Whenever I have the occasion to discuss with practitioners of alternative medicine the pros and cons of their methods, I hear sooner or later the argument “WE TREAT THE ROOT CAUSES OF DISEASE !!!” This remark emerges regularly regardless of the type of treatment the practitioner uses, and regardless of what disease we might have been talking about.
The statement is regularly pronounced with such deep conviction (and almost audible exclamation marks) that I am inclined to conclude these practitioners fully and wholeheartedly believe it. The implication usually is that, in conventional medicine, we only treat the symptoms of our patients. Quite often, this latter notion is not just gently implied but also forcefully expressed.
I have often wondered where this assumption and the fierce conviction with which it is expressed come from. The answer, I have come to conclude after many years of having such debates, is quite simple: it is being taught over and over again during the practitioners’ training, and it constitutes a central message of most ‘textbooks’ for the aspiring alternative practitioner.
It is not difficult to find the actual origin of all this. The notion that alternative practitioners treat the root causes is clearly based on the practitioners’ understanding of aetiology. If a traditional acupuncturist, for instance, becomes convinced that all disease is the expression of an imbalance of life-forces, and that needling acupuncture points will re-balance these forces thus restoring health, he must automatically assume that he is treating the root causes of any condition. If a chiropractor believes that all diseases are due to ‘subluxations’ of the spine, it must seem logical to him that spinal ‘adjustment’ is synonymous with treating the root cause of whatever complaint his patient is suffering from. If a Bowen therapist is convinced that “the Bowen Technique aims to balance the whole person, not just the symptoms“, he is bound to be equally sure that “practically any problem can potentially be addressed” by this intervention.
Let us assume for a minute that all these practitioners are correct in believing that their interventions are causal treatments, i.e. therapies directed against the cause of a disease. Successful treatment of any root cause can only mean that the therapy in question completely heals the problem at hand. If we abolish the cause of a disease, we would expect the disease to disappear for good.
This, I think, begs a crucial question: ARE THERE ANY DISEASES WHICH ARE REPRODUCIBLY CURED BY AN ALTERNATIVE THERAPY?
I have contemplated it frequently and discussed it often with practitioners but, so far, I have not identified a single one. I have no problem naming diseases which conventional medicine can cure – but, in alternative medicine, I only draw blanks. Even those alternative therapies which might be effective are not causal but symptomatic by nature. Honestly, I have not yet come across a single alternative treatment for which there is compelling evidence proving that it can produce more than symptom-relief.
But, of course, I might be wrong, over-critical, blind, bought by the pharmaeutical industry, dishonest or stupid. So, the purpose of this post is to clarify this issue once and for all. I herewith invite practitioners to name a disease for which there is sound evidence proving that it can be cured by their therapy.
89 Responses to Alternative practitioners treat the root causes of disease !!!
Leave a Reply to edzard Cancel reply
This site uses Akismet to reduce spam. Learn how your comment data is processed.
Mild depression – St John’s wort
yes, i had thought of this one too – but then i rejected it. SJW acts similar to synthetic anti-depressants. to the best of my knowledge, they do not cure depression but bring symptomatic relief.
Depression is an illness classified and identified by it’s symptomology. Nothing more.
If you are to say that either SJW or antidepressants only “bring symptomatic relief” you are effectively saying that they do indeed “cure” the illness.
Let’s not go down the DC route where he becomes so desperate to reject the notion of any alternative or herbal medicine working he decides that all of psychopharmacology is bunk (if not in fact all of psychology).
i think you are not correct: the trials do not show that SJW cures but that it reduces the symptoms of depression.
It was that SJW and ADs were being treated as equivalent that I initially objected to.
There is nothing that treats the “root cause” of depression (or indeed any mental illness) because the “root cause” is unknown.
Thus it makes sense to exclude SJW from your question.
It doesn’t make sense, and may have unintended consequences, to state that SJW and ADs are equivalent.
As it stands SJW has similar effects in MH for mild depression but for more severe depression it’s next to useless and ADs aren’t.
Also SJW has worse relapse rates, more known and unknown interaction effects with other drugs (birth control for one I believe) which mitigate against it having less side effects than ADs (though this could simply be that people underreport side effects of SJW because of their expectations regarding side effects.)
In short depression doesn’t have a medically identifiable root cause. Ergo arguing that something only treats symptomology in depression (or in the majority of MH conditions) is, I feel, rather a poor shortcut to a decent conclusion.
ADs are better than SJW for serious cases of depression. Thus there is a better reason to assume that whatever the root cause of depression is ADs treat it better than SJW (if either treat it at all.)
I agree – and I speak as a long-term user of antidepressants. They “cure” depression in the same way that painkillers “cure” pain, which is to say, not at all, they just make it more bearable.
There again, how many diseases are there which we in conventional medicine can reliably cure %100 of the time? I think primary and secondary syphilis probably hits the spot. A single dose of appropriate antibiotic and the job is done. A ruinous disease has been cured. The treponemal causative agent has been eliminated.
I suppose a chiropractor could treat the other cause by deliberately hurting someone’s back. Which would mean they wouldn’t really fancy a shag..
MARTIN: vulgarity will not help much. but you are right about syphilis – and you forgot hundreds of other infectious diseases. rest assured: the list does not end here.
YET THE CHALLENGE I SET IS NOT TO NAME DISEASES WHICH ARE CURABLE WITH CONVENTIONAL MEDICINE; THE CHALLENGE IS TO NAME SOME THAT ARE CURABLE WITH ANY TYPE OF ALTERNATIVE MEDICINE.
“effective” rarely means that it works in 100% of patients.
A fairly large quantity of a homeopathic preparation (before it’s dripped onto sugar pills) will help with dehydration, surely?
NICE JOKE! but my challenge was not meant as a joke.
Would chronic / persistent phantom limb pain be considered to be a disease ? Treatment for this includes mirror box therapy which has become mainstream medicine but was alternative, it has been researched and can have reproducible effects. My first encounter with this way of working was while training as a practitioner in neuro-linguistic-programming way back before mirror boxes were taken up in pain clinics.
interesting!
i know little about this approach and how well it is proven. assuming it is, it would be a perfect story showing how an alternative becomes mainstream, once it is proven. this would render alternative treatments a contradicition in terms.
I think as highlighted above pain is more of a symptom than a condition, so therefore a cure may not be possible but rather management of a symptom.
Also, the creation and use of the mirror box has been attributed to Vilayanur S. Ramachandran (don’t know if this 100% accurate), who is a respected neuroscientist known for his work in the fields of behavioral neurology and visual psycho-physics.
https://en.wikipedia.org/wiki/Mirror_box
He talks about it in his TED talk: http://www.ted.com/talks/vilayanur_ramachandran_on_your_mind.html
The nature of alternative medicine is that it works quite well in situations where there really are alternatives. There are many alternative treatments for the common cold, because none interferes effectively with the disease process. There used to be many alternatives for pneumonia, but antibiotics put paid to that.
If chiropractic, osteopathy, acupuncture, Chinese herbal medicine etc all help backache (which they sometimes do) it does not mean that the treatments are wrong, but it does mean that their fanciful explanations are rubbish. As soon as a “really good” treatment surfaces, the alternative ones become complementary ones which sometimes continue, because they are pleasant, and sometimes fade away, because they are either horrible or expensive.
Sanatoria were once a good alternative treatment for TB. With the advent of streptomycin, they became complimentary for a while. Eventually they fell out of favour, because they turned out to be expensive state-funded hotels.
When I was at medical school, we learned about a whole range of operations for peptic ulcer. The fact that there were so many gave the clue that these were actually alternative treatments. The discovery of the helicobacter pylori organism has not made these barbaric procedures complimentary, but redundant.
So. My answer to your question is that alternative therapies are useful until something better comes along, but that they cannot get “to the root of the problem” BY DEFINITION. Your challenge cannot be met. The failure is however not in the treatments, some of which are quite helpful, but in the crazy explanations their practitioners amuse us with.
I think a distinction be needs to be made between alternate variations in surgery like your example of the range of operations for peptic ulcer and alt med treatments, many of which seem to have ne effect beyond a placebo.
i do not think that anyone was not making that distinction.
In regards to any CAM healing a disease. What about nutritionist’s curing Type II diabetes through a whole foods plant based diet? Since CAM practitioners generally spend more time with their patients and see them more often, nutritional counseling is more effective than when preformed in a hospital or Family Medicine setting.
for most reasonable physicians, nutrition is not alternative but mainstream – particularly in the realm of diabetes.
It always bugs me when homeopaths talk about treating “the true” cause of the disease rather than just the symptoms. The selection of a specific medley of homeopathic remedies is based solely on the symptoms the patient is presenting, under the assumption that “like cures like”. By the very definition of the practice, homeopaths are operating on the symptoms and nothing else.
No. Of course, from outside it looks like the homeopaths are just treating symptoms. But for the true hoeopath, the reason, the root cause of a person being ill is, that his vital force (is that the proper term in English?) is out of balance. The symptoms just lead the homeopath to select the proper remedy. If successful, this woud restore the vital force’s balance – and thus the root cause is faught successfully when the patient has recovered.
https://en.wikipedia.org/wiki/Vitalism
There are a few alternative terms. “life force” is fine with me. 🙂
someone asked me to define “CURE”: a treatment which causes the end of a disease.
Intelligence. I should know, I had it. Not anymore, thanks to alternative therapy, God bless.
From long experience on Wikipedia and elsewhere I can state with confidence that morgellons and chronic Lyme disease are both curable using alternatives to medicine. They are alternative diseases, after all.
What about mindfulness meditation and mild anxiety?
Research by Sara Lazar suggests it changes activity in areas of the brain that process emotion and the fight or flight response. It also helps prevent rumination and decreases the effects of negative thoughts and has some promising results in the literature.
An issue with this question is that in most cases you wouldn’t expect a ‘cure’ from alternative therapy but you might use it as an adjunct to other treatments (such as combining meditation with exercise and anti-depressants for anxiety). I certainly agree that we shouldn’t be claiming alternative medicines are a cure but I don’t think all people that use alternative medicine are claiming that!
interesting!
show us sound evidence from clinical trials or better from systematic reviews which demonstrates that MM cures anxiety.
to the best of my knowledge, it reduces it but does not necessarily end it for ever.
There has been a fairly recent meta-analytic review on mindfulness meditation by Hoffman et al. (2010) available here;
http://www.corpusmentis.nl/artikelen_projecten_online/artikel_review_mindfulness.PDF
It suggests it’s moderately effective for improving anxiety and mood symptoms.
A smaller study by Miller et al. (1995) also showed good results after 3 year follow up (although only included 18 subjects) – http://www.communicationcache.com/uploads/1/0/8/8/10887248/three-year_follow-up_and_clinical_implications_of_a_mindfulness_meditation-based_stress_reduction_intervention_in_the_treatment_of_anxiety_disorders.pdf
Certainly not a cure but evidence it may help in both short and longer term
the conclusion of the meta-analysis is: “These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.”
trials of MM face formidable methodological problems — in particular, we cannot be sure wether the observed effects are specific ot non-specific in nature.
i agree with you: IT IS CERTAINLY NOT A PROVEN CURE.
Personally, I have never heard the term “subluxation” correlated with the “root cause of disease” spiel before in the way you have done it.
When “root cause” is used, is when patients are taking pain killers and muscle relaxers, that in short, mask the pain but do not address the underlying cause: be it weakness, posture, joint fixation, or repetitive movement. This could be directly treated with exercise, ergonomics or posture training, adjustments, and other stuff.
As for the assumption that a cure is required: It may not be the case. The root cause can be inherently worth treating. Such would be the case with somebody who has a poor diet, does not exercise, needs to quit smoking, has plaque on their teeth, or (I might humbly suggest) has a dysfunctional spine.
Making the jump claiming to “cure” a disease is considered tacky. For example, my dentist tells me flossing my teeth can add six years to my life. Proper dental alignment also improves breathing during sleep and can prevent a lot of disease. His focus, however, isn’t on curing diseases, he just wants to care for my teeth. A chiropractor should (and usually does) have the same approach, but with treating the human frame.
1) personally, i have – many times.
2) i assume you are talking about back pain – this is a symptom, not a disease.
3) poor diet etc. is not a disease either, it may lead to one.
4) my challenge is about treatment and your last point seems to be about prevention.
Thank you for your reply Edzard. You are delightfully succinct:)
1) I find this type of interpretation echoed frequently in non-chiropractic forums, less among chiropractors, but I can’t speak for your experiences.
2) I agree. I think “low back pain” is sometimes called a disease, but prefer to keep it a symptom. You would be correct in assuming that I was referring to the underlying condition such as degenerative joint disease, chronic postural sprain/strain, etc.
3&4) True, and as chiropractors our treatment is commonly for prevention. I was attempting to explain that the subluxation is the idea linking spinal health with whole body health, subtly different from what is portrayed in your article. I don’t think the average modern-day chiropractor would make claims to cure such diseases, since “subluxations” have been all but removed from chiropractic schools. This goes back to point 1) and your experiences.
How about the Epley maneuver for BPPV (vertigo)?
cheers
not alternative (just because some chiros do it, it does not make it alt med) and not of proven efficacy, i’d say.
but if you know more than i do (wich might well eb the case) please show us the link to sound evidence.
I submit that it is well established that the only condition for which there is any evidence that any form of CAM offers relief is Sinum Demandavi Gravis.
so far, nobody seems to have been able to name a single disease that can be cures by alternative medicine. this is amazing, in my view. shall we conclude there is none?
Martin: re 4th March comment. This is a seriously childish and even retarded comment.
I still don’t understand why treatments such as acupuncture and chiro are pitched against conventional medicine. They are stimulative therapies; there is no medicinal additive – which makes it an unfair fight. They’re often employed when conventional care has little to offer suffering patients, and patients do report benefits. I’ve never agreed with the war of words between camps. CAM isn’t for everyone, but then neither is the list of side-effects accompanying conventional medicine. The world is big enough for different schools of thought to co-exist…
David: you seem to propose that different rules apply to different health care professions.
if acupuncturist or chiros claim to be able to treat asthma, for instance, you suggest that is fundamentally different from such a claim made by a doctor for a drug or non-drug treatment. in my view, this is a deeply counter-productive notion.
the double standards you seem to promote are dangerous and serve nobody, certainly not the patient or consumer.
The forms of treatment differ entirely. Compare conventional medicine with homeopathy and Chinese herbal medicine, by all means, with a medicinal remedy administered to target cell types and diseases. Chiro and acupuncture offer contrasting mode. Not all treatments stand shoulder to shoulder, although I understand why you’d have them all tested in the same way. One size does not fit all – in trial or application.
yes they are different!
so what?
if the claim is MY THERAPY IS EFFECTIVE FOR XY, we need proof, not half-digested notions like the ones you seem to be offering.
your arguments are complete rubbish.
Incapable of debate without turning nasty..? I thought you wanted discussion, not a trade of insults.
My naturopath “cured” my friend’s 3 year-old of asthma. The girl had been on steroids for 3 months and my friend was worried about the impact over a life-time. In the naturopath’s judgment, the girl did not have asthma. She had raw bronchial tubes that needed to be healed. My understanding is that the naturopath slowly reduced the conventional treatment and provided naturopath treatment which included probiotics (and possibly other things). After a month, the child no longer had “asthma” or raw bronchial tubes.
In this case, the diagnoses by the conventional practitioner was wrong, which I suspect is common.
But even if the conventional practitioner had determined that the bronchial tubes needed to be healed, I would be surprised if they would have thought to work on gut flora.
There is a huge difference between adding steroid to the body’s chemistry and strengthening gut flora which is supposed to be there. So we also need to distinguish between a drug that has to be taken continually and a substance (whether pharma or neutra) that is temporary and in some cases replenishing a deficiency.
Have you considered possibility of misdiagnosis? Because in my country doctors put the final diagnosis of until about 5 years, when child is able to do proper spirometry.
David
Who do you think it pitching altmed against conventional treatments? It is usually altmed supporters who, at the first sign of any criticism of their favourite altmed treatment immediately engage in tu quoque fallacies, decrying the alleged failings of some conventional treatment or other as if that negated the harm of altmed or improved the evidence of its efficacy.
But as Prof Ernst has said, we don’t need the double standards we currently have where, for example, homeopathic and herbal products are given the false imprimatur of MHRA ‘regulation’ without providing a jot of evidence they are efficacious.
As stated previously, I do not agree with the war of words between conventional and alternative – I don’t even like the term alternative; it undermines the common goal of patient healthcare. Understandably, both sides of the fence will respond to criticism and aggress when challenged. That’s human nature, unfortunately.
David
It is not a war of words: it’s a war of evidence, with altmed promoters trying to inveigle their favourite therapy into the mainstream with anecdotes, cherry-picked or methodologically poor trials, usually bereft of critical thinking skills and knowledge of the scientific process.
David: yes, i want debate.
thus i demonstrated that your argument is rubbish and said so. it is up to you to show that i am wrong. to claim than an argument is rubbish is not an insult; you cannot insult an argument.
No, I do not agree that you have; nor do I agree that your comparisons are valid against all modes of treatment. It’s not up to me to show or prove anything to you – I represent myself and none other. As for evidence, my understanding is that RCTs exist where acupuncture exceeds placebo effect (notably for pain relief). Is that fictitious?
if you do not want to demonstrate that your notions of double standard are correct, so be it –
but do not expect me to say that they are anything else but rubbish.
So, are there any adequately powered and satisfactorily designed RCTs that demonstrate the potency of acupuncture beyond placebo? I suspect your powers of research are far greater than mine. I’ve heard there are such trials; is that fictitious?
there are >1000 trials of acupuncture, and some suggest that it is more than a placebo.
but even the most optimistic results only suggest it to merely reduce symptoms. and that is the point of this post: NO ALTERNATIVE MEDICINE HAS BEEN SHOWN TO CURE ANY DISEASE!
For many patients with chronic disease and recurring symptoms, it is often a case of management rather than cure. If treatments like acupuncture can’t cure but can reduce symptoms, I can live with that. I’ve heard many patients express their gain from treatment with gratitude. There must surely be a place for it…
i do not dispute that!
read the article!!!
alt med practitioners make claims about cures. if these claims are bogus, they are ill-informed, dishonest, not trustworthy…you choose.
I went to see my holistic healer yesterday with a knee pain problem. Instead of treating the symptom, he said he needed to visualise the inner structures of my knee and see if its natural structure was disordered. He needs to be sure what the cause of the pain is, to ensure he uses the right treatment.
Of course my holistic healer is an NHS GP so the visualisation technique will be an MRI scan.
I didn’t tell him that as part of the evil medical industrial complex he is only supposed to treat the symptoms.
Guy – fairly unhelpful post. Although I am sure you felt it was both amusing and informative when you wrote it it is in fact neither.
Firstly – your GP would not have carried out an MRI scan
Secondly – disordered natural structures of the knee (as you’ve called it) is not a disease (see title)
Thirdly – What if the knee disorder was in fact the symptom of an underlying hip or foot problem?
I know that (from reading the gist of the responses on this blog) I will now by met with some ridicule and ad hominem style reproach.
why should anyone take offence to this comment? the points are not wrong – they just might miss the fact that guy wanted to instill some humor into the alt med debate; not an easy thing to achieve, particularly faced with comments like yours. [is this ad hominem? i don’t think so]
By ridiculing and misrepresenting the argument of someone else’s stand point in a debate is perhaps not the best way to introduce humour. Plus he wasn’t faced with comments like mine as mine was added after his.
I have been an avid reader of your blogs and subsequent posts and have always enjoyed the exchange between the contributors even if they are a little icy at times.
I look forward to reading more humorous posts in the future and may even add some humour of my own.
What about Transcendental Meditation and anything related to stress?
TM is described as being designed to take advantage of the normal tendency of the mind to settle down when the eyes are closed in order to facilitate the attainment of the deepest possible rest by undoing the effects of experiences that give rise to in appropriate spontaneous mental activity (a lose summary of the definition of “yoga” from the Yoga sutras). See http://www.psychosomaticmedicine.org/content/44/2/133.full.pdf for physiological research of this state.
In its most recent scientific statement published in Hypertension, the American Heart Association reported that TM, unlike all other meditation and relaxation techniques, had sufficient evidence to say: “The overall evidence supports that TM modestly lowers BP.” -page 6 of the online version.
http://hyper.ahajournals.org/content/early/2013/04/22/HYP.0b013e318293645f.full.pdf
BTW, to settle a bet, if you were to edit the chapter on “Complementary and Alternative Approaches to Management of Patients with Heart Disease” in _BRAUNWALD’S HEART DISEASE_ today, would you cite the 9-year-old “Canter PH, Ernst E: Insufficient evidence to conclude whether or not Transcendental Meditation decreases blood pressure: Results of a systematic review of randomized clinical trials. J Hypertens 22:2049, 2004” or the 2 week old Scientific Statement of the American Heart Association just published in Hypertension? 😉
i think i would take some time, assess the evidence, evaluate both statements and then decide.
I only had time to read the abstract: “modest, mixed, or no consistent evidence” is not a billion miles away from what I wrote in ‘Braunwald’,in my humble opinion.
There’s what the summary and clinical recommendations section on meditation says:
Summary and Clinical Recommendations
The overall evidence supports that TM modestly lowers BP. It is not certain whether it is truly superior to other medita- tion techniques in terms of BP lowering because there are few head-to-head studies. As a result of the paucity of data, we are unable to recommend a specific method of practice when TM is used for the treatment of high BP. However, TM (or medi-tation techniques in general) does not appear to pose significant health risks.32 Additional and higher-quality studies are required to provide conclusions on the BP-lowering efficacy of meditation forms other than TM.
The writing group conferred to TM a Class IIB, Level of Evidence B recommendation in regard to BP-lowering effi- cacy. TM may be considered in clinical practice to lower BP. Because of many negative studies or mixed results and a pau- city of available trials, all other meditation techniques (includ- ing MBSR) received a Class III, no benefit, Level of Evidence C recommendation Thus, other meditation techniques are not recommended in clinical practice to lower BP at this time.
I’ve been in touch with Robert Brook, the lead author of the story since there is an apparent ambiguity between that and the Conclusions section:
Conclusions
Numerous alternative approaches for lowering BP have been evaluated during the past few decades. The strongest evidence supports the effectiveness of using aerobic and/or dynamic resistance exercise for the adjuvant treatment of high BP. Biofeedback techniques, isometric handgrip, and device- guided breathing methods are also likely effective treatments. There is insufficient or inconclusive evidence at the present time to recommend the use of the other techniques reviewed in this scientific statement for the purposes of treating overt hypertension or prehypertension.
Wikipedia editors have claimed that the Conclusions section trumps the Summary and Clinical Recommendations section, but after asking, I inserted this into the talk section of the wikipedia page:
I just had a conversation with the lead author of the AHA statement, Robert D Brooks concerning this issue. While he emphasizes that the following is only his personal opinion and that any formal statement would have to come in response to something in the Letters to the Editor, he said to me:
” I would ask that you simply say that in discussion with me we confirm that the LOE is B and COR is IIB, the lack of mention in the conclusions does not change this conclusion.” -(personal communication with Robert D Brooks, lead author of the AHA scientific statement on alternate treatments for hypertension)
What formal response to a Letter to the Editor would be required to note that the brief conclusion section of the AHA scientific statement is not meant to trump or contradict or otherwise be taken to be more important than anything said in any of the Summary and Clinical Recommendations sections?Sparaig2 (talk) 21:06, 7 May 2013 (UTC)
Other than the spelling of his name (Brook, not Brooks), he had no problem with what I said.
So…
The most important part is not the abstract or the conclusions but what each Summary and Clinical Recommendations section says, which, in this case, is that:
The overall evidence supports that TM modestly lowers BP.
and:
Thus, other meditation techniques are not recommended in clinical practice to lower BP at this time.
That section also calls for more and better research all around, especially “head-to-head” studies on the effects of TM and other forms of meditation. I’m certainly in favor of that as are all the TM researchers I know.
By the way, I mentioned hypertension as an example of where TM is an effective treatment only because the evidence is sufficiently strong to get a passing grade from the AHA. TM only effect, according to the yogic tradition, is that it allows the mind to settle down, countering the “fluctuations” that spontaneously arise in the present due to past experience.
While many/most people who suffer from hypertension have some stress-related component(s) associated with this condition, they are, I would expect, often very minimal, and TM’s effects on hypertension are correspondingly minimal.
Where TM should have the most obvious effect is in situations where there is a great deal of stress.
TM taught in a school in a low-stress neighborhood to high-income students should have a minimal effect on grade scores and other measures of cognitive ability, and likewise it should have a minimal effect on behavioral issues.
On the other hand, TM taught in schools in high-stress neighborhoods to low-income children should have an extremely positive effect on grade scores, fights etc., and in fact, at the Vistitacion Valley Middle School, the transformation of the school was so remarkable after TM was introduced that the principal was given a national award as “middle school principle of the year.” He credits TM with allowing all the other programs he introduced to actually have an effect on the students as they were calm enough to actually accomplish something.
The situation where TM should have the MOST positive effects are in situations where psychological stress are the only real cause of the problem in the first place. The three preliminary/pilot studies on TM have been uniformly very positive, with patients showing 50% reduction in symptoms within a few months.
In fact, the latest study, on civilian refugees from the Congo, shows the most dramatic effect of all, as you might expect since they don’t have ongoing stress from guilt issues as combatants might: 50% reduction within a month of TM, and asymptomatic thereafter.
There are far fewer studies on TM’s effects in this area, but both the Veteran’s Administration and the Department of Defense are spending many millions of dollars currently, studying various forms of meditation and how they effect/prevent PTSD. Within a few years, the US military may well embrace these practices as an official part of military training, and in fact pilot projects in mindfulness training already exist in the Marine Corps. My own expectation, as a TM true believer, is that eventually TM will become a standard practice for all military members as the research on TM and stress tends to be more consistently positive than it is for mindfulness techniques. The scientific evidence will guide the final policy on the matter in the military, of course.
Regardless, I think you will find that long-term studies on TM, etc., and their effects on stress will convince you that al least some alternate therapies are as effective as proponents believe they are.
much more wishful thinking than evidence, as far as i can detect!
No doubt. Getting people together to perform head-to-head studies on the effect of various meditation practices on a variety of situations appears to be very difficult.
There’s only one head-to-head study I know of on mindfulness vs TM vs Relaxation Response, and that was published nearly 25 years ago. Each form of meditation studied had its own advocate involved in the design of the study and each teaching procedure was designed to attempt to normalize expectations for the various techniques being studied:
http://www.ncbi.nlm.nih.gov/pubmed/?term=langer+alexander+meditation
That this is the only such study I am aware of speaks volumes I think.
(for some reason there’s less emotional attachment to “progressive muscle relaxation” than to mindfulness or TM so that is often used instead of another “meditation” as the alternate therapy)
conductiong clinical trials is difficult in most areas. this, however, is no reason to allow claims which are not supported by sound evidence.
Call it a prediction, rather than a claim…
Specifically, the pattern found in http://www.ncbi.nlm.nih.gov/pubmed/?term=langer+alexander+meditation
will tend to show up in any new head-to-head studies on TM vs mindfulness vs Relaxation Response:
On matters that are primarily related to stress, TM will come in first. On cognitive abilities that the mindfulness practices address directly, mindfulness will come in first. On every parameter, the Relaxation Response and no-treatment will tend to be a distant third.
as Mark Twain said: predictions are difficult, particularly about the future.
Sigh. Please insert “PTSD” as appropriate in the previous post where it makes sense. Non-reviewable blog editors are a pain.
Out of interest, what are the risk factors that have been identified when using TM, and other forms of meditation, for treating PTSD?
There is a general concern that any relaxation technique can “stir up” old memories and cause anxiety, which is called “Relaxation Induced Anxiety” in a few places I have seen and there’s a more extreme term mentioned in the DSM-IV called “Kundalini Syndrome” which can get pretty dangerous for the practitioner.
Any formal school of meditation likely teaches their students strategies for handling/minimizing these issues.
One issue that is more common with meditation research, as Dr Ernst has pointed out, is that meditation researchers are often meditation advocates as well, so unexpected side-effects might tend to go unnoticed or at least un-noted because it doesn’t fit with the pre-conceived notions about meditation that the researcher has. This is normal experimenter bias with an extra twist: most researchers don’t view their research subject as spiritual but I would venture to say that most meditation researchers do, at some level.
The solution for this is, of course, more and better research, performed by researchers without an emotional interest in the topic they are researching. Unfortunately, up until recently, there hasn’t been enough interest to attract non-biased researchers.
With the advent of large grants for the study of PTSD, and this recent quasi-endorsement by the AHA, that situation is starting to change, I believe.
Thanks very much for your interesting and detailed reply. You’ve enabled me to find a research paper containing some information I’d been seeking for ages. Oddly enough, I found what I was looking for in the method rather than the results.
hmmm…
For some reason, I thought the DSM-IV used the term “Kundalini Syndrome,” but apparently they use “Religious or Spiritual Problem” instead. http://en.wikipedia.org/wiki/Kundalini_syndrome#DSM-IV:_Related_categories
1 Timothy 6:10 – so yes, in a way, they kind of do.
Not really.
An elementary illness is an illness with a single cause, and is cured when that cause is addressed. A compound illness is an illness made up of two or more elementary illnesses, with two or more causes. A compound illness is only cured when all of the causes are addressed.
The concept of ‘root cause’ is a bit of a red herring. Many elementary illnesses have causal chains, which can be found by asking “what is the cause of this cause”. Any treatment that successfully breaks the chain can cure the illness. A person who has scurvy because they are not consuming sufficient Vitamin C might find their illness cured by marriage, or by getting a job, such that they can afford decent food, or by getting out of a job or situation that restricts their diet, or by being put into a senior care home, where healthy meals are provided. On the other hand, they will not be cured by a ‘medicine’ of Vitamin C tablets, they will simply convert the illness into a chronic illness, supported by chronic medicines.
There are many illnesses that can be cured, but not by medicines: http://healthicine.org/wordpress/diseases-cured-medicines/
Many illnesses are physical, mental, spirit, or community blockages. A physical blockage can be cured by a chiropractor, or even a massage therapists – but these are not recognized as cures by our medical system, which thinks only medicines can cure.
Cure is not defined for most diseases. If you cure someone’s diabetes, or arthritis, or obesity – or even scurvy, it can’t be proven, because cure is not defined for any disease not caused by a parasite – except a few cured by surgery. This is not due to the disease, it is due to the poverty of medical thought, of medical science.
Cure is not defined in many medical reference books. The word cure is disappearing from medicine, because it serves medical manufacturers to avoid cures.
http://healthicine.org/wordpress/disappearance-cure/
to your health, tracy
@Tracy
Where to start with so much nonsense?! “A person who has scurvy because they are not consuming sufficient Vitamin C …will not be cured by a ‘medicine’ of Vitamin C tablets, they will simply convert the illness into a chronic illness, supported by chronic medicines.” Do you seriously imagine a physician confronted with a patient suffering from scurvy is merely going to prescribe vitamin C tablets and do nothing about the patient’s diet?! This is ignorant flapdoodle, and a total caricature of modern medicine.
“There are many illnesses that can be cured, but not by medicines.” Of course, what’s new? Many illnesses are most appropriately cured by surgery (which you admit, grudgingly, in your diatribe), others are managed by psychotherapy, physiotherapy, lifestyle advice, or other, nonpharmaceutical intervention. For Pete’s sake, the most common forms of injury — small wounds — are treated with elastoplast, bandages or, at most, sutures. The only ‘medicines’ used in such cases are antispetics. I’m seriously fed up with all the people who come on this blog to state as a fact that real doctors merely dole out pills to be taken for ever until the patient dies of the medicines’ side effects. And I’m neither a physician nor a surgeon, so I don’t have a partisan axe to grind. Such utter stupidity flies in the face of everyday experience.
“Many illnesses are physical, mental, spirit, or community blockages. A physical blockage can be cured by a chiropractor..” What the f*** is “a blockage” in a medical sense?! Do you have even an aphid’s fart of an idea of the extent of current knowledge of disease causation? You appear not to know even as far as biology 101. It seems to me you have a serious blockage somewhere between your brain and your typing fingers. And it looks like it’s going to take more than elbow grease and a toilet brush to shift.
“Cure is not defined in many medical reference books. The word cure is disappearing from medicine, because it serves medical manufacturers to avoid cures.” Fortunately, the words “unbelievably” and “idiotic” still appear in dictionaries, and are highly applicable to this comment.
@Frank it’s wonderful that you’ve had such a great experience with modern conventional medicine, but I have to question whether this is the standard ‘everyday experience’. I’m not sure where you live, but in the UK, despite all the best efforts of the good hard-working people in the NHS, many are left dissatisfied with their experiences. My patients regularly complain of being fed up with being fobbed off with medications that make their situation worse, which is one reason they end up looking for alternatives. I’m not suggesting for a minute that this is the case for everyone, or even the majority, but certainly a significant number. People who test low for vitamin D, for example, and in my experience given supplemental vitamin D without dietary advice. People with acid reflux are often given PPIs, without advice on the nutrient deficiency that can result from long-term use. There are many other common examples.
So overworked doctors’ deficiencies is ameliorated by going to an acupuncturist and playing pin-cushion??
If the workload is creating deficiencies that require amelioration, the doctor should not be seeing patients. The physician should perform all diagnostic, therapeutic and preventive procedures with due exactitude and devoting the necessary time. The health of the patient is the first consideration.
@Bjorn
‘So overworked doctors’ deficiencies is ameliorated by going to an acupuncturist and playing pin-cushion??’
The job of an acupuncturist is not just to ‘play pin-cushion’, it is to look at a patient’s life through the lense of Chinese medicine and make appropriate suggestions about diet, lifestyle etc. In fact, it is spelled out very clearly in the Neijing that leading a balanced life is fundamental to health, and the cornerstone of any therapist’s job. This truth, I believe, has been largely forgotten in conventional healthcare. Well-informed CAM practitioners are in a position to give these aspects proper attention and sometimes change the course of people’s lives without the need for potentially dangerous medication.
If “jm” had addressed the questtion, its comment had perhaps contributed to the discussion.
@Tom.
Then what is the purpose of the tongue-scrutiny, the pulse-palpation and the pin-pricking?
I have to say that you are mistaken in your assumption that modern medicine forgets/omits/neglects lifestyle and diet. It certainly does not in general. Of course you can always find the rotten apples but the reality is different. Further, there has lately been a very strong upsurge in this interest among physicians. That medicines have side effects is unavoidable. The only way they cannot have them is by not having any effects at all. What all good doctors learn in school and by experience and continued education is to balance the pros and cons and monitor when called for. I for example am able to work in my profession thanks to a medicine that certainly can have side effects but they are under control, monitored and acceptable.
Even if you see customers, who utter their dissatisfaction with modern medicine there are several factors at play that have nothing to do with failure of medical science and technology but instead its facilities and resources for performing adequately. That is another question altogether.
One is , as I said, overload and lack of time. Another is the fact that many problems of modern people are existential rather than medical and cannot be ameliorated with neither pills nor pins. What they need most is coaching and help with coping. In that respect modern health care systems are not up to par. On that we can surely agree.
This thread has the heading “Alternative practitioners treat the root causes of disease !!!”
If alt-practitioners kept to soothing and coaching their customers and giving them good advice like go easy on the booze, exercise and eat healthier and helped them fulfill those requirements, then we could agree that alt-practitioners were treating the root causes of the problems of many a modern man in need.
BUT…
The salient question and what is the central purpose of this blog and this discussion is the “switch” part of alt-practitioners’ “Bait and switch” scheme. I am being frank and honest here. Acupuncture/TCM is a typical “Bait and switch” racket based on false pretenses.
The customers are baited by elaborating on the shortcomings of the HC-system, promises of “cure” and giving them a soothing, relaxed cozy time and talking about simple and self-evident life style factors. Then comes the “switch” They are told by the alt-practitioner that he/she has something modern medicine cannot give, a ridiculously old magical medicine that is even described in ancient books and administered by looking at the tongue, feeling the pulse and diagnosing foreign, mystical features like heat or cold, Yin or Yang, Qi and all that jazz… And the remedy is sticking thin needles (which were not technically possible to manufacture some hundreds of years ago) into the flesh to “balance” all that fantastic jargon and thereby correcting something that no one has been able to define or detect.
And on top of that, the alt-practitioners live in a self-fulfilling fantasy, counting their positive reviews but forgetting to count the one’s who did not improve, like the lady who cut my hair the other day and described three terrifying sessions of acupuncture for tennis-elbow that only got better by exercise and massage and time, like mine have.
(I sometimes claim that I am living proof that all kinds of ailments get better by avoiding acupuncture 😀 )
Now, which is it that is working? The tender loving care and good advice as long as it lasts, or the archaic sympathetic magic based on prescientific imaginary “elements” and bodily structures that no one can find – and a therapy modality that involves practically arbitrary injurious interventions that involve a risk of serious consequences like in the recent case of a Norwegian succumbing to sepsis after the palm of his hand was used as pin cushion?
Why not skip the make-believe and stick[sic] to evidence based lifestyle coaching and TLC?
@Tom
“My patients regularly complain of being fed up with being fobbed off with medications that make their situation worse, which is one reason they end up looking for alternatives.” That’s like saying that funeral directors deal mainly with grieving people who’ve lost a relative: your practice is selective for the type of people who attend, not representative of the general public.
Vitamin D deficiency is one example where supplements of the vitamin are the best remedy. It’s available only in a few foods. What’s needed to correct vitamin D deficits is lots of exposure to sunlight. I’m sure very few GPs don’t realize that, but in the UK climate, and with mainly elderly patients showing the problem, there’s really not a lot to be gained by advising sunbathing. (In any case, exposure of skin to sun increases the risk of malignant melanoma: there’s nothing straightforward in this world!)
The risk of long-term use of PPIs causing B12 and other deficiencies is very low. I couldn’t find the problem listed on the omeprazole package insert, and on the lansoprazole package insert the problem is listed along with literally scores of other adverse experiences possibly attributable to the PPI in fewer than 1% of people who take the drug. Prescribers of PPIs are obliged to reassess their patients annually. They should be alert to problems associated with long-term use. Of course, no doctor is perfect; we know and expect that, but this is really not rocket science.
Perhaps it’s considered OK to insult people without checking the facts? Here are the facts. Feel free to check them if you don’t believe me.
Of the three major reference books that recommend ‘treatments’ for scurvy:
MERCK’s Manual of Diagnosis and Therapy, Harrison’s Principles of Internal Medicine, and Lange’s Current Medical Diagnosis and Treatment, all three have as their first recommendations: supplemental Vitamin C, although they do not agree on the does. Only MERCK recommends a change in diet, and the change recommended is twice the RDA, without
specific time frame.
Not one of the three uses the word ‘cure’. I have images of the pages if you like, as proof.
None of those three reference books contains a definition of the word ‘cure’ and none uses the word cure in any logical, consistent fashion. The DSM 5 also does not define the word ‘cure’ and as near as I can determine – does not contain the word cure at all.
Cure, cures, cured, and incurable are not defined in the following medical dictionaries – please check if you don’t believe me: Webster’s, for example, jumps from ‘culture’ to ‘curettage’, without reference to ‘cure’.
– The Oxford Concise Medical Dictionary, Ninth Edition, 2015.
– The Bantam Medical Dictionary, Sixth Edition, 2009
– Webster’s New World Medical Dictionary, Third Edition
Cure does not appear in Barron’s Dictionary of Medical Terms, Sixth Edition, 2013, although ‘incurable’ does appear, and uses the word ‘cure’ to define incurable if I remember correctly.
– Medical Terminology for Dummies, Second Edition, does not contain the word “cure”.
To be honest, when I first noticed this, in the treatment references, I was surprised. I was astonished when I looked for ‘cure’ in Webster’s New World Medical Dictionary Third Edition, and found there was no entry. Since then, I have found many medical reference books that do not contain the word cure – most recently, while in Australia, I found a Nurse’s Dictionary that does not contain the word cure.
Cure is simply not medically or scientifically defined for any disease not caused by a parasite, or cured by surgery. There are, as far as I am aware, no official medical tests for cured for any disease not caused by a parasite. If there are, I’d love to know about them.
to your health, tracy
Does the fact that a well known, ubiquitous term is thoroughly defined and explained in all major general dictionaries, has been omitted as superfluous in several specialised dictionaries, indicate a problem? No it does not. Your obsessive scrutiny of this serves no purpose.
I asked my Mac to look the term up and it immediately came up with several very thorough and detailed dictionary and encyclopedia articles. and in addition an elaborate Wikipedia piece.
Your obsessive rant about this trivial matter is totally pointless.
You obviously want to be appreciated as a health guru but you do not exhibit even the most basic knowledge of the subject. You will sadly be offended by our upright appraisal of your production but here we do not beat about the bush when it comes to people pretending falsely to be able to inform about or practice health care.
This is noting personal, We are just stating verifiable facts. If you do not understand or appreciate our honesty and are offended by it, then so be it. But please understand it is not animosity, only upright appraisal of your actions.
Tracy Kolenchuk
“Modern or Science based Medicine” (science= Physics & Chemistry) dispensed with the word “Cure” long back and moved to managing diseases.
So every disease is managed with drugs, which in turn with their adverse effects create new medical conditions in turn requiring another set of drugs.
A cured patient is bad for business.
@Tracy
You can’t cure scurvy. You can cure the symptoms, but they return if you don’t sustain vitamin C levels.
“…all three have as their first recommendations: supplemental Vitamin C, although they do not agree on the does. Only MERCK recommends a change in diet, and the change recommended is twice the RDA, without specific time frame.”
Scurvy is an exceptionally rare condition (these days). When the symptoms do present, the immediately important measure is to restore vitamin C beyond normal levels so the symptoms disappear as swiftly as possible. That’s best done with supplemental vitamin C, which should be administered at least until disappearance of the symptoms. That’s why your sources cite that as the treatment.
Only a total numpty among medics would not think to advise a patient to remedy their diet when a vitamin deficiency disease has been diagnosed. (The possible exception is vitamin D deficiency, where the patient needs exposure to the sun as well as supplemental vitamin D.) In picking on vitamin C as an example, you’re digging yourself a substantial hole because, of course, many altmed practitioners recommend taking massive overdoses of vitamin C supplements as a prevention or cure for both common colds and cancer. So if you support pseudo-medicine as opposed to real medicine, you ought to be on the side of vitamin C supplementation!
If you post stupid nonsense, you must be prepared to be insulted. You rant about the word ‘cure’ is further stupid nonsense. You reckon cure is not defined medically or scientifically for any disease not caused by a parasite. I don’t know if you’re using the word ‘parasite’ in its general or specific (microbiological) sense, but if you eliminate the Plasmodium parasite from someone’s body and thus relieve the primary symptoms, they may still suffer consequences, sometimes for life if the infection involved the brain. If you eliminate Mycobacterium tuberculosis from someone’s lungs the cavities remain. It’s a rare condition — including infections — that doesn’t leave some sequelae.
That’s why ‘cure’ can have only a fuzzy definition. Look in the English dictionaries: some define the word as symptom relief, others as (something like) total disease reversal. But the latter seldom happens in people suffering from the chronic, ultimately terminal, sexually transmitted disease we call ‘life’.
I had a look over some of the commenter Tracy Kolenchuk’s web. It is really a sad and absurd reading. He seems to have an extraordinary imagination with which he is building his own home made “air-castles” about health and diseases that have little or no relation to any medical or biological reality whatsoever. He very evidently has no working knowledge of these subjects.
I hope he does not put these abnormal fantasies into practice and hurt someone.
I see in some comments on his web that the infamous health fraud Joe Mercola has advertised it. That is sadly no surprise.