“It Worked For Me”

Acupuncture Needle, CC Licenced via Acid Pix

“It Worked For Me” : these are the four words I always expect to hear when I get into a discussion on Alternative Medicine. In many ways, it’s very difficult to argue against. If you are not particularly careful in replying, you can come across as highly insensitive. How dare you assume that you know their circumstances better than themselves! Are you accusing them of lying? Furthermore, there is almost always a readymade refutation should you challenge any aspects of the assertion. It happened, you were not there, I was.

“It Worked For Me” is a minefield, and yet it needs to be tackled.

In the case of most alternative therapies, it’s implausible in the extreme for the putative cure to have been the cause of the recovery. Scientific studies have established, far beyond reasonable doubt, that homeopathic pills contain no active ingredient. These pills, by themselves, are utterly useless. Further studies have established that Chiropractic back manipulation is of no use beyond providing temporary relief to lower back pain in some cases. Other studies have demonstrated that Acupuncture, the insertion of needles in the skin, does little from a medical perspective. The list goes on and on. Whatever they say is working, it’s obviously not the particular treatments themselves.

And yet, many people swear by them. They had back pain, they went to an aromatherapist, and the pain disappeared. They felt very unwell, they went to a naturopath, and felt much better. Some people have reported the end of chronic pain and illness from going to alternative practitioners. They have reported the clearing up of allergies, the ending of depression, fatigue, lots of things.

So what is happening? Clearly, it’s difficult, without full information, to comment on any individual case, but here are some of the things that may be happening:

1) The Placebo Effect. The Placebo Effect relates to the tendency of people to report improvement after all manner of interventions, medical or none. Significant study has been done on this, and, while measurable improvement (beyond what would happen without intervention) is almost never seen, the effect refers to a strong tendency to make people feel better in themselves. It’s triggered by lots of things: the dosage, the nature of the dosage, the ambiance of the consulting room, the attitude and friendliness of the therapist, and much else. We all feel better from having spoken to someone who listens and helps us talk more easily. The Placebo Effect is particularly strong when it comes to non-specific symptoms, such as pain, fatigue, low mood and general feelings of un-wellness. It has less of an effect for specific, clear symptoms, such as cuts and infections.

2) Regression to the Mean. This refers to the natural tendency of the body to get better. Given enough time, back pain tends to get better by itself, sleep cycles are re-established, and allergies clear up, at least for a while. Just because a therapy was invoked before the recovery happened, doesn’t mean it caused or accelerated the recovery. It may have happened quite naturally, and there is no way of knowing this without careful analysis.

3) False Memory. Our memory of an event is actively re-created every time we recall it, so by necessity, many details of what actually happened tend to get lost, particularly the aspects that do not resonate with the main story. So it might be forgotten that the person was on antibiotics at the same time as visiting a homeopath, or that the recovery didn’t happen quite as fast as they remember. Even worse, the memory tends to become even more fixed with the telling as the weeks and years go by.

4) Belief contamination. We tend to view the world based on our inherent beliefs. Ghost hunters see and hear ghosts everywhere. Right-wingers tend to see left-wing conspiracies everywhere, and vice-versa. So too with people with an invested belief in their chosen form of alternative therapy. They will reach for signs of it working, even when the evidence is very slim.

5) Cognitive Dissonance. Once we have established a story about ourselves, we hate admitting we might be wrong about it. So when challenged on any aspects, our brains tend to go into overdrive to defend our position. This can have the effect of further changing our memory of it, bolstering the false memories even further.

6) Subjectivity. People don’t normally establish criteria for success beforehand, then judge the outcome based on these pre-existing criteria. Instead, there is a tendency to retro-fit a meaning after the event, which gives them much greater latitude to define what success means. The bar can be set as low as the person wishes.

7) Maslow’s Hammer, or “if the only tool you have is a hammer, it is tempting to treat everything as if it were a nail”. This is where people do not understand the limitations of their thinking. If we know of only one major way that a problem can be solved, we are unlikely to conceive of other alternatives to solving the problem. So, lack of knowledge of alternative modalities limits us to conceiving just one answer to the problems we have.

None of this, by the way, imputes deliberate action or foul play on the person making the claim. It’s just the way our minds work. When it comes to how our brain interprets the information we get from our environment, we are truly a funny lot.

If confronted with a personal anecdote and asked to explain it, it is far better to avoid engaging in a particular diagnosis, as you are unlikely to win that battle. It is possible, however, to engage in a hypothetical situation, on why we should be sceptical of personal testimonies. You could also imagine yourself experiencing a magic cure, then testing yourself on how you might have interpreted it incorrectly.

In the end, we are all too easy to fool. Convincing ourselves that a discredited modality works is the easy bit. Trying to establish that we might actually have got it wrong is much more difficult. “It Worked For Me”, as a reason for believing in a treatment, is simply not good enough.