Sometimes you find good skepticism in strange places. One example of this has been Cracked.com. Normally, Cracked.com is a humor site based on the magazine that I used to read sometimes back in 1970s. Unfortunately, the magazine folded several years ago, but the website lives on. For example, Cracked.com once did a snarky article making fun of the “heroes” of the antivaccine movement and contrasting them to “villains” like (of course!) Paul Offit. It even featured for emphasis the infamous “baby eating” poster that Age of Autism ran a couple of years ago that featured Steve Novella, Paul Offit, and other champions of vaccine science sitting around a Thanksgiving feast featuring as its main course a baby. In general, many of the articles in Cracked.com take the form of lists, like 8 New TV Show Ideas Almost as Stupid as ‘Grey’s Anatomy’ and The 5 Most Insane Examples of Chinese Counterfeiting. Unfortunately, some of you forwarded an article of this form with the title 6 New Age Cures That Aren’t As Full Of Crap As You Think.
If I see much more of this, I might have to reassess my opinion of Cracked.com as an unlikely seeming place to go for skepticism and critical thinking. Let’s just put it this way. Some of “New Age cures” that Cracked.com characterizes as not being “as full of crap as you think” are actually more full of crap than you think. Acupuncture, for example, which is number six on the list (given that these lists usually run from the highest number to the lowest). After starting out promisingly enough characterizing the idea of qi as nonsense, the article veers into the quackademic medicine explanation of how acupuncture “works” that buys into every trope that apologists of placebo medicine use to justify the use of acupuncture. First, though:
It’s probably not very surprising that science has been unable to locate chi energy on any X-Rays.
Which is true enough and a good start. Too bad it had to be ruined by what follows:
What might be surprising is that despite this, actual scientific studies that don’t involve a single “spirit crystal” show that acupuncture actually freaking works. Yes, according to that article in The Wall Street Journal, “neuroimaging studies show that it seems to calm areas of the brain that register pain and activate those involved in rest and recuperation,” all of which sounds surprisingly official for a pain-relief method that involves repeated stabbing.
No, acupuncture doesn’t work. When you look at the totality of the evidence, it’s most consistent with placebo effects. As I’ve pointed out time and time again, acupuncture does no better than sham acupuncture. Or, to be more precise, it doesn’t matter where you stick the needles. it doesn’t even matter if you stick the needles in. My favorite example of this is a classic study in which twirling toothpicks actually produced more apparent symptom relief than actual “real” acupuncture. That didn’t stop the investigators from trying to spin the study as evidence that acupuncture “works.” Good luck with that. When the real therapy doesn’t perform any better than the sham therapy, what do we normally say? That’s right. We normally say that the treatment doesn’t work. It’s a placebo. Yet the authors tried to say that the study indicated that both real and sham acupuncture worked. One wonders what they would say if a drug company did a clinical trial where its new drug didn’t work any better than a placebo and tried to spin the results as saying that their drug works.
In any case, the WSJ article referenced cites a whole lot of dubious quackademic research, including that of Helene Langevin, some dubious functional MRI imaging studies, and other tropes that regular readers of this blog should be intimately familiar with. The article itself even concludes with:
“I don’t see any disconnect between how acupuncture works and how a placebo works,” says radiologist Vitaly Napadow at the Martinos center. “The body knows how to heal itself. That’s what a placebo does, too.”
Yes, it’s the rebranding of a CAM modality as a “powerful placebo” that can heal.
This article also misinterprets another study:
That’s actually one theory on how it works. When an acupuncturist sticks a tiny needle in your skin and twirls it around, she’s not quite harming you enough to cause real pain, but she is harming you just enough for your body to act in self-defense and release a natural chemical called adenosine, which acts like a local anesthetic.
No, no, no, no, no! I explained in great detail why the infamous “adenosine” study shows nothing of the sort. Its results were mildly interesting, but were in no way strong evidence that acupuncture “works,” much less that it works through releasing adenosine. Acupuncture mavens sure did sell, sell, sell that study, though, didn’t they? They’re still selling that study. What was most disappointing to me is that the peer reviewers at a really good journal didn’t catch the faulty reasoning in the conclusions of that study.
I spent the most time on acupuncture because it’s what I know the most about, but the other five “New Age” therapies being billed as not being “not as full of crap as you think” are, for the most part, equally hooey. For instance, there’s aromatherapy, about which, I’ll admit, Cracked.com has a good line, “It should go without saying, but inhaling something’s ‘life energy’ in order to become stronger only works for evil wizards and mummies. No matter how strongly you concentrate the smell of flowers, you’re still just smelling flowers.” That’s an awesome quote. Too bad it, too, is ruined by what follows, which is basically more acceptance of credulous treatments of aromatherapy. The authors Pauli Poisuo and Alexia Franklin would have done well to read skeptical treatments of aromatherapy by the Skeptic’s Dictionary, the Bay Area Skeptics, the Digital Bits Skeptic, Steve Novella, or Lynn McCutcheon.
Oddly enough, in the seven years I’ve been blogging, I haven’t written much about aromatherapy at all. Maybe I’ll have to rectify that sometime.
I tend to put aromatherapy in the same category as massage. There’s a lot of woo in massage therapy, where all too many masseuses buy into various forms of energy woo. From my perspective, massage feels good. It helps you relax, and it can sooth tight muscles. Unfortunately, too many massage practitioners can’t just leave it at that. It can’t just be massage. Oh, no. It has to be a “therapy.” The same thing with aroma. There’s no doubt that warm baths with pleasant-smelling oils can make you feel quite relaxed and good. Why not leave it at that? Aroma therapists, alas, can’t. They have to label it as a “therapy” and infuse it with all sorts of energy woo. I’ve said it before about massage therapy, and Steve Novella says the same thing about aromatherapy:
I am not just being picky. Attaching the word “therapy” to the back end of an activity is an attempt to give it a status it may not deserve – and that status is subsequently used to garner insurance coverage, hospital resources, consumer patronage, and research dollars. It is also used to constrain how we think about an intervention – implying that perhaps there is some specific mechanism as work, when none need exist.
Unfortunately, the Cracked.com article takes the thinnest gruel of evidence to try to argue that aroma therapy might not be the crock that we know it to be through science.
Next up is St. John’s Wort. It isn’t quite as unskeptical to think that there might be something to St. John’s Wort. St. John’s Wort, is, after all, a natural product, and it could well work as a drug. Certainly, it’s been hyped, but more recent evidence has been disappointing. Actually, this is one area where this article isn’t quite so bad, and even gets it mostly right:
Hold on, don’t run out to the grocery store and buy a case of the shit just yet.
See, the problem is that, unlike Prozac, there’s no real way to regulate whether a capsule of St. John’s wort is going to contain enough hyperforin to do any good. That’s one of the problems with herbal cures — they’re not regulated in any way, not for effectiveness or even to find out if they actually contain what their labels say.
And, sure enough, tests on commercially available brands of St. John’s wort found wildly fluctuating dosages that don’t necessarily resemble the dosage claimed on the bottle. And even when the dosage is correct, it’s only effective for mild to moderate depression. So unless you feel like rolling the dice with your depression (or relying on a nice placebo effect), see a damned medical professional.
They also make a similar point with Ginseng, which doesn’t really do anything at the doses commonly found in energy drinks. I’ll give that one to them.
I can’t give it to them, however, that they seem to think that results suggesting that alternating fast days with “pig out” days might prolong life:
Then again, you can accidentally reap a benefit from fasting if you’re really bad at it. Recent research suggests that if you alternately stop eating and then pig out every second day, your body gains a whole host of new weapons to combat diabetes and coronary heart disease. The specific sort of bodily stress and hunger caused by fasting forces the body to use up glucose of the body as nutrition, which in turn reduces the number of fat cells in the body — which in turn reduces diabetes risk and symptoms and decreases cholesterol.
Wow! Real research! Well, not really. The article cited appeared in Medical Hypotheses. You remember Medical Hypotheses, don’t you? It’s not as though I haven’t written about MH on many occasions. It’s a journal that is very friendly to cranks, doesn’t require any actual evidence. In other words, it’s a journal for wild-ass speculation. No wonder antivaccinationists love it. It did, after all, publish Mark and David Geier’s article that served as the basis of their use of chemical castration to treat autism. Of course, there is copious animal research suggesting that caloric restriction prolongs life. There’s even fairly recent research that suggests that fasting might increase the efficacy of chemotherapy and that intermittent fasting might be beneficial. Equating these sorts of studies with “detox” fasts, however, is quite a stretch in the service of an argument that fasting is good for you, particularly given that the majority of the evidence comes from animal studies and not humans.
Finally, the authors take on biofeedback. They actually make a good point, namely that biofeedback is relaxation and the illusion of control:
When you tell a stressed person to calm down, odds are that she will panic more at being unable to calm down. But when you tell a person that she can physically control her heart rate, muscle tension and hand trembling by concentrating real hard and telling these body parts to stop being assholes, you give that person an illusion of control, the effect of which is that she stops worrying about it.
In fact, biofeedback’s evidence base at present is pretty weak, at least for EEG-based biofeedback. For other forms of biofeedback, there might be some utility, but the evidence is fairly mixed. For example, it looks most likely that biofeedback probably doesn’t work to alleviate labor pain. In fact, what biofeedback proponents say about it is actually fairly revealing. Take, for instance, what the University of Maryland, that bastion of quackademic medicine, seems to conceded about biofeedback:
Researchers aren’t sure exactly how or why biofeedback works. However, there does seem to be at least one common thread: most people who benefit from biofeedback have conditions that are brought on or made worse by stress. For this reason, many scientists believe that relaxation is the key to successful biofeedback therapy. When your body is under chronic stress, internal processes like blood pressure become overactive. Guided by a biofeedback therapist, you can learn to lower your blood pressure through relaxation techniques and mental exercises. When you are successful, you see the results on the monitor, which encourages your efforts.
Alright, maybe I was too hard in the beginning. Biofeedback might “work,” but only to the extent that it aids in relaxation and is used for conditions in which anxiety or chronic stress are contributing factors. I suppose that, when you boil it down, this article had two major turkeys (its take on acupuncture and aromatherapy), two semireasonable items (St. John’s Wort and ginseng), and two borderline clunkers.
The problem, though, is that the entire point of the article seems to be to argue that certain New Age “cures” aren’t total bunk because they “work” by real scientific mechanisms that aren’t related to the “New Age” magical mystery mechanisms claimed for them by their proponents. Unfortunately these “New Age” cures are not cures at all. At best, they might be marginally effective treatments (herbal remedies, biofeedback). At worst, they’re total quackery (acupuncture and aromatherapy). In no way are they “cures.” In some cases, they aren’t even “New Age.” After all, what makes biofeedback “New Age” anyway? Its connection with meditation and the like is rather tenuous, and it requires monitoring of specific physiologic parameters, such as EEGs, blood pressure, or the like.
I know, I know. Perhaps I expect too much from Cracked.com, but it’s generally been pretty good before (and often quite funny). It’s disappointing to see an article there that flirts a little too closely with credulity. Here’s hoping this is just a single misfire.