Dr. Robert Bazell on MSNBC

In "Mind-body medicine needs a check-up," posted today on MSNBC, Dr. Robert Bazell writes skeptically of the burgeoning field of alternative and complementary medicine. There is always plenty to be skeptical about, to be sure. Charlatans and quacks proliferate in the area of alternative medicine precisely because there is so little regulation and accepted certification. You can't simply say you're a medical doctor and begin practicing (well, you can, but you can be arrested for such things). In alternative medicine, you can do lots of things without any meaningful certification.

That said, Bazell is too high and mighty for his--or our--own good. While his language allows for the existence of creditable and helpful alternative medical practitioners, his arguments proceed as if they don't exist:

"As I have written before, many practitioners of alternative medicine either see no need for their claims to be tested with scientific studies, or simply ignore results if they don't like they way come out."

Ah, yes: "many"--not a very scientific assertion there, Dr. Bazell. This leaves the distinct possibility that "many" others do exactly the opposite and are actually helpful healers. But he can overlook that to imply, in a number of different ways, that the entire field is suspect precisely because traditional Western medical practice does not accept it.

As for ignoring results if they don't like the way they come out, alternative medical providers have not cornered the market on that particular attitude by any means. Western medical doctors likewise do this all the time--a fact that, I should note, routinely keeps alternative types of knowledge and understanding from getting anywhere in the traditional medical world. Take, for example, all the studies that have been done that show that back pain is by and large not dependent upon physical conditions. And then look at all the back pain clinics that are set up around the country, by good old accredited medical doctors, and tell me (or tell Dr. Bazell) that these doctors are not simply ignoring results that they don't like.

Newsweek on the placebo effect

Here's another mainstream media take on placebos. Sharon Begley acknowledges from the outset how resistant both doctors and patients can be about the very concept of the placebo effect. Then she writes:

"But the fact remains that placebos are at least somewhat effective and sometimes very effective for some patients. Rather than railing against that finding or pretending it doesn't exist, what we should be doing is learning how brain activity that corresponds to the expectation of cure translates into clinical improvement."

I remain rather flabbergasted that so many people would rather ignore evidence that placebos often work than figure out what exactly is going on. How odd that the doctors who require clinical evidence before drawing conclusions on treatment will nevertheless overlook or disavow knowledge of clinical evidence that has proven, over and over, that placebos can and do work under many circumstances. So it's not clinical proof they really want; what they really want, like so many of us, is to have their own preconceived ideas to be continually affirmed.

New study: back pain largely mind-induced

In the Daily Mail, a British paper, an article about new research that claims that most back pain is not from actual physical injury. (Note that this is no news to TMS sufferers, or followers of Dr. John Sarno.)

The study was specifically looking at trends in health following the reunification of Germany in the early '90s.

Shortly after East and West Germany were reunited, statistics show that 84 percent of West Germans were affected by back pain, compared to 69 percent of East Germans. By 2003, the percentages has just about equalized.

What accounted for the rise in back pain among residents of the former East Germany? "Researchers blame increased exposure to media reports on how back pain could be a severely disabling condition," says the Daily Mail, and quoted the published study directly:

"After reunification, all those 'myths' and misconceptions about back pain being pervasive in Western societies immediately spread to East Germany."

The study claims that only about 15 percent of back pain is actually due to a structural problem of some kind.

The Daily Mail found not too much receptivity to this idea at home, however. "British experts said if back pain is all in the mind, this is only true in a very few cases."

And right here is exactly why so many people seem to reject out of hand the idea of mind-induced pain, because it's often said to be "all in the mind." Neither traditional doctors nor many patients want to be told this because the implication is that the pain is somehow imaginary.

So let's be clear here: when people talk about the mind creating pain, this does not mean the pain is "all in the mind." The pain is still very much in the body.

Personally, I don't see what's so hard to understand about this, but it seems to trip lots and lots of people up. They hear about how the mind may create pain and think that means someone's basically making it all up.

In the case of back pain this is completely not true. The pain is real, and really happening in your body. Mind-induced pain is real, physical pain. Just like mind-induced embarrassment can turn your actual cheeks actually red.

Another mainstream go at the mind-body connection

This time in Parade.

I'm thinking this sort of article is largely a good thing, part of the slow, steady effort that will be required to get the general public, over time, clued in to the reality of the mind-body connection.

So of course there's the typical arms-length introduction--this "may seem like New Age thinking"; note the implication that "New Age thinking" is assumed to be foolish and wrong. And then we're walked through the subject with a focus on extreme examples (the hypnosis subjects told they were touching something very hot who develop a burn blister, for instance).

This gets people's attention, I suppose. To me, it would be much better to talk about, say, how psychogenic back pain is far too often incorrectly approached as a physical ailment (see previous post).

But we'll get there someday. We'll really have to.

London Times article on mind affecting health

I find it odd when articles appear out of the blue, lacking any particular context for why it is appearing in a given publication at a given time, but that seems to be what happens in newspapers in particular. So here's an out-of-the-blue article about the mind-body connection in the (London) Times. The article's lead source is Harvard's Herbert Benson, although we are not told why the Times in London is abruptly quoting him.

The title--"Mind Control: Meditate Your Way to a Healthier Body"--is kind of random too. The article is basically about some actual, documented ways the mind can affect the body, not always having to do with meditation. Comments from actual, traditional medical folks who are open to the concept are included. This is not any sort of self-help article, as the title may imply.

The article is straightforward and informative, but I can't help feeling that its utter randomness is connected to how we culturally tend to look at mind-body medicine topics, when we bother to look at all, in this sort of cordoned off manner. We put some aspect of it on display in a sort of curio case; we can read it, go, "Hmmm. Interesting," and then proceed on with our usual world view.

Oddly enough, the article even pays lip service to the idea of using this information effectively, asking at one point, "So can we implement this mind over matter approach in our daily lives?" It proceeds, however, to fail to answer the question in any but the most general of terms.

"By repeating mantras to yourself, or practicing conscious repetitive actions such as tapping each time you think about the relevant topic," we are told, "you can manipulate your mind."

Oh, okay. Will do!

Better Harrington interview

The Boston Globe has one that positions Harrington more reasonably than Salon managed to.

What too many journalists miss is the reasonably expansive area between the extremes. They miss, willfully or otherwise, the fact that the mind-body connection is not a black and white scenario with "only physical causes" on one side and "the mind generates all disease" on the other. Writers (such as in the Slate review, previously noted) love to pretend it's black and white, so you get western medicine wearing the white hat and (as the Slate headline had it) "The unscientific allure of mind-body medicine" embodying everything silly and superstitious.

But that's a false and foolish dichotomy. Just because western medicine has a powerful understanding of the physical side of disease does not in any way rule out that the mind can play a very important role as well.

If over time I appear here to berate western medicine, it's not because I don't believe that germs cause disease, or that there aren't actual physical circumstances happening when something is wrong with your body. But there is no way--absolutely no way--that western research can prove its position, and by and large its practitioners, and followers, have no justifiable reason to dismiss the psychological/emotional element of bodily disorders. And yet that's all most of them seem to do.

That's what I've had enough of, and will continue to write about.