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Yves here. This post addresses a pet peeve of mine, and I suspect of many readers. While engaging in physical and mental health maintenance is a good idea (and some physical practices like exercise have a positive effect on mood), a whole industry of wellness providers has sprung up to exploit this desire. Their promotional efforts have even resulted in not just “wellness” schemes being covered by some health care plans but even pressure by employers for employees to sign up and be monitored by wellness specialists (in the US, they can’t be required to participate because ERISA). Recent surveys show employers are keen about these schemes, employees markedly less so.
KLG’s overview:
Wellness is one of the “keywords of the day,” along with its cognate, mindfulness, with intentional, holistic, artisanal, and deliverable only slightly lower on my list. While wellness was a useful concept when first described in the late 1950s, it is now basically a racket designed to separate people from their money and to assuage the conscience of large employers who have no real feeling for their employees.
In his recently published Mind the Science: Saving Your Mental Health from the Wellness Industry the clinical psychologist Jonathan Stea of Calgary dissects what the Business of Wellness has become, accompanied by recommendations and warnings for the unwary. It is doubtful that many of these unwary souls will find Dr. Stea’s book in their Barnes & Noble beside the works of the one and only Medical Medium, but they should!
Dr. Stea provides excellent advice on avoiding the pseudoscience of Mental Health and by extension Physical Health, which are not separable and are too important to be left to the whims of this particular “market.” True wellness has a deeper history that can carry the day, but only if we are intentional and mindful in what we do while remembering that the whole body, mind included, is the subject and object of healthcare.
By KLG, who has held research and academic positions in three US medical schools since 1995 and is currently Professor of Biochemistry and Associate Dean. He has performed and directed research on protein structure, function, and evolution; cell adhesion and motility; the mechanism of viral fusion proteins; and assembly of the vertebrate heart. He has served on national review panels of both public and private funding agencies, and his research and that of his students has been funded by the American Heart Association, American Cancer Society, and National Institutes of Health
Wellness is everywhere these days, but what does it really mean? Jonathan Stea, a clinical psychologist and therapist in Calgary, entered that swamp and has emerged with answers in Mind the Science: Saving Your Mental Health from the Wellness Industry, which was published earlier this month by Oxford University Press. It is a brisk read, with the foundation of his arguments well supported by a deep engagement with the relevant literature. Dr. Stea also regularly confronts “Wellness” on social media. He is doing essential work there and in Mind the Science, which begins with a description of “The Evolution and Seduction of Pseudoscience.”
What is pseudoscience as applied to health? Its beginnings lie in Clark Stanley’s “Snake Oil Liniment,” which really existed in the early 20th-century, with thousands of iterations to come, as noted below. According to Dr. Stea, pseudoscientific practices in mental health include Ayurveda [1], Biosound Therapy, Chelation Therapy, Energy Medicine (Therapeutic Touch), Thought Field Therapy, Naturopathy (Acupuncture, Homeopathy, Orthomolecular medicine [2]), Hyperbaric Oxygen Therapy, Ozone Therapy, Past Life Regression Therapy, and the Narconon Program of Scientology.
This is an incomplete list. Many of these therapies sound plausible to the layperson, which is a key to their popularity. Chelation therapy, for example, is used to treat heavy metal poisoning (e.g., lead, cadmium) with compounds that bind to heavy metal ions, most of which have a net positive charge of +2 or +3. When bound to a chelator, these poisons can be excreted in urine. Hyperbaric oxygen can be used to treat wounds infected with bacteria that are killed by oxygen. But there is no evidence that this or any other of these high-sounding practices will have any effect on mental illness. No, chelation therapy will not flush unnamed “toxins” out of the brain and the body and restore mental and physical health. Moreover, ozone is toxic. We have no past lives to which we can regress. There is, however, much evidence that in the hands of self-described “therapists” these “therapies” can be dangerous. For example, Mind the Sciencerecount the sad story of Kirby Brown in Chapter 5: Falling for Fake Scientific News.
According to Dr. Stea, the only protection against quackery is to “become literate in science and mental health.” He begins with one Bill Maher being interviewed by Larry King [3] on December 15, 2005. The substance of Maher’s argument was that Western medicine is toxic, from pain relievers to vaccines. On his own show Real Time with Bill Maher earlier in 2005 Bill Maher had stated:
I don’t believe in vaccination either…That’s another theory that I think is flawed, and that we go by the Louis Pasteur theory (the germ theory of disease), even though Louis Pasteur renounced it on his own deathbed and said that Béchamp was right; it’s not the invading germs, it’s the terrain. It’s not the mosquitoes, it’s the swamp they are breeding in.
Here Maher is referring to the 19th-century argument about the “germ” and the “terrain” theories of disease that is now perfectly understandable in the (unfortunately seldom made) distinction between the cause of a disease and the agent of a disease. [4] In the case of malaria, it is the “swamp and mosquitoes” (together the cause of the disease) and the species of Plasmodium (agent of disease) the mosquitoes transmit when feeding on humans. Another example is the distinction between the agent of tuberculosis (Mycobacterium tuberculosis) and the cause of tuberculosis. The cause of the White Death that killed millions was removal of rural people to overcrowded, fetid tenements in big cities such as London and Manchester as an “economic necessity” required by the Industrial Revolution. A more recent example is the distinction between the cause of AIDS in the Global North, centered in the United States, and the agent of the disease (HIV), which was transmitted through distinct but complementary behavior in the Global South (e.g., sub-Saharan Africa).
According to Dr. Stea, “(T)o become literate in science means adopting the intellectual humility that is associated with the scientific spirit while at the same time constantly learning about science and finding a balance between trusting expertise and remaining skeptical about scientific claims.” Our current scientific leadership could follow this lesson a bit better, but I digress. An example from real life has appeared from Dr. John Turner, a chiropractor who developed a proprietary protocol called Quantum Neuro Reset Therapy (QNRT™) that “initiates a quantum shift in the nervous system by resetting the brain’s response to emotional triggers for both past and present emotional trauma and stress.” Quantum is a protean word, but “science literacy involves knowing just enough about quantum physics to understand that the alternative medicine practitioner trying to sell (keyword) you a therapy apparently based on quantum physics doesn’t understand quantum physics” [5]. Mind the Science is filled with other examples just as distant from any reasonable conception of science and scientific evidence as QNRT™.
The Wellness Business [6] had its origins in the work of John Harvey Kellogg, yes, of Battle Creek, Michigan, at the Battle Creek Sanitarium (established in 1878), which was a medical center/spa/grand hotel that attracted “celebrities” of the late-19th century. Kellogg was an advocate of “biologic living,” in which every health condition could be treated with “physical exercise, adequate sleep, and a diet replete with fruits, grains, vegetables and milk”. [7] Kellogg was followed by Bernaar Macfadden, perhaps the first well-known health “influencer” (there is very little new under the sun) and his magazine Physical Culture. Kellogg and Macfadden “brought 19th-century ideas of health moralism into the new era of mass marketing and celebrity culture, championing the fantasy that your health could be controlled with a virtuous lifestyle” (see Michelle Cohen; virtuous is doing heavy lifting here). Kellogg and Macfadden have a multitude of successors, especially in anti-psychiatry and wellness movements of today.
Ambivalence about psychiatry dates to its beginnings in the opposing views of the German psychiatrist Emil Kraepelinand the Austrian neurologist Sigmund Freud. According to Kraepelin, psychopathology is the result of abnormalities in the brain. The much better-known Freud was the “Father of Psychoanalysis.” As illustrated by the first two editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I, DSM-II), psychoanalysis was the ruling paradigm in the beginning, but with DSM-III the Kraepelin thesis largely supplanted psychotherapy and neuropsychiatry has dominated for the past 60 years.
It was easy for many to dismiss psychotherapy through the middle of the 20th century, just as it has become easy to criticize neuropsychiatry, which can sometimes be reduced to “Yes, we have a pill for that” (Bill Maher was not entirelywrong). The psychiatrist Thomas Szasz became a leader in the mid-century antipsychiatry movement with his publication of The Myth of Mental Illness (1960; still in print), in which he argued there is no such thing as mental illness. As late as 1996 he wrote:
I believe viewing the schizophrenic as a liar would advance our understanding of schizophrenia. What does he lie about? Principally about his own anxieties, bewilderments, confusions, deficiencies, and self-deceptions. He pretends that he is not confused, impotent, and insignificant; he is confident, powerful, and supremely significant.
This is nuts nuts incorrect. The causes of schizophrenia are not known, yet, but it is certain that both Kraepelin and Freud would have had something useful to contribute to the understanding and treatment of schizophrenia. The condition is certainly not due to the patient lying about himself, not now and not in 1960.
So, where are we today in the Wellness Business? According to Dr. Stea, far down the rabbit hole of pseudoscience. Perhaps the best example is one Anthony William Coviello, known to his followers as the Medical Medium. Following John Harvey Kellogg and Bernaar Macfadden of one hundred years ago, the Medical Medium has built an empire on his view of wellness, which began when he was a 4-year-old and an elderly man spoke into his right ear, “I am the Spirit of the Most High. There is no spirit above me but God.” This has continued to the present day, as “Anthony continues to tell us that he has been greeted by the man’s voice every morning from that day forward as he’s provided with paranormal information about the health status and necessary treatment of anyone he encounters.” Medical Medium operates now with endorsements from these (and many other) “A-Listers”: Dwayne “The Rock” Johnson, Sylvester Stallone, Robert De Niro, Hilary Swank, Novak Djokovic, Liv Tyler, and Gwyneth Paltrow (of another famous wellness empire called Goop).
Medical Medium covers it all, with canned answers to virtually every human illness, from anxiety and depression to cancer, autoimmune disease, and blood clots. I have tutored medical students in Hematology for the past 15 years, so I downloaded the Medium’s 2-pager on Blood Clots. I was greeted by this:
- When you have elevated blood fats from a diet too high in radical fats (this applies to all fats, whether they are healthy fats or not) and proteins – whether from animal or plant sources, such as butter, milk, yogurt, cheese, eggs, chicken, beef, pork, lamb, oils, nuts, seeds, soy products, fish, ghee, chocolate or any other–your blood will become thick. Thick blood has trouble carrying ample amounts of oxygen and macro minerals such as magnesium and trace mineral salts. This can prevent proper blood flow.
- One way someone can form blood clots is from pathogens such as viruses and bacteria, or poisons such as toxic heavy metals, pesticides…and countless other toxic chemicals. Pathogens and toxins trigger an alarm that prompts white blood cells and other immune cells to attack and consume these invaders. If the pathogen or chemical invaders are not completely consumed, more immune cells will join in and cluster around these invaders. As this clump of immune cells flows into smaller blood vessels and capillaries an obstruction is created. This is one variety of blood clots.
Lots of medical words, but this is nonsense from start to finish that never describes an actual blood clot. And no, an aggregation of immune cells, which would be unusual in the blood, is not “a variety of blood clot.” Nevertheless, in this healthcare guide you can “Find out more about how to heal blood clots, including more on the foods to avoid (plus additional foods to watch out for), foods to eat, and supplements with dosages in the NYT best-selling book, Cleanse To Heal,” which is a paean to one of the most common tropes in the alternative medicine of the wellness business: “Flush out the toxins! And by the way, we will show you how to detox if you will only buy this book! And several companion volumes.”
Which brings us to the question “Why alternative medicine?” Mind the Science addresses this question throughout the book by distinguishing difficult science from attractive pseudoscience. While one may think the dividing line is clear, this is not always the case. QNRT™ has nothing to do with the quantum or the brain. Light therapy for Seasonal Affective Disorder may work for some but the mechanism remains obscure. Dr. Stea is somewhat contradictory about the chemical imbalance theory of mental illness but does point out that the simple model associated with serotonin is a gross oversimplification but may be valid for some even if the exact mechanisms are unknown. “Science versus pseudoscience” is beyond the scope of discussion for now.
The most convincing answer to “why” is that people seek alternatives when conventional practice does not serve their needs. This is true in psychology, medicine, and political economy. In each of these the sense of touch writ large, therapeutic and otherwise, has been obliterated as community has been thoroughly alienated and commoditized under Neoliberalism. However, we should always keep in mind the distinction between traditional medicine and alternative medicine. Traditional medicine often works. Tu Youyou was awarded a Nobel Prize for her discovery of the anti-malarial drug artemisinin. Her search was motivated by ancient Chinese medical texts that recommended tea from wormwood as a treatment for malaria. The active ingredient in this tea is artemisinin. [8] Ethnobotanists the world over have learned much about the utility of traditional medicine. Much to the astonishment of our current Professional Managerial Class (PMC), humans have been good at inductive reasoning and engineering for a very long time. The definition of “alternative medicine that works” is “medicine.”
Perhaps the most useful approach to wellness is to go back to the first use of “wellness” as a clinical term by a physician who focused on public health. Halbert L. Dunn published a paper in the Canadian Journal of Public Healthin 1959 entitled “What high-level wellness means.” I have not been able to gain access to this paper but his related paper “High-level wellness for man and society” (1959) from the American Journal of Public Health and the Nation’s Health is here. It addresses how mental health and wellness are dependent on one another and are the normal state of being only when people live in a healthy society. We do not live in a healthy society. Nor did everyone in the United States or Canada 65 years ago, but that is not the point.
Halbert Dunn begins this paper with (emphasis added):
The awakened interest of public health circles in full-time local health departments and in the family and community programs of health maintenance is an indication that health workers are becoming more “health oriented.” This shift in emphasis is in accord with the frequently quoted fundamental objective expressed in the Constitution of the World Health Organization, “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity…
It is my thesis…that both medicine and public health must undertake a multiple and thoroughgoing exploration of the factors responsible for good health. Without prejudice to the importance or the continuation and support of existing medical and health programs involving preventive, curative or rehabilitative research and activities, it seems clear that many of today’s and tomorrow’s problems call for the stimulation and development of a new major axis of interest directed toward positive health – one strong enough to activate physicians, health workers, and others in devoting a substantial segment of their time, resources and creative energies toward understanding and culturing good health in a positive sense.
This is illustrated in Figure 1: The Health Grid, Its Axes and Quadrants (redrawn for clarity). Sixty-five years later one is struck by the assumption that public health is a real concern of the people, through a native, functional public health system that includes healthcare providers across the spectrum, accompanied by the natural assumption that public programs will be devoted to such. Wellness is attainable only in a favorable environment through social and cultural institutions. Those of us of a certain age do remember this imperfect but perfectible pre-1978 world before the Neoliberal Dispensation. And therein lies the minor weakness of Mind the Science. Although Dr. Stea does recognize that he is a practicing psychologist in a city that provides mental healthcare as a right, his situation is rare. Mental health care is not widely available, especially for those at the greatest risk. And for most people, environment is probably the critical factor determining mental health.
This simple diagram from Halbert Dunn also addresses the Kaepelin-Freud argument. Mind is a function of the brain. It is reasonable to expect that poor physical and mental health are often caused by a poor environment and that the agent(s) of psychopathology lie in insults to the brain in that poor environment. Some of these are reparable, by therapy and/or therapeutics, despite what the wellness and anti-psychiatry movements say.
But it would be much better for all, rich and poor alike, if we lived in an environment that –through the intermediation of social and cultural institutions – virtually everyone has enough to eat, a safe and comfortable place to live, a school to attend for as long as desired (within reason), a rewarding job at a living wage, and expectation that in the case of an unlucky accident the necessary healthcare, mental and physical, will be readily available. Dunn has been criticized as the founder of “The Wellness Movement,” but his view of wellness as dependent on community is far removed from wellness as a commodity to be purchased, often at great cost, by solitary, alienated individuals.
When social and cultural institutions provide what is needed, through the active contributions of citizens instead of consumers (the Neoliberal word for citizens), virtually all of us can live in the upper right quadrant of high-level wellness and those who cannot due to illness live in the upper left quadrant with their poor health protected. Very few will live in the two lower quadrants. And those with the wherewithal can still Goop all they want, while the Medical Medium eventually withers on the vine for lack of business.
Notes
[1] The “Science of Life” in Sanskrit, 5000 years old and generally experienced in a completely denatured form outside of South Asia, as are other most other forms of traditional medicine. This vitiates any value they may have.
[2] Quackery involving mega-dosing on water-soluble vitamins (e.g., vitamin C) as a key to health, Orthomolecular Medicine was introduced by Linus Pauling in the 1950s. Pauling was awarded the Nobel Prize in Chemistry 1954 for his many contributions to chemistry and the structure of molecules (e.g., his classic text The Nature of the Chemical Bond and the alpha-helix). Pauling was also awarded the Nobel Peace Prize in 1962 for leading the early anti-nuclear movement and became the only single Nobel Laureate with two prizes. People tend to listen to Nobelists, even when they speak nonsense. This is especially true for the ersatz Nobel Prize awarded by the central bank of Sweden, Elinor Ostrom excepted.
[3] For our international readers, Larry King was a radio and television talk show host in the United States for over fifty years beginning in the 1950s. I began listening to him very late nights in the laboratory in the late-1970’s. His Larry King Live on CNN was “must-see TV” from 1985 until 2010. He was quite good at his job. Bill Maher is a comedian and political talk show host for the past thirty years. He is also quite good at his job.
[4] Agent versus cause (reviewed here) has been presented most effectively by Richard C. Lewontin, who was a pioneer in molecular evolution.
[5] And there is this, from a mashup of Richard Feynman and Niels Bohr that any undergraduate who got to the end of calculus-based physics will appreciate.
[6] Dr. Stea refers to this as the Wellness Industry, but I think “business” in the sense of the third entry in the Oxford English Dictionary is more appropriate: mischievous or impertinent activity. This usage goes back to 1466 in the Paston Letters: “Ther ys but few within oure plasse but they know how yt is with her, and al by her awne bessynes of her tunge.” This is Late-Medieval English that is easily followed.
[7] There is also a good case that Kellogg based his advice on his rather severe Seventh Day Adventist faith: “He warned against sedentary lifestyles, meat, sugar, caffeine, tobacco, alcohol, sex, and obesity – the latter of which was considered both a slight against physical attractiveness and a health hazard. He referred to masturbation as ‘self-abuse,’ advising that it could lead to mental illness, cancer, and moral destitution.” He recommended barbaric treatments for both boys and girls to prevent this “self-abuse.” One can only wonder at what happened behind his closed doors.
[8] Tu Youyou shared her Nobel Prize with William C. Campbell and Satoshi Omura, whose work led to ivermectin as treatment for elephantiasis and river blindness.
26 comments
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Thanks. I’m going to repeat that by now very old quote:
You know what they call alternative medicine that’s been proved to work? – Medicine.
And acupuncture doesn’t work either?
Surely not all of these alternative therapies are useless. What will we be left with?
Placebo effects. Which, I promise, isn’t a snarky answer. I was once a stalwart among the evidence based medicine brigade but I have come to think that placebo effects deserve some interest and maybe even use.
I don’t have references to hand but an advanced search of NC stuff will turn up some interesting articles on why the placebo effect might deserve a second look since this is the site that challenged some of my preconceptions. My only caution is to what extent it deserves public resources!
That’s not correct. Acupuncture does reduce inflammation. Some solid studies on that, to the degree I was able to get my insurer to pay for it (appeal to NY State, they reviewed the research and overrode the insurer).
Fair enough. Like I said, I’m open to changing my mind in the face of new facts (like the quote attributed to Keynes).
My former ultimate boss wrote a highly EBM based textbook on rheumatology which became the UK medical standard (plus he was the debunker of Vioxx) but he now has a much more nuanced view.
My take on the whole medicine and wellness thing is that something that works for others might not work for you and vice versa. At one time I wasn’t a believer of acupuncture and Chinese medicine, but my mindset has gradually shifted to where for most ailments, I would look to those two as a first resort, only to visit Western doctors if all else has failed. It also helps that I currently live in Taiwan where it’s easy to find skilled practitioners.
When I was a small child, there was a period of time when I was constantly having nosebleeds in addition to having boils all over my lower body but mostly on my bu**ock. After multiple visits to multiple doctors and ingesting a ton of Western medicines, I was finally taken to an old Chinese acupuncturist who then proceeded to put a couple of needles on my ears. Needless to say, on the way home, I could not help but express my very strong skepticism of the entire ordeal. The thing is that one visit was all it took to cure whatever it was I had been suffering from. I am not saying acupuncture is the answer to all illnesses (certainly I don’t think it can cure cancer), but it can certainly yield beneficial results.
Another recent find that has pissed me off to no end is the following: a couple of years ago (just before Covid) a doctor in the United States diagnosed me with a “mild” case of sleep apnea and very predictably she arranged for me to undergo CPAP therapy. Unfortunately, I could not adjust to sleeping with a mask on my face, and I decided to give up on that approach after two months and three different masks. Earlier this year, I decided to give Chinese acupuncture a try, and I was able to sleep better as long as I kept up my once every 3 weeks visit to the doctor while drinking some prescribed herbal medicine. This last month however, the Youtube algorithm finally surfaced something that has worked for me really, really well: sleeping with a mouth tape. Apparently the whole thing went viral when people like Gwyneth Paltrow started doing it, so yes this is the same Gwyneth Paltrow, the actress that’s been pushing those dodgy Goop Wellness products. Anyway, I have slept better in the last month than in the last 2 decades, so I really could not care less about “studies” that have found the practice to be no more than a gimmick because it’s certainly working for me. Since mouth tapes are cheap, I can also certainly see why doctors would not recommend them, you know just like a certain Covid prophylactic whose name can not be said even until now.
I am not a medical professional, so I am not here to give medical advice, just to share some of my personal experiences.
I think the interrelationships between various forms of therapy/treatment are very complex, much more than just assuming a placebo effect can explain. I’m very much a rationalist when it comes to medicine, but like you, I’ve had enough unexplained experiences (including one with acupuncture), which makes me reluctant to dismiss all complementary treatment forms.
In addition to the placebo effect (which, if it works, is still treatment), I think a lot of treatments work, but not for the reasons the therapists understand. A straightforward example would be various Ayurveda mouthwashes. These seem to have a very positive effect on oral health, but the research I’ve seen indicates that its primarily the simple mechanical cleaning effect of sloshing high viscous fluids that benefits, not the various complex concoctions (although some undoubtedly do have an antibiotic and antiviral influence). But the ‘ritual’ of putting together the concoction may aid in helping people keep up with a healthy habit. It reminds me of the old story of a garden centre owner who gave a guarantee to anyone who bought a tree from him that he’d replace any failures immediately, without question – the condition being that twice a week they had to add the liquid fertiliser he gave them to the tree when the were watering it. He allegedly never once had to replace a tree. When asked what was in the fertilizer bottle,he said it was just coloured water. It worked by reminding people to actually water their new trees.
I also would not rule out that some Chinese medicine works exactly as is claimed – by the cumulative impact of the ingredients, rather than by way of one specific active ingredient, as assumed by mainstream medicine.
That said, the placebo effect is itself not fully understood, and many so called ‘placebo’ impacts are more due to bad study design and interpretation than anything else (I’m sure Terry F. could add more to this). I think any doctor will confirm that patient outcomes can be improved simply by making them feel more reassured (wish is undoubtedly how a lot of complementary therapy works). My local doctor is very good on this – he trains in lots of younger GP’s and one told me that he puts a strong emphasis on eye contact and physical contact with the patient – sometimes just a reassuring hand on the shoulder or hand. Older patients in particular seem to appreciate this very much.
Thanks for the shout out but you pretty much nail it yourself.
The only tidbit I’d add is ALWAYS accept an invitation to be in a clinical trial. You’ll get brilliant care, fast and comprehensive scans and blood tests etc. I’m a control patient in a study of the joints of Premier League UK footballers. Already know that the terrible osteoarthritis that has afflicted mum has begun in me (though at this stage it’s just a shadow on a knee xray). At least I can write up an end of life care plan saying “shoot me” :p
Ayurveda helped me get rid of severe migraine headaches. Its philosophy is derived from nature itself.
Almost every Rumble and Utube commercial that I’m forced to skip through after the requisite 5 seconds is healthcare related with occasional one coming from political campaigns. Have advertisers somehow targeted me for these ads because of my age? Why aren’t they trying to sell me a car which I’m in the market for?
Some people on here have disagreed with me so take this with appropriate pinch of salt. But I have definitely found that if I press skip ASAP at the 5 second point when watching on tablet/phone and make sure I watch in Linux Firefox with all the extensions to cut ads (both YouTube and content creator) when in my laptop then it seems YouTube/Google have given up on me.
Very few ads compared to my peers. The ones I get are somewhat correctly targeted but interestingly are rarely the “you must watch 15 seconds” type.
It always creeped me out when the HR department at a huge corporation, usually the least honest people in an org like that, get all excited about their latest wellness program. “Why yes, I’d love to sign up for a program where I give you backstabbers even more very personal data about my well being. I know you will only use it to make me weller, so there’s absolutely nothing to worry about!!!!!!!!!1111” This article rightly points fingers at the wellness industry, but it also gets a lot of useful things mixed up with the wellness industry that have been around a long time and definitely help people as much or more than the “solutions” the mainstream medicine industry pushes. It’s great to point to the science, but with so much science caught up with the same monied interests as the alt medicine industry, I wouldn’t invest much in either one. How many medical science papers have been retracted due to BS from high paid doctors just trying to cash in by publishing BS? Either industry seems equally scammy to me.
The first link pointing to the survey… follow that to IBI who did it, and all they provide is a glib infographic of their summary. I want to know what the survey questions were.
Whenever I read the privacy policy of a wellness program that my employer has offered, it’s all a general handwave. No way would I participate. Pretty sure the info isn’t covered by HIPAA.
KLG, your work is much appreciated. Hopefully, I can add a thing or two, as your subject runs into my own experience and study.
I’m not sure anti-psychiatry belongs in the same category as QNRT. You make a few references to either the movement or its key claims, such as the acknowledgment that the chemical imbalance theory of mental illness is at best questionable – I’d say debunked. The quote you chose from Szaz is unfortunate, because schizophrenia is understood to be the mental illness which is caused by physical differences in the brain; the ‘personality disorders’ and the rest of the untestable “diagnoses” filling the DSM are not. For recent work on this, a book I always reccommend is Bruce Levine’s A Profession Without Reason.
Two other relevant books spring to mind: the first is investigative journalist Robert Whitaker’s Anatomy of an Epidemic, and the second is Visions of Social Control by … someone, the last name is Cohen – a sociological reader. While the first will give some key facts, such as that outcomes for mental health patients receiving heavy psychiatric care are terrible, the second will allow us to zoom out and reconsider some social problems from different angles. One view outlined has us ask for whom a defined problem is in fact problematic; this, I think, gets us closer to the truth. ADD, and later ADHD are examples of people not fitting into institutions, in this case schools, and Industry springing up to monetize the problem, rather than solving it. Drugging children who can’t stay still, which is most children, borders on barbaric. Psychiatry is a hugely profitable means to try to hammer square pegs into round holes, when we might instead ask why we have a mode of living which many clearly have trouble adapting to. Psychotherapy, in my view, is a less scientific means of doing the same, and also the soft edge of the system of social control, by which behavior inimicable to power is problematized and its actors neutered.
Freud always bothered me a little, because he recognized that urban industrial life was alienating, and was the cause, ultimately, of neuroses- that’s what Civilization and its Discontents is about – but instead of concluding that society should change, he sought to change the individual.
It’s my reading of your conclusion that we’re on the same page on this; sorry to nit-pick; I have much more to say on the subject. Very valuable post, and, again, most appreciated.
Not nitpicking at all! Thank you very much for the engagement.
I am sure sure anti-psychiatry doesn’t belongs in the same category as QNRT. It is fascinating that mental illness presents differently in different times and places, but there are people who just cannot distinguish between what’s going on in their head and what’s real. Call it schizophrenia or bi-polar or whatever – being able to go without sleep for days or weeping in terror at the sight of things no on else can see is illness.
An illness that in some cases can be managed by very rigid structure and in many by meds.
Postpartum also seems very much a consequence of something happening to the body.
The rest of, or most of it, we’ll, isn’t the checklist method of diagnosis an industry giving up on the intractable problem of inconsistent diagnosis?
But for most of it, James Thurber’s 1937 book, Let Your Mind Alone is easy to find. Been thinking about this a lot following a recent work lunchtime learning where the guest speaker explained that 25% of the population is neuroatypical. Why not decide that being taller than 6’2″ is gigantic?
How could you omit the regular colonic irrigation? : )
T. C. Boyle wrote one of his funniest novels about the Kellogg project.
https://en.wikipedia.org/wiki/The_Road_to_Wellville
G. W. Post was an imitator of Kellogg. Breakfast cereal is junk food to a lot of us third wave health zealots. If you want to see
great unintentional classic comedy there are the Euell Gibbons grapenuts cereal ads. Perhaps Boyle’s inspiration was watching those inescapable spots.
Much of what is called mental illness in the diagnostics and standards manual are just normal variations in human personality and behavior, with some genetic basis (probably combined effects of a number of genes) and modified by life experiences. In some social environments those variations are more accepted and put to use in common social roles, in other social environments they lead to social exclusion and inability to fuction socially. The reason why we see so many more people diagnosed with a “mental illness” now is that our society has become more inflexible in how it makes use of its people; in fact the subset of society that sets the rules doesn’t want or need many people and considers them an undesired surplus. In, say, a neolithic village, they would have been put to use in some role that justified their continuing inclusion in the community. But there is no pill or diet or exercise regime that is going to cure the problem of being unwanted and rejected by one’s society.
After you take away that broad range of so-called mental illnesses, which maybe should be called “social adjustment problems”, there remain psychoses and dementias that make a person a danger to themselves in even supportive social environments. Almost all resulting from rare genetic variants or from damage to the brain caused by environmental toxins. Those are medical conditions that may or may not (yet) be treatable.
I think this is the crux of the issue.
I have had ME/CFS for two decades now. I have tried a variety of treatments and know people who have tried even more. It is easy to criticize the decisions of sick people who go to a doctor and are told there is nothing to be done, that they will simply have to struggle with walking up stairs, eating most foods, thinking, communicating, or socializing for the rest of their lives. But please ask yourself what you would do in my shoes. The commentariat here is filled with frighteningly intelligent, driven people. I very much doubt most here would shrug and give up.
While alternative medicine has its share of potentially dangerous treatments with little or no evidence to support them, I have seen as much damage happen via what seemed like promising mainstream medical treatments (ie Rituximab and exercise therapy, not to mention the mRNA vaccines which, while not used to treat ME, did make the illness worse–seemingly permanently–for some people I know).
Say what you will about homeopathy, but it seems rather unlikely for magic water to make someone worse. Particularly as it applies to chronic illnesses with no good treatment options, I wonder why some people get so concerned about it. The dispute feels religious.
In my now-long experience with this illness I can also say that of the rare recovery stories I hear there are some belonging to both camps. In my experience in the world of the fairly ill, anyone claiming that either alternative medicine or western medicine is the only way has some blinders on. Nakedcapitalism is so often at the forefront of acknowledging when seemingly-problematic societal behaviors are actually rational responses to bad situations. It usually sees through false dichotomies to point the finger at the true culprit, often in the form of the Monopoly Man. Unfortunately, I see the opposite in quips like the one about how “alternative medicine that works is just called ‘medicine'”, an argument which is simultaneously semantic, circular, and a “from authority” argument devoid of any real-world value. It conflates “insufficient evidence” with “is proven not to work”. It gives, in my opinion, far too much credence to peer reviewed science when everyone reading nakedcapitalism regularly will know what a mess that is. The authoritative arrogance in particular risks supporting dangerous (but profitable!) policies, such as those limiting the availability of ivermectin once it became a potential rival to new covid treatments.
I grow tired of the crusade-like tone of people who insist that alternative medicine = snake oil. Some of it does, surely. But the same is true of western medicine, if in somewhat different ways. I think a truly humble, scientific perspective could acknowledge that.
For those who refuse to treat themselves with anything which has not been proven to work in several large double blind placebo controlled trials I wish them luck (and I mean that). But I very much hope they will show a reciprocal respect for the decisions the rest of us make when we have no good options, only a “plateful of maybe a little less bad” [1]. The condescension is tiring, and it seems strange that so much energy is spent shaming people for seeking solutions to problems that Western medicine cannot fix.
[1] From Leviathan Wakes
I was in Australia from 2002 to 2004. Doctors there were far more tolerant of what they called “complimentary medicine” than US docs are of alternative medicine.
I’ve been treated with acupuncture (actually “moxibustion”) and experienced immediate relief from a painful pinched nerve. The practitioner was a family member who had a thriving practice of people who allopathic/western medicine couldn’t help. With his practice, the people who slipped through the cracks of western medicine were getting some relief.
Meanwhile, the acupuncturist himself died of (treatable) pneumonia. He hadn’t appreciated that western medicine is good for some things. Sad but true.
Meanwhile, I’d suggest the message is this: practice humility.
This post is provocative because It’s all over the map. Is alternative medicine being disparaged or not? To me it’s clear that some of “wellness” treatments are snake oil, while, from personal experience, I know that much of alternative medicine works well and is the only help available. By alternative medicine I mean treatments regular doctors know nothing about. Knowledge is the best defense against false claims of all kinds.
“Flush out the toxins!” is not a trope. Why is it that detoxification is not acceptable in mainstream medicine?? Maybe back in the 19th century it was “a fantasy that health could be controlled with a virtuous lifestyle” when infectious disease was the big danger. But now it is civilizational diseases that are running rampant, against which healthy lifestyle is hugely important, even controlling since we have antibiotics and antivirals for the infectious dangers. Yes it is the environment both physical and social that is the cause of most disease today. Things have changed and become very dark indeed.
Thank you for your comment. Since NC is not the London Review of Books, there was not enough space to include everything in the discussion of Mind the Science, which covers a lot of ground. Some material that did not get out of my notes addresses your concerns.
Anecdotal evidence, especially in the form of “personal experience,” is not scientific evidence. The following is a simple rule of thumb that does not get into the epistemological weeds so loved by most philosophers of science (who generally have no clue about the practice of science: I have always taught my research students the following – once is an anecdote, twice is data, three times is a result, but only if the result leads to further results.
Regular doctors are human just like everyone else, and there will be things they know nothing about. In my experience in medical education, most physicians are familiar with “alternative medicine” because they learn of it from their patients. And knowledge is indeed “the best defense against false claims of all kind.” The question is, “What is knowledge?” Jonathan Stea is enamored of Evidence-Based Medicine (EBM) in his book, but he seems to not realize that EBM depends on “evidence from whom for what purpose.” Dr. Stea states that there is no anti-cardiology equivalent of anti-psychiatry, but he does not refer to the literature on the diet-heart hypothesis that led to the substitution of healthy fat and protein in the Western diet for mostly refined carbohydrates. The result was an obesity epidemic. In a related matter, cholesterol is not “evil” except in those who are afflicted with familial hypercholesterolemia or similar conditions. The overuse of statins, which to my knowledge were the first “blockbuster drugs,” is tapering off in something of an “anti-“ stance toward conventional cardiology.
“Flush out the toxins” is a trope (“figurative or metaphorical use of a word or expression” according to the Oxford American Dictionary). This does not mean that toxins are not “flushed out” of the body upon acute exposure. Chelation therapy is included in the post. Animals have other endogenous mechanisms, too, do deal with this, including glucuronidation and the addition of glutathioneto xenobiotics so they can be excreted in the urine and feces (Wikipedia is a reasonable source for these details). We also have multidrug resistance proteins that are sometimes too active when they flush chemotherapy drugs out of cancer cells, which is counterproductive. But, this does not mean the Heavy Metal Detox Smoothie from the Medical Medium has any validity other than to make those who drink this stuff feel better about themselves, which is not to be disparaged. But the Heavy Metal Detox Smoothie is indeed a trope along with other similar recommendations from the alternative medicine/wellness world. Notice the disclaimer at the bottom of the title card in the video: “No health or wellness claims are made in connection with this drink.” Then what is this for? Ditto for his Wild Blueberry Challenge. Medical Medium is the exemplar of the alternative medicine/wellness universe.
As to your conclusion, no one can deny, except Big Ag and Big Food, that our food-like substances and air/water pollution along with a seriously inhuman political economy are problems with long-lasting effects. However, the tropes of alternative medicine/wellness are not the solution to these. Real food, clean air, and clean water are. Along with medicine that views each individual as a whole person and not the disease or condition of the moment.
Western medicine has, as we all know, become far more commerce than medicine. And it’s distorted further by the modern legal foundation of patents which ensures that only new synthetic molecules which can become ‘property’ will ever be promoted for ‘healing’ by big pharma, which controls the dialogue around ‘health’. And of course, ‘healing’ itself is not what modern medicine is concerned with. It’s only interested in ‘treatments’, where no condition is ever cured, but where we’re told to ingest–preferably daily–meds that will maintain us all in a suspended state of not-quite-health.
That’s the wonderful chronic illness model of contemporary medicine. I don’t think there’s even a way for medicine to ‘correct’ itself; it’s far too profitable, and everyone on the inside, doctors included, have wrapped themselves in the flag that it’s all ‘scientific’, while everything else is just various forms of scams and superstition. But medicine is itself now often a perversion of science, whereby only that research which leads to blockbuster treatments becomes seen, and everything else–which is a giant, rich, complex world, and which sometimes includes ideas from ‘alternative’ worlds–fades sadly into the background. In my own experience, I have found a lot of wisdom and effectiveness in many alternative treatments in my adult life–often after painful and fruitless dallies down the conventional paths. Not always of course, but enough to find that I often try alternative methods first now–if they’re non-invasive.
And as it happens, NC had the perfect graph in their links just last week expressing with perfect vividness how american medicine is now mostly an epic extraction of our money and health, all at once: https://x.com/MaxCRoser/status/1833853074609144169
Historical Quibble:
Pauling was also awarded the Nobel Peace Prize in 1962 for leading the early anti-nuclear movement and became the only single Nobel Laureate with two prizes.
I believe Pauling was the second. Madame Marie Curie received her second Nobel in 1911. She had received her first (shared with Pierre Curie and Henri Becquerel ) in 1903.
An early mover into the mental wellness business in the early 2000s were the Branson clan (father giving his siblings corporations to move into the sector).
The global war against all those opposed to capitalist imperialism launched by Bush and Blair and the growing financial crisis no doubt contributed to the growth of the problem but the private sector moved in because of the low risk and lack of oversight.
Financially, the private sector only need an empty office, no expensive medical equipment and for many in the sector minimal training.
On top of this, there is the problem of defining mental health, which gives the private sector the ability to create more illnesses and definitions of illness from its position of power and corporate control, thus claiming that those in power are okay, those without are mentally ill and need help.
Looking at the sexual abuse charges against entertainers and politicians, one can see how power excludes them from the issue of mental health problems as well as criminal liability