Since 2012 was rung in a month and a half ago, I’ve been writing a lot more about placebo medicine than I have in a while. Specifically, I’ve written a lot more about placebo effects than usual. This proliferation of posts on the topic was sparked by how Harvard University’s very own not-a-PhD faculty, credulous promoter of acupuncture and all things “integrative medicine,” and generally clever propagandist for woo, Ted Kaptchuk seemed, like Elvis, to be everywhere for a while. The message he was spreading was, although he didn’t admit it or put it that way, a response to the growing body of evidence in so-called “complementary and alternative medicine” (CAM) (or, as its proponents like to call it these days, “integrative medicine”) demonstrating rather conclusively that most CAM modalities are in fact nothing more than elaborate placebos and that whatever nonspecific effects are observed due to these treatments are, when studied in carefully controlled studies, indistinguishable from placebo effects. While some CAM apologists don’t want to face that message, Kaptchuk appears to embrace it whole-heartedly by arguing that placebo effects are powerful. Unfortunately, as they say, he exaggerates. A lot.
On the other hand, I rather like that CAMsters like Kaptchuk are finally just admitting that CAM is nothing more than placebo medicine. It makes it easier for me to remind people that intentionally practicing placebo medicine is unethical (because it requires lying to the patient) and paternalistic, just like 60 years ago when conventional doctors did actually order placebos for patients. In a perfectly Orwellian turn of phrase, advocates of “health freedom” and CAM advocates are in essence advocating a return to that sort of paternalism. As I’ve pointed out before, CAM cloaks itself in rhetoric suggesting that it “empowering” patients to “take control” of their health. In actuality it denies them the most important tool to do that: A appraisal of the rationale behind a proposed treatment, along with an assessment of its potential benefits and risks based on science, not fantasy. Instead, it substitutes tooth fairy science, pre-scientific vitalism, and utter faith in the practitioner for science and reason. It’s not for nothing that recently one CAM apologist argued that placebo effects were “proof” for the existence of God.
It’s also not for nothing that I have recently started comparing CAM to The Secret, with its “law of attraction.” The Secret, as you might recall, is a New Age belief system popularized by Oprah Winfrey that claims that a person attracts to himself what he really wants. In other words, your thoughts “become things.” If you believe the woo-meisters, basically thinking something makes it so. As I’ve pointed out before, this sort of wishful thinking is infantile but it meshes scarily well with a lot of what various alternative medical systems preach, systems such as German New Medicine, Biologie Totale, and various other forms of quackery emphasizing “mind-body” medicine. This sort of thought, I point out, is not without parallels in mainstream society. For example, prosperity theology has a lot in common with The Secret, except that you don’t get good things by thinking about them and wishing really hard for them. Rather, you get good things by thinking about them and praying real hard for them. One could look at God as being the intermediary or tool in prosperity theology who provides good things to those who believe whereas in The Secret it’s the universe that somehow magically manifests our thoughts and “attracts” to us what we want. That is, after all, why the New Agers call it the “law of attraction.”
A lot of people thought I was exaggerating when I likened the cult of placebo that CAM is developing into to The Secret. I even admit that there were times when I wondered if I had stretched a good analogy a bit too far. Then I saw this post by Sherry Gaba entitled The Law of Attraction and the Placebo Effect. It is, appropriately enough, on Deepak Chopra’s group blog IntentBlog. There it is, in black and what, exactly what I’ve been saying all along, only from the credulous side. I’ll show you what I mean. First, she describes the placebo effect in woo terms:
Most people are aware of what is known as the placebo effect. This is a phenomenon that occurs when someone is told that a pill or a medication they are taking is a cure for a health condition even though it is just a simple sugar pill with no medicinal qualities. People that believe they are taking a “cure” actually have mild to extremely positive results from taking the placebo, leading to a partial to complete cure of the condition without any real medical intervention.
This is, of course, a massive misrepresentation of the placebo effect. Placebo responses only “work” for subjective symptoms. They don’t “cure” anything. At best, placebo responses are due to a change in perception of subjective symptoms that leads to their bothering the patient less. Even so, they’re variable and unreliable, not something that a doctor would want to hang his hat on when he needs to relieve a patient’s symptoms. At worst, placebo effects do not exist. Rather, they’re due to artifacts in clinical trials, confirmation biases, and observer effects. Either way, nonexistent of the “beer goggles of medicine,” placebo effects are unlikely to be of much clinical use but increasingly are the rationale used to justify CAM.
Now here’s the kicker:
The placebo effect is, in reality, the medical proof that the Law of Attraction really works. The Law of Attraction simply says that what you focus in on in your life is what you will receive. In the medical case the patients taking the placebo focused in on becoming healthy and overcoming a medical condition, which is exactly what happened. Some people believed so strongly in the effectiveness of the placebo that they were completely cured. Some people were not “cured” but they no longer focused in on the negativity in their life and their ongoing health issues, instead they became happier and more mentally healthy. This in turn led to a better quality of life that significantly improved their environment and enjoyment of the world around them.
This is delusional thinking at its finest. First, again, Shaba has a hugely inflated view of the power of placebo, thinking that it can cure disease when it cannot do anything more than possibly make subjective symptoms seem less troublesome without actually doing anything to affect the pathophysiology of the disease. Yet here it is being sold as “medical proof that the law of attraction really works.” In other words, as I put it before, in the fantasy world that is CAM, thinking something makes it so. It really is The Secret. Given some of the magical mystical aspects of CAM, in which modalities like reiki, therapeutic touch, and “energy healing” are represented as channeling healing energy into patients from a “universal source,” much of CAM is religious in basis. Maybe the comparison to prosperity theology isn’t so off-base after all.
Of course, on the surface these ideas seem relatively happy and harmless. After all, there is a grain of truth buried under all the woo. There’s little doubt that our emotions, desires, and thoughts shape our lives. Every person who has ever achieved great things achieved them at least in part because he wanted to achieve them really, really bad. However, in most cases, barring freak occurrences, for that thought to “manifest” itself as things, it must first be channeled into hard work, often over a long period of time with much sacrifice. That is what results in success and obtaining what one wants. In a way, it’s true that the thought and desire are the first steps, but they are not enough. Part of growing up is to realize that, to achieve your thoughts and desires requires more than just thinking and wanting really hard. The Secret bypasses the hard work and leads to regression straight back to the fantasies of childhood. In many ways, so does a lot of CAM. In fact, Gaba is more right than she knows when she likens the placebo effect to the law of attraction. Well, not quite. She’s more right than she knows when she likens the placebo effect as viewed in CAMworld to the law of attraction because that is what it is: The unrelenting belief that wishing makes it so.