MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

This blog is almost entirely about critical thinking as it applies to the realm of alternative medicine, and I have written about it more often than I care to remember. For instance, in one post I concluded that criticism  in alternative medicine is directed almost exclusively towards those who are outside the realm. Criticism from the inside is as good as non-existent.

The consequences of this situation are easy to see for everyone, and they can be dramatic:

  • The journals of alternative medicine publish nothing that could be perceived to be negative for the practice of alternative medicine.
  • Self-critical thinking has no tradition and has remained an almost alien concept.
  • The very few people from the ‘inside’ who dare to criticise alternative practices are ousted and/or declared to be incompetent or worse.
  • No action is taken to initiate change.
  • The assumptions of alternative medicine remain unaltered for centuries.
  • Progress is all but absent.

But what exactly is critical thinking? The ‘Foundation of Critical Thinking‘ defines it as follows: Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness.

In an article in the Scientific American Heather butler recently provided further clarification. Here is a short extract from this most commendable paper:

START OF QUOTE

Though often confused with intelligence, critical thinking is not intelligence. Critical thinking is a collection of cognitive skills that allow us to think rationally in a goal-orientated fashion, and a disposition to use those skills when appropriate. Critical thinkers are amiable skeptics. They are flexible thinkers who require evidence to support their beliefs and recognize fallacious attempts to persuade them. Critical thinking means overcoming all sorts of cognitive biases (e.g., hindsight bias, confirmation bias).

Critical thinking predicts a wide range of life events. In a series of studies, conducted in the U.S. and abroad, my colleagues and I have found that critical thinkers experience fewer bad things in life. We asked people to complete an inventory of life events and take a critical thinking assessment (the Halpern Critical Thinking Assessment). The critical thinking assessment measures five components of critical thinking skills including verbal reasoning, argument analysis, hypothesis testing, probability and uncertainty, decision-making, and problem-solving. The inventory of negative life events captures different domains of life such as academic (e.g., I forgot about an exam), health (e.g., I contracted a sexually transmitted infection because I did not wear a condom), legal (e.g., I was arrested for driving under the influence), interpersonal (e.g., I cheated on my romantic partner who I had been with for over a year), financial (e.g., I have over $5,000 of credit card debt), etc. Repeatedly, we found that critical thinkers experience fewer negative life events. This is an important finding because there is plenty of evidence that critical thinking can be taught and improved.

Is it better to be a critical thinker or to be intelligent? My latest research pitted critical thinking and intelligence against each other to see which was associated with fewer negative life events. People who were strong on either intelligence or critical thinking experienced fewer negative events, but critical thinkers did better.

Intelligence and improving intelligence are hot topics that receive a lot of attention. It is time for critical thinking to receive a little more of that attention. Keith Stanovich wrote an entire book about What Intelligence Tests Miss. Reasoning and rationality more closely resemble what we mean when we say a person is smart than spatial skills and math ability. Furthermore, improving intelligence is difficult. Intelligence is largely determined by genetics. Critical thinking, though, can improve with training and the benefits have been shown to persist over time. Anyone can improve their critical thinking skills: Doing so, we can say with certainty, is a smart thing to do.

END OF QUOTE

We cannot learn to be intelligent, but we can learn how to think critically. If my blog helps some readers to achieve this aim, I would consider the effort worthwhile.

38 Responses to Critical thinking is good for you – please give it a try!

  • Surely though, ‘critical thinking’ and ‘intelligence’ overlap so greatly that it’s difficult or impossible- or even unnecessary- to disentangle them.
    Thatcher gained two degrees- Law and Chemistry- both of which seemed to me to be be rather difficult, especially the latter, but maybe that’s a personal thing. But to me she was vindictive and abusive, as is the qualified airline pilot Norman Tebbit. Clever, but to me not intelligent.
    The late Logos Bios regularly used to disparage those of a non- scientific or non- medical background such as myself, arguing that they were not qualified to hold an opinion on anything they hadn’ studied ( leading inevitably to the ludicrous claim that no one who hadn’t studied homeopathy for years had a right to object.
    But any argument is going to be won partly by winning over at least part of the middle ground, not preaching to the converted.
    What people like Logos Bios could not, or, worse, would not, understand is that facts are one thing (and lies), but logical and reasoned argument are at least AS important. It’s the difference between knowledge and wisdom.
    To my shame, I’d never even heard the phrase ‘critical thinking’ until I encountered this blog a few years ago. Although, without being too ‘ad hominem’ about it, I do think the style v. content T rubric is often useful here.
    As I’ve said before, it’similar to the argument about what people call ‘pornography’, in that in many ways the argument is only tangentially about what it seems ( in this case, whatever one’particular views, it’s aboutprudishness, linguistic , definition, repression, censorship, patronisation, feminism/ femininity, masculinity etc).

  • Perfect commentary and summation on this pivotal point.
    Perhaps “alternative-medicine” practitioners should be called “alternative-logic” practitioners?
    Of course they would re-name themselves “complementary-logic” practitioners….as they don’t understand illogic is the antithesis of logic not simply a viable alternative.

    • i tried to express this once:
      edzardernst.com/2015/11/alternative-logic-in-alternative-medicine-popular-fallacious-and-dangerously-wrong/

  • I would love to give it a try, but try to find a website that will evaluate you. Hundreds ABOUT critical thinking, some for children that are not free. I could not find a single free test.

  • CT involves intellectual discipline certainly, and it is an aquired set of skills. Once aquired it becomes second nature to apply them.

    Other ways of thinking can be contrasted with CT.

    One highly significant other way is WT – wishful thinking.

    A devout desire for something to be true easily morphs into imaginary reasons for believing that something is true, without a well-honed critical thinking skill-set to bring to bear on the question of whether the desired something is true.

    MT – magical thinking or superstition is another mode of illusionary thinking.
    https://www.scientificamerican.com/article/superstitions-can-make-you/

    Placebos provide opportunities for these two modes of thinking.

    • Excellent point, Leigh. I’m nicking that for future use.

      • The classic case of misleading placebo comparison is, of course A+B v A comparisons where A is standard care and B is a placebo. Tailor made for WT/MT to provide spurious results.

        • The vaccine industry has mastered this approach. Rather than using a true placebo in a vaccine trial, they use another presumed safe vaccine as the “placebo”, which isnt. No surprise when the new vax passes the test with equal results to the old vax.

  • I recommend that the proponents of EBM (Evidently Baseless Medicine) take up critical thinking also.

    1 &3. Any serious criticism that rocks the boat of EBM is crushed. Take Dr Thompson of the CDC on the MMR vaccine science fraud that he admitted that he and his colleagues participated in. Or take Dr Wakefields being pilloried for making the mild suggestion in his study that the MMR vaccine requires more study for possible bowel effects.

    2 & 4 After 100 years there is finally some consideration of alternatives to the cancer industry’s approach of cut, burn and poison. Meanwhile millions have suffered and died under this orthodox hegemony. Any doctor attempting anything outside of this “Standard of Medical (un-)Care” could lose their license no matter how benign the treatment. Same could be said of most other branches of medicine. They dont even consider alternatives to drugs and surgery. Thats why we have an Alternative Medical industry in the first place. Its all the people who prefer to think outside the straight jacket!

    3. The third point is actually is one of the good points of homeopathy (which I assume he is referring to) vs conventional med (CM). Classical homeopathy has certain fixed principles that practitioners strive to follow. CM just runs on fads since they have no valid definition of disease or cure. Oh, today we are giving VIOXX. Oops not a good idea. Oh, today we are doing radical mastectomies. Oops not a good idea. Oh, today we are giving Hormone Replacement Therapy. Oops not a good idea. Oh, today we are giving Thalidomide or DES. Oops not so good for the next generation. And on, and on, and on. We are all guinea pigs in this uncontrolled experiment called EBM.

    I dont see much critical thinking in CM when it comes to its basic (lack of) principles.

    • “Evidently Baseless Medicine”
      you are priceless in your display of BS!
      THANKS

      • What is the base of Evidently Baseless Medicine (EBM)? It seems to be, do whatever seems expedient to get rid of the symptom or few symptoms that you are focused on at the moment, regardless of side effects or long term consequences. That is a structure built on quicksand.

    • Oh, today we are giving Thalidomide or DES. Oops not so good

      I have treated many prostate cancer patients successfully with DES and I have taken thalidomide myself, which is the standard first-line treatment for myeloma.

      Dr Wakefields being pilloried for making the mild suggestion in his study that the MMR vaccine requires more study for possible bowel effects.

      Andrew Wakefield main crimes were fraud and performing proceedures on children without consent in the course of his clinical trials.

      Classical homeopathy has certain fixed principles that practitioners strive to follow. CM just runs on fads

      Fixed principles = dogma
      Fads = changing practice in line with new evidence

      they have no valid definition of disease or cure

      I have no idea what you are intending to say here. Homeopathic remedies are based on constellations of symptoms with no attempt to understand physiology or pathology.

      • https://www.washingtonpost.com/news/theworldpost/wp/2018/10/17/pharmaceutical/

        “It is clear that the pharmaceutical business model is one that pursues profits rather than public health objectives. In making forecasts for the biotech and pharmaceutical sector, Goldman Sachs analysts even asked, “Is curing patients a sustainable business model?” Profit-making has become so entrenched in the drug industry that it requires a fundamental transformation — one that compels it to deliver public value and spark genuine market-invigorating innovation. We can do this only if we begin to focus on what really matters: putting patients over profits. As the opioid crisis shows, breakdowns in this system can quickly become a national security issue. Let’s treat matters of health as such. “

      • Ok, lets substitute Vioxx or any number of drugs for DES & Thalidomide, if you like those. But many were injured by DES & Thalidomide before those fads were stopped. The fixed principle of “like cures like” (LCL), call it dogma if you like but it is a principle that is eternal; as effective today as it was 200 years ago – try it yourself! Whereas DES to prevent miscarriage and Thalidomide for morning sickness are in the dustbin of history as so many other ad hoc allopathic therepeutics are, or soon will be, like chlolesterol-lowering drugs for heart disease. Conventional doctors are unwilling to try out or even acknowledge LCL even when they use it accidentally, which is a mystery to me. The homeopathic definition of disease is all the signs & symptoms that anyone experiences at one time, which is rational. The allopathic definition of a disease is whatever a doctor can get his colleagues to agree to – totally irrational.

        • Roger

          Like Cures Like is a notion that Mad Sam pulled out of his arse 200 yers ago. It is utterly unsupported by science or evidence. I repeat, as ever, there is NO worthwhile evidence that like cures like.

          The homeopathic definition of disease revolves around miasm and psora. Utter nonsense which Sam similarly pulled out of his arse. If you want to claim that homeopathy has moved on from these outdated notions, I’ll find you plenty of homeopaths who’ll tell you that you’re wrong. Isn’t Mad Sam supposed to be infallible?

          Imaginary absurdity piled upon imaginary absurdity, Roger. You believe in it because you believe what your eyes see and not what the science tells you.

          Homeopathy is flat-Earth medicine.

          • You dont have to believe LCL. Experience it for yourself. Sitting on your arse and just intellectualizing, you are not going to be able to pull anything out of it or anywhere else. You also have zero understanding of miasm. Miasm is his archaic word for the concept of epigenetics which he pioneered 200 years ago. Allopathic medicine is 150 years of barbarism tarted up to look modern.

          • Tell me, Roger. One example of Like Cures Like. Not a homeopathic remedy.

            Just one.

            And miasms are the same as epigenetics? Utter toss. Beyond stupid. Run away, Roger. You’re just making a fool of yourself on a public forum.

          • I will give you several. Cancer is sometimes cured allopathically long term using radiation treatment. Radiation of course causes cancer. Many of the chemotherapy drugs which cure in some patients, also cause cancer. Many of the antidepressant drugs cause suicidal ideation and other depressive thoughts. Allopaths use Ritalin (an upper) to treat ADHD. In some of the patients these treatments are not curative but palliative. Homeopathy (the process) can be used to palliate also, if the remedy is not a close enough simillimum to lead to a complete cure. There are many other examples of homeopathy used accidentally in allopathy. You will frequently see the symptoms for which a drug is indicated listed in the “side effects”

            Dr Hahnemann’s theory of miasms says that improperly allopathically treated diseases (ie. suppressed), primarily in his day syphilis, gonnorhea and skin diseases, led to the corresponding syphilitic, sycotic and psoric miasms that can be transferred to the children. The children may not have the disease but they have the miasmatic tendencies for similar symptoms.

          • Well done both of you. Exactly the responses I hoped for.

            All the LCLs you cite are explained via established science. Ionising radiation, gate theory, histamine release, etc.

            Standard stuff.

            Absolutely none of which can be applied to homeopathy.

          • Great but you can explain comprehensively for all these unique unrelated examples with LCL.

          • “established science” explanations of the effects of drugs, when they are available (which they frequently arent) are very limited. They might identify one or two chemical pathways that they effect but they cant explain the wide latitude of their specific effects on the entire mental, physical and emotional system. Talk about pulling something out of their a*s, take the example of the phoney “chemical imbalance” explanation of depression that was sold to us for so long. So of course they cant begin to explain all the effects of the psychiatric drugs. The weeds get even deeper when trying to determine the effects of various herbs containing hundreds of compounds. So there is nothing standard about finding a biochemical explanation for these allopathic palliations, suppressions and rare cures due to conventional drugs.
            How do you account for the very common occurence that the “side effects” of allopathic drugs frequently contain the symptoms that they are meant to cure? Sounds like LCL.

          • “Absolutely none of which can be applied to homeopathy.”

            No kidding. Where have you been?

          • So, Lenny, I dont think they have begun to explain how actual cures have been effected. Allopaths are mostly clueless on how systemic cures are effected, when they do happen, despite their hand waving.

          • Allopaths are mostly clueless on how systemic cures are effected, when they do happen, despite their hand waving.

            Another pathetic unevidenced and nonsensical claim dragged out of your arse.

          • Lenny, you hate homeopathy so much that you are not wiling to face what is right in front of your eyes. LCL is operating around you all the time. I just gave you a small sample. Just keep reading the “side effects” of allopathic drugs. Better yet, do a homepathic proving with a couple of your pseudo-skeptic buddies.

            Giving an explanation that shows that a drug targets a couple of biochemical pathways does not explain a comprehensive systemic cure on all levels mental, physical and emotional. They just wave their hands and say it cured everything else. What about all the other patients with the same allopathic “disease” that it didnt cure? Maybe only palliated or did nothing?

          • the real sceptic did many more provings than you will ever be able to do: http://www.1023.org.uk/

          • Have you ever read the protocol for doing a proper homeopathic proving? Read Jeremy Sherr’s book or Paul Herscu’s book on the subject. Read the text of various provings. The 1023 folks are just grandstanding for media attention. Chugging a vial of homeopathic “Sleeping pills” doesnt begin to amount to a proving. If you seriously want to understand homeopathy follow a proper protocol with a supervisor and do it “blinded” for a remedy that has already been proven.

          • good to know that you have no humour either

          • “proper homeopathic proving”

            ROFL!

          • So tell me Alan what do you know about a homeopathic proving and have you ever participated in one?

          • do you really think that one has to participate in a proving [or anything else] to be able to assess whether it is reasonable?

          • LOL!

            You used the phrase ‘proper homeopathic proving’, so you tell us how you believe we could differentiate between a ‘proper’ proving and any other kind.

          • “Proper homeopathic proving”

            So by your logic, Roger, all the previous provings which don’t conform to these protocols can be regarded as improper and thus invalid? And if not, why not?

          • There are generally accepted standards for how to conduct a proving which include blinding and placebo control. But that doesnt invalidate other provings. Its a self-correcting process. If not enough provers or supervisors are available to conduct with all proper controls then the results are still useful. Remember that provings are done in spare time when homeopaths are not making a living and there is no long line of provers & supervisors standing by to do this work.

            Symptoms in the materia medica for a remedy are rated 1 to 4 in the repertories based on whether or not it has been confirmed in clinical practice by being cured by the remedy. If a symptom is only seen in a proving but has not been used in practice it is rated as a 1.

            When the materia medica for the remedy is written up the most prominent symptoms (ie. most cured in practice) are emphasized.

            Even if a remedy is used on a patient and doesnt cure, no harm is done. It has no effect. And the homeopath moves on to try to find a better match.

            Compare that to conventional medicine where they use toxic chemicals on people who are already sick, or possibly worse they give them false hope by deliberately giving them a placebo. For some reason in allopathic practice placebos dont do much for long-term serious chronic disease or serious acute diseases. Homeopaths must use a better brand of placebo.

  • An important article! I think the worst enemy of critical thinking is the psychological phenomenon of cognitive dissonance reduction found by Leon Festinger in the late 1950s. If a person faces informations, thoughts or situations leading to cognitions which contradict his or her personal attitude or beliefs usually an uncomfortable feeling occurs. This so called cognitive dissonance will motivate the person to reject these uncomfortable, contradictory cognitions. He or she will actively avoid informations, thoughts and situations likely increasing the dissonance. This cognitive dissonance reduction is a more or less unconscious process. A lot of psychological experiments have confirmed the existence of cognitive dissonance reduction as a widespread phenomenon. For me the findings of Leon Festinger look similar to psychological conflict, resistance, repression and defense mechanisms in the psychoanalysis of Sigmund Freud. Best regards Jens Christian Heuer

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