Evidenced based woo, or the confessions of a hippy scientist, part 2

As a scientist, one of the things that irritate the hell out of me is when people dismiss complimentary therapies by saying that they aren’t evidence based.
We live in a narrow minded, sceptic’s culture, whereby anything that hasn’t been proven to be true in a double blind randomised controlled trial is dismissed as quackery. I have coined the term “flat earth syndrome” to describe this way of thinking. Because let’s be honest, it just isn’t a very scientific way of thinking. Science keeps on disproving itself, and many of the beliefs we hold true today were dismissed as quackery yesterday!
 
It isn’t in the patient’s interest for different therapists to dismiss each other. What people need is for western and complimentary therapists to work together and respect and value each other. If a person gets relief from a therapy which isn’t backed up by published evidence, if it helps them, if it is part of the patchwork quilt of holistic support, does it really matter if is evidenced based or not?
 
As a scientist, especially as I published papers in several high ranking journals, including medical ones, I feel entitled to say this.
 
First, many alternative therapies simply haven’t been studied in double blind randomised controlled trials, and never will be, because it is too costly and there simply isn’t the financial or social impetus to do so. It doesn’t mean that they do not work-it just means that we haven’t looked!
 
Second, clinical trials (and I know what I am talking about having worked in the biotech and pharma industry for many years), are based on the precept that every drug is given at the same dose per Kg of weight and affects everybody in the same way-that is your body, my body, everybody’s body and metabolism, metabolises every drug in the same way. We know that this simply isn’t true. Most complementary therapies approach each person as a unique individual and treat them as such-hence making them unsuitable for clinical trials. With therapies such as touch based healing in particular, it is very difficult to establish a baseline because the sham treatment itself tends to induce results.
 
Third, medicinal chemistry completely ignores the mind body effect-there is ample evidence that if people believe that they are given treatment (whether by a person or a sugar pill), the effect on the body can be very real indeed.
Fourth-I believe that many of the subtle effects of complementary therapies can simply not be quantified yet -because we lack the tools to measure their effects.
 
And fifth-there is a lot of what so-called “circular science” in research-sadly we tend to only fund projects set out to prove something we already know to be true.
 
Another interesting fact, is whilst people believe that much of clinical medicine is based on solid clinical evidence-only one third of the Royal College of Obstetrician Green top guidelines are actually based on randomised controlled trials, the rest are based on non randomised clinical studies or personal opinions (http://www.ncbi.nlm.nih.gov/pubmed/24922406)
 
Much of the quality of the alternative therapy also lies in the ability, personality and dare I say, energy of the practitioner. We know that intention if extremely important in healing. I once had a massage in a posh place in Cambridge-it was brand new, looked great, heck it even had showers with changing lights in them. But the woman who massaged me was obviously thinking about something else whilst massaging me-I don’t know, maybe she was thinking about what she was going to have for diner. Needless to say, even if technically good, the massage felt crap. It was such a huge disappointment! Such a contrast with the beauty of the space! On the other hand I have had a massage in somebody’s spare room, nothing massively special looks wise, but it was one of the best massage I ever had, because the therapist really put heart and soul into her work. I felt transformed afterwards. Then I also had an experience with someone who was obviously very good as what she did technically, but I just didn’t “click” with her so won’t be going back. You know what I mean?
 
What my work as a doula has taught me is the incredible variety of the human population. In everything there is a continuum, a spectrum. One person’s miracle therapy (and yes that include Western medicine too!), is going to do bugger all for another. And vice versa.
 
This is where a doula’s strength lies-she won’t be coming at you with a readymade recipe of support-she will tailor-made one for you. This is why is it so difficult to explain what a doula does, this is why it is so difficult to quantify why it works (though there is actual evidence that having a doula affects hard clinical outcomes-see the Cochrane database review for this http://www.cochrane.org/CD003766/PREG_continuous-support-for-women-during-childbirth), but this is also the very nature of why it is so special, and why it works. It is designed with YOU and only you, in mind 🙂
 
I think it is healthy to always retain a critical mind. And also to trust one’s instinct. But I think it is also unhealthy to point blank dismiss stuff you haven’t tried for yourself. My challenge to you is: try various therapies and see if they work for you. Many of them you won’t “get” or know if they work for you unless you give them a go.

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