherapy” seems unlikely to help anyone but the chiropractor who is enriched by her patronage.

            If I recommend something based only on anecdotal evidence, it could be wrong. She might end up trying something that is harmless and costs nothing.

            Chiropractic care costs nothing? Really? Because in my experience, having used a chiropractor for years, they are expensive in terms of both time and money.

      2. Harriet Hall says:

        What you are recommending is upper cervical chiropractic, or NUCCA. It is based on the fanciful “hole in one” idea and is not even supported by the great majority of chiropractors. It is based on a myth, is a useless treatment, and can lead to nonsense like this: http://www.sciencebasedmedicine.org/no-touch-chiropractic/

        1. whoa says:

          It makes sense to me and I do it on myself, for free, and it’s like a miracle.

          1. whoa says:

            Actually I don’t necessarily do NUCCA, I just try to correct the atlas, and the spine in general. The atlast is the most important though. This is part of my general yoga practice.

            I know this from years of everyday experience. It is much better than waiting for the RCTs that will never happen.

          2. WilliamLawrenceUtridge says:

            It makes sense to me and I do it on myself, for free, and it’s like a miracle.

            It killed Lana Dale Lewis. Same with Kristi A. Bedenbaugh, and Laurie Jean Mathiason and others.

            I went to a chiropractor for years. I would always feel better the day after a neck adjustment. Then I stopped going. Now, whenever my neck feels tight, I don’t go to a chiropractor. I always feel better the next day, it costs me nothing, and my risk of a stroke is zero.

        2. whoa says:

          That’s nice Harriet, you harrassed one chiropractor and got her in trouble because she practiced NUCCA. In your mind, that proves that all NUCCA is a scam and should be abolished.

          I wish you would mind your own business and stop going after people just because their medical philosophy differs from yours.

          1. Harriet Hall says:

            Apparently you can’t read. I reported that chiropractor for treating patients without touching them and for delusionally believing she was touching them. I criticize NUCCA because there’s no supporting evidence and no credible rationale for why it should work. If you believe otherwise, you should provide the evidence for your belief rather than accusing me of something I didn’t do.

            1. whoa says:

              YOU don’t think the e is a credible rationale for why it should work, because you have a different ph8losophy.

              Why should you impose your philosohpy on others? Is there anything more arrogant?

              1. WilliamLawrenceUtridge says:

                Why should you impose your philosohpy on others? Is there anything more arrogant?

                When your philosophy is “I can cure people by snapping my fingers”, it means you are delusional.

                Do you seriously believe that people can heal without physical contact or at the very least complcated machines? In which case you’ve gone from arrogant to flat-out crazy.

              2. simba says:

                Have you credible evidence for this treatment?

                Given, of course, that we’ve already discussed the placebo effect for variable conditions. You can argue that the placebo effect cannot possibly explain the fact that these exercises helped you, but then you have to explain, with good evidence, (a) how you know this and (b) how you would distinguish this from all the other people who said, say, bloodletting helped them. Oh, and (c) what evidence, aside from this or hearsay, you have that this treatment will likely help IvandaVGV.

                Pointing out that there’s no supporting evidence for a treatment, and no plausible means by which it would work, isn’t ‘having a different philosophy’ or ‘imposing that philosophy on others’. It is basic assessment of reality, and telling the truth.

                If I asserted smelling salts would stop someone’s nose bleeding, there’s no obvious reason why that would help so I need to provide some evidence. It looks disingenuous for you to latch on to something that implies a ‘philosophy’, to you, and to ignore the plain question looking for evidence. It makes you look like you have none.

              3. Harriet Hall says:

                If you do think there is a credible rationale, what is it?

            2. Peter S says:

              Back in the day I went to a Qigong practitioner who had been highly recommended, he didn’t touch me, just moved his hands over me, moving energy presumably. Although I was supposed to lie there with my eyes closed I opened them at one point and saw what he was doing and it was all I could do not to burst out laughing. Needless to say the “treatment” had no effect.

      3. Peter S says:

        Persuaded me. Well, not exactly.

        http://www.atlantotec.com/en

    2. simba says:

      IvandaVGV- thank you for your post.
      I agree entirely, we don’t know enough about pain. And too many health care professionals, or random people giving advice, assume that they DO know about pain, because they’ve experienced it. So a lot of the time there are not enough options, and those options are clouded (because some of them are based off incorrect information), and other options which may be valuable don’t get mentioned at all.

  28. whoa says:

    “You appear, and correct me if I’m wrong, to be arguing that the brain is accurate enough to figure out in most cases if something ‘works’ without needing to resort to studies, that our subjective perceptions and experiences are enough to allow us to do this. To me that seems obviously false, so maybe your position is a different one to the one you’re conveying?”

    The brain evolved over extremely long periods of time and is optimized for survival and social relationships. Most of what it does is extremely fast and outside of conscious awareness.

    Determining what medical treatments work can be extremely complicated and is never perfect. But I do think we have some awareness of what makes us feel better or worse. If we were as stupid as “skeptics” claim we are, we could not have survived.

    And I think other animals are extremely intelligent also, in their own ways.

    “Skeptics” tend to have little respect for nature or human nature.

    1. Andrey Pavlov says:

      But I do think we have some awareness of what makes us feel better or worse. If we were as stupid as “skeptics” claim we are, we could not have survived.

      Ahem. You do realize that until the last century and a half or so we really didn’t survive particularly well, right? And that mere survival is kind of not what we are going for around here. Unless you really would like to argue that you’d much rather live sometimes in the early 1000′s because well, people survived back then without all this nonsense we skeptics keep spouting on about. Or like how 25% of the world’s population died during the Bubonic Plague. Or myriad other examples.

      Yes, sure, our brains are good enough for us to survive as a species. And maybe that is good enough for you but personally I’d rather we thrive rather than just survive. And funny that, how after the advent of science and the proliferation of science based medicine firmly rooted in the ideas of scientific skepticism our population went from only 310 million worldwide in the year 1,000 CE to 1.65 billion in 1900 and (a gain of only 1.5 million per year) to 7 billion today (a gain of 47 million per year). Gee, I wonder what changed in the last 114 years to increase our population and ability to survive by 31 fold.

      1. whoa says:

        Our species survived very well for a very long time as hunter-gatherers. There was a high infant death rate, but that is true of most species and is nature’s mechanism for keeping the species healthy.

        Now our average lifespan is much longer, espeicilly in advanced countries, but that is mainly because modern medicine has disabled nature’s infant mortality mechanism.

        1. n brownlee says:

          ” There was a high infant death rate, but that is true of most species and is nature’s mechanism for keeping the species healthy.”

          “Nature” has no intention of keeping our species, or any species, healthy. “Nature” has no intentionality.

          1. whoa says:

            Did nature personally tell you that?

            1. n brownlee says:

              I want to be sure I’m understanding you. Are you saying that “Nature” DOES have intentionality, that what happens to people, animals and other living things, as well as the physical processes of this planet and the rest of the universe- that it’s all guided by some entity, or entities?

            2. WilliamLawrenceUtridge says:

              Did nature personally tell you that?

              Does nature talk to you?

              Do you see any evidence that nature is a goal-directed entity or force? Because after thousands of years of looking, nobody else has found any such thing that is convincing in any way.

        2. simba says:

          Again this is not relevant to the original point you were making- that people must know what makes us better or we wouldn’t have survived. All we need is for enough of us to survive to reproduce.

          High infant mortality has little to do with that and doesn’t actually support your point. I mean, if anything it’s an argument that we’re not good at knowing what makes people better unless we use science. Because infant mortality wouldn’t have been high if people could easily figure out treatments to lower it. Modern medicine allows us to figure out what works, because simply having lots of people take various things and decide if it ‘worked’ for them doesn’t tell us anything.

        3. WilliamLawrenceUtridge says:

          Our species survived very well for a very long time as hunter-gatherers. There was a high infant death rate, but that is true of most species and is nature’s mechanism for keeping the species healthy.

          Nature has no such mechanisms, nature isn’t even a thing. On Earth there is no decision-making aside from that done by humans, generally for short-term gains. Our species didn’t surive “well”, individuals lived to their 50s at best until agriculture became a thing, at which point disease began exerting a much higher selection pressure. Further, there was a high maternal death rate as well. In addition, there’s evidence that one of the selection pressures was on human-human combat.

          Nature doesn’t exist to “keep species healthy”, because “nature” doesn’t exist beyond our projection of a single cohesive web onto all living things. Natural selection is a “good enough” process that only keeps living things alive long enough to breed as a species, which also doesn’t work out that well since extinction is a common event. “Nature” such as it is, is blind and indifferent. Selection pressures are often intraspecies-specific and outright harmful to individuals, including humans. You don’t seem to understand evolution very well.

          Now our average lifespan is much longer, espeicilly in advanced countries, but that is mainly because modern medicine has disabled nature’s infant mortality mechanism.

          “Nature’s” infant mortality mechanism? So there’s a planner somewhere murdering babies? Stop anthropomorphizing. The average lifespan is longer for many reasons, including vaccines, antibiotics, trauma treatments, acute care facilities, a reliable food supply, sewers, and an awareness of what causes dieases. Your descriptions of human evolution and longevity are cartoons.

    2. simba says:

      Ah, but does what makes us feel better or worse, actually make us better or worse?
      I always feel better with warm lemonade after a cold. A hotly-debated issue here is whether that lemonade is fizzy or flat- because it only ‘works’ if the person’s mother made it that way.

      http://www.sciencebasedmedicine.org/spin-city-placebos-and-asthma/
      Could you take something, feel better or think you’re getting better, and actually be the same or worse? I know I’ve seen friends with chronic wounds who that happened to- they thought the wound was getting smaller with treatment and looking better, when it was measured it was actually a little larger than before, and compared to photographs of the last time it looked more inflamed. The mind is a wonderful and complex thing.

      1. whoa says:

        Yes of course wishful thinking is a powerful deceptive force. But it is not caused by lack of intelligence or logic.

        For example, many people are certain they will go to a nice place when they die. No one can test this belief one way or the other, so everyone believes whatever they like. It is based on what they heard from authority figures, not on logic or evidence.

        Most thinks are completely unknown, but most people like to have a sense of knowing more than they can, based only on logic and evidence.

        So yes, RCTs can help dispell some of those illusions.

        But wishful thinking, and the placebo effect, are actually very limited, according to my experience anyway. If a patient wants to see their wound as gradually healing, when it is actually getting worse, eventually they will have to face reality.

        1. simba says:

          It’s irrelevant what it’s caused by- one of the points repeatedly made on this website is that intelligence, and logic, have nothing to do with the placebo effect. Intelligent people will support false treatments as much as anyone else, because they are subject to the same kind of cognitive errors. So I don’t know where you got that from. The point is that our brains, however intelligent, were not intended to sort out which treatments work and which don’t, and do not measure the world around us (or record our experiences) accurately.

          And people don’t have to eventually ‘face reality’ for most conditions- if you’ve got a condition with any variability, a condition which isn’t able to be objectively assessed, or something that will go away by itself, it’s easy for people to believe something works when it doesn’t.

          Regardless of this, the placebo effect means that what you have been saying, that people can tell for themselves what works and what doesn’t, is not true. Because people can tell what makes them feel better- but they may just feel better because they’ve done something.

        2. simba says:

          Read the article I linked to above- while those people were feeling better, they were being deprived of oxygen and were damaging their lungs. Take ineffective treatments for your asthma for a few years and, even if they eventually face reality, the damage is already done. That’s if they don’t die before then, or end up getting injured in some way by whatever ineffective treatment they’re using.

        3. WilliamLawrenceUtridge says:

          Yes of course wishful thinking is a powerful deceptive force. But it is not caused by lack of intelligence or logic.

          I doubt anyone here ever said it was a lack of attention to either of these things. The essence of skepticism is awareness of the ways things can appear smart and logical when they actually aren’t. Cognitive biases is not about intelligence.

          But wishful thinking, and the placebo effect, are actually very limited, according to my experience anyway. If a patient wants to see their wound as gradually healing, when it is actually getting worse, eventually they will have to face reality.

          How do you know your experience represents the experience of all other humans?

          Placebo effects have calmed tremors in Parkinson’s patients, have allowed the wheelchair-bound to walk, have eased pains that nagged for decades. There’s clear research showing the placebo effect can have incredibly powerful subjective benefits.

          Yes, everyone will face reality – and the importance of medical research is in ensuring that the reality they must face is better than a reality with no treatment.

    3. weing says:

      Isn’t there a book about slow and fast thinking by Kahneman? Sure, the fast thinking described, has allowed us to survive, but the slow thinking has allowed us to thrive in the Red Queen’s race. We use both modes on a daily basis in medicine. I know that I do. We also have to be keenly aware of the limitations of each.

      1. whoa says:

        I agree with you about that weing.

        afaik, K & T were mainly studying logical thinking, which is generally slow and linear.

        1. Jopari says:

          Logical thinking is slow and linear because it relies on facts to derive a reasonable solution rather than performing leaps of logic, speeding the process but thrashing the results.

          Sure, eventually people will have to face reality, but likely if they were to use scientific methods instead of guestimating, they would face it before it worsened.

          The mind is great at making decisions quickly, but accuracy isn’t it’s strong point. The mind is easily manipulated and can have an effect on the body, the placebo effect is evidence of this. RCTs are not the only way, experience is fine, but make sure you have scientific evidence, keep a log, keep records, test different scenarios (unless life-threatening, just a prebut) recording objective results, no happy feelings , often you’ll find that this provides way better insight.

    4. WilliamLawrenceUtridge says:

      The brain evolved over extremely long periods of time and is optimized for survival and social relationships. Most of what it does is extremely fast and outside of conscious awareness.

      Which suggests, does it not, to be poorly-adapted for non-survival, non-social based reasoning, does it not? And science is essentially nothing but non-survival, non-social based reasoning, right?

      Determining what medical treatments work can be extremely complicated and is never perfect. But I do think we have some awareness of what makes us feel better or worse. If we were as stupid as “skeptics” claim we are, we could not have survived.

      Straw man again, skeptics don’t think people are stupid, skeptics think that the cognitive heuristics that accompany a human brain are poorly-adapted for cause-and-effect reasoning and drawing inferences when emotions play a strong role in the results or conclusions. Skeptics further acknowledge the fact that peope considered “intelligent” can go off the rails of intelligent thought if they do not have an adequate touchstone to the correcting nature of empirical results and use their intelligence to avoid changing their minds rather than seeking out better information.

      I for one, as a skeptic, frequently despair of ever making progress in an increasingly complex society because of the intractable nature of human cognition. Not because people are stupid, but because people are people, and are much better at short-term social decision making than they are at long-term, global problem solving. And unfortunately, many of the problems we face are long-term and global.

      “Skeptics” tend to have little respect for nature or human nature.

      Sounds like you have insufficient respect for skeptics to even understand their reasoning and objections. But it looks like you have tremendous respect for your own opinions.

  29. whoa says:

    One typical mistake made by K & T involved testing subjects’ understanding of conditionals. As you can imagine, their subjects did not do well. People are stupid and illogical after all, right?

    No, it was because K & T failed to understand that in natural language the meaning of “if” depends on the context. Sometimes “if” is biconditional and sometimes it is not.

    That is the kind of mistake K & T often made, showing that researchers often have tunnel vision and can be blinded by their motivations.

    1. WilliamLawrenceUtridge says:

      You’re pretending that K&T represents the whole of the literature on the subject, which they don’t. Further, you keep using the word “stupid” when that is not what these studies show. These studies show that human cognition is flawed, not that people are dumb. You keep knocking down a straw man.

      1. whoa says:

        I did NOT pretend K & T represent the whole literature. I was asked for a specific example, so I gave one.

        If you want an entire literature review of this subject, then you would have to pay me.

        And if K & T are so respected in this field, why did they get away with such a stupid mistake?

        1. WilliamLawrenceUtridge says:

          Did K&T ever use the word “stupid” in their study?

          Further, my point has consistently been that it is not about intelligence, it is about systematic distortion. I don’t believe you have ever addressed it.

          1. whoa says:

            The experiments showing subjects were not good at conditional reasoning might not have used the word “stupid” in its conclusions. But it is clearly implied. What do we call someone who is bad at reasoning, if not “stupid?”

            People like K & T look at the world and its history and wonder why there has been so much chaos. And they wonder why so many people believe in mystical things that “smart” scientists “know” are imaginary?

            Well it turns out there is a good explanation and their research “proves” it — people are stupid, unless they are educated into modern, enlightened, rationality.

            K & T, and the whole cognitive science crowd, and most of current mainstream science, have things pretty much backwards, imo.

            1. WilliamLawrenceUtridge says:

              The experiments showing subjects were not good at conditional reasoning might not have used the word “stupid” in its conclusions.

              Are you sure you aren’t projecting your own assholish judgementalism onto them?

              But it is clearly implied. What do we call someone who is bad at reasoning, if not “stupid?”

              Human.

              It seems there’s something going on here though. Cognitive psychology consistently finds that there are gross errors in reasoning that divert humans from the correct answer to the preferred answer, and you take offence to this. Why? Why do these imperfections, with such an obvious evolutionary history of expedience in a totally different environment with totally different evolutionary pressures offend you so? Why do you so strenuously object to what is clearly a large and convergent body of findings that point to humans being prone to fallacies? What so offends you, what so outrages you, what is so incredibly hateful to you, about the idea that we aren’t perfect?

              People like K & T look at the world and its history and wonder why there has been so much chaos. And they wonder why so many people believe in mystical things that “smart” scientists “know” are imaginary?

              Have they said this anywhere, or are you projecting again? And how else do you explain the consistent, repeatable finding in cognitive psychology that shows humans are prone to picking sides, refusing to change their opinions and desiring to be right at all times? Scientists themselves are prone to these errors in reasoning, hence Sagan’s famous dictum, you are the easiest person to fool and the use of things like statistics, replication and public peer review to check conclusions. If discovering the truths about the natural world was easy for humans, it wouldn’t have taken 100,000 years to realize the solar system was heliocentric.

              Well it turns out there is a good explanation and their research “proves” it — people are stupid, unless they are educated into modern, enlightened, rationality.

              Wow, again, it is you who are using the word “stupid”, as if having a human brain prone to errors were somehow deliberate and chosen. Again, you’ve missed the point. And much of the research doesn’t explain these errors, it uncovers them.

              K & T, and the whole cognitive science crowd, and most of current mainstream science, have things pretty much backwards, imo.

              Yeah, very much YO. Consider that your opinion might be wrong. But you won’t, because you are human, and cognitive psychology shows that humans are prone to resolving cognitive dissonance in their favour through a decision that one’s interlocutor is biased, mean or ignorant, because you can never be wrong.

              You’re yourself a rather obvious victim of the findings of cognitive science you so hate.

            2. Andrey Pavlov says:

              Well, WLU said it quite well.

              The only person here calling people stupid is you, whoa. What would I call people who are not good at conditional reasoning? Well, people. What do you call someone who is not good at plumbing? Or not good at medicine? Assuming they aren’t plumbers and doctors, they are just people. Getting good at anything – including conditional learning, reasoning, logical rigorous thought, science, art, or even plumbing – takes years of concerted effort and practice. Something you clearly lack.

              So I would just call them “people who haven’t learned and practiced diligently in that specific field of study.”

              It is you that is calling them stupid. Not us.

              Now, a better question is what would you call willful ignorance and consistent straw man attacks despite being pointed out numerous times?

              I’ll give you one guess what I’d call that.

        2. weing says:

          “And if K & T are so respected in this field, why did they get away with such a stupid mistake?”
          I still don’t know what mistake you are going on about. It’s quite possible the mistake only exists in your mind and misinterpretation of their research. You mentioned something about brainwashing not taking. I never thought of a doctorate as brainwashing. I suppose it could be if done wrong. I suspect you had already been brainwashed before coming to the program. I would not pay a penny to someone that gave me a nonscientific interpretation of psychological literature.

          1. simba says:

            Whoah: “And I said that human beings are not all complete fools that can’t ever trust their own perceptions and experiences. The research that supposedly shows that is largely elitist paternalistic bs.”

            Just to clarify what’s happening. Whoa is apparently going to demonstrate flaws in that research and thus show that humans can actually wholly trust their own perceptions and experiences, as opposed to the consensus position here which is that personal experience is an unreliable way of assessing efficacy of treatments. This will presumably involve citations which will allow us to look up the information for ourselves.

            The position Whoa is arguing against was well-expressed by WilliamLawrenceUtridge as : “skeptics don’t think people are stupid, skeptics think that the cognitive heuristics that accompany a human brain are poorly-adapted for cause-and-effect reasoning and drawing inferences when emotions play a strong role in the results or conclusions.”

            Sorry about the recap, but this conversation has a history of being dragged on odd tangents and jumping all over the place, I thought a reminder of the original proposition might be acceptable.

          2. Sawyer says:

            This whole rant seems like a huge distraction from the topic at hand, but there is a lesson applicable to medical research if we wade through the weeds. Whoa is using the word “mistake” in place of what other scientists would most likely call a “limitation” or “weakness”. This is a big no-no. We’ve seen this exact same strategy when quacks arrogantly attempt to trying to dismiss the entirety of medical literature. They claim that scientists are utter buffoons for making bone-head errors, when in fact the very scientists they are critiquing would readily admit the limits of their methods and conclusions if you ask them nicely.

            While MANY people don’t understand the distinction between a mistake and a limitation in science, this is one of the few concepts almost everyone gets exposed too when pursuing a Ph. D, regardless of their field. I guess Whoa never got the memo.

          3. whoa says:

            That’s right weing, professors at Stanford cannot possibly be wrong.

            1. weing says:

              I never said that. Kahneman never said that either. He actually pointed out several in his book. Are you sure you didn’t make a mistake?

        3. MadisonMD says:

          if K & T are so respected in this field, why did they get away with such a stupid mistake?

          Self-deception by cognitive human flaws. But then, you are paradoxically arguing that highly evolved human brains do not make such errors.

          1. Bruce says:

            Having casually read through this thread, a quick summary is that a study saying that people get things wrong is being attacked because the people doing the study may have got it wrong?

            If they got it wrong, does it mean people always get it right? If so, does that mean they actually got it right, but that means that people get things wrong…

            Humans are fallible… deal with it.

  30. whoa says:

    “Pointing out that there’s no supporting evidence for a treatment, and no plausible means by which it would work, isn’t ‘having a different philosophy’ or ‘imposing that philosophy on others’.”

    If there are no big expensive RCTs that does not mean there is no supporting evidence.

    And if you think there is no plausible means for it to work, maybe you just don’t understand how it works.

    I understand yoga and I know it can work. Lots of people agree. It is not simiply because it’s a form of exercise.

    1. simba says:

      “If there are no big expensive RCTs that does not mean there is no supporting evidence.” That’s nice. That’s a point that has been raised repeatedly here by those in favor of SBM. That also has absolutely nothing to do with anything anyone has said to you on this thread. You are again arguing with what you would like people to have said, rather than what people have actually said.

      So you recognise the need for supporting evidence, and you apparently know of some. In order to look in any way credible you need to provide it. This has been said to you a couple of times. So now by repeatedly ignoring it you really really make yourself look like you have none.

      Harriet Hall also asked you what you think the credible rationale is. Again, you haven’t explained to us how you think it works.

    2. KayMarie says:

      You can look to see it the “why it works” seems to be based off of the known physical world or at least something that can be potentially studied and measured or if the “why it works” relies on mystical magical what-nots. Especially when the people who claim they understand the what-nots all seem to have different mystical magicals.

      Are you claiming that certain poses relax certain muscles, or strengthen certain muscles that help improve posture, or that the whichever energy you are shooting up your spine is aligning things. One has some chance of being rigorously studied and measured, the other is just whatever judgements or interpretations you are putting on a wholly subjective experience that can’t be measured by someone outside of yourself. Even if two people can discuss them and agree that they think they were feeling the same thing or they will put the same interpretation or judgement on different experiences because it feels like the right thing to do. That doesn’t make them measurable or mean they fix the thingy you think they are fixing.

    3. Harriet Hall says:

      You’re being evasive. If there is supporting evidence and a plausible means for upper cervical chiropractic to work, please present the evidence and explain the plausible means.

      What does yoga work “for”? How do you know it can work? Lots of people agree, but lots of people disagree too: do you think counting those who agree constitutes proof? If it’s more than a form of exercise, what is the “more”?

      1. Peter S says:

        Here is the explanation on one website. Uh… ok right.

        “When there is a misalignment of the Atlas, the interactive communication between the brain and the rest of the body is disturbed, which can lead to a neurological deficit.

        The anatomy of the spinal column is comparable to a precision mechanism: the slightest shift of the Atlas from its correct anatomical and physiological location can have negative repercussions on the entire musculoskeletal, postural, circulatory and parasympathetic nervous systems, as well as the body in general.”

        1. Harriet Hall says:

          Yep! That’s their so-called reasoning.
          “the slightest shift of the Atlas from its correct anatomical and physiological location can have negative repercussions”
          And they know this how? Because BJ Palmer said so when he invented the “hole in one” fantasy a century ago.
          Aren’t we impressed?!

          1. Peter S says:

            Not to mention the countless people whose problems magically resolved within minutes of receiving the treatment. Just read the testimonials!

            1. WilliamLawrenceUtridge says:

              The amazing thing to me is that they consider health to be so fragile. I mean really – any time you turn your head, tilt it, bend over or jump, you’re shifting the atlas from its alleged correct position. And how a dramatic, violent, high-velocity, low-amplitude thrust (or whatever it is) can correct this is beyond me. It’s rather like attempting to fix the setting of a Fabrege egg by hitting it with a hammer.

              Or, if I understand the other nonsense, by brushing it with a feather.

              1. Peter S says:

                So you don’t think this is the one true cause of ALL ailments? Then you must believe root canal cavitations are the one true cause, like Dr. Simon Yu.

                http://www.preventionandhealing.com/articles/Dental_The_Root_Cause_of_Chronic_Illness.pdf

                Mold, perhaps? Candida? Subclinical hypothyroidism?

                Why is it that to be credible in the CAM world, a theory has to explain EVERYTHING, and a treatment has to be universal?

              2. simba says:

                Ah, but modern medicine only treats the symptoms, and doesn’t individualize things to patients dontcherknow.

                First time I heard that about homeopathy, that it treats the causes as opposed to modern medicine which only treats the symptoms, I instantly knew that the person talking didn’t know anything about either. And bear in mind I was into homeopathy at the time.

              3. whoa says:

                Health is not that fragile. The balance of the atlas is not likely to be disrupted in any natural situation. By “natural” I mean things that we evolved to withstand, over extremely long time periods.

                We did not evolve to withstand automobile accidents, for example, or surgery with general anesthesia. That is type of thing that can disrupt the balance of the head on the spine.

                I believe that fibromyalgia can result from this kind of imbalance. That is why I replied to Lisa’s comment, because it sounded like she might have fibromyalgia.

                Mainstream doctors cannot figure out why people get fibromyalgia, and they have no good treatments.

                I felt that I had to provide this information when I read Lisa’s comments, because she is suffering terribly and is probably not aware that subluxations can cause extreme pain.

              4. simba says:

                Whoa- what is your evidence for NUCCA?

                Trying something for yourself doesn’t actually tell you anything about whether it works or not. It’s counterintuitive, but there you go- life is complicated and people aren’t unbiased accurate measures of our health, as you’ve said. Bloodletting worked for lots of people.

                One favourite near me is to drink from a certain holy well, or tie a rag to the tree above it, for rheumatoid arthritis pain, fever, and eye conditions. People who try it find benefit. Does that mean it’s a cure?

              5. Andrey Pavlov says:

                I felt that I had to provide this information when I read Lisa’s comments, because she is suffering terribly and is probably not aware that subluxations can cause extreme pain

                Yes, orthopedic subluxations are indeed painful. Which is why we reduce them after the trauma causing them.

                The kind of subluxations you are talking about, however, do not exist.

              6. WilliamLawrenceUtridge says:

                Health is not that fragile. The balance of the atlas is not likely to be disrupted in any natural situation. By “natural” I mean things that we evolved to withstand, over extremely long time periods.

                But by saying that the position of the atlas is vital to and causes so many vague ailments, you are kinda saying it is fragile. And your appeal to nature is nonsense, like all appeals to nature. Why would a “natural” force be any different from an “unnatural” one, and how does one define such? What specific forces acting on the atlas did we “evolve” to withstand? And of course, your position seems to be unfalsifiable, which is unsurprising, with goalposts that have wheels installed to help you move them by declaring any specific point that contradicts your assertions to be “unnatural”.

                We did not evolve to withstand automobile accidents, for example, or surgery with general anesthesia. That is type of thing that can disrupt the balance of the head on the spine.

                Did we evolve to withstand falls from trees? What about being charged by a buffalo? What about jumping off of a high cliff into water, a situation which would be analogous to rear-ending a vehicle and having your airbags go off. And how would anesthesia disrupt the balance of the head more than REM sleep, when all muscles go lax? Do people in comas have such problems? Is it only when you have surgery upright?

                I believe that fibromyalgia can result from this kind of imbalance. That is why I replied to Lisa’s comment, because it sounded like she might have fibromyalgia.

                Again Mary, you shouldn’t try to diagnose people over the internet. Your assumptions could be very, very wrong and Lisa probably has heard of fibromyalgia. Further, your belief that FM is caused by atlas imbalance – any evidence to support it, or do you just “know a bunch of stuff about physiotherapy”? Sounds like you’ve spent a lot of time talking to chiropractors and have drunk the resulting Kool-Aid. And the thing about chiropractors, when all you can do is manipulate spines, but you believe you can treat any and all health conditions, that means you have to treat all of those health conditions with spinal manipulation. When all you have is a hammer.

                Mainstream doctors cannot figure out why people get fibromyalgia, and they have no good treatments.

                True, but that doesn’t mean that your speculation within that void is automatically correct. Your criticism of mainstream doctors applies equally, if not more, to your own assertion that fibromyalgia is caused by the atlas being loose.

                I felt that I had to provide this information when I read Lisa’s comments, because she is suffering terribly and is probably not aware that subluxations can cause extreme pain.

                Are you sure it’s not because you’re a self-important victim of the Dunning-Kruger effect who doesn’t actually treat patients of even the fake chiropractic sort, and perhaps simply shouldn’t offer unsolicited health advice?

      2. whoa says:

        “do you think counting those who agree constitutes proof?”

        Harriet, it is not “proof.” For those of use who practice and believe in yoga, the evidence is our daily experience. If you tried it yourself, with an open mind, maybe you would agree.

        Sometimes “skeptics” say that yoga is nothing special, just another form of exercise, and any kind of exercise is good for health. That is partly true, and partly not true.

        Most forms of exercise will help keep the muscles and joints in alignment, and that is important for all aspects of mental and physical health. Not exercising will almost inevitably cause imbalances.

        Yoga is special because of the emphasis on systematic stretching. I am actually not claiming that yoga is better than other forms of physical therapy, such as Alexander technique, Tai Chi, Feldenkrais, etc. I combine aspects of different techniques myself, so what I do is not just yoga.

        One main goal of all of these is to correct what chiropractors call “subluxations.” Mainstream medicine denies they are real, because there are no big RCTs demonstrating them. If the big drug companies can’t sell something, you probably won’t see a lot of RCTs studying it.

        If you allow your body to get badly out of alignment you will have more aches and pains as you get older. You also may have decreasing energy and all kinds of other mental and physical problems, most of which mainstream medicine considers inevitable results of aging.

        It would be possible to study the long-term effects of yoga, of exercise in general, and of the various kinds of physical therapy. But the big drug companies won’t fund it, so it might never be done.

        Meanwhile I guess we should park ourselves on the couch and watch TV, while waiting for scientific proof that yoga has special benefits. After all, we don’t want to take a chance on doing something that is not backed up by RCTs and sanctioned by mainstream medicine. Oh horror — we might be just IMAGINING that it makes us feel better.

        1. simba says:

          So you have no evidence then for specific benefits of yoga beyond exercise and stretching, no evidence for efficacy of NUCCA, or any evidence that it’s problems with the atlas joint that is causing/could cause IvandaVGV’s problems (or that yoga could cure this, which is presumably why you brought it up).

          I’m sure yoga makes you feel better. Walking the dog makes me feel much better. Exercise is part of mainstream medical recommendations, as is stretching in many cases (including exercise as a distraction for pain). There are even RCTs on it, and specifically on yoga (431 results for ‘yoga randomised controlled trial’ on pubmed, more than 2000 for yoga in general).

          So the fact that ‘subluxations’ haven’t been definitively demonstrated despite much research done on them suggests it’s less to do with some kind of conspiracy, and more to do with the fact that they don’t exist. Seriously, read up on NCAM and look through pubmed, look up Nansel and Szlazak 1995: there is even a Journal of Vertebral Subluxation Research.

          You keep returning to your beef with RCTs despite the fact that literally no-one else here considers them to be the only acceptable form of evidence. As has been said only many, many times. You are at the point of making things up you would like your opponents to have said (“park ourselves on the couch and watch tv”) while ignoring what we are actually saying, and asking you.

          There is more to evidence than ‘I think it works for me and other people like it!’ and ‘RCTs’. There’s a whole spectrum in between.

          So you said yoga worked ‘not simply because it is a form of exercise’. Now you say it works because it’s exercise with an ‘emphasis on systematic stretching’. That seems like semantics to me.

          1. simba says:

            Whoah-

            http://www.sciencebasedmedicine.org/homeopathy-and-evidence-based-medicine-back-to-the-future-part-v/ The table in the centre here talks about the hierarchy of evidence- search that term on this website and you’ll come up with many results.

            Here’s a reasonably good explanation of the types of evidence that are used. This will give you a better idea of the kind of evidence people here are talking about. http://updates.pain-topics.org/2011/03/pain-research-all-that-glitters-is-not.html

        2. simba says:

          Again, it was the evidence for NUCCA that you were asked for. Now you suddenly try and switch the topic to yoga. So, have you evidence for NUCCA?

          1. Harriet Hall says:

            I second that. Whoa, where is your evidence for NUCCA? Put up or shut up.

        3. Harriet Hall says:

          “the evidence is our daily experience”

          That is evidence that you “think” it helps you. It is not objective evidence that it “does” in any objective sense.

          “Yoga is special because of the emphasis on systematic stretching”

          Why would I want to spend my time doing systematic stretching? Just because you think it’s a good idea? What are the objective benefits?

          “One main goal of all of these is to correct what chiropractors call “subluxations.” Mainstream medicine denies they are real”

          Even many chiropractors have denied that they are real. Not because of a lack of RCTs, but because they don’t show up on x-ray, because chiropractors disagree about which vertebra is subluxed, and because there is no evidence of any kind to show that they exist.

          “It would be possible to study the long-term effects of yoga, of exercise in general, and of the various kinds of physical therapy”

          It’s not only possible; there are plenty of studies. Just check PubMed. There was no need for funding by big drug companies.

          “Meanwhile I guess we should park ourselves on the couch and watch TV, while waiting for scientific proof that yoga has special benefits.”

          Don’t be ridiculous! We know there are plenty of proven benefits for exercise. The alternative to waiting for better studies of yoga is not sitting on the couch, it’s exercising in whatever way you want.

          1. whoa says:

            “Why would I want to spend my time doing systematic stretching? Just because you think it’s a good idea? What are the objective benefits?’

            I am not trying to sell you anything Harriet. If you don’t want to try it, don’t.

            Yes there are plenty of studies on exercise. I meant comparing various kinds of exercise, to see if yoga has special benefits.

            Maybe no one can agree on exactly what is meant by “subluxation.” But anyone who practices yoga, or other similar things, knows from their own extensive experience that the spine can get out of balance, and that it can be corrected.

            Mainstream medicine generally believes that people inevitably get out of shape as they get older. Actually, many diseases and pains can be avoided, by correcting subluxations.

            If you have never experienced this, it is understandable that you don’t believe it. But it really is too bad your mind is so closed that you would not consider trying it.

            1. MadisonMD says:

              Mainstream medicine generally believes that people inevitably get out of shape as they get older. Actually, many diseases and pains can be avoided, by correcting subluxations.

              Non-sequitur of nonsense.

            2. simba says:

              “Yes there are plenty of studies on exercise. I meant comparing various kinds of exercise, to see if yoga has special benefits.” This is irrelevant. The point you were trying to make is that subluxations and yoga have no research on them because drug companies won’t fund it. Instead you just hadn’t searched for the research.

              You were using this to support your claim that the reason subluxations haven’t been shown to be real is because drug companies won’t fund the research.

              So, (a) they do have research on them therefore (b) there must be some other reason subluxation hasn’t been shown to be real. Logic.

              I don’t feel I’m misrepresenting your position here, and I don’t think that ‘comparing various kinds of exercise’ was your only point. It’s not the one people were addressing, it’s not the one that made up most of your post. Heck, here, word-for-word, is what you wrote.

              “One main goal of all of these is to correct what chiropractors call “subluxations. Mainstream medicine denies they are real, because there are no big RCTs demonstrating them. If the big drug companies can’t sell something, you probably won’t see a lot of RCTs studying it…

              It would be possible to study the long-term effects of yoga, of exercise in general, and of the various kinds of physical therapy. But the big drug companies won’t fund it, so it might never be done.”

              We are looking at your claims, reading your posts, responding to your points.

              You have yet to provide citations or any evidence, address any criticisms of your points, or admit when you have been blatantly wrong or insulting. You are repeatedly misrepresenting other people’s ideas (your hangup about RCTs for example, or your idea that people without perfect cognition are ‘stupid’). You reject other people’s experiences and ideas on the basis of your own ‘personal experience’: never mind that other people have had psychogenic pain, because you haven’t, so those people are just neurotic. These are all signs of a closed-minded person.

              Maybe if you provided good evidence to support your position there would be a possibility you could persuade people, but thus far you have decided not to do that, so you have no way of knowing how ‘open-minded’ anyone is. Didn’t your science education tell you something about the value of assertions without citations or supporting evidence? That would not fly in most undergraduate essays.

              So what is the evidence for your claims on NUCCA, and on yoga as a cure for subluxations (not its benefits as general exercise) and on the existence of subluxations?

            3. WilliamLawrenceUtridge says:

              Mainstream medicine generally believes that people inevitably get out of shape as they get older. Actually, many diseases and pains can be avoided, by correcting subluxations.

              No it doesn’t. Real medicine recognizes that the body experiences many inevitable declines in functioning with age, but it also recognizes that the function of the body and mind can be preserved through a large number of lifestyle practices – primary among them being exercise, followed by a diet high in fruits and vegetables, getting adequate sleep (which exercise and proper diet help with) and low stress. Real medicine encourages people to exercise so they can avoid the declines that come with inactivity, declines you don’t notice during youth because your inherent reserves of health and function are much deeper.

              You appear to be recommending chiropractic adjustment as an alternative to exercise, as if it were an effective treatment for a sedentary life. And if you’re not, you should really stop using the word “subluxation” because it has a generally-understood (and fallacious) meaning. And subluxations can’t prevent or cure any diseases beyond musculoskeletal complaints (which aren’t diseases). Your assertions about subluxations are actually contradicted by a considerable body of research that finds little benefit to chiropractic adjustments beyond back pain. And your attribution of “subluxation correction” to yoga is also questionable since you would have to demonstrate that a) subluxations exist b) that they impair health and c) that yoga corrects them. No research has proven any of these three points.

              Exercise is good for you. It’s not magic.

        4. Peter S says:

          “If the big drug companies can’t sell something, you probably won’t see a lot of RCTs studying it.”

          If there was such a thing as a subluxation, don’t you think drug companies would be trying to patent drugs to treat them? The problem isn’t the drug companies, but the lack of evidence for subluxations.

        5. Andrey Pavlov says:

          I am actually not claiming that yoga is better than other forms of physical therapy, such as Alexander technique, Tai Chi, Feldenkrais, etc. I combine aspects of different techniques myself, so what I do is not just yoga.

          What is the emoticon for laughing uproariously?

          It is not terribly common that a single individual comes along who embodies just about every single epic pseudoscientific failure. And you have an amazing alacrity at demonstrating many of them in a single post; a giant shotgun blast of blazing stupid spewing forth relentlessly.

          I waffle between laughing at how absurd you are and feeling sorry that you are so woefully misguided.

        6. weing says:

          “Yoga is special because of the emphasis on systematic stretching”
          You do realize that you can stretch too much, as noted here.
          Also, how do you know that those “subluxations” are real?

        7. MadisonMD says:

          Mainstream medicine denies they [subluxations] are real, because there are no big RCTs demonstrating them.

          Not only does whoa continue to beat the straw man that SBM denizens believe RCT is the only acceptable evidence, but he applies this in nonsensical manner to anatomic pathophysiology. He is creating the absurd claim that someone would require RCT, say, to conclude that people can get enlarged thyroid, tumors in the stomach, tooth abscesses, or acne! How absurd. How ignorant.

          It is scarcely possible whoa is this thick? Not really. The alternative explanation is trollery. He is just saying dumb stuff for amusement, to get a response. Well Bravo. Yawn.

          1. WilliamLawrenceUtridge says:

            No, I think whoa has drank the kool-aid and come to embrace iconoclasm to such a degree that his/her identity is now defined by it. It’s much like stan or steve-o, the idea becomes respected not based on the evidence, but on the degree to which it is denigrated by real science and medicine. Truth is claimed on the basis of not being believed by doctors. It’s like watching Louis CK argue with his daughter about the correct pronunciation of Fig Newtons. I’m contemplaing calling Whoa “Mary” from now on, based on that being Louis’ daughter’s name (as far as I can tell from the world’s shortest google search).

            Whoa, if we continue to disagree with you, will you threaten to hold your breath until we agree that subluxations exist?

        8. WilliamLawrenceUtridge says:

          How did we get on yoga? I thought we were talking about how people aren’t stupid, a point we all seem to agree on. Though there are stupid people of course.

          Yoga is special because of the emphasis on systematic stretching. I am actually not claiming that yoga is better than other forms of physical therapy, such as Alexander technique, Tai Chi, Feldenkrais, etc. I combine aspects of different techniques myself, so what I do is not just yoga.

          Seems like you can’t reall talk about how great yoga is then, since you don’t actually do yoga.

          Is it better than pilates, the ancient Roman stretching technique used to condemn Jesus? Ha, I kid and profane.

          One main goal of all of these is to correct what chiropractors call “subluxations.” Mainstream medicine denies they are real, because there are no big RCTs demonstrating them. If the big drug companies can’t sell something, you probably won’t see a lot of RCTs studying it.

          Your understanding is a little simplistic and wrong. Subluxations are asserted, but have never been proven (and in particular have never been proven to influence health). If you give chiropractors the same patients, xrays and test results, each will diagnose different subluxations in different places. The inter-rater reliability is extremely poor.

          Also, despite your assertion that no studies occur because Big Pharma, an insulting and frankly stupid argument (have you never heard of the NIH?) there are over 6,000 articles discussing chiropractic care on pubmed alone, including over 400 clinical trials and over 600 review articles.

          It would be possible to study the long-term effects of yoga, of exercise in general, and of the various kinds of physical therapy. But the big drug companies won’t fund it, so it might never be done.

          Do you know what pubmed is? exercise long term returns 14,806 results, nearly 3,000 clinical trials and over 3,000 review articles. Geez, even yoga long term gets 37 review articles, 19 clinical trials and 133 items total.

          Maybe fact check a little before you just write down what your chiropractor spoon-fed you at your last adjustment?

          Meanwhile I guess we should park ourselves on the couch and watch TV, while waiting for scientific proof that yoga has special benefits. After all, we don’t want to take a chance on doing something that is not backed up by RCTs and sanctioned by mainstream medicine. Oh horror — we might be just IMAGINING that it makes us feel better.

          Calm down there Don Quioxte, and lay off of the windmills. Nobody here ever said exercise wasn’t good for you, quite the opposite. Nobody here ever said yoga wasn’t good for you (though Dr. Novella has noted it is infected with woo and its claimed specific benefits are questionable. If you like yoga and can keep it up for years – do it. Where the area is grey is claiming it’s better than say, jogging, or pilates, or even just stretching and shaking out your muscles.

          I’m sure yoga makes you feel better. Certainly it’s way, way better than siting on the couch. Is it better than other, comparable forms of exercise? That’s where the problems are.

          So maybe stop trying to face fuck opinions into our mouths and pretending we say things we haven’t. Nobody claims yoga is of no benefit, no jackbooted thugs are coming to take away your yoga mat. Settle down there champ, and maybe stop assuming you know what anyone here thinks.

    4. Andrey Pavlov says:

      If there are no big expensive RCTs that does not mean there is no supporting evidence.

      Do you seriously not realize you are only carrying on a conversation with yourself? There is even an entire post right here on SBM talking about how the idea that only RCTs can provide evidence is simply wrong. I don’t have any idea who you think you are talking to when you babble on like this.

      And if you think there is no plausible means for it to work, maybe you just don’t understand how it works.

      Oh, well then do enlighten us!

      I understand yoga and I know it can work. Lots of people agree. It is not simiply because it’s a form of exercise.

      Well then you should have no problem enlightening us. And please, do tell us “how it works” by some means that isn’t related to it being exercise.

      1. MadisonMD says:

        I said the same thing yesterday. Yet, this ‘whoa’ dude keeps beating that straw man. Repeating straw-man arguments after it is pointed out, shifting the argument to dozens of tangents, and going after HH, and all the talk about ‘logic,’ I think the posts look a helluva lot like those of Hank “troll” Nickerson under a new pseudonym… though without the accusations of murder and what not.

        Maybe tomorrow he’ll get bored of SBM and go back to burning down my kids’ house in minecraft.

        1. simba says:

          It’s quite nice to know that the person you’re arguing against can’t make a sound argument without repeatedly and blatantly misstating your position. It suggests that they know, consciously or unconsciously, that your position is logical.

          1. simba says:

            It also suggests the possibility of reconciliation if they stop to actually read, and realise you’re arguing more similar things than they had thought.

        2. Andrey Pavlov says:

          Perhaps this is HH. You make a reasonable case for it anyways.

    5. WilliamLawrenceUtridge says:

      And if you think there is no plausible means for it to work, maybe you just don’t understand how it works.

      Yeah, also possible is that it just doesn’t work.

      I understand yoga and I know it can work. Lots of people agree. It is not simiply because it’s a form of exercise.

      Are you referring to yoga being to refer only to the physical aspects of the entire Indian art of yoga, which includes mental and spiritual disciplines as well as physical? Yes, the original version of yoga includes far more than just gentle stretching and weight bearing exercise. Whether yoga, in all of its guises, offers anything superior to equivalent-intensity physical exercise and periods of mental relaxation and deliberate calm, is an open question.

      1. whoa says:

        Mental and spiritual, and physical.

        1. WilliamLawrenceUtridge says:

          And your proof that it’s better than, say, qi gong, jogging, walking pilgrimages, high-intensity resistance training, volunteer work, is?

  31. Jopari says:

    Posted a little too high up. Whoa, RCTs are not the only form of evidence. Let me clarify as much as I can, and others can correct me later.

    If you want to use experience so be it. Have a friend record the orientation of your spine with a translucent print of the anatomically correct alignment. Then, have that friend record down your perception of pain, if it’s even there to begin with and record if you feel it after, honesty is required. Then, when the pain occurs again, record same data but don’t perform chiropractic treatment. After same amount of time, record if pain persists, and how long it takes to dississipate if not.

    There, a reasonably based experiment not reliant on subjective things like happy feelings and others. The only thing left to do, is to repeat with large amount of subjects, and show the results. Research does not all need to be funded by drug companies.

    1. Jopari says:

      Forgot appropriate blinding. replace doing nothing with physical exercise that resembles chiropractice in some way. Also, people who participate should be mostly chiropractice ignorant. Expand your circle of friends.

      Instead of saying that studies are being carried out by drug companies, do some yourself with adequate controls, or cease sputtering hypothesis.

      1. Jopari says:

        Of course, I’m thinking off the top of my head. So I’m probably erroneus or missing something.

      2. simba says:

        I was just wondering how to blind for the manipulation. Get blind drunk and have a trustworthy friend manipulate your spine while you sleep? Do it twice, get them to flip a coin to decide if they do it first or second time, then record the results.

        Please note this may have other adverse effects…

        1. opari says:

          *grin* With Whoa’s tendency to nitpick instead of answering the question, I’m thinking of writing something resembling a legal document. But from a phone?! Nah…

          1. simba says:

            It’s good mental exercise anyway. I’m really enjoying reading everyone’s responses. All things considered, people are being very patient, and providing good feedback on communication.

          2. simba says:

            I selfishly want you to write the legal document comment so I can read it…

            1. Jopari says:

              :-P
              Nope.

        2. n brownlee says:

          “Get blind drunk and have a trustworthy friend manipulate your spine while you sleep?”

          I’m pretty sure I’ve done this. A long time ago, in a land far, far away..

  32. Teodor Lewi says:

    I was getting a little confused by why “scam” was being capitalized, before realizing that it was shorthand for complementary and alternative medicine. I still don’t know what the “s” stands for, though.

    Perhaps explaining acronyms should be on this writer’s list of to-dos.

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