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Reiki & Alternative Medicine
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In this episode, Megan and Frank discuss the alternative medicine practice known as "Reiki," a kind of touch energy healing. What is Reiki, and how is it supposed to work? Is there scientific evidence of Reiki's effectiveness, or is it all just a placebo? And if so, would that really be a problem?
Hosts' Websites:
Email: philosophyonthefringes@gmail.com
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Bibliography:
Frontiers | Does Reiki Benefit Mental Health Symptoms Above Placebo?
What is Reiki? Energy Healing and Chakra Work — Lisa Kern
Does Reiki Work? - The Atlantic
Evidence and explanation in Cicero's On Divination
Tylenol Is Popular and Safe, Yet Nobody Knows How It Works | Scientific American
Siegel - Predictive Analytics, Revised and Updated
The Phantom Pattern Problem - Gary Smith; Jay Cordes - Oxford University Press
A radical new hypothesis in medicine: give patients drugs they know don’t work | Vox
The weird power of the placebo effect, explained | Vox
The Power of Mind over Body | Plus
Placebos Work—Even Without Deception | Harvard Medical School
Hume, David: Causation | Internet Encyclopedia of Philosophy
Researchers are still working to prove that antidepressants are more effective than placebo
Medical Nihilism - Jacob Stegenga - Oxford University Press
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Cover Artwork by Logan Fritts
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Music from #Uppbeat (free for Creators!):
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License code: GAXUNUBZXURBJU22
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Transcript
Introduction to 'Philosophy on the Fringes' Podcast
00:00:04
Speaker
Welcome to Philosophy on the Fringes, a podcast that explores the philosophical dimensions of the strange. We're your hosts, Megan Fritz and Frank Cabrera.
Exploring Reiki and Alternative Medicine
00:00:12
Speaker
On today's episode, we're talking about Reiki and alternative medicine.
00:00:16
Speaker
We will explore the evidence for its success, the mystery of its function, and ask ourselves what the domain of medicine really is.
00:00:39
Speaker
Hey guys, welcome back to the show. Today we're talking about Reiki and kind of alternative medicine in general. But before we get into that, Frank, what's new?
00:00:51
Speaker
ah Not much. I guess we've mentioned this already, but we should mention it again because the ah companion lecture series this podcast, From Aliens to Bigfoot, A Philosopher's Guide to the Strange with Audible and The Great Courses, is coming out soon. Was that December 2nd was the date?
00:01:07
Speaker
no Okay, what is it? that our third December 3rd? December 4th. December 4th. December 4th. It is yes soon. It is dropping like it's hot. It will be hot. And there will be two episodes of fully new content.
00:01:23
Speaker
but I realized fully new. When you say a fast, it kind of sounds. Fully nude? Yeah. but but um There's no visuals at all, in fact. So we may have recorded it nude. You would never know. We're working on a website for it, too. We are. oh the website's going to be great if if it all comes together like we want it to. um What we're hoping to do is have all of our podcast episodes on there, all of our um our lecture series on there, in addition to having like an annotated bibliography of each of the episodes and the sources that we cite therein. um and some sources for teaching. um I've taught some classes that cover some of these materials. Yeah, I mean, youve I don't think we've mentioned this on the podcast before, but you teach a course that is based on this podcast. I do, Philosophy of Strange Things. Yeah. um So we'll hopefully have some teaching material for at least some of the topics also. And yeah, these annotated bibs and um transcripts. And it should be a cool place, especially if you are um an educator who's interested in Maybe teaching on some of these topics. We're hoping to make it kind of like a resource place for you. Yeah. so so yeah forthcoming. Forthcoming. Yes. um But the the lecture series, December 4th, as far as we know, we haven't heard anything different.
Understanding Reiki as Energy Healing
00:02:36
Speaker
um Let's start with what what Reiki is. Yeah, because why are we talking about it? i had never heard of this until Megan introduced me to this topic. So we should start with what it is. right what What is Reiki, Megan? So this is a quote from a scientific meta-analysis, a meta-analysis of scientific studies done on the practice. And this is the definition they use. So it should be...
00:03:00
Speaker
pretty official, I guess. um It says that Reiki is an energy healing technique or biofield therapy in which an attuned therapist places their hands on or near the client's body and sends energy to the client to activate the body's ability to heal itself and restore balance.
00:03:27
Speaker
It was developed in Japan at the end of the 19th century by Mikau Usui. would say Usui, maybe. Maybe?
00:03:38
Speaker
Yeah. Of Kyoto. Yeah. um And from what I remember and what we've been reading about this, he was sort of inspired by Christian faith healings, although this is in no way related to Christianity. He just sort of he found the idea like the laying on of hands and faith healing in some Christian denominations compelling.
00:04:01
Speaker
Yeah, I'm not sure of the history, but yeah but yeah, that seems to be a pretty good definition of of what we... So we watched a documentary on this start to see sort of what this practice looked like. I don't want to call what we watched a documentary. More like an extended infomercial, let's let's say. all right ah so So a little more about this. right So here's some other quotes from like websites that you can find. You can schedule appointments to get Reiki done. A holistic healing modality that translates to universal life energy, best described as a high frequency energy that breaks up energetic blocks in the body to promote balance and harmony in mind, body, and spirit.
00:04:39
Speaker
Just pause for a second. I always hate when they have like three ontological aspects of the person, like mind and body. Okay, dualism, but like... Three-ism, tri tri-ism, that just seems too much. i have a mind, a body, and a spirit.
00:04:52
Speaker
And a soul. And a soul. Four things. Yeah. Too much. And then like a third eye. Yeah. I don't know. There's a lot. Yeah. right Anyway. Anyway. um Yeah. so So that's what it is, right? im and I think the best way to understand like what it is is just to watch like a video of people doing it so Can I add some info here? I think it's important. um So it for those of you who haven't heard of Reiki, you might be thinking, who cares? But if you haven't heard of Reiki, then you should have heard of Reiki because it's actually pretty popular. hmm.
00:05:23
Speaker
About 0.5% of U.S. adults report regularly using Reiki, which is over 1.2 million people in the United States alone. And 1.1% of adults reported using it in the previous year.
00:05:38
Speaker
And about 15% of hospitals offer Reiki as a pain relief solution. Yes, I was surprised by this to learn that prominent, prestigious hospitals associated with names like Yale, Duke, Johns Hopkins offer this service.
00:05:55
Speaker
Yeah. It's not like you can have your Reiki master come in with you as your friend. It's like they offer it there. They have people who can do it there. Yeah. um So it's it's what's it supposed to do? Why would people get Reiki? It's healing, but what does it heal?
00:06:08
Speaker
it It heals your whole your whole person, I think. So basically the idea is that it's so the Reiki, what do they call them? Do they call them a master? Reiki master. Okay.
00:06:21
Speaker
um So the Reiki master is basically an energy channeler. Mm-hmm. They are like the conduit between an energy field that is pervasive in the universe and your body, which for some reason isn't getting that energy from the universe. Unclear why. Yeah. But it's not.
00:06:41
Speaker
And once they have trained to be this conduit, they're able to send the energy into you to heal you. through their hands, either by touching you or at least their hands need to be like, well, actually. Not well, actually. Right. So there's there's I guess there's three different kinds of Reiki. right. So you can yeah either do they touch your head or something like that or they they put your hand their hands above you and not touch you. hover yeah But they can also do what's called distant or distance Reiki, where actually I guess you can be miles and miles away and they can perform this service for you and and allegedly you will be healed by it, even though you're very, very far away. Like they'll do the the some hand motions and other things. It doesn't even, it at least possibly, does not even have to be synchronous because there are many yeah YouTube channels. yeahs Yeah, we watched we watched some YouTube videos. i made I made Megan watch some stuff she didn't want to watch.
00:07:34
Speaker
Yeah. We watched some YouTube videos and where the a Reiki session was recorded. And the idea was that you could benefit from the recording of the Reiki session. Even though obviously it's not happening at the time you're watching it. And it's really just a picture of someone's hand. In the corner of the screen. With some like some like Enya playing. I mean, there's other things that go into the ah Reiki session as well, we should say. So it's not, you know, there was just like hands. It'd be kind of boring. But there's a whole setup, right? There's ah ambient music being played, incense being lit, essential oils, you know nice, nice soothing surroundings. Very relaxing situation. Like you're about to get like a deep tissue massage. kind of Yeah. Yeah.
00:08:14
Speaker
um Except your clothes are on. So, okay. So it channels the energy into you. And restores you. Yeah. Yeah. And restores you. I guess I want to kind of a lot. So in the definition from the meta-analysis, they talk about a biofield. Yeah. Which I have a kind of definition of that. From the same source. yeah The same source. The biofield is believed to be an organizing energy field of any living system That regulates and helps maintain the biological system.
00:08:44
Speaker
ah This notion is a shift from the mechanical chemistry based view of the current dominant biomedical paradigm to an information based view where the biofield is a multi-level organizational concept where information flows within and between various levels of an organism.
00:09:00
Speaker
That was a mouth. It sure was. An energy field. Yeah, it was an energy I can't help but feel like we're talking about Star Wars when we say that. Well, but it's specific. It's not just an energy field. It's like one specific to the human body, I think, is important. So anyway, so they put their hands on you in various... They start with your head because your head is the balancing spot in your body. So they start there. They spend a lot of time there. And then they kind of move down your body.
00:09:26
Speaker
And it's supposed to create balance and harmony in the person getting Reiki. The energy goes to the spots that need balancing, which, you know, is convenient. You're not like, oh, I got too much Reiki in my arm. I forgot to turn over or something like that. You know, it goes where it's needed.
00:09:45
Speaker
And yeah, we can do Reiki at a distance, supposedly. And ah so ah a basic tenet, apparently, of Reiki is that the flow of energy varies according to the degree of disharmony in the person. So, you know, for you, it'd probably be like, it'd be a pretty big flow.
00:10:03
Speaker
I have so much harmony. I'm i'm so harm and harmonious. Yeah. Actually, you really are. Okay. So i think that's a good a good enough explanation. So I guess listeners might be wondering, why are we talking about this specifically? This is obviously a kind of like alternative medicine. Stick with Yeah. what's What's special about this? And I guess, Megan, you were and kind of inspired to sort of delve into this a little bit more by an article in The Atlantic. Yeah, I titled i teach this article in my philosophy of yeah science class. Yeah, entitled Reiki can't possibly work. So why does it? So you you read this, you were inspired by this, you taught Reiki in your in your class. You taught Reiki, you did philosophy of Reiki. Frank keeps saying, he's been saying this all day. Like, what what did you how did you do Reiki in your class?
00:10:50
Speaker
I want it to be really clear. I only taught about Reiki. Yeah. Yeah. so So how did you incorporate this into your philosophy of science class? Right. So, I mean, yeah it's it's basically what this Atlantic article title, which we'll obviously link to, ah says.
00:11:04
Speaker
Sounds super weird. Is super weird. Really. I mean, we were watching these Reiki sessions on YouTube and it was it was pretty like uncomfortable for me. Like, it just seems extremely bizarre. And the weird thing is that apparently... Something like over 80% of studies show moderate to strong evidence supporting the merits of Reiki treatments for pain relief. So that's that's sort of like the puzzle, right?
Efficacy and Challenges in Reiki Research
00:11:28
Speaker
it seems like there is evidence for its efficacy. But also, if if that's true, the mechanism is a little obscure or or conflicts with current scientific paradigms. This is something acknowledged in that meta-analysis that we quoted from already. They acknowledge that this kind of sounds like vitalism. So vitalism was this old view in the history of science that a lot of people believed up until, know,
00:11:52
Speaker
19th, 20th century, that there's something really, really special about living organisms, that there's like a sharp distinction in nature between living organisms and non-living organisms. The living organisms have a special force, a vital force that and that makes it alive, that makes it distinct from non-living matter. right yeah There's a sharp distinction. Everyone's watching the new Frankenstein movie this week, so we're all freshened up on on vitalism.
00:12:16
Speaker
Yeah, Kant, right, even thought he thought that there would never be a Newton for the blade of grass because, you know, living things were so special. um So it kind of sounds like that, but that's a discarded notion in in biology and all of that. um Yeah, the notion of energy sounds really obscure. Like when I think of energy, I think of the physicist's definition of energy, like the capacity to do work, to create force that makes things move. That's energy, right?
00:12:39
Speaker
Cars go faster, they have more energy. Cars go slower, they have less energy. That's why I think of i think them energy. it's It's a little unclear what they're talking about when they talk about energy field. So like things like that make it kind of weird, but then also allegedly there is research supporting its efficacy and the lots of anecdotal evidence.
00:12:56
Speaker
that it works. That's the point. Yeah, a lot of anecdotal evidence. The bulk of this Atlantic article is actually kind of talking to practitioners and nurses and doctors and patients in hospitals and asking them about their experience with Reiki. And you have um these quotes from all these people who basically just accepted a Reiki treatment, not at all expecting it to work and kind of being really cynical about it and basically just being like, fine, do whatever for me.
00:13:23
Speaker
You know, so I can get the real drugs afterward. And they get the treatments and they find that their pain is gone. And they're like shocked about this. They really didn't expect it to work. And I found this just super interesting because, as i've kind of already said, Reiki just doesn't seem like anything. Yeah. Like most of the the session we watched, like the the woman just had her hands on the person's head and that was it.
00:13:45
Speaker
Yeah. Like some alternative medicines, they do stuff, you know, acupuncture. they They actually stick needles in you. Yeah. You know, with supplements, you're actually swallowing something. But Reiki is like almost nothing. And yet the evidence to support it is in some cases even stronger than some like regularly used drugs. so really strange, yet no identifiable mechanism. So obviously a great candidate. for Philosophy on the Fringes podcast. So we're really puzzled by this, so we delve a little bit deeper. So, I mean, let's go back to that Atlantic article. right So one one quote early on on in the article says, over the past two decades, a number of studies have shown that Reiki treatments help diminish negative side effects of chemotherapy, et cetera, et cetera. So it has a link to one of these studies. So I clicked on that. And i was like, all right, what's this study look like? And I think, actually, I want to really quick clarify that most of what they talk about in the Atlantic article is the use of Reiki to diminish pain. Yes.
00:14:38
Speaker
Yeah. Not necessarily to like cure cancer, but like it's mostly used to treat pain. It does seem like it's its practitioners and proponents have a very ah modest view of it. It's supposed to be used in conjunction with other stuff. Yeah. I don't think they're thinking that you can regrow a limb through Reiki or anything like that. Commenters on the YouTube videos of it have a very immodest view of it. Yeah. and think it helped them get their jobs. Yeah. Yeah.
00:15:00
Speaker
um So yes, I looked at one of these articles, of these studies. um So this one was in the Journal of Alternative and Complementary Medicine. That was already not a good start for me. Complementary medicine. yeah kind Yeah, not a good start for me at least. So it' said a large scale it's called a large scale effectiveness trial of Reiki for physical and psychological health. So I looked at like the the design of this this article and one they or the study. And one thing that jumped out to me is that it was a it wasn't a placebo-controlled trial. It was single-arm trial. So they had they had Reiki masters and their Reiki clients. And then they did a pre-test and a post-test for things like stress. So they they measured their stress levels before they got the Reiki. They measured their stress levels after they got the Reiki.
00:15:40
Speaker
And you know lo and behold, their stress levels decreased. yeah But one one sort of issue with this, if you're coming kind of coming out this from standard scientific medical research methods, this is not really like a great study, right? Because there's no there's no control, right? where When you do a study to see if a drug works, you've got to have a control group, a group of individuals that don't get the drug. They get a placebo or something like that, ah sugar pill, right? And then you see if the drug does better than than the sugar pill. So that's that's one sort of, you know, that's just one study mentioned in the Atlantic article. Well, that's something we need to be aware of. Like, what kind of study are they pointing out here?
00:16:19
Speaker
Because we want, you know, we want, if we're going to say a method is it works. where We want the best kind of evidence for it. And at least in medical research, the best kind of evidence is a randomized controlled trial, a placebo randomized controlled trial. You have a control group that gets something that's not the treatment, but may be the treatment, or they're led to believe that it could be the treatment. It's a placebo, right? um It's randomized. you have you You get individuals that are randomly selected. So in that study, they weren't randomly selected. right They were just and they were just the clients of the Reiki masters. ah You want the study to be blinded. You don't want to know if you're in the the group that's getting the placebo or the group that's getting the treatment. And you want it to be really, really large. So that that study wasn't an example of that sort of thing. But at least according to this meta-analysis that we mentioned at the beginning, there have been randomized controlled trials, placebo controlled trials of Reiki where Reiki has been shown to be effective. So what's what's going on there is is is the kind of another puzzle. right So there have been placebo controlled trials, either according to this this meta-analysis. So then it does seem like there is evidence for it, right? does It does pass the test, the gold standard. It does pass the randomized controlled trial placebo standard.
00:17:36
Speaker
Yeah, although I know that you're skeptical of their the choice of placebo. yeah ok so So here we're just presenting sort of the the evidence, right? like I mean, right off the bat, though, so I don't want to i don't like be a killjoy immediately. But, I mean, you know part and parcel of Reiki is that you are immediately put into an extremely relaxing environment. Yeah. ah You know, you're laying down on a bed. For some people, like, that alone is like, whew, you know.
00:18:05
Speaker
I'm laying down in a nice dark room on a bed. That's amazing. There's nice music playing, nice smells. ah Usually you have like a cloth over your eyes and, you know, someone's maybe gently holding your head.
00:18:18
Speaker
Like that's really like you're going to feel better. yeah You're going to feel better no matter what. You know, even if that's all they do. And it's not like a Reiki master. It's just like the janitor. You know, I'm going to feel relaxed in that case. Yeah, right. So I think it one difficulty with with testing ah Reiki by using like placebo control trials, yeah it's hard to come up with a placebo. or It's hard to come up because the two groups, they they're supposed to not know if they're getting real Reiki or sham Reiki, like fake Reiki. But how do you actually do Reiki or fakey. Yeah. And that's sort that's sort of my question about like a lot of these ah RCTs, the randomized controlled trials that were alleged to be successful that that meta-analysis talks about. Like, how did they really control for, did they really, was it really a good control, right? Yeah. so um Because anything that could plausibly pass as Reiki that wasn't is still going to have a lot of the yeah yeah still going to have a lot of the features of it. Right. So just i took one I looked at one of these studies mentioned the meta-analysis.
00:19:20
Speaker
i just as in I was curious. right I just picked one at random. And checked out its method. I wanted to see how they set up the control group. Like what did the placebo group look like? Like the group that wasn't getting real Reiki, but was getting something that was kind of like Reiki. And then we're testing to see if Reiki is better then than the fake Reiki. Yeah. and i'll Call it fakey. Fakey. And so one thing that that kind of bothered me about this one study, um this is this study was called The Effect of Reiki on Depression in Elderly People Living in Nursing Homes, um is that the the real Reiki group, they were they had Reiki performed on them by a Reiki master.
00:19:57
Speaker
But the the fake Reiki group, like the control group, the placebo group, they had Reiki performed on them by the nurses that worked in the nursing home. So, like, I think if I were, and and then they were randomly put into groups, right? They were, some people were put in the the real Reiki group, some people put put in the fake Reiki group. I guess if if I were in that in that situation, I would probably be able reasonably infer which group I were in based on who was doing the Reiki. Like, ah some guy comes in, right? You've never seen him before. he probably has, like, really, like,
00:20:27
Speaker
elaborate dress and stuff like that, you know, a distinctive demeanor. And he's doing these techniques on you. Obviously, that's the real group. Whereas the ones that had the Reiki performed on them by the nurses, that the people they knew, the nurses that worked in the nursing home, Clearly, that's going to be the fake Reiki.
00:20:44
Speaker
I don't know. So at least that's like one question a skeptic might raise about this ah this kind of this this study. Was the placebo group, ah was it constructed correctly? like could they really Could they really tell which group they're in? Because if they could tell which group they're in, then they might think, oh, I'm in the fake group, so I'm not going to... I'm not going respond well. It doesn't say that they were nurses who worked there. They could have been nurses from somewhere else.
00:21:08
Speaker
And, you know, they could have put them in ponchos. But I guess thats these are the kinds of questions you have to ask about the studies mentioned in in the meta-analysis. that like How well were the the fake Reiki groups set up? How well were the look was the control group set up cause it's really difficult to set up the control group. When you're testing drugs, when you're testing a pill or whatever, it's easy to set up the control group. right You can just give them a a sugar pill or something that's causally inert. It's not going to do anything. And it can look exactly like the drug you're testing. um But when it comes to Reiki, I think things are a little bit more difficult. this doesn't settle the question, right? Maybe these studies mentioned in then in the meta-analysis were good. I don't know. i'm I'm curious to know what someone who knows more about medical research methodology would say. But I think these are the kinds of questions the skeptics can have. Like, how well were these placebo groups set up? I mean, you could even, I feel like from the the Reiki perspective question, like if it's even possible to know that you're getting fakie, you know what I mean? Like, because you do, you know, you're supposed to go through this training to be a Reiki master, but obviously someone could just like, they could just like be a conduit for the biosphere energy.
00:22:21
Speaker
Just, you know, maybe they're just like a really good person and they really want to heal them. They do a lot of, like, hand movements, too. remember that in the documentary we watched, the woman was, you know, it was like she was drawing on her hand with a finger. Oh, yeah, that's I guess that's required. Yeah, so that's sort of part of it, too. Yeah, yeah. All right.
00:22:39
Speaker
So anyway, like, yeah, I'm not here to settle the the evidence there, but... um but Yeah, that meta-analysis is definitely worth checking out if you're interested in this, especially you're skeptical of it. Like, what what do you have to say about these placebo-controlled randomized trials that allege to show that the real Reiki group did better with respect to things like stress and pain than the fake Reiki group? That's an important question. It's interesting. One interesting aspect of Reiki is that even though it was developed in Japan, um they do they they have like like some Indian metaphysics. Hindu, they they they refer to chakras. Yeah, they talk about that. That kind of confused us a little bit. Yes, I think so. I mean, we're not yeah we're not experts in... it they It originated in India, I suppose. Maybe it migrated to Japan as well. But ah yeah, I'm not... the the the total The metaphysics really of it is a little bit obscure to me. But... Okay, so let's suppose that we were somehow able to put together the perfect randomized control trial, you know, multiple of them.
00:23:37
Speaker
And it turns out that Reiki works and Fakie doesn't. yeah and And that's just it in the it uncontroversial. the The test results are great. The tests were well-performed. They controlled for all the variables.
00:23:53
Speaker
There's still this mystery at the heart of Reiki, even supposing, you know, best case scenario with these with these tests and trials. There's still the mystery at the heart of it, which is that we have no idea how it possibly could be doing anything right. We don't know the mechanism. Especially when it comes to distant or distance Reiki. That that is even more puzzling because then you're not even in the room. You might even be in the same building or in the same state as the person you're treating. like How could that possibly do anything? mean, guess energy is weird though, right? Apparently. Yeah.
00:24:27
Speaker
But like, I mean, energy is it. I guess, you know. you yeah oh OK, so it's like it's like a medium, almost like an invisible like ocean. You're manipulating it and the waves like travel through space. We've observed at the quantum level, you know, what people might call like spooky action at a distance. Right. Yeah.
00:24:44
Speaker
Right. but But some people don't like that, right? like I mean, that's still regarded as like a puzzle, as like a challenge. Like Einstein didn't like that. You know, the people still try to, you know, come up with interpretations of quantum mechanics to sort of soften the metaphysical weirdness of those sorts of things. That we have seemingly observed it. Yeah.
00:25:00
Speaker
So, you know, it it would at least be like, yeah, I suppose that doesn't really. Yeah, that's how that's how Deepak Chopra gets all his things going. Yeah. What about the quantum? Yeah. Yeah.
00:25:12
Speaker
Yeah. But OK. Anyway, but but that's so this is like a genuine, ah genuine problem, I think. Right. And it sort of was mentioned in in the meta analysis as like limitations of the study. There's is this question of how does it work? So even if you have evidence that it does work. You so still got to ask the question, how does it work? And if you can't come up with any plausible causal mechanism, some intelligible, understandable causal mechanism, to explain how it works, you might think that it should be rejected, even if you have some evidence that it's correlated with, say, positive treatment outcomes. So this is an instance of a kind of more general principle, epistemological principle, which might go something like this. It is rational to predict given B only if there's some plausible causal connection between a and B.
00:26:01
Speaker
So I think that's an interesting principle to kind of talk about. It it sort of raises questions about the nature and relationship between explanation, causal explanation, causality, and evidence.
00:26:12
Speaker
And this is something that I explore a little bit in one of my published papers on on Cicero's ah dialogue on divination. There's a paper I wrote called Evidence and Explanation in Cicero's On Divination. We mentioned this in the astrology episode a while back. is One of Cicero's objections to astrology that he raises in this paper has to do with there not being a plausible mechanism. like How could the stars affect us, he says. They're so far away.
00:26:38
Speaker
So this kind of thing comes up in this dialogue about divination and astrology. So the the dialogue between Cicero and his brother. And in the dialogue, his brother Quintus defends things like divination and astrology, reading entrails and other things like that. And interestingly, in in the dialogue, Quintus says that that he doesn't know how it works, but that doesn't matter. and Yeah. He says, I consider the outcomes of these practices that should be investigated rather than their causes. We see that these signs almost never deceive, but we do not see why this is so. I do not ask why, since I know what happens. I am content with this, that even though I do not know why this happens, I do know what happens. Yeah.
00:27:18
Speaker
So ah Cicero doesn didn't like that though, the the character Cicero. He says, no, that's not good enough. in In addition to doubting the correlations between entrails and political disasters, he says that there needs to be a plausible mechanism to explain these sorts of things. right if If entrails and of animals are going to predict political disasters and military disasters, there used to be some causal connection there. And and here's what he says.
00:27:42
Speaker
Surely, if entrails have any prophetic force, Necessarily, that force either is in accord with the laws of nature or is fashioned in some way by the will and power of the gods. What possible connection can there be with, I shall not say, the gall of a chicken, whose entrails some men assert give very clear indications of the future, but the liver, heart, and lungs of a sacrificial ox? And what natural qualities there are entrails enables them to indicate the future? In other words, there's no plausible causal connection between the divination practices and what happens. So they couldn't actually be predicting things. And that's like super fascinating because I think intuitively, or you might think that who like, who cares about like knowing why it works? If you have something that's like reliably working,
00:28:25
Speaker
ah you know, isn't that good enough? i don't know how my car works, really, you know, not a mechanic, but, it you know, reliably works. I'm going predict that's going to work tomorrow. going trust in it. And isn't that ah good enough? So thoughts about this, thoughts about this principle, Megan, this, this idea that, you know, you can't just go predicting things. You need to have some kind of understanding about why these things are correlated. You have to have some understanding of whether a causes B, like B causes A, or whether A and B are the joint effects of some common cause You need some kind of causal knowledge ah in order to like effectively predict things. Any thoughts about this? Well, what keeps going through my head is just for some reason.
00:29:06
Speaker
i just keep thinking the fault dear Brutus is not in our entrails. So ah and a modification of Shakespeare. That's what go through your head. Yeah, for like two minutes now you've been talking. um Yeah. um OK, so you mentioned this a while ago and I found it compelling. So what if the the Oracle of Delphi yeah or God, you know, comes down and he says to us, hey, um every time you wear a blue sock, yeah you know, you are going to be really hungry that day or something like that.
00:29:38
Speaker
That's a good one, I think. You know, I personally can't find any plausible causal connection yeah between wearing blue socks and being extra hungry on any given day. But if like the Oracle of Delphi or God told me that, I'd probably feel pretty safe just accepting it because they seem like an epistemic authority. Yeah, yeah.
00:30:00
Speaker
It's also I guess it says if there is mean plausibility here I feel like is the big thing that this turns on because obviously there's a lot of things that we know causally related now where like the explanation for how they're causally related would not have seemed plausible to someone a couple centuries ago. Yeah, so I think the principle, so I articulate and try to defend this principle in the paper. I'm not really sure I believe it anymore these days. But because of the kind of case that you just mentioned, it does seem like we can imagine cases where it's just so predictably successful, the method of prediction is so successful, it's a complete black box to you. You have no idea what the mechanism is. And it just works every single day. Maybe it tells you the winning lottery. Every single lottery number is every single day. world's a weird place, you know? Yeah. And so, like, why do you need to know how it works? Yeah, I'm sort of not sure I believe the principle anymore. But I will say that, like, you can find applications of this principle in the history of science. So one famous example of this is the case of continental drift. Continental Drift was his theory constructed by the scientist Alfred Wegener. I think the guy that you worked at your undergrad, he loved this stuff, right? Hank, what was name? Hank Frankel. Henry Frankel, really, but everyone knew him as Hank. Yeah. Rest in peace, Hank. You were an amazing professor. You wrote like tomes on this stuff. He literally wrote three massive volumes on it. About the history and the development of continental drift, the idea that the continents have moved, right? That were once all smooshed together. He a philosopher, but he wrote most of his writing was on geology. I could see myself doing that someday, just like completely giving up philosophy and just like doing like history and like every now and then like making a philosophical comment or something. Yeah, but the idea like the continents were all once smushed together, Pangea, a giant continent, and then they sort of slowly moved over time.
00:31:49
Speaker
this This idea was constructed by a guy named Alfred Wegener in like 1912, and he had some evidence for it. He noticed the obvious thing to us now that South America and Africa kind of fit together like puzzle pieces. There's also data on the fossil record that that he pointed out. like You can sign find similar fossils and similar strata in South America and Africa. That's kind of weird, right? they're far They're separated. But no one believed him. It was ridiculed because there was no, they could not come up with a mechanism for why the, for how the continents could move. It was only till like the 1960s, like the late 1960s, the theory of plate tectonics, the and the thing you learn in like ninth ninth grade earth science class, the idea that, you know, there's these plates that are shifting around, shifting around around the crust and, you know, they smoosh together. That makes mountains and volcanoes and all that. I think one of the Ice Age movies is about that. Oh, yeah the yeah the shifting of the plates? I think so, yeah. Continental drifts. Yeah. Yep. So continental drifts is the idea that the continents move and plate tectonics is the mechanism. Yeah. So before they had the mechanism, though, it was pretty much roundly rejected, even though there was a lot of compelling evidence. Look at all these correlations, you know, it was rejected. So, I mean, you can find an instance of this principle sort of in the history of science. But yeah, some people reject it. Another a group of folks that seem to reject it these days are the big data folks, and the guys that like data science and in data mining. In his book called Predictive Analytics by Eric Siegel, he says, quote, We usually don't know about causation, and we often don't necessarily care. The objective is more to predict than it is to understand the world. It just needs to work.
00:33:19
Speaker
Prediction trumps explanation. I want to say like another thought that I have about this principle is the, I'll put on my David Hume hat. yeah David Hume, a 18th century Scottish philosopher um and who was skeptical of causation in general. He thought that the word causation basically denoted a totally empty concept outside of just correlation.
00:33:47
Speaker
Right. that To say that we have a mechanism, you know, a causal mechanism, we're sort of lying to ourselves that really, you know, when you get down to the the brass tacks, it's not it's no more illumined to us who think that we have a causal mechanism. You know, the the actual nitty gritty mechanism of it isn't actually more illumined to us than just someone who observes Reiki working time after time.
00:34:10
Speaker
Yeah, I know Hume says this, and I won't say too much about this. You can also find in Hume, ah differently so you can find passages that suggest causal skepticism, but you can also find passages that suggest things.
00:34:20
Speaker
don't want to do, yeah, of course, of course. Other things, yeah. Of course, I don't want to do Hume exegesis here, but I do think, I find it a compelling point. But clearly, like, so, you know, here's an example. Lung cancer and yellow teeth are correlated.
00:34:33
Speaker
Of course, you can't get rid of lung cancer in the population by whitening people's teeth, right? They're correlated, but the one doesn't cause the other. you gotta You gotta stop the people from smoking cigarettes to stop the lung cancer, right? The lung cancer and the yellow teeth are the joint effects of the common cause, smoking cigarettes. So, you know, lung cancer and yellow teeth are correlated, but, like, clearly, like, neither causes the other. What the cause is is smoking cigarettes. So examples like that, like, you know, it's hard to buy into causal skepticism or whatever when you have these kinds of examples like that where like there's clearly a distinction between correlations where that you can change by manipulating things and correlations you can't by manipulating things. ah
00:35:14
Speaker
mean, I think in my skeptical of causation moments, which are a lot of moments these days, but I, you know, I would say, well, no, the, the, the smoking lung cancer correlation, that's differentiated from the white teeth lung cancer correlation, just in virtue of there being another correlation that when, when the smoking me is stopped. Yeah. Yeah. and I'm willing to concede that maybe from, from God's point of view, there's no distinction between correlation and causation, but for us, you know, fallible humans and all of that, there is. So maybe what we could say, you know, if we wanted to be human about it or whatever, is like, well, you know, to say something is causally related is just to say that we have knowledge of how to manipulate one correlate to affect the other. Yeah, it's a very popular view of causation and and philosophy of causation and philosophy of science, like this manipulability, manipulation idea. Causation is all about manipulation. Yeah. um Anyway, that's a little bit of an aside. But back to back to the principle, right? So we need to be clear that the the principle says, you don't it doesn't say you need to know what the mechanism is in order to predict things. You don't need to know what the mechanism was being skeptical of the idea of a mechanism. Yeah, okay. Yeah, yeah. yeah But I think someone might say, so you're saying we need know how it works in order to use it for prediction? That's way too strong. Because as you pointed out, I was surprised to learn this, apparently we don't actually know how Tylenol works. Yes. Yeah. I mean this is still something of a mystery, like what the actual biochemical pathways are that like explain how Tylenol works. If you're my parents, you would say Tylenol doesn't work. Yeah. ah They are convinced that Tylenol is sugar pills because apparently they do nothing for their headaches. As we'll get to soon. Let's not downplay. Good point. Let's not downplay the placebo effect. Yes.
00:36:56
Speaker
But yeah, we don't know how Tylenol works. But yeah, so but the so the principle I mentioned at the outset is not going to say you should then therefore not take Tylenol because we have some very plausible ideas. there the The problem is we have multiple theories that both seem equally good. It's not like we're we're lacking for a plausible theory. We have two plausible theories about how it works. right So the principle says if you have no plausible mechanism in mind for how A and B are connected, then you shouldn't use A to predict B or vice versa. So maybe that's just a very weak constraint, but you know you can find people that reject even that weak principle. um So I think maybe the best defense of the principle, and something I talk about in the paper, is that if there is no plausible causal connection between you know a and B, then it's probably a coincidence. And if it's a coincidence, you shouldn't use it for predictive purposes because the coincidence is probably going to go away soon. So there's a fun website that that charts all these spurious correlations, like correlations between weird things that, you know, are obviously coincidences. So my favorite one i always talk about is there's ah there's a very strong correlation between the amount of films that Nicolas Cage appears in and people who drowned by falling into a pool. do You look at the data, and the more films he's in that year, the high the more drownings there are that year. And it's a very it's a significant statistically significant correlation. So...
00:38:16
Speaker
That's interesting. But you know obviously, at least from my point of view, that's just a coincidence. Right. It's not like Nicolas Cage is somehow causing in some way people to drown in pools or vice versa. It's just a coincidence.
00:38:27
Speaker
I don't know. okay consider Nicolas Cage is an incredible actor who makes extremely engrossing movies. yeah When someone falls in a pool who can't swim, they need someone else to save them. yeah But the more people are watching Nicolas Cage movies, the fewer people there are. Yeah. So maybe maybe Megan's come up with a case where there is a plausible causal connection. i never thought of that. I know I'd be distracted.
00:38:51
Speaker
Yeah. But I think that's the idea, right? There's no plausible causal connection. Then it's probably coincidence and you shouldn't use a predictive purposes. It's probably the correlation probably going to go away soon. yeah I remember the the the one I like to use ah the the iPhone and murder or the iPod is iPod. It's such an old study, I guess. But um iPods and murder rates were synced for about four or five, six years, something like And there was news articles where like, what's going on? Are people murdering each other for the iPod? it was just a complete coincidence. The iPrime wave. And it went away. And that was it. And there's so many things like that. This ah book that we mention a lot, in I think, in the podcast and in our published work, The Phantom Pattern Problem, The Mirage of Big Data. by Gary Smith and Jay Cordes, talks a lot about this. As we are able to gather more and more data, you are going to be hit with more and more fake correlations, phantom patterns, spurious correlations, things that look like they're connected, like a meaningful connection, but actually it's just a coincidence. And if it is a coincidence, you shouldn't be predicting one on the basis of the other. Yeah.
00:39:49
Speaker
All right. So but before we even get to, you know, needing a mechanism, we have to see if this actually works. And we've already talked about some ways that people have gone about trying to do that by doing these randomized controlled trials and having placebo controlled trials, importantly. But what we've learned from the research that we've been doing for this episode is that sugar pills might also work. Yeah, I think that was one of the outcomes of our our research is that the the placebo effect. So when when you take ah a fake pill and then you feel better, um that this is like a lot more puzzling than than we had thought and a lot more powerful than than we had thought. um And that's sort of where we where we ended up. We had learned something from from this research, right something about the placebo effect. Yeah, the placebo effect super duper interesting. And i think there's been a lot of breakthroughs in studying the placebo effect in the last few decades. There's even like arms of research units called like placebo studies. right That's all they do is study the placebo effect. um So yeah, like we we learn a lot of cool stuff that is philosophically relevant. So one thing that's important is that when you take, say, ah ah when you're in a placebo-controlled trial, and let's say you're in the place the placebo arm of the trial, and and you feel better after getting the sugar pill, um I think the the inclination of most people and most doctors and scientists is say, oh, that that's just an illusion, that's just a mirage, it's just the placebo effect. But there is psychosomatic. Psychosomatic. Yeah, it's fake. You're psyching yourself into thinking you feel better because you don't know you got the fake pill. Yeah. Yeah.
00:41:20
Speaker
And and one thing that's kind of misleading about saying all that is that there are like distinctive and significant biochemical markers of the placebo effect. So when you take the sugar pill and you feel better, like something's going on in your brain. that that is And what's going on in many cases is that it leads to the release of endorphins. Endorphins are those those neurotransmitters, I think, that that make you feel better. It stands for endogenous morphine, as discovered in the 1970s. So, yeah, they've studied what goes on in the brain where when people are experiencing the placebo effect. and they And they've determined that this is what's going on there. It does lead to the release of of endorphins. They know that when you give someone a drug that that ah that blocks opioid receptors, then that also blocks the placebo effect. And so things like that suggest that you know there's actually biochemistry to the placebo effect. And it's not just a sugar pill, right? There's been studies where people have gotten fake surgeries. So they put someone under, they say, we're going to you know we're to cut into you and fix you. But it was all fake. ah Those people report feeling better. They've given people fake oxygen to treat simulated altitude sickness in an altitude sickness study. Those people report feeling better. In some cases, there's even physiological markers of of lot like less altitude sickness. oh This one's my favorite. The the bigger the sugar pill, yeah the better it works. Bigger pills are better. yeah And more pills are More pills are better. If the treatment session is longer or more elaborate, that also leads to a a better effect, say less pain or less stress or something like that. um Here's and one one of my favorite ones. And this is something that's not acknowledged by doctors and nurses. When someone sees themselves getting the morphine of injection, it's more effective. the Seeing yourself being injected.
00:43:03
Speaker
When the nurse says, all right, time for your morphine shot. That's like twice as effective as it just being administered by a robot or something like automatically. I wonder if that's why they give you a fake epidural button. It's not really a fake button, but like there's only so much epidural medicine in there. Yeah.
00:43:22
Speaker
So once once you're out, you're out. But you can push the button like an infant. I bet you that I bet you that leads to some placebo effect. of course. yeah Right. Yeah. Yeah. yeah And of course, more unsurprisingly, more empathetic caregivers leads to ah a better a better effect as well. So, I mean, this learning all this, learning how powerful the placebo effect is, learning that it's not just sort of an illusion, that there's like that there's a genuine biochemical change. That your body's changing. Yeah. That really made me like like re rethink a little bit, like the whole alternative medicine regime.
00:43:55
Speaker
Yeah, because obviously sugar pills and Reiki aren't, you know, they're two of a mass. We'll put our cards on the table. I don't think Reiki works. I don't think there's a biofield or whatever, right? One of those cards should be, though, that we have not gotten Reiki. Yeah. I don't think there's a, okay, so I misspoke.
Skepticism and the Nature of Biofields
00:44:11
Speaker
Maybe it works, but I don't think there's a biofield. Yeah, it doesn't work by channeling universe energy into your body. Yeah, yeah, yeah, yeah, yeah. No, I mean, I'm on the same page.
00:44:21
Speaker
i am ah I'm a skeptic. But the alternative medicine field is huge, right? And it encompasses so much. So we we've been only been talking about Reiki, but a lot of things we've been talking about could apply to things like homeopathic medicine. Yeah. Oh, I should I guess I should say so homeo homeopathy, homeopathic medicine is its own huge field of, you know, what what some might call medicine. But it's it's a a separate like you you have to reject conventional medicine to accept homeopathic medicine because it rests on metaphysical ideas like like treats like. So if there's something that in a large amount, some substance that in a large amount would cause a particular symptom, using a very diluted amount of that substance can cure the symptom.
00:45:05
Speaker
And by very diluted, mean very diluted, like less than one parts per million. Mm-hmm. So homeopathic medicine is where like one or fewer parts per million of some substance is contained in water or whatever. yeah And then you ingest it um in in an attempt to cure the symptoms that a larger amount of that substance would cause. Yeah, and the standard critique is like it's so diluted that it's basically just water.
00:45:30
Speaker
Yeah, it's totally sub-therapeutic. At least, you know, that's what can be. But many people report that it works. That it works. something. It reduces pain or things like that. Mm-hmm. Yeah. Yeah. I mean, um yeah, lots of different kinds of – there's some people that my family used to know who sell a thing called LifeWave patches. Mm-hmm. And there it actually kind of reminds me of Reiki because how it's supposed to function is that it harnesses energy, but it's energy from the sun, I think. And you you wear the patches on your skin where you have pain and it's supposed to like harvest energy from like the outside world, like the sun and deliver it straight to that area. can just you know yeah I feel like you could just go in the sun. You'll get that energy. You need the patch ok for some unknown, totally unknown reason like a magnifying glass. Yeah. like It focuses the light.
00:46:22
Speaker
yeah Yeah. Yeah. So all kinds. But again, people and people and these patches, Frank, like you don't even want to know how much they cost. Don't tell me. It's e's absolutely absurd. And people pay for it because, again, the the the reporting on it is almost universally amazing. Yeah. So I said it made me reimagine in what sense? I guess I'm like a little bit less like disdainful of it because like, you know that's my initial inclination, right? It's like, okay, this is nonsense. They're preying on people. They're charging money for nonsense. They're bad, right? This is all terrible. um but But yeah, I guess i I don't feel as unsympathetic as I as i used to because yeah, maybe it's just one giant placebo factory. Like that's how I'm thinking about the whole alternative medicine regime. It's a giant placebo factory and that should not be read as a dismissal
00:47:07
Speaker
Because it does actually affect your body. Yes, yes, right. Not the way they're saying it will, maybe. And there was one quote from that Atlantic article we we mentioned that really really struck me. on So the one of the nurses at ah at a VA hospital that's really into Reiki, and she she has to deal with a lot of snide comments from her colleagues. Sure. Yeah. And she said, quote, why do we have a problem accepting when somebody says, I feel better? That helped. And that really struck me. It's like, yeah, you know, it made them feel better. I i don't i don't accept the metaphysical like explanation for why it made them feel better, but yeah maybe it did. like We know how powerful the placebo effect is, and it could be induced in many, many contexts and in many, many ways. It's highly possible that they did feel better and in a genuine sense. and of And it was placebo, but that doesn't mean it didn't happen.
00:47:53
Speaker
Yeah, so, like, okay, so maybe you're more sympathetic to alternative medicine because maybe it actually does help people in this real sense. It does relieve their pain, even if it's not how they say it will work.
00:48:04
Speaker
But, like, if people knew how it worked... Then like, would they buy it Probably not. it seems like they kind of need this like mystical, um you know, stage setting to make it appealing or to make it, you know, work.
00:48:22
Speaker
And so that's like, that's like deceitful, like at the heart of the idea of placebo is like a false belief. And you're suppose you're a doctor or a nurse or something, and you want to and you know you want to you know take advantage of these things to help people. You don't believe they actually are what they say they are. You believe it's just the placebo effect, um but you want and but you want to you want to help your patients. It seems like you can only do that if you if you deceive them. You have to kind of lie to them. And that seems bad. right It seems to violate a a core principle of medical ethics, this principle of respect for autonomy, informed consent and all of that.
00:48:56
Speaker
So that that seems that seems troubling. But I think there's kind of a way out of this kind of ethical worry, because it's not really just the belief or the expectation that you'll get better that generates the placebo effect. So that is one mechanism, but there's other mechanisms as well. So in our research on the placebo effect, we learn about some other cool stuff. So for instance, here's an important one. If someone's taking a drug, like a drug that's real, an active drug that actually does something, If after, say, five days, you substitute that drug with a sugar pill, it will still have the same effect. Do they know your effect? Yeah, and you don't tell them. Yeah, you don't tell them. You don't tell them, yeah. The body is conditioned to have the response. So yeah, belief and expectation, conscious belief and expectation can generate the placebo effect. But unconscious conditioning can also generate the placebo effect. You just know you've gone through the motions of taking pills so many times in your life that the mere fact that you take it can just generate the placebo effect. And most interestingly, there's one Harvard medical professor named Ted Kaptchuk that specializes in these kinds of studies, this kind of
The Placebo Effect in Alternative Medicine
00:50:09
Speaker
work. And he'll just tell people outright, hey, this is a placebo. This is so fascinating. Yeah, this is perhaps the most fascinating thing I think we learned in our research on the placebo effect. Yeah, this guy, Ted Kapchuck, he's done a lot of interviews and like Vox and stuff like that explaining his work. And yeah, he'll say, look, I was bothered by the deception. wanted to see if I could just be honest and forthright with my patients, my subjects, and tell them this is sugar pill. Take it anyway. You're searching placebo. Right. Like you have to lie to your patients. And this guy was like, I don't want to do that.
00:50:43
Speaker
So ah so i'm just going to tell him. And it still worked. Yeah. So yeah I think one of the most famous studies was about IBS or irritable bowel syndrome, yeah which is one of the most hard to treat diseases. yeah You know, you you feel you have IBS, it bloating, you know, that kind of thing, like stomach pain, diarrhea, things like that. Pain, all sorts of different foods. Really hard, really hard to treat. Often there's no discernible signs that anything's wrong, even though the patients report ill effects and and bad symptoms. and stuff like that. so really hard to treat. And so, yeah, in in this study, he gave them sugar pills and they responded very well to it. um To quote from an article that we'll link to in the bibliography. By the end of the trial, nearly twice as many patients treated with the placebo reported adequate symptom relief as compared to the control group. 59% versus Also, on other outcome measures, patients taking the placebo doubled their rates of improvement to a degree roughly equivalent to the effects of the most powerful IBS medication. So wait, the control group was no pills. Yeah, mean, I don't know what it was. maybe maybe Yeah, probably no pills. But 35% of them still reported feeling better? Yeah, mean, regression to the mean, something like that. Just your body heals itself. But yeah they they did better than the control um group. yeah that's another i mean That's another thing, obviously, to mention when it comes to measuring effects of anything, alternative medicine, drugs, placebo, is that your your body doesn't want to heal itself. So there is the you do tend to feel better over time. Yeah. But the placebo effect can piggyback off of that. You feel better ah like just naturally over time, but you're taking a sugar pill and then you know you you're conditioned to think like that the pill did something. yeah So he says, ah to continue, nevertheless, ah says Kapchuck, these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual. Right.
00:52:34
Speaker
So that's that's super interesting. I like how he thinks about it as ritual and and performance. Like often we don't think about medicine in that sort of way. We think about it kind of like, I don't know, know the way a plumber approaches a problem or an electrician approaches a problem. There's a problem be solved. yeah You have your tools, you fix it. yeah The body's broken, you fix it. But he's saying, no, no, no, there's there's a there's a lot of importance to the performance, the ritual, the the context um to it. And this leads to him giving a a really peculiar definition of of the placebo effect. when you When you think about this question too much, you sort of get into strange places with what what you're actually talking about. Because normally we think of placebo as the sugar pill. But he says that when I think of the placebo effect, I think of it as, quote, a surrogate marker for everything that surrounds a pill, including the ritual symbols and doctor-patient encounters. right The context of care is the idea.
00:53:29
Speaker
Yeah. I mean, you know, I love this yeah because I'm all about i think ritual is super powerful, not as just sort of like window dressing or deception or self-discovery or anything like that. But that that literally like so much of our life is actually ritual and it really like determines what things are. hmm.
00:53:50
Speaker
You know, not not just like for us as individuals, but like it determines what they are actually. So I think I mean that I'm thinking of the of medical care um and like the the ingesting of medicines and stuff like that as ritual and the ritual as the thing that does the work is I think like a super interesting way. Yeah, we shouldn't overstate the case, right? So, like, a sugar pill is not going regrow a limb. It's not going to change the underlying problem, right? If you have, like, a tumor. Nothing's going to regrow a limb, though. Yeah, it's a matter of speaking. It's not going to make the tumor go, like, be smaller or whatever, right? It's going to... Will it not? I mean, i don't know, like... if the if If it can condition the body to respond in particular ways. So it has a lot to do with like what the brain's capable of. It can release endorphins. right can It can change the way in which the brain's connections to other parts of the body. So hormone-fueled cancers, I mean, potentially, it could treat those. Yeah, but there's still like there's still things it can't do it's it's not i can't do. It can't do everything. It it works really ah best, at least according to the researchers, on symptoms, not the underlying problem. It's not going to cure staph infection, probably. Yeah, yeah. Yeah. So like symptoms, not the underlying actual problem. But the symptoms matter, right? People care mostly about the symptoms. Sometimes there's not a clear line between the symptoms yeah and the problems, like in the case of IBS. Yes. Right. Yeah. I was surprised to learn that like IBS is a lot more complicated than than I had thought. like there's a lot ofs The brain's connection to the gut is like a source of problem. Very complicated. Yeah. Yeah. It's partly a neurological problem. It's not just like a problem in the gut. Yeah.
00:55:23
Speaker
But yeah, I like that definition he gave. It kind of reminded me of a a theater, like the the setting of a theater. you know You can have two performances of a play where they read the exact same dialogue, but the lighting and the scenery and all those other things is better in one. The effect on you is going to be better, too. And that's sort of the idea.
00:55:43
Speaker
Yeah, so thinking of medicine this way, I mean, there there would be quite a lot of implications for shifting our thinking of medicine to this kind of framework rather than, I think, what sort of becomes standard, which is like diagnosis plus like prescription sort of framework, right? Yeah, it's like a business transaction, right? yeah like When you go to the doctor, it's like it's like having a a plumber or your HVAC guy like installing something. yeah that's it they There's a problem, they're trying to fix it, and that's it, and you pay them. Yeah, yeah. I mean, as you know, my experience with medical doctors has been pretty transactional. Yes. I recently went to a dermatologist and it it was it it made me think of when we were preparing for this episode. i I thought of this because my what happened was I went in there and she suggested a medicine for the issue I was going in there for.
00:56:42
Speaker
And I knew something about this medicine, which is that it has a lot of really unpleasant side effects and that there was an alternative that had similar function, supposedly, but fewer side effects. So I mentioned, hey, could I have this one instead? And she said, oh, they're the same thing.
00:56:58
Speaker
And I said, well, you know, no, they're not. I mean, they're not right. Like they're different they're different substance. Yeah. And she's like, oh, you did your research. yeah um And she's like, no, you know I like it when people come in. Here's this is a quote. She goes, I like it when people come in knowing what they want. um So it is like literally I mean, literally, they they are even thinking about it as as just like a business transaction where they tell you what you need to take and then they give it to you and then you take it. Yeah.
00:57:25
Speaker
Yeah. so So this would be a big shift away from kind of that paradigm um to something like where the doctor is a caretaker of you and maybe even a mommy or daddy. Yeah, I mean, this is one sort of question. The philosophy of medicine is like, what is what is the doctor? What's the nature of the doctor patient relationship? I mean, as a matter of fact, given all the money involved and yeah insurance and all of that, it's's it's a business transaction, of course. But it wasn't always that way. And, you know, need not
Appeal of Alternative Medicine
00:57:56
Speaker
be that way. i think one of the draws of the alternative medicine regime is that the relationship between the doctor and patient in those contexts is not like that. I've never been to an alternative medicine person, but we watched some videos. I can you know think about what it might be. you ever been in a like ah like a naturopathic store?
00:58:13
Speaker
I don't think so. Oh, well, let me tell you. a lot of crystals. Yeah, but they're so friendly. Yeah, very friendly. They want to hear about all of your problems. yeah And everyone who goes in there wants to talk about all their problems. And that's what people want. They want a healer or some like some kind of parental figure or a friend or a mentor or something like that. They don't want to go to someone that looks at them as a problem and just tries to fix it with a tool. right They don't want to be viewed as as like a mechanism right that's broken and needs to be so fixed, you know? Yeah. And I mean, in fact, like, you know, conventional drugs, like often they just treat symptoms rather than underlying causes as well.
00:58:50
Speaker
so So sometimes people talk about this in in as like bedside manner. But I think that sort of understates the the significance of it. Right. Bedside manner just sounds like it's like ah a frivolous frill or something. But right as as the research that we've ah touched upon, talked about, it's it's much more significant than that. Like the context of care has a huge medicinal effect. Yeah. Yeah, exactly. And drugs themselves, like actual drugs that you are prescribed, in a lot of cases, they sometimes don't have much of a medicinal effect. ah We've already talked about some where we don't really know the mechanism of them. But antidepressants, and especially like SSRIs, SNRIs, those sorts of antidepressants that are obviously, I mean, you know,
00:59:37
Speaker
extremely popular, um you know, all of us probably are either on it or know someone who's on one. There is not a lot of evidence that they are more effective than placebo. Yeah, this is a very controversial topic, but it's it's I think it's I think the evidence is a lot ah weaker than people might. Given everything we just said about placebo, that's not like a slam on that. Maybe that means everything's great. Yeah.
01:00:00
Speaker
ah But yeah, you can find lots articles and maintain the news on this. i Here's a few. This is from the website Quartz. Researchers are still working to prove that antidepressants are more effective than placebo. That's like shocking because like there's millions of people on them. They don't even know if it's more effective than placebo. And that's the result of a large scale meta analysis. Yes. Depression drugs are failing and placebos are to blame, according to Labiotech.eu, Europe's leading biotech news website. Yeah, this is all like very shocking. And the efficacy declines sharply over time yeah as well. What I what i came up came upon from my brief research on this, it's it's effective for people with like severe yeah depression. But it's really the evidence that it's more effective than placebo for mild to moderate depression is really not there.
01:00:44
Speaker
Or anxiety. Yeah. Yeah. So I guess, don't know, maybe we should of kind of wrap this up. We're getting close to over time. Mm-hmm. What have learned? What's the most important thing you think you learned from this, Megan?
01:00:57
Speaker
Well, you know, i think I feel pretty disillusioned. Really? About medicine. I mean, actually, I was probably disillusioned about medicine. You've had a rough time with the doctors recently. i have. You kind of misdescribed your story a little bit. Like the the the doctor or whoever dinner didn't seem to like that you came in with knowledge. No, she was not. She she she found it up to be a bit of a frontery. Yeah. Yeah. I think she said, i like when people come in knowing what they want. I i think she wasn't being sincere. Yeah. No, she she did seem a little irritated by it. That's true. Another recent case is that I had to take legal means to get my medical records from a place because they just wouldn't give me the result of a random blood test. It took me like two months. I did get it, finally. So I was maybe a little pessimistic about medicine before we started researching for this episode, but this didn't help.
01:01:51
Speaker
Part of me feels like nobody knows anything. Yeah. Nobody knows anything about how the body works or how to fix it. And like maybe the the best evidence we have is that like being happy and feeling safe and loved is like a good problem. You read these stories. It reminds I read these stories to Theo, our three-year-old, and, like, there's one story in her her her book of Spanish stories where the the bunny is sick, and they try to give the bunny all these cures, and at at the end of the story, the bunny's like, I just need some hugs. And, like, you maybe that's just you. Maybe that's literally the best. Like, that's the thing we have the most evidence for of all medical prescriptions. I'd kind of came away with a a more positive ah viewpoint. Like, wow, our minds are a lot more powerful than I thought. I'm not going to do a whole like Deepak Chopra mind over matter stuff. But, you know, our minds are a lot more powerful we thought. And there's like there's a lot more to, you know, that like mindset. This is the third time you've referenced Deepak Chopra in this episode.
01:02:50
Speaker
no I think it's the second time. I'm pretty sure it's three, but OK. Yeah, you know, there's there's a lot you can do with the, you know, yeah there's a lot your mind can do, you know. Yeah. Your brain and all that. Yeah. yeah like And like and like and helping you. And yeah yeah, a lot of these like synthetic drugs, they they they kind of, ah they they simulate natural things that your brain makes. like endorphine Like morphine is, you know, just piggybacks off of endorphins. Yeah, of course. yeah So that was cool. i felt I felt like my mind was more powerful than than I had thought.
01:03:20
Speaker
Yeah, definitely. i mean, with yeah the birth of our second child, for a variety of reasons, but mostly because my epidural with our first kid was awful, i I chose not to have one. And that was its own battle. But it was really, it was a mental battle, as everyone says, um because, like, pain management and stuff is so mental. And, like, the, ah it is really fascinating how just, like,
01:03:48
Speaker
thinking about things differently changes how things feel. it It was just like extremely bizarre to actually experience that. um And then there's, I guess there's just evidence that this is true. So yeah, brains are pretty powerful and that's cool.
01:04:03
Speaker
So you're, you're more of an optimist about, oh think so about us as individuals. Yeah. I agree that like that it does seem like I was shocked to learn about the antidepressants being like not as effective as is is commonly assumed. Like I didn't I didn't know that, you know. So I guess, yeah, I mean, a little less confidence in mainstream medicine, but I'm not sure. but You were telling me about a book, weren't you? About. Oh, yeah. This is the recent book I wanted to check out. I read the review of it a few years ago. it's called Medical Nihilism by the philosopher Jacob Stegenga. And it basically argues that like mainstream medicine is not all it's cracked up to be. it's It's best for treating acute problems. But when it comes to like chronic conditions, things like IBS, autoimmune disorders, hormone problems, it's really not that great. There's really not much it can do. And argues this because of just like all these effects are yeah small. Yeah. Small effect sizes in medicine. A lot of drugs that have bad side effects are really barely better than a placebo. Yeah. Stuff like that. So haven't read the book, but it seems really interesting.
01:05:04
Speaker
It says our confidence in many medical interventions ought to be low. and that that Mine are. Yeah. I'm already there, Jacob. Yeah. so Yeah. Yeah. You fall. You know, if you if you get in a car accident, you want to go to a doc, like a real doctor. But you like break your leg. Yeah, of course. Right. Stuff like that. Of course. Right. You know, cancer. You got the chemotherapy and all that systemic issues are. are Yeah. We're still confounded by them. Yeah.
01:05:27
Speaker
Fascinating. And, i you know, I guess I've also I haven't considered, you know, doing Reiki, but who knows? Maybe I will. But you considered ah hypnotherapy, you know, hypnobirthing. We talked about that in the hypnosis episode. kind of want to do all of these things at least just once. Yeah. Just to see. Yeah. Just to see what it's like. I don't know. So if anyone wants to ah fund me. If we weren't leaving on a trip soon, probably would have got Reiki for- For the show. For the show. Yeah. But we- Would you have done it?
01:05:57
Speaker
It would have had I think we'd have to flip a coin. there's There's no sense in both of us doing it. Yeah. I could just watch. Yeah. You could watch. Yeah. Oh, my God. Okay. um I think we're out of time. We're, like, super out of time. If you guys have stuck a stuck around for the extra, like, 20 minutes, then, you know, God bless you. Hopefully this was interesting to you. We thought it was fascinating. Please join us next time for another episode on Some Topic.