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

“energy” healing

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A recent article  by a South African homeopath promoted the concept of homeopaths taking over the role of primary care practitioners. His argument essentially was that, in South Africa, homeopaths are well trained and thus adequately equipped to do this job responsibly. Responsibly, really? You find that hard to believe? Here are the essentials of his arguments including all his references in full. I think they are worth reading.

Currently, the Durban University of Technology (DUT) and the University of Johannesburg (UJ) offer degree’s in homoeopathy. This involves a 5-year full-time theoretical and practical training course, followed by a Master’s level research project. After fulfilment of these criteria, a Master’s Degree in Technology (Homoeopathy) is awarded. The course comprises of a strong core of medical subjects, such as the basic sciences of Anatomy, Physiology, Medical Microbiology, Biochemistry and Epidemiology, and the clinical sciences of Pathology and Diagnostics. This is complemented with subjects in Classical, Clinical and Modern Homoeopathy and Homoeopharmaceutics4,5

By law, any person practicing homoeopathy in South Africa must be registered with the Allied Health Professions Council of South Africa (AHPCSA). This is essential, as the Council ensures both medical and homoeopathic competency of practitioners, and that the activities of registered practitioners are closely monitored by the Professional Board. The purpose of the AHPCSA is to ensure that only those with legitimate qualifications of a high enough standard are registered and allowed to practice in South Africa, thus protecting the public against any fraudulent behaviour and illegal practitioners. Therefore, in order to ensure effective homoeopathic treatment, it is essential that any person wishing to prescribe homoeopathic medicine or practice homoeopathy in South Africa must be registered as a Homoeopathic Practitioner with the Allied Health Professions Council of South Africa. This includes conventional Medical Practitioners (dual registration is allowed for Medical Practitioners with both the Health Professions Council and AHPCSA)6,  as homoeopathy requires several years of training in order to apply effectively in clinical practice… 

Registration with the Council affords medico-legal rights similar to those of a medical professional, where treatment is limited to the scope of homoeopathic practice. Thus a homoeopath is firstly a trained diagnostician, and with successful registration with the Council, obtains the title Doctor. A homoeopath is trained and legally obliged to conduct a full medical history, a comprehensive clinical examination, and request further medical investigations, such as blood tests and X-rays, in order to fully assess patients. This is coupled with the ability to consult with specialist pathologists and other medical specialists when necessary, and refer a patient to the appropriate practitioner if the condition falls outside the scope of homoeopathic practice. A homoeopath may also legally issue a certificate of dispensation (‘Doctor’s note’) with appropriate evidence and within reason, and is deemed responsible for the diagnosis and treatment of patients under their care6. A homoeopath is not trained or licensed in any form of surgery, specialist diagnostics (e.g. colonoscopy or angiograms), cannot prescribe prescription medication and is not lawfully allowed to conduct intra-venous treatment of any kind. However, a registered homoeopath is licensed to use intra-muscular homoeopathic injectables in the treatment of various local or systemic complaints when necessary.

Conventional (allopathic) medicine generally targets specific biochemical processes with mostly chemically synthesised medication, in an attempt to suppress a symptom. However, in doing so, this usually negatively affects other biochemical reactions which results in an imbalance within the system. Homoeopathy, by contrast, seeks to re-establish a balance within the natural functioning of the body, restore proper function and results in the reduction or cessation of symptoms.  Homoeopathy therefore enables the body to self-regulate and self-heal, a process known as homeostasis that is intrinsic to every living organism.

Conventional medical treatment is by no means risk free. Iatrogenic (medically induced) deaths in the United States are estimated at 786 000 per year, deaths which are considered avoidable by medical doctors7,8. These figures put annual iatrogenic death in the American medical system above that of cardiovascular disease and cancer as the leading cause of death in that country9, a fact that is not widely reported! South African figures are not easily available, but it is likely that we have similar rates. Although conventional medications have a vital role, are sometimes necessary and can of-course be life-saving, all too often too many patients are put on chronic medication when there are numerous effective, natural, safe and scientifically substantiated options available….

According to the World Health Organisation (WHO), homeopathy is the second largest system of medicine in the world, and world-wide use continues to grow in developed and developing nations10. Homoeopathy is widely considered to be safe and effective, with both clinical and laboratory research providing evidence for the efficacy of homoeopathy11. As the range of potential conditions that homoeopathy can treat is almost limitless, and that treatment is not associated with adverse reactions, homoeopathy should be considered a first-line therapy for all ages. As homoeopaths in South Africa are considered primary health care practitioners, if a conventional approach is deemed necessary, and further diagnostics are required, your practitioner will not hesitate to refer you to the appropriate health care practitioner. Homeopathy is also used alongside conventional medicine and any other form of therapy, and should be seen as ‘complementary’ medicine and not ‘alternative’ medicine.

 

Conclusion

Homoeopathy is an approach that is widely considered to be safe, and when utilised correctly, can be effective for a wide range of conditions. As a primary health care practitioner, a homoeopath is able to handle all aspects of general practice and family health care, including diagnostics, case management and referral to other practitioners or medical specialists. A registered homoeopath is legally responsible to ensure the adequate treatment of their patients, and is accountable for all clinical decisions and advice. A registered homoeopath understands the role of conventional medicine, and will refer to the appropriate specialist in cases that fall outside the legal scope of practice.

 

 

References

1. http://homeopathyresource.wordpress.com/what-is-homeopathy (accessed 31 March 2010)

2.  Bloch R, Lewis B. Homoeopathy for the home. Cape Town, South Africa: Struik Publishers: 2003

3. http://www.dut.ac.za/site/awdep.asp?depnum=22609 (accessed 1 April 2010)

4. http://dutweb.dut.ac.za/handbooks/HEALTH%20Homoeopathy.pdf (accessed 1 April 2010)

5. http://www.uj.ac.za/EN/Faculties/health/departments/homeopathy/coursesandprogrammes/undergraduate/Pages/default.aspx (accessed 1 April 2010)

6. http://www.ahpcsa.co.za/pb_pbhnp_homoeopathy.htm (accessed 6 April 2010)

7. Starfield, B. Is US Health Really the Best in the World? JAMA 2000; 284(4).

8. Null G, Dean C, et al. Death by Medicine. Nutrition Institute of America 2003. 9. http://www4.dr-rath-foundation.org/features/death_by_medicine.html (accessed 7 April 2010)

10. http://ukiahcommunityblog.wordpress.com/2010/03/04/worldwide-popularity-grows-for-homeopathy-alternative-medicine/#comments (accessed 7 April 2010)

11. http://liga.iwmh.net/dokumente/upload/556c7_SCIEN_FRA_2009_final_approved.pdf (accessed 7 April 2010)

I found this article extremely revealing and scary. It gives us an important glimpse into the way some or perhaps even most homeopaths think. They clearly believe that:

1) Their training is sufficient for them to become competent primary care professionals, i.e. clinicians who are the first port of call for sick people  to be diagnosed and treated effectively.

2) Homeopathy is scientifically proven to be efficacious for an ‘almost limitless’ range of conditions. Interestingly, not a single reference is provided to support this claim. Nevertheless, homeopath believe it, and that seems to be enough.

3) Homeopaths seem convinced that they perfectly understand real medicine; yet all they really do is to denounce it as one of the biggest killer of mankind.

4) The fact that homeopaths cannot prescribe real medicine is not seen as a hindrance to their role as primary care practitioner; if anything, homeopaths consider this to be an advantage.

5) Homeopaths view registration with some sort of governing body as the ultimate legitimation of their trade. Once such regulatory measures are in place, the need to support any of their claims with evidence is nil and void.

This article did remind me of the wry statement that ‘HOMEOPATHY IS TO MEDICINE WHAT THE CARPET INDUSTRY IS TO AVIATION’. Homeopaths truly live on a different planet, a planet where belief is everything and responsibility is an alien concept. I certainly hope that they will not take over planet earth in a hurry. If I imagine a world where homeopaths dominate primary care in the way it is suggested in this article, I start having nightmares. It seems to me that people who harbour ideas of this type are not just deluded to the point of madness but they are a danger to public health.

Researchers from the ‘Complementary and Integrative Medicine Research, Primary Medical Care, University of Southampton’ conducted a study of Professional Kinesiology Practice (PKP) What? Yes, PKP! This is a not widely known alternative method.

According to its proponents, it is unique and a complete kinesiology system… It was developed by a medical doctor, Dr Bruce Dewe and his wife Joan Dewe in the 1980s and has been taught since then in over 16 countries around the world with great success… Kinesiology is a unique and truly holistic science and on the cutting edge of energy medicine. It uses muscle monitoring as a biofeedback system to identify the underlying cause of blockage from the person’s subconscious mind via the nervous system. Muscle monitoring is used to access information from the person’s “biocomputer”, the brain, in relation to the problem or issue and also guides the practitioner to find the priority correction in order to stimulate the person’s innate healing capacity and support their physiology to return to normal function. Kinesiology is unique as it looks beyond symptoms. It recognizes the flows of energy within the body not only relate to the muscles but to every tissue and organ that make the human body a living ever changing organism. These energy flows can be evaluated by testing the function of the muscles, which in turn reflect the body’s overall state of structural, chemical, emotional and spiritual balance. In this way kinesiology taps into energies that the more conventional modalities overlook and helps remove all the guesswork, doubt and hard work of subjective diagnostics. This is a revolutionary way to communicate with the body/mind connection. Through muscle monitoring and the use of over 300 fingermodes we can detect and correct the cause of the problem and effect a long lasting change for better health and wellbeing. Our posture could be considered to be the visual display unit from our internal bio-computer. Our posture / life energy improves as we upgrade the way we respond to life’s constant challenges and demands.

You do not understand? Let me make it crystal clear by citing another PKP-site:

PKP is a phenomenological practice – this means practitioners use manual muscle testing to demonstrate to the client how much or how little they are able to move in relation to their problem. PKP practitioners have tests for more than 100 muscles, and dozens of other tests that they do so they can clearly show you how your movement is affected by your problem. This muscle story shows a person how their life is unfolding, and it also helps to guide on how to transcend the situation and design a future which is more in alignment with nature and the laws of the cosmos… PKP is about living life more wisely.

In case you still have not understood what PKP is, you might have to watch this youtube clip. And now that everyone knows what it is, let us have a look at the new study.

According to its authors, it was an exploratory, pragmatic single-blind, 3-arm randomised sham-controlled pilot trial with waiting list control (WLC) which was conducted in the setting of a UK private practice. Seventy participants scoring ≥4 on the Roland and Morris Disability Questionnaire (RMDQ) were randomised to real or sham PKP receiving one treatment weekly for 5 weeks or a WLC. WLC’s were re-randomised to real or sham after 6 weeks. The main outcome measure was a change in RMDQ from baseline to end of 5 weeks of real or sham PKP.

The results show an effect size of 0.7 for real PKP which was significantly different to sham. Compared to WLC, both real and sham groups had significant RMDQ improvements. Practitioner empathy (CARE) and patient enablement (PEI) did not predict outcome; holistic health beliefs (CAMBI) did, though. The sham treatment appeared credible; patients did not guess treatment allocation. Three patients reported minor adverse reactions.

From these data, the authors conclude that real treatment was significantly different from sham demonstrating a moderate specific effect of PKP; both were better than WLC indicating a substantial non-specific and contextual treatment effect. A larger definitive study would be appropriate with nested qualitative work to help understand the mechanisms involved in PKP.

So, PKP has a small specific effect in addition to generating a sizable placebo-effect? Somehow, I doubt it! This was, according to its authors, a pilot study. Such an investigation should not evaluate the effectiveness of a treatment but the feasibility of the protocol. Even if we disregard this detail, I assume that the results indicate the effects of PKP to be essentially due to placebo. The small effect which the authors label as “specific” is, in my view, almost certainly caused by residual confounding and hidden biases.

One could also go one step further and say that any treatment that is shrouded in pseudo-scientific language and has zero plausibility is an ill-conceived candidate for a clinical trial of this nature. If it should be tested at all – and thus cost money, effort and patient-participation – a rigorous study should be designed and conducted not by apologists of the intervention but by more level-headed scientists.

According to its proponents, Vibrational Medicine (VM) is a healing system that uses the ancient art of dowsing to identify the cause of a disease (or dis-harmony in the body). This therapy is a meeting of eastern and western forms of healing since we often use a western understanding of the body and how it functions and combine this with the eastern practice of rebalancing energies within the body to bring about healing. Sometimes the actual cause of a disease can appear to be far removed from the apparent symptoms when taking the western viewpoint. However everything is connected and especially so within the body. The body is always striving to heal itself but sometimes it can get ‘blocked’. These ‘blocks’ can be caused by many things including biochemicals, toxins, emotions, viruses, parasites or bacteria. The main aim of vibrational medicine is to clear these ‘blocks’ to allow the body to function correctly.

I am intrigued and surprised; for instance, I had no idea that there is such a thing as a western understanding of the body and how it functions. But what does this mean? How does VM work? The answer seems simpler than you may have thought: VM works by rebalancing the minute vibrational frequencies that make up the energy field within the atoms, molecules, organs and systems within the body. A block or a disharmony within the body can be thought of as being like an orchestra with an instrument that is not tuned correctly. The remedies  applied are then ‘re-tuning’ the body’s energy so that the body (the orchestra) plays a more harmonious tune again.

I see, that is impressive! And what diseases can be treated with VM? Don’t tell me it is a panacea! Yes, it is: Because vibrational medicine can work on many levels within the body (for instance it can work on the aura and chakras, the cellular level or it can work on particular organs or systems within the body) it can therefore be used to treat any condition that affects the mind or body of any person or animal.

How utterly miraculous! But in case you find this too vague and not sufficiently technical, here is a more scientific explanation from a different source:  The  term ‘vibrational’ is connected to the field of Quantum Physics where it is  found that all living beings (people, animals and plants) have a unique  vibrational frequency or energy field.   Kilian photography is one of several scientific methods which have  illustrated the existence of this field.   If one picks a leaf from a tree and applies a high voltage to its energy  field, it can be photographed and observed.   As the leaf dies the field becomes smaller until it disappears when it  is dead.  Also, a ‘quantum’ of energy is  released by an atom when it reaches a stable state.  This is unique to that particular atom.

I did suspect that quantum physics had to be involved. This is as good as it gets! I am sure you are as fascinated as I am and keen to learn more. The exciting news is that, at the Scottish School of Vibrational Medicine, you can complete your knowledge to diploma-level: This course will cover the major range of topics covered in the course of obtaining the Diploma in Vibrational Medicine and is a “broad brush” coverage of the whole course. During the course specialist and unique Homeopathic remedies will be used and students will take some remedies home with them to try at leisure the working of these remedies.

Now I understand; VM seems to be a bit of homeopathy, naturopathy, spiritual healing all mixed together. Sounds convincing – wait until our Health Secretary hears about this one! The NHS might never be the same again.

Where I live, some of the old-fashioned, privately-owned shops that used to dominate our high streets have survived the onslaught of the supermarkets. Our bakery is such a quaint remnant from the past. Surprisingly, it also is more holistic and more therapeutic than any alternative health centre I have come across.

The first thing that strikes anyone who enters the premises is the irresistible smell. Customers’ well being hits the ceiling, and the local aromatherapists are in danger of going out of business. The intense stimulation of the customers’ olfactory system relaxes their mind and puts them into a meditative state as they patiently wait to be served. Everyone in the queue has a little word with the baker’s wife, and progress is therefore slow – but we don’t mind: the chat is holistic counselling at its best, and our slow movements towards the counter are healthier than tai chi.

“You are looking well today,” says the baker’s wife, thereby gently arousing me from my aroma-induced meditation and indicating that she is about to focus her shaman healing-energy on me. Her diagnosis is spot on; the alternative therapies I enjoyed while waiting have re-balanced my chakras and got my qi flowing nicely – no wonder I am looking well!

The whole-wheat scones are finely balanced and nutritious; so I order three—one for the walk home and two for tea later. Prices have gone up a bit but, as with all holistic therapies, the more you pay, the more it’s worth. “Here you are,” she says, handing me her dietary delights. As I pay, our hands touch ever so briefly, just long enough for me to experience the instant transfer of healing energy that is so characteristic of Therapeutic Touch.

“Take care now, and God bless”, she says. As I walk out of her aura, I contemplate her words full of empathetic spiritual guidance and ancient wisdom. “That was expensive”, my wife mutters back home. I beg to differ: not only did I get the most wholesome food for my physical body, but I received holistic and patient-centred aromatherapy, counselling, meditation, tai chi and energy healing for my emotional, psychological and spiritual needs.

If only our Health Secretary knew about this traditional, yet integrated and therefore cutting-edge approach to cost-effective health and holistic well-being. We could all have it for free, and it might even save the NHS from its current crisis!

In the UK, we have about 150000 practitioners of Spiritual Healing (SH). They treat all sorts of conditions claiming to channel ‘healing energy’ into the patient’s body which enables him/her to heal itself. The plausibility of SH is very close to zero and, despite numerous trials, its clinical effectiveness remains unproven. A new and, in my view, remarkable study of SH was aimed at investigating whether “SH could support patients with breast cancer”.

Spiritual Healing was provided by 4 healers registered with the National Federation of Spiritual Healers. Twelve patients with breast cancer undergoing long-term hormone treatment and experiencing its adverse-effects as onerous, self-referred themselves and were given ten weekly sessions of approximately 40 minutes each. Data collected included participant’s daily records, direct observations noted by the healers, the researcher’s field diary and a one-to-one semi-structured interview.

The alleged positive effects of SH included alleviation of the physical adverse-effects of their treatment, increased energy levels, enhanced well-being, emotional relaxation, and re-engagement with pre-cancer activities. Although one participant admitted considering a drug holiday prior to joining the study, none of the participants felt tempted to stop their hormonal treatments while receiving SH. The authors concluded that “these qualitative findings indicate that SH has the potential to support patients with breast cancer in the maintenance of their long-term orthodox treatments. Further research is needed to test SH as a cost-effective complementary therapy, for those undergoing long-term cancer treatments.”

As I already mentioned, I think this study is remarkable. Having done quite a bit of research into SH myself, I know how bizarre this intervention truly is. A typical treatment session might be with the patient lying on a couch in a relaxing atmosphere, often accompanied by soothing background music; the healer would talk gently but very little to enable the patient to be comfortable and relax; the SH itself might be performed by the healer moving his/her hands at a distance over the body of the patient; the healer would explain that this may cause the sensation of warmth as the ‘healing energy’ enters the body. Altogether, the experience is exotic to say the least.

It is therefore not surprising that SH generates a host of non-specific effects, including the most enormous placebo-response I have ever witnessed in any clinical trial which I have been involved in. I am mentioning this, of course, to point out that the above-noted effects are entirely compatible with those of placebo. As the study has no control group, there is no way of knowing what the effects of SH per se might have been. The fact that patients self-referred themselves to SH would only amplify this placebo-response. In the discussion of the paper, we find a further interesting pointer regarding patients’ prior experience with conventional health care professionals: “participants felt they were left to cope alone as their side-effects were trivialized.”  This seems to suggest that the group of patients were indeed highly selected and all had suffered badly from previous experiences of poorly administered heath care. Thus their expectations of SH were probably high which, in turn, would exaggerate the placebo-response even further.

All of these phenomena might well be fascinating and could provide ample material for relevant research. They deserve to be analysed carefully and discussed openly and critically. Unfortunately none of this happened in the present study. The authors do not even consider the possibility that the observed effects could be related to anything else than their SH. Their stated aim to investigate whether SH supports cancer patients is not even approached; the authors simply assume a cause-effect relationship without demonstrating one. I find this is more than just a missed opportunity; in my view, it is pseudo-science. And this is the reason why I find this study remarkable.

Reiki is a form of  healing which rests on the assumption that some form “energy” determines our health. In this context, I tend to put energy in inverted commas because it is not the energy a physicist might have in mind. It is a much more mystical entity, a form of vitality that is supposed to be essential for life and keep us going. Nobody has been able to define or quantify this “energy”, it defies scientific measurement and is biologically implausible. These circumstances render Reiki one of the least plausible therapies in the tool kit of alternative medicine.

Reiki-healers (they prefer to be called “masters”) would channel “energy” into his or her patient which, in turn, is thought to stimulate the healing process of whatever condition is being treated. In the eyes of those who believe in this sort of thing, Reiki is therefore a true panacea: it can heal everything.

The clinical evidence for or against Reiki is fairly clear – as one would expect after realising how ‘far out’ its underlying concepts are. Numerous studies are available, but most are of very poor quality. Their results tend to suggest that patients experience benefit after having Reiki but they rarely exclude the possibility that this is due to placebo or other non-specific effects. Those that are rigorous show quite clearly that Reiki is a placebo. Our own review therefore concluded that “the evidence is insufficient to suggest that Reiki is an effective treatment for any condition… the value of Reiki remains unproven.”

Since the publication of our article, a number of new investigations have become available. In a brand-new study, for instance, the researchers wanted to explore a Reiki therapy-training program for the care-givers of paediatric patients. A series of Reiki training classes were offered by a Reiki-master. At the completion of the program, interviews were conducted to elicit participant’s feedback regarding its effectiveness.

Seventeen families agreed to participate and 65% of them attended three Reiki training sessions. They reported that Reiki had benefited their child by improving their comfort (76%), providing relaxation (88%) and pain relief (41%). All caregivers thought that becoming an active participant in their child’s care was a major gain. The authors of this investigation conclude that “a hospital-based Reiki training program for caregivers of hospitalized pediatric patients is feasible and can positively impact patients and their families. More rigorous research regarding the benefits of Reiki in the pediatric population is needed.

Trials like this one abound in the parallel world of “energy” medicine. In my view, such investigations do untold damage: they convince uncritical thinkers that “energy” healing is a rational and effective approach – so much so that even the military is beginning to use it.

The flaws in trials as the one above are too obvious to mention. Like most studies in this area, this new investigation proves nothing except the fact that poor quality research will mislead those who believe in its findings.

Some might say, so what? If a patient experiences benefit from a bogus yet harmless therapy, why not? I would strongly disagree with this increasingly popular view. Reiki and similarly bizarre forms of “energy” healing are well capable of causing harm.

Some fanatics might use these placebo-treatments as a true alternative to effective therapies. This would mean that the condition at hand remains untreated which, in a worst case scenario, might even lead to the death of patients. More important, in my view, is an entirely different risk: making people believe in mystic “energies” undermines rationality in a much more general sense. If this happens, the harm to society would be incalculable and extends far beyond health care.

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