As a species, we have exemplified a knack for generally having a tremendously hard time dealing with the unknown, and as such, often expend a lot of energy rationalizing and conceptualizing what may be, in an effort to avoid the horrors of simply not knowing. Which is fair. That’s really not so much of a problem on its own. Things mostly get problematic when unevidenced ideology is repeated enough to begin parading itself as truth. Especially so if blindly accepted by the public, seemingly affirmed by flawed or fraudulent research and biased researchers, or even perpetuated by systematic and institutionalized means.
My intent here is to thoroughly and compassionately outline how this is the case regarding some prevailing thought in parts of the healthcare field, why it can be counterproductive (if not outright harmful), how we’ve gotten here, and how we can potentially contribute to course-correcting as we continue to go forward.
Language, and the frontier of the mind: a tale of two Trojan horses
Despite its obvious importance, language can also be a bit of an unsuspecting hurdle in the pursuit of truth and understanding. Labels and definitions are transient, and may evolve as we further our investigations of natural phenomenon, but principally, and invariably, whatever *is* will not change accordingly as we choose to shift our views and/or associated terminologies. The ultimate consequence of this is that it matters somewhat less what exactly it is that we call things, and more that we have the capacity to relay a common understanding of the mere existence, differentiation, and function of them.
For an example, we know that cells exist. They’ve been seen under microscopes, and have been studied extensively. We know there are specific variations in their type, characteristics, and functions because the observational results are consistent and reproducible. Being able to convey the existence of these basic things through particular definition is so crucial for building that foundational knowledge and providing society with the potential to expand upon it. Whether or not cells were ever called “cells” is really not so important, because they are always going to be whatever they naturally are, devoid of descriptive inherency, despite any transient or changing, widely-accepted definition. An example of an existing thing driving the elucidation of our rhetoric to go about describing it – the horse pulling the cart, if you will.
Though, interestingly, so too may the cart pull the horse.
It is an interesting thing to invent a term to describe something that has no basis in reality. As I will detail below, this strategic use of language by specific ideological proponents has contributed to systematic flaws in healthcare services and research, substantial wasting of taxpayer dollars, and the overall debasement of scientific knowledge.
Everything psychological is biological
There is a seemingly innocuous but pervasive idea relentlessly promoted by the $4.2 trillion dollar wellness industry of a “mind-body connection” that treads into the old philosophical domain of Cartesian mind-body dualism. At first, the notion that what we refer to as operations of the mind might have any implication on physical operations of the body seems kind of absurd to even discuss, considering that it’s pretty obvious that if you “think” about lifting a cup, you can most certainly move your arm, grasp it with your fingers, and lift the cup. Though the issue is of course more complex than that, moreover, the real controversy of the argument comes into scope when considering the vast array of artificial falsities that attempt to hide themselves behind simple natural truths.
The mind itself is not a real, tangible thing, though it is a pretty generally useful human concept – the subjectively perceived product of our operational brain chemistry. Sensory perception and activities of the brain result in thought, memory, and bodily motor control via signal transduction throughout the nervous system working in conjunction with the musculoskeletal system. Emotional states can also have bidirectional implications with autonomic function such as hormone production, but it is really important to clearly emphasize that the brain does not simply control the body from some external seat of consciousness, it is a physically integral part of the vessel itself. None of the aforementioned is short of incredible, and yet the beauty of such basic facts of human biology can then become so easily obscured by the introduction of esoteric and pre-scientific ideology into the discussion.
Alternative-health gurus tend to attempt justifying their beliefs (and products) with scientific context and complex-sounding neurological terminology, most often in conjunction with references to some mystical divinity of the mind or a dramatic overemphasis on self-importance; and of course, there are people who want to hear this. Much as with the phenomenon of confirmation bias, this kind of sensationalism can easily result in a distinct vacuum of thought – an echo chamber, self-perpetuating, and deeply-penetrating. Though in preaching to the world that the fundamental key to health, wealth, love, success, and happiness stems from some sort of arbitrarily determined “spiritual” component such as enlightenment or energy balance, which may be achieved through a very particular set of exercises, lifestyle, or other means of which they can surely be imparted (for a small fee plus tax, of course) – they induce a sense of incompleteness, or shortcoming, and undermine our pure, biological, and intrinsic capacity to simply be, and be content – much like any other living and respiring creature – without compounding upon ourselves all these unnecessary encumbrances of human invention.
The infiltration of pseudoscience into national healthcare
Even across highly reputable science-based institutions for medical services and education, you will be pretty hard pressed to come by one these days that does not endorse pseudoscience in some form or another. This affirmation usually comes packaged under operations of a local “integrative medicine” branch or department, though the observational result is that the entire institution itself is what must then own the statement. To fully understand how this has come to be requires a careful look at some important U.S. political history, and the story behind the country’s most controversial government agency, the National Center for Complementary and Integrative Health (NCCIH).
Largely due to the efforts of a single but powerful legislator, Senator Tom Harkin (D-IA), whom was convinced his allergies were cured with bee pollen, the NCCIH was established in October 1991 to “research alternative methods that medical science considers false or implausible” – only back then it was called the Office of Unconventional Medicine. Some of these pseudoscientific methods include homeopathy, acupuncture, reiki, energy healing, meditation, crystals, spinal manipulation, qi gong, tai chi, hypnosis, and an array of herbs and botanicals – all advertised as being miraculously more capable of addressing the “whole person” than conventional medicine.
The agency was soon renamed the Office of Alternative Medicine (OAM), and Joseph J. Jacobs, MD, MBA, a medical scientist with no previous background in alternative medicine, was named as it’s first director. Jacobs immediately clashed with Harkin over his insistence of adhering to rigorous scientific methodology. Though, as chair of the congressional committee that provided funding to the OAM’s parent agency, the National Institute of Health (NIH), Harkin was able to use his political leverage in order to both publicly and privately pressure the office into funding pet studies of his own interest, and ultimately drive Jacobs to resign out of sheer frustration in 1994.
After four years under the new direction of Wayne Jonas, a political ally of Harkin’s and fellow homeopathy promoter, then-NIH director Harold Varmus moved to place the OAM under more strict scientific control. Harkin retorted by then re-establishing the OAM as an independent NIH “center” with more immunity against regulatory jurisdiction, thus giving rise to the National Center for Complementary and Alternative Medicine (NCCAM). Since 1999, the agency’s annual funding has sextupled, while the quality and substance of the research produced has remained remarkably pitiful. A few examples of some of the biggest NCCAM projects funded were for whether prayer can treat diseases (after $22 million, they concluded that it does not), whether magnets can cure arthritis, carpal tunnel, and migraine headaches (after $2 million, they concluded that it does not), and 352 projects evaluating the efficacy of dubious palliative treatments for diabetes, such as whether expressive writing may reduce symptoms (after $110 million, they declined to publish their results).
In 2002, Saul Green, a brilliant biochemist from the Sloan-Kettering Cancer Institute performed and published a formal review of all OAM/NCCAM grants and reports. He discovered that many of the grants had been going to the same researchers over and over again, but more curiously, that so few of the experimental results were ever published. He noted that when results were published, they were worded quite carefully so as to convey that the results were interesting, although uninterpretable, and that additional research would need to be performed because they did not have enough funding to do it properly.
Despite the track record up to this point, American taxpayers were reportedly dishing out around $34 billion annually for CAM studies by 2009. Three years later, the Journal of American Medical Association (JAMA) published a critique of NCCAM and their substantial wasting of research money, referencing the steady stream of funded projects with invariable failure “to prove that complementary or alternative therapies are anything more than placebos”. The commentary concluded with a call for rationality, suggesting the NCCAM “either refrain from funding studies of therapies that border on mysticism… or shift its resources to other NIH institutes”.
Two years later, in 2014, the NCCAM was rebranded once again, this time as the National Center for Complementary and Integrative Health (NCCIH). There has been speculation within the medical field that the agency’s name change was simply an attempt to strategically distance itself from both the word “alternative”, and their slew of funding for questionable studies. The agency still remains today.
Society tragically misses the point
I would like to take a step back now and just touch on two crucial things that I feel there really needs to be more discussion on; the irrelevance of personal opinion, and medical ethics.
Something does not necessarily need to be proven or supported by science for you to be able to enjoy it, let alone to just do it. Maybe you like country music. I, or anyone else in the world might not happen to share your affinity, but why would that ever stop you from listening to your heart’s content? Similarly, we do not need multi-million dollar studies to tell you that something like listening to country music is objectively good or bad, because truthfully, it’s more likely to be neither – and you either happen to like it or you don’t. A study that attempts to determine such a factor is destined for futility, simply because self-reported measurement will always hinge on arbitrary subjectivity governed by all sorts of external factors, and it would be incredibly unethical to set up an experimental trial where a person or group is withheld a real treatment in order to serve as a control, or worse, a guinea pig to affirm someone else’s personal beliefs.
Even if there were any gleanable data from trying to observe and measure any physiological effects from subjective stimuli, there is always the pitfall of causation versus correlation, confounding factors, and the simple fact that, at the end of the day, people really do tend to believe whatever they want to believe. The point here is to try and remain aware of these things, set aside our own biases, and ask the right questions that can propel our collective knowledge forward.
The fundamentally-flawed promulgation of “spirituality” in healthcare
Alternative medicine practitioners tend to promote themselves as being able to address the needs of the “whole person”, which is an unnecessarily divisive marketing scheme that does strongly appeal to a certain demographic, particularly distrusting of conventional medicine and pharmaceutical companies. But in allowing subjectivity of opinion to directly influence and integrate with the beautiful objectivity of science – we do not enhance the current state of science, but rather degrade it. As the late, great, Professor Emeritus of Clinical Medicine at Stanford University, Wallace I. Sampson so concisely put it:
“While the public is distracted by terror attacks, wars, and personal and business scandals, modern medicine’s integrity is being eroded by New Age mysticism, cult-like schemes, ideologies, and classical quackery, all misrepresented as ‘alternative medicine’. Using obscure language and misleading claims, their advocates promote changes that would propel medicine back five centuries or more. They would supplant objectivity and reason with myths, feelings, hunches, and sophistry. NCCAM is presented as a scientific vehicle to study alternative medicine’s anomalous methods, but it actually promotes the movement by assuming that false and implausible claims are legitimate things to study.
We know that ill-conceived research produces misleading results. The results then lead to repetitive cycles of unproductive work to explain what was found, usually just to disprove the erroneous results. As a result of all this, claims continue.
Tens of millions of U.S. citizens lack medical insurance. Millions of illegal residents produce economic burdens on local medical systems. While real medicine and technology can solve these problems and prolong productive life, ‘alternatives’ appeal mostly to disaffected health dilettantes, and add nothing to public health. Worse, CAM’s fuzzy thinking and radical social ideology lead to wrong-headed policies such as the denial of HIV as the cause of AIDS, and the recent fears of vaccinations and electromagnetic fields.
Special commercial interests and irrational, wishful thinking created NCCAM. It is the only entity in the NIH devoted to an ideological approach to health… NCCAM could be dissolved, its functions returned to other NIH centers, with no loss of knowledge, and an economic gain. Funds could be invested into studies of how such misadventures into ‘alternative’ medicine can be avoided, and on studying the warping of human perceptions and beliefs that led to the present situation.”
Misadventures into “alternative medicine”
Each year, especially here in the West, there are increasingly large numbers of entrepreneurs and researchers flocking to tap into the ongoing “mindfulness” craze; penning self-help books and blogs, developing apps, integrating practices into corporate and school wellness programs, running expensive meditation retreats – and ultimately going as far as to unsubstantiatively declare their conjectured metaphysical and/or epigenetic basis as a panacea for all things ranging from stress and depression to addiction and cancer. Supposedly distilled from its original roots in the unquestionable dogma of universal dharma and reincarnated lamas, the Westernized concepts of mindfulness purport to be a secular package of Buddhist values, though whether these beliefs and practices have any business being integrated into school curriculum or workplace training is certainly a far more complex issue of institutional imposition of will and religious freedom altogether.
There is nothing at all wrong with purposeful relaxation (and should in fact be more broadly encouraged), but we do already have a perfectly functional name for that – relaxation, purposefully. There is no conceivable reason to over-complicate it, or affirm some arcane belief system in the process. This is especially true with regard to gravely serious and life-threatening cases, such as with cancer, where it is not only cruel, but recklessly irresponsible to instill belief that wishful thinking can or will help rid them of their ailment. Though, of course, this has not prevented alternative practitioners such as Deepak Chopra from making a fortune doing just that.
While I do find it profoundly unsettling, I don’t really find it all that surprising that artificial concepts such as mindfulness have garnered so much attention these days. We live in such a highly competitive world, unstructured breaks tend to be viewed as an indicative marker of laziness, or a lack of productivity; while a meditation break may instead be glorified within the workplace – a fanciful display of one’s attention to their own health, to which we might all benefit from adopting into our own lives if we would only put forth the effort. The result of which is a bit of an incomprehensible hypocrisy, facilitating the triumph of a monolithic and highly marketable brand over what is otherwise always available to us all without a salable label – a bigger psychosocial problem than I believe we are yet recognizing it as.
Analogously to how yoga as an arbitrary brand of exercise aggressively endeavors to identify with (and reserve some exclusive possession over) the natural, and obviously healthy, human activities of stretching, breathing, and exercising; most any rendition of mindfulness makes the attempt to lay intellectual claim to the innate phenomena of being in the present moment, and thusly capitalizes on individual insecurities in perpetuating itself and pressuring others into imitation. Indeed, we live in an era where in walking through a city or university campus, you might encounter 9/10 people holding a screen up to their face – though this may likely have much more to do with a cultural redefinition of connectivity than people not being “mindful” of the present moment – who are we to say?
Being cognizant (or “mindful”) in our day-to-day existence surely isn’t anything profound, it’s as diverse and natural as it gets – listening to the breeze, watching dogs play, picking out individual parts of your favorite songs, laughing with others, feeling the heat of the sun on your skin, or the sand grains beneath your feet, being aware of the perceptions of others, and of your fleeting thoughts and emotions – and understanding that none of it really matters in the grand scheme of the universe. What mindfulness isn’t, is abstract human conceptions of spirituality, or contrived breathing patterns and guided imagery, it isn’t obscure ceremony developed to “facilitate mindful living” – it’s not something you practice, it’s not something you teach, it’s not something you learn – it just is.
In misinterpreting new age spirituality for real neuroscience, people may be dangerously misled to believe that artificial conceptions of the “mind” have supernatural or all-encompassing command over their physiological health, or other external aspects of existence (read here about Deepak Chopra apologizing for his personal meditation causing an earthquake in southern California). While all people should have a fundamental right to indulge themselves in whatever activities they choose to – the healthcare field should absolutely be held accountable for the endorsement of any psychologically-detrimental belief system, especially one that often fosters narcissism and self-absorption, and also has historical rooting in human exploitation and population control through the dulling and reprogramming of natural thoughts. It should be a primary virtue of all healthcare professionals to strengthen individuals, not lull them into an induced complacency.
The sun shines on both sides
It certainly comes down to opinion, but if you’d asked me, the most fundamental goal of every individual should just be to find simple contentment in their own natural experience of existence; without meticulously-manufactured belief systems, without harming or controlling others, and without the need for coping mechanisms or induced positive thinking, because that’s the baseline. Everything else is extraneous, and inevitably leads to unnecessary suffering.
There is no “there” to which you are not already. The sun shines on both sides.
Compassion and empathy for one another should certainly be a cornerstone for humble individuals of an intelligent and coherent society, but in striving for that, we ought to take a hard look at the true nature and deep roots behind the practices we suggest and prescribe, and the institutions that we construct and operate in the name of healing.