Here is a short break from the astonishing festival of chiropractic that has followed the British Chiropractic Association (BCA) v Simon Singh defamation case, and the absurd NICE guidance on low back pain.
Singh’s statement already has over 10000 signatories, many very distinguished, Sign it now if you haven’t already. And getting on for 600 separate complaints about exaggerated and false claims by chiropractors have been lodged with the General Chiropractic Council and with Trading Standards offices.
The BCA has exposed the baselessness of most of chiropractic’s claims more effectively than any sceptic could have done.
The University of Westminster is seeing the light?
It is only recently that the University of Westminster suspended entry to degrees in homeopathy and remedial massage and neuromuscular therapy. Luckily for science, they have a new Dean who knows bullshit when she sees it. I suspect than she has been instrumental in starting to restore Westminster’s reputation. The job isn’t finished yet though. According to the UCAS site Westminster still offers
- Chinese Medicine: Acupuncture with Foundation (B341) 4FT Hon BSc
- Health Sciences: Complementary Ther with Foundn (B300) 4FT Hon BSc
- Health Sciences: Complementary Therapies (B255) 3FT Hon BSc
- Health Sciences: Herbal Medicine (B342) 3FT Hon BSc
- Health Sciences: Herbal Medicine with Foundation (B340) 4FT Hon BSc
- Health Sciences: Naturopathy (B391) 3FT Hon BSc
- Health Sciences: Naturopathy with Foundation (B392) 4FT Hon BSc
- Health Sciences: Nutritional Therapy (B400) 3FT Hon BSc
- Health Sciences: Nutritional Therapy with Foundn (B402) 4FT Hon BSc
With the possible exception of herbal medicine, which could be taught scientifically. all the rest is as delusional as homeopathy.
Rumour has it that Naturopathy may be next for the chop, so it seems appropriate to help the dean by showing a bit more of what the hapless students get taught. Remember that, according to Westminster, this is a bachelor of science degree!
Psychotherapeutic Approaches in Naturopathy 3CMW606
“This module is a core subject for BSc (Hons) Health Sciences: Naturopathy and option for BSc (Hons) Health Sciences: Complementary Therapies; BSc (Hons) Health Sciences: Therapeutic Bodywork; Graduate Diploma in Therapeutic Bodywork.”
Lectures 3 – 5 of this course are about the Theory and Application of EmoTrance.
EMOTRANCE? No I had never heard of it either. But it takes only two minutes with Google to discover that it yet another product of the enormous navel-gazing self-help industry. A new variant is born almost every day, and no doubt they make buckets of money for their inventors. You can download a primer from http://emotrance.com/. The web site announces.
“EmoTrance REAL energy healing for the 21st Century”
Here are three quotations from the primer.
And then I thought of the lady in the supermarket whose husband had died, and I spend the following time sending her my best wishes, and my best space time quantum healing efforts for her void.
It doesn’t matter how “bad”; something is or how old, it is ONLY AN ENERGY and energy can be moved with consciousness in quantum time, easily, and just for the asking.
Is EmoTrance a Science?
Now back to Westminster
Here are a few slides about EmoTrance
So it is pure vitalistic psycho-babble. The usual undefined use of impressive sounding words like “energy” and “quantum” with no defined meaning. Just preposterous made-up gobbledygook.
Before getting to EmoTrance, the course Psychotherapeutic Approaches in Naturopathy (3CMW606) had a lecture on Flower Essences. The evidence says, not surprisingly, that the effects of flower essences is not distinguishable from placebo “The hypothesis that flower remedies are associated with effects beyond a placebo response is not supported by data from rigorous clinical trials.” (See Ernst Wien. Klin. Wochenschr. 2002 114(23-24):963-6). Here are two of the slides.
This last slide departs from the simply silly to the totally mad. Dowsing? Kinesiology?
Pendulums I’m told from more than one source that the use of pendulums is not uncommon. both in teaching and by students in the Westminster University polyclinic Apparently they provide an excellent way to choose a ‘remedy’ or make a diagnosis (well, I expect they are as good as the alternatives). If in doubt, guess.
Of course pendulums were popular with Cherie Blair who is reported to have taken her son Leo to a pendulum waver, Jack Temple, rather than have him vaccinated with MMR. At least her delusions affected fewer people than those of her husband (the latest Iraq body count is about 100,000).
Kinesiology was originally a word that applied to the perfectly sensible science of human movement. But Applied Kinesiology more often refers now to a fraudulent and totally ineffective diagnostic method invented by (you guessed) a chiropractor. It has been widely used by alternative medicine to misdiagnose food allergies. It does not work (Garrow, 1988: download reprint).
General Chiropractic Council It is a mind-boggling sign of the incompetence of the General Chiropractic Council that they manage to include kinesiology within their definition of “evidence based care”. Their definition is clearly sufficiently flexible to include anything whatsoever. The incompetence of the GCC is documented in superb detail on jdc325’s blog (James Cole).
Council for Healthcare Regulatory Excellence (CHRE) is yet another example of the network of ineffective and incompetent quangos that plague us.. It is meant to ensure that regulation is effective but utterly fails to do so. The CHRE is quoted as saying “[The GCC] takes its role seriously and aspires to, and often maintains, excellence.”. Like endorsing kinesiology and ‘craniosacral therapy’ perhaps? Quangos like the CHRE not only fail to ensure regulatory excellence, they actually endorse rubbish. They do more harm than good.
The reading list for the course includes the following books. I guess the vibrational medicine (whatever that means) was covered already in the now infamous ‘amethysts emit high yin energy‘ lectures.
Hartman S (2003) Oceans of Energy: The Patterns and Techniques of EmoTrance: Vol 1.DragonRising. ISBN: 1873483732.
Lynch V and Lynch P (2001) Emotional Healing in Minutes. Thorsons: London. ISBN: 0007112580
Gerber R (2001) Vibrational Medicine for the 21st Century. Piatkus Publishers: London.
Gurudas (1989) Flower Essences and Vibrational Medicine. Cassandra Press: California, USA
Hartman S (2000) Adventures in EFT: The Essential Field Guide to Emotional Freedom Techniques. DragonRising. ISBN: 1873483635.
Hartman S (2004) Living Energy: The Patterns and Techniques of EmoTrance: Vol 2. DragonRising.ISBN: 1873483740.
Hartman S (2006) Energy Magic: The Patterns and Techniques of EmoTrance: Vol 3. Dragon Rising.ISBN: 1873483767.
Sylvia Hartman’s books seem to feature heavily in the reading list. I just got news of her latest effort
Welcome to a special update to the June 2009 newsletter to announce Silvia Hartmann’s latest book “Magic, Spells & Potions” is now available to pre-order from our site. The eBook edition will be released this Sunday, the most magical day of the year.
If you do pre-order this exciting new book, not only will you be amongst the first to receive your copy, but you will also be entered into an exciting competition for Silvia Hartmann’s handmade copal amber magic pendant. Each paperback book pre-ordered will also be signed by the author and contain a unique blessing for the reader.
Because this is a serious book on real magic, potions and fortune telling if you are a beginner Silvia has provided ample sample spells and potions for you to practice working with before you start covering the advanced material.
What? No honestly, I didn’t invent that.
The idea that stuff of this sort is appropriate for a bachelor of science degree is simply ludicrous. I have no doubt that Westminster’s new dean can see that as well as anyone else. She has the delicate diplomatic job of extirpating the nonsense, I wish her well.
Fascinating! Re pendulum diagnostics they seem to be even more deluded than their colleagues from the Royal London Homeopathic Hospital: http://www.ncbi.nlm.nih.gov/pubmed/11934908
Woo-mongers seem to be rather keen on holes in the body. It is rather disturbing.
Excellent post David. I assume the pain from banging your head against a brick wall dissipates eventually.
I think that we are missing some of the positive aspects of this rubbish.
On the positive side there is “no good or bad energy” so they do have modern physics on their side ! You wouldn’t want any “nasty” energy flowing around your meridians or quantum healing ley lines would you (I might have got a bit confused in the last sentence).
I guess there are very few physicists around who have managed to identify “softened” or “loose” energy. It’s probably only a matter of time before hard science catches up though.
Also, with respect to “Pain Protocol”, asking “where does it hurt” is not a bad start. It does all go rapidly downhill afterwards though.
I used to think that drawing pictures of fossils was academically sterile but is Nobel candidacy stuff compared to this nonsense.
If ‘energy’ gets ‘stuck’ in the body as the slides suggest then it is surprising that exploding persons and body parts is not a normal hazard of walking down the highstreet. I did not notice any of that when I was in town earlier. Nor did there appear to be victims about the hospital earlier when I went to donate platelets. If the CAM practitioners are hiding this problem we should be told.
Apparently “there are more than 400 types of psychotherapy, each with its own theory and working hypothesis. Surprisingly (sic), all of them seem to … work more or less equally well”.(1)
I wonder if EmoTrance is more cost-effective than more orthodox psychotherapies? If so, the University of Westminster might have a money spinner.
Reference: (1) Placebo effects: understanding the mechanisms in health and disease. Fabrizio Benedetti. OUP 2009
It’s good to hear that Westminster has a new Dean with a working bullshit detector – I can’t see the naturopathy Hon BSc lasting for too much longer given the obviously ludicrous nature of the course.
Coincidentally, I have been having some rather one-sided correspondence with the University of Westminster recently regarding some research on “detox” body wraps that they don’t seem to want to discuss with me. I’m not sure why they are so reticent given that the results of the apparently unpublished research have already been trumpeted by the Daily Mail.
PS – thank you for your kind remarks regarding my article on the GCC’s incompetence.
That’s an interesting comment, though it begs the question of how effective any of them is.
It also begs the question of how much pure bollocks it is necessary for (a) the practitioner, and (b) the patient, to believe in order to get what is probably just a tea and sympathy effect.
What would happen to a GP who decided that ‘intuition’ was the best method for prescribing for a patient? Or pharmaceutical ‘picture cards’?
This stuff is truly mind-blowing. And with personal NHS healthcare budgets the latest loony idea from the dept of health, if this takes off we would at presumably all be able to ‘access’ as much quackery as we like.
Or is this EmoTrance course all a big hoax? Please someone tell me it is a deliberate joke!
Well, be fair. There is always the possibility that that the purely random choice of diagnosis or treatment made by a pendulum could actually be better than a naturopath’s intuition.
I think that you are referring to the paper by Hróbjartsson and Gøtzsche “Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment.”
J Intern Med. 2004 Aug;256(2):91-10
The review summarized data from 156 trials with 11 737 patients, and concludes “We found no evidence of a generally large effect of placebo interventions. A possible small effect on patient-reported continuous outcomes, especially pain, could not be clearly distinguished from bias.”
I find it strange that, although this paper (and their first one) generated a lot of hostile comment, the general consensus seems to be that placebos can have a clinically important effect. For example, the American Pain Society have a sensible “position statement” on the ethical use of placebos in pain management, and they don’t bother to mention the Hróbjartsson and Gøtzsche systematic review.
There are two opposing opinions of using placebo effects in clinical practice: (i) to do so is a sham, bogus; or (ii) we should be trying harder to use placebo effects without deception in ordinary medicine. My opinion has recently changed from (i) to (ii).
I think that tea and sympathy are likely to be at least as effective as the most theatrical bollocks, except for true believers. And I am not sure about the ethics of trying to convert true believers to skeptics.
the British Medical Association have guidelines on how GPs should refer to alternative practitioners. These guidelines might answer your question. They say GPs may “suggest that patients visit a particular type of therapist … and may then offer to recommend a suitable individual. In doing so, however, they must satisfy themselves that the individual is competent in the therapy concerned.”
With regard to formal referral to a chiropractor or osteopath, or to a doctor or nurse who also practices complementary medicine, the BMA guidelines say: “the GP must first be satisfied that the patient will benefit from the type of treatment involved. This presupposes that the GP has some knowledge of the basic principles of the therapy, and some belief in its efficacy.”
A literal reading would suggest that a GP who believed in the efficacy of EmoTrance and knew something about ‘intuition’ in diagnosis and pharmaceutical ‘picture cards’ could refer (formally or informally) to a naturopath with a BSc (Hons) Health Sciences: Naturopathy from the University of Westminster. Being an optimist, I doubt that this is what the BMA want their guidelines to mean. I hope the guidelines mean that belief in efficacy should be based on good scientific evidence. And therefore that a GP should refer only if there is scientific evidence of efficacy.
This begs the question: is it ethical to refer for a treatment where there is good scientific evidence that it is effective, and that sham treatment is equally effective. I.e. should a GP who believes that sham acupuncture is effective, refer a patient for real acupuncture because sham acupuncture is not available?
Again you raise some fascinating questions.
One thing that intrigues me enormously is as follows. If you do a non-blind comparison between acupuncture and no acupuncture, sommonly the acupuncture does a bit better (and so does the sham acupuncture). But how much of this effect is a real placebo effect and how much is just fluctuations in the condition and regression to the mean? There is remarkably little information about this, but a good argument can be made that you don’t even need to invoke a placebo effect to explain much of the apparent effects of ineffective treatments. Echinacea cures your cold in seven days when otherwise it would have taken a week, No placebo effect needed to explain that.
Likewise low back pain is notoriously variable and if you get the treatment when you are at your worst, the next day you’ll probably feel better, but you would have done without the treatment too. Again no need for a placebo effect.
The BMA’s advice to GPs seem to me to be quite disgraceful, because they, like the department of Health, have failed entirely to grasp the nettle of deciding whether or not a ‘therapy’ is total nonsense. If it happened that, for example, homeopathy was utter nonsense (to take an uncontroversial example) then the phrase “competent in the therapy concerned” is utterly meaningless. You can’t be competent in utter nonsense. All that it means (as interpreted by HR box-tickers) is that you have spent several years being miseducated in untruths.
The BMA are not alone in failing to grasp the nettle. The RCGP are even worse and the RCP and RCS haven’t helped either. The Department of Health continues to evade the main point. In stark contrast, most scientific societies have made pretty firm statements.
Does Sylvia Hartmann’s new book include the recipe for Polyjuice Potion? (1) It might be worth buying if it does.
Reference: (1) Rowling, J.K., Harry Potter and the Chamber of Secrets, Bloomsbury, 1998
If you do a trial comparing acupuncture to no treatment (or chiropractic or placebo) to ‘usual care’ you control for regression to the mean, natural course of the disease, and other time-dependent confounding factors. These factors are only a problem in uncontrolled, before-and-after studies — which are commonly used as evidence by CAMists.
The problem with a open trial of acupuncture (or chiropractic or any placebo) is that there is likely to be a positive bias in the people getting the extra attention, and a negative bias in the people deprived of the extra attention. The outcome measures are subjective: self reports of pain and disability, which are particularly susceptible to the biases of “seeing what you want to see, and saying what you want the practitioners to hear” (the cognitive scientists have several explanations and technical terms for this).
And, if the absolute benefits are small, I find it difficult to understand how you can justify the treatment. The acupuncture and chiropractic community will say that they are providing a “package”, and that the evidence applies to the package, not the particular intervention. If so, I wonder why we don’t just just try the box without the contents. Would be cheaper and as effective.
Is it the case that when I was at school, 45 years ago, a doctor could have prescribed me something with no actual medicinal value but with a nice Latin name? Or was that ever possible? And is it now forbidden?
I was a bit poorly with something non-specific, my mum and I were expecting a prescription, we got one, nice red medicine if I remember rightly….and I stopped feeling poorly…..
If it was the case, then were any trials done on the effectiveness of those prescriptions?
In the past doctors were able to prescribe placebos using a code for the pharmacist. In recent years this has been deemed unethical as it involves deceiving the patient and so in conflict with the principle of informed consent.
On the other hand with the known over prescribing of antibiotics in the past . . .
I recall from a long time ago (late 50s) that there would be an occasional prescription for aqua rubrum.
I’ve done it myself once. When my son was in his early teens he decided that he couldn’t sleep without a dose of promethazine syrup. I got a friendly pharmacist to top up the bottle with simple syrup until the promethazine was diluted out of existence, and my son didn’t notice the difference.
I expect I’ll now get letters from homeopaths saying that I proved that hoemopathic promethazine works. But no, I failed to bang the bottle on a leather-covered book after each dilution so the magic spell was broken.
It is a sign of the absurdity of the BMA’s position that they now frown on this practice but at the same time say it is OK to send a patient to a homeopath, as long as the homeopath has been properly miseducated. That is, to my mind, just gross intellectual dishonesty.
Muscleman and David
thanks, I’ve been wondering about that for years.
David, looks as if it would be a hell of a lot cheaper for the NHS to allow this placebo- prescribing again rather than messing around with elaborate ones like homoeopathy, as you say.
‘Aqua rubrum’, there must be a market to sell it in chemist’s, £2 a bottle, GPs could suggest patients buy a bottle, but of course even if that was deemed ethical, which I guess it still would be, despite not being prescribing, once the patient saw the bottle it would by law have to give the contents as water and sugar and colouring, so…..
. .. but of course, thanks to the insane laws, the homeopathiic pills do not have to be labelled with their ingredient. In fact now, thanks to the MHRA, they can even be labelled with indications in the absence of any evidence whatsoever. The law, in this area, is an ass.
this makes me think of alcohol labelling, surely another anomaly which needs reform: it seems to me that alcoholic drinks don’t have to have a list of ingredients in the UK (!). So my suspicion that certain beers taste of artificial sweetener in England, but not in Belgium or France, can’t be checked…..
Beer in Britain can contain a wide range of things not permitted under European purity laws. All sorts of sugars, ordinary sucrose, molasses sugar, invert sugars, lump sugar, raw can sugar can all be found along with torrified wheat and oats etc, etc. They are not inferior beers per se, just different. The one ingredient that is dodgy, especially when overused is caramel. It is sometimes added to make a beer seem ‘heavier’ than it actually is. It is added to some whiskies o make them darker as ignorant people think darker whisky is stronger or older. Caramel overused is bitter in an unpleasant way.
The other reason ingredients are not given is it would be too easy to copy the other guy’s award winning beer, tweak one ingredient then undercut him. Also one handful of a particular flowery hop as a dry hop is not necessarily an ‘ingredient’ in the same way the hops in the boil are but can make a big difference in the beer.
All this applies to decent real ale of course and the chemical brews of the uk produced ‘lagers’ should be avoided at all costs.
I once took a Spanish colleague to the pub and talked him through a pint of good bitter and got him to think of it as ‘ale’ rather than ‘beer’ which to him was continental lager. After learning to appreciate it on its own merits as a different drink allowed him to enjoy it. I like numerous European lagers and every Czech beer I have ever tasted (Staropramen Dark!!) as well as Belgian lambics and still have a soft spot for fizzy New Zealand beers. Next time you are in a British pub try the guest ale which is almost certain to be real ale and will be interesting.
I wasn’t talking about real ale, and I’m well aware of its qualities having been in the Campaign for Real Ale.
My point was that alcoholic drinks don’t have to have the ingredients listed. So ‘non-craft producers’, shall we call them, can put no end of things in. Yes, indeed the ‘lagers’ made in the Uk are to be avoided, it would be very interesting to have lists of their ingredients.
Like lack of proper labelling for homoeopathic products so there is at least one major anomaly in the UK.
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Reading those slides make me weep. I only worry about the people enrolled in these courses; when something is presented as fact in a lecture-based environment and accredited by a University it does seem to afford it some legitimacy. But of course, it’s nonsense. How are “academics” in this field able to peddle such rubbish? Who employs them? How do they make a living from this? The mind boggles..
I’ve read a lots of material on this site, and this is a complete eye-opener. I also gather that as it doesn’t come under the banner of apparently “useless” Arts and Humanities it won’t be affected by the teching cuts..
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