Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
We know all about the sixteen or so universities that run “BSc” degrees in hokum. They are all “post-1992” universities, which used to be polytechnics. That is one reason why it saddens me to see them destroying their own attempts to achieve parity with older universities by running courses that I would regard as plain dishonest.
Older universities do not run degree courses in such nonsense. Academics (insofar as they still have any influence) certainly would not put up with it if they tried. But nevertheless you can find quackery in some of the most respected universities, and it gets there not via academics but (guess what) via Human Resources. It creeps in through two routes. One is the “training courses” that research staff now have to do (the “Roberts agenda”). The other route is through occupational health services.
Quackery in training courses
It isn’t easy to find out what happens elsewhere, but I was certainly surprised to find out that UCL’s own HR department was offering a course that promised to teach you the “core principles” of Brain Gym and Neurolinguistic Programming, both totally discredited bits of psycho-babble, more appropriate to the lifestyle section of a downmarket.women’s magazine than a university. I gather that HR’s reaction after I brought this to light was not to ask what was wrong with it, but just to get angry.
In a spirit of collegiality I offered to run a transferable skills course myself. I even offered to do it for nothing (rather than the rumoured £700 per day charged by the life style consultants). I proposed a course in ‘How to read critically’ (subtitle ‘How to detect bullshit’). This seems to me to be the ultimate transferable skill. Bullshit occurs in every walk of life. My proposal was moderately worded and perfectly serious.
Guess what? Despite several reminders, I have never had any response to my suggestion. Well, I suppose that HR people now regard themselves as senior to mere professors and there is really no need to reply to their
letters.
Quackery in occupational health. Leicester sets a good example
If you work at a university, why not search the university’s web site for “complementary medicice” or complementary therapies”. If it is a real university, you won’t find any degrees in homeopathy, or in amethysts
that emit high yin energy. But some quite surprising places are found to be recommending magic medicine through their Occupational Health service, which usually seems to be part of HR. In fact at one time even UCL was doing it, but no soon had somebody sent me the link than it disappeared. As a matter of historical record, you can see it here (it had all the usual junk, as well as harmless stuff like yoga and pilates).
While looking for something else I stumbled recently some other cases. One was at the University of Leicester, a very good university (and alma mater to the great David Attenborough who must have done more to point out the beauty of science than just about anyone). But we find on their staff wellbeing site, alongside some perfectly sensible stuff, a link to complementary therapies.
The list of ‘therapies’ includes not only the usual placebos, acupuncture, reiki, reflexology, but, even more exotically, a fraudulent Russian device called SCENAR therapy. They have a nice leaflet that explains all these things in words that run the whole gamut from meaningless gobbledygook to plain wrong. Here are some examples from the leaflet.
Reflexology
“In the feet, there are reflex areas corresponding to all the parts of the body and these areas are arranged in such a way as to form a map of the body in the feet”
Reflexology has been shown to be effective for:
- Back Pain
- Migraine
- Infertility
- Arthritis
Well no, there are no such areas in your feet. That is sheer imagination. And reflexology has not “been shown to be effective” for any of those conditions. These claims for therapeutic efficacy are not only lies. They are also illegal.
“Reiki
Each hand position is held for a few minutes, and during this time healing energy will flow into you, balancing your energy system, releasing stress, soothing pain, and promoting your body’s natural ability to heal itself.”
This is sheer idiotic mumbo-jumbo. The “flow of healing energy” is totally imaginary. Such talk is offensive to anyone with half a brain. Insofar as they claim to heal anything, it is also illegal. The comes SCENAR.
“What is SCENAR?
SCENAR is an acronym for Self Controlled Energo- Neuro Adaptive Regulator. It is a reflex biofeedback device which when used by a qualified practitioner, can help to alleviate acute and chronic pain. It is licensed in the UK for pain relief but experience has shown that it is helpful in a wide variety of conditions.”
This is even more seriously nuts than the others. The term “licensed” means merely that it is electrically safe. It certainly does not mean that it works. Pubmed shows only three publications about the SCENAR device, all in Russian,
One sales site (apparently Russian) makes the following modest claim.
“A prime goal of the Russian Space Program was to provide space travelers with a portable medical device that would become their “universal medical assistant” in space. So from the beginning, the SCENAR was designed to replace an entire medical hospital, with all its staff, diagnostic and treatment facilities, even the pharmacy. A universal, non-invasive, portable regulator of body functions (among other things) was envisaged.”
The SCENAR device (right) looks like a TV remote control (perhaps it IS a TV remote control -we aren’t anywhere told in comprehensible terms what’s in the box. The Russian site sells also the rather baffling accessory on the right. The mind boggles.
SCENAR device |
Remote rectal-vaginal electrode for SCENAR |
How does this rubbish get onto the web site of a good university?
I presume that it is just another sign of what happens when universities come to be run by non-academics. No doubt the occupational health people are well meaning and kind, but just scientifically illiterate. What about the HR person in charge of them? They are not known for scientific literacy either (which would not matter if they stuck to their job). But perhaps they just didn’t notice. There is only one way to find out. Ask. So I sent this letter.on 10th September.
| Hello
I am a pharmacologist and I have a side interest in public understanding of science, alternative medicine.and medical fraud I was quite surprised when Google led me unexpectedly to your complementary therapies page at http://www.le.ac.uk/staffwellbeing/complementary_therapy.html There is, sad to say, a great deal of information on these pages that is simply not true. For example it has NOT been shown that reflexology has been shown to be effective in any of the conditions which you list, as far as I know To take only one more example from this page, the SCENAR device is an even more extreme example. It is well known to be fraudulent. and has been investigated by the Washington State Attorney General. This sort of thing is not what one would expect from a very respectable university, and it must be a great embarrassment to your excellent medical scientists. Apart from the many scientific inaccuracies (which greatly impede the efforts of those of us who try to improve public understanding of science), you are, I hope, aware that there is a legal aspect. Since May this year, new regulations have made it illegal to make claims for health benefits if evidence cannot be produced to show that the claims are justified. I would like to put it to you that many of the claims made on this page are not only immoral, but also illegal. I wondered whether you , or your HR department, would like to make any comments Best regards David Colquhoun |
I got an immediate and very sympathetic response from the Director of HR and a week later, on17th September, he wrote
“Hi David,
I have discussed the matter with my manager of Staff Counselling and Welfare and have agreed that it is probably safest that we remove the references to ‘complimentary’[sic] therapies from the site entirely.
Thank you for your helpful input and the recommendations for reading matter.”
So there is a lesson here. If you find this sort or stuff on your own institution’s web site, all that may be needed is a simple letter that points out what nonsense it is. Admittedly the HR man seemed rather more worried about whether the claims were illegal than whether they were true, but either way, it worked.
Only one little snag. As of 6 October the pages still have not been removed.
On the assumption that they eventually will be removed, I have kept copies of the Wellbeing page, of the Complementary Therapies page, and of the ‘explanatory leaflet’. They stand as part of a historical record that
shows, once again, what can happen when scientific matters get into the hands of HR. Fortunately Leicester University has an HR director who is willing to listen to advice.
Follow-up
Something seems to have gone seriously wrong. Despite the rapid response, virtually all the nonsense is still there on 13th October. It seems not to be so simple after all.
And despite several reminders, the advertisement for SCENAR ‘therapy’ is still on the University web site on December 14th. I know that no decision by HR can be made with fewer than 25 meetings and an awayday in Majorca, but this is getting ridiculous.
71 Responses to Quackery creeps into good universities too -but through Human Resources
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In a couple of places I can think of I have seen this sort of stuff appear via the local Staff Association rather than OH, David.
Speaking as the other half of a medic who has worked in occupational health, I would be surprised if the OH doctors were keen on “special access to CAM”. The OH doctors I have met are just as evidence-oriented as most other physicians – though of course there are doctors, perhaps notably GPs, who are CAM enthusiasts, and a fair bit of OH work is done by “GPs with an OH interest”. However, it is certainly possible that the same pressures visible in the NHS to be very respectful of the CAM therapies “that are popular with the punters” are present in some OH departments.
OH are certainly formally tasked with helping the employer “manage” employee health in the workplace, and you can see the potential for conflicts there WRT CAM “therapies”. Reducing it to its most basic, if you told an employer (including a Univ) that paying for employees consulting OH to be referred rapidly to a “holistic” mumbo jumbo-therapist would reduce sickness absence days and save the employer money, you can see how the bosses might consider this a shrewd investment, regardless of the reality (or not) of the therapy.
One of the things Mrs Dr Aust regularly does in her OH role is to try and get to the bottom of why people are consulting OH – often “workplace stress” – and then get them to address this in ways for which there is actually some evidence base.
Actually I tried first to write to the OH doctor, but I was told it was nothing to do with him, and I don’t think the letter ever reached him.
I suspect that the quackery is often allowed to persist through sheer laziness, Somebody puts it there and nobody gets round to saying it’s rubbish, even when they know it is. The price of liberty (from nonsense) is eternal vigilance, I guess.
Is the University of Wales a “good” university? They have a quack nutrition MSc course with Patrick Holford as a visiting lecturer on it (as well as John Briffa, Maryon Stewart and a load of names I don’t recognise). It’s run by the same acupuncture college that UCLAN is collaborating with over TCM…
http://www.wales.ac.uk/defaultpage.asp?page=E7053&prog=NC-MSC/NT&inst=NC
Interesting points about Occupational Health, Specific Learning Disability support in universities seems to becoming increasingly CAM like especially in recommendations for dyslexic students. I have been doing some (very slow) digging into this and suspect it comes about because it is expensive to see an Educational Psychologist for diagnoses and recommendations so universities and students prefer to see lower cost, less qualified, options (~£500 vs ~£50) which include teachers with a diploma from the British Dyslexia Association. This diploma is evidence based and the BDA are generally immune to quackery but compared to the several years plus it takes to qualify as a EdPsych these teachers are severely lacking in an evidence based education specific to learning disabilities. This makes them prey to quackery and if not them then their HR masters. Somebody with an EdPsych degree is going to carry a lot more heft in an argument with an HR department over resources for students than somebody with a 70-80 hour diploma plus some teaching experience. An HR bod is going to look at the cost of coloured overlays vs that of a laptop computer and make a cost based, rather than evidence based, decision on support.
The University of Wales also underwrites the McTimoney Chiropractic College and their nonsense courses on subluxations.
Tangentially relevant to this post but there appears to be controversy about reported NICE draft guidance regarding spinal manipulation for low back pain. While people like Edzard Ernst are troubled, others are jubilant:
“But other experts have vigorously defended the guidance. Dr Nefyn Williams, a clinical senior lecturer in general practice and a GP in Llanfairfechan, Wales, said he was delighted spinal manipulation was included.
‘Hallelujah. Spinal manipulation only has a small to moderate effect compared with standard care, but has important psychological benefits,’ he said.”
Thanks for drawing attention to that Claire.
The NICE consultation can be found here.
This is what I just sent to them.
Hmm. Slight storm-in-teacup. I haven’t had a chance to consult Mrs Dr Aust (who sees lots of back pain patients) but I would bet most doctors would read this as:
(i) what really matters in treating back pain is to get the person mobile and physically active;
(ii) to do this doctors need to get the patients to “manage” their back pain to the point where they feel able to be physically active;
(iii) the best way to do this by miles is with standard cheap and effective painkillers, with paracetamol as the first choice;
(iv) HOWEVER, if the patient cannot or will not take painkillers, even with advice and guidance, and if this is impeding them being physically active, a placebo intervention may be considered since what really counts is (i) above.
Forgot to mention earlier: when people are referred to Occ Health, a lot of employers keep costs down by having a “Nurse-led service”. Without wishing to get into a big argument, it is possible that this may have a bearing upon the likelihood of CAM therapies (including the quackier ones) being on the list of offered options.
Incidentally, the NICE draft guidance flatly contradicts what the Welsh GP educator is quoted as saying in Pulse (Claire’s quote above).
NICE say:
“There is no evidence of benefit in psychological outcomes [with manipulation].”
– though one suspects it could be argued that it would depend on the individual patient. If one imagines a patient who is a fanatical anti-Evil-Big-Pharma-drugs natural health type who believes whole-heartedly in CAM, then the placebo effect of manipulation on their “psychological outcomes” might be rather different than if the patient was DC…!
@ Dr Aust, you’re probably correct to say that most doctors will view this as a ‘placebo’ intervention but I wonder how, if it becomes official NICE guidance, it would be viewed by most chiropractors? As an endorsement or official imprimatur to be used in advertising their therapies? There are also long-term consequences for medical education, as outlined in point (3) above by DC.
I’m not so sure it is a storm in a teacup, I rather fear that NICE could be influenced by the fact that chiropractic is officially-recognised and “regulated”. Perhaps we are paying the price of official recognition of quasi-religious quackery. It seems to me like good reason to try to stop the same thing happening to acupuncture and TCM, as recommended by Pittilo’s dreadful report,
“So there is a lesson here. If you find this sort or stuff on your own institution’s web site, all that may be needed is a simple letter that points out what nonsense it is.”
The problem with this is that Emperors (especially those with their fingers on your salary and/or promotion) do not take kindly to being told that they have no clothes. I work for a private sector company with a strong science base, but this has not stopped the HR department promoting reflexology and other nonsense.
As a friend once put it: “The difference between Personnel and Human Resources is that Personnel look after you while Human Resources look after themselves”.
I don’t suppose it will reassure (!) DC that the “NICE Back Pain Guideline Development Group” included:
“Mr Peter Dixon (Chiropractor) – Chairman General Chiropractic Council, London”; and:
“Mr Steven Vogel – Vice Principal (Research and Quality), British School of Osteopathy, London”
I do agree with Claire’s point about the Chiros likely feeling “vindicated” by things like this, though they are not being if you read carefully. And it is also true that that is how it is likely to play across much of the more CAM-friendly parts of the media:
– which of course the draft guidance doesn’t say anywhere.
I suspect acupuncture will be a slightly different debate, as there is a substantial lobby in medicine (notably among the pain people) for “medical acupuncture” (needling but no meridian mumbo-jumbo). They are very clear that there is no evidence for the kind of meridian mumbo-jumbo that the trad Chinese acupuncture is into.
I can sympathise a lot with Chris. Even in universities, people feel intimidated into silence for fear of retribution. I think that in reality that danger is not nearly as great as people seem to think, but it the fact that the perception exists is a very sad commentary on the state of academia.
I’d imagine that the danger might be bigger in the private sector, but you wouldn’t be commenting on the company’s main business. Perhaps it could be raised informally in conversation with some senior person to test the waters?
One possible approach that might cut some ice with the management, either in a Univ or possible in science based business, is the “this makes us a laughing stock” approach.
There is a story that used to do the rounds that this was the thing that usually convinced US states with fundamentalist-rich legislatures not to pass crazy laws mandating the teaching of Intelligent Design in schools. That is, the whisper:
“If you pass this, people will think that us folks in xxxxxx are a bunch of hick morons and we’ll be a national joke”.
In the business context, HR and similar nitwits may well argue that the nonsense saves the company money by increasing employee satisfaction and decreasing sickness absence. I suspect the actual evidence for this is probably pretty thin, but an alternative tactic in response is to say:
“the damage to our reputation as a company whose core business depends on evidence-based reality will be more costly than anything that we could be gaining”
PS Re. the dangers of retribution for “rocking the boat” in Univs and elsewhere, I suspect one’s fear of backlash is inversely proportional to how secure one feels in one’s job and (related) how employable elsewhere. I am sure Univ people would feel more secure in kicking up a fuss if they had £ 200K a year in grant money then if they had a tenth of that.
Dr Aust (Oct 7 8:21pm) makes a good point about what the guidance actually says in contrast to how it might be interpreted.
On the broader question of tolerance for pseudoscience in medicine, Dr Val, a new poster on Science Based Medicine gave her personal perspective yesterday.
With Mrs. Dr Aust in mind, this caught my eye:
“…I completed a residency in Physical Medicine and Rehabilitation, a specialty that is not dissimilar to farming if you consider that getting people up and moving is 50% of what we do. …”
In case Mrs Dr Aust is interested in “getting up and moving” techniques from livestock farming, if childhood memory serves correctly one needs patience, calmness, determination and the preparedness to be out in all weathers crying “hup! get on there”. Additionally, an ashplant (ash sapling) can be useful for the more stubborn beasts and good collie is a great help. Though I imagine incorporating these last two into her practice might be problematic!
Mrs Dr A tells me that a key skill (with humans with back pain rather than our four-legged friends) is explaining to people the purpose of taking painkillers (i.e. “get you up and moving which will help make you better” rather than “numb your pain which we can’t do a thing about, sorry”), and re-assuring them that they will NOT get addicted to Nasty Big Pharma Pills.
According to her, a very common problem is that people don’t take the pills at the recommended doses – e.g. if they are told “1 g of paracetamol, so two tablets”, they commonly take one tablet (500 mg) because they are worried about side-effects or “getting dependent” if they take two. The result, of course, being that they don’t take a properly pain-relieving dose and thus don’t reduce the pain enough to get mobile.
I suspect some of this kind of thing is in “patient education programmes”, but having a sympathetic, knowledgable and empathetic doctor to explain it to you one-to-one clearly helps a lot of people.
Incidentally, Mrs Dr A grew up on a dairy farm, so I will have to ask her if she sees the parallels Claire is referring to …
I have to say I did raise my eyebrows at the farming parallell as I’m not sure the “hup! get on there” approach is translatable to humans in pain! Of course Dr V was making a humourous aside and I suppose some qualities that make for good animal husbandry – calmness, patience, determination – are useful in other contexts.
Regarding the importance of explaining the purpose of prescribed therapy, it’s obviously vital but I sometimes wonder if more time needs given to exploring where patients might be getting their negative attitudes to medical treatments from and to explaining why such sources may be misleading? This might be a tall order though to fit into a time limited GP consultation.
Could I make a few points apropos the above.
1) I did a survey this morning in my office and asked 10 people about chiropractors. They all thought they were “proper” “medically qualified” doctors who just happened to specialise in back pain. None of them had ever been to a chiropractor. A public perception issue here I think.
2) HR departments. To repay the sins I committed in a previous life (presumably) I spend all my working life talking to HR departments (including a number of very BIG pharmas). The new buzzword is “Human Capital Management” so employees have gone from being personnel to resources to capital. One can only hope that they manage their human capital better than the banks have managed their financial capital.
3) Regarding Claires last comment – “hup! get on there” is almost certainly transferable to humans in pain (albeit with added expletives) if they are in the army.
4) I think acupuncture is probably rubbish and has just become a standard part of our mumbo-jumbo world. As ever though I fall over sometimes in arguments because I lack the medical knowledge to answer some halfwits smart-aleck question. So (courtesy of some mumbo-jumboist) how would acupuncture differ from the TENS pain relief offered in childbirth.
Nice to see that they ensure that ‘qualified practioner’ is in charge (and presumably charging through the nose). Imagine what would happen if they just let the nurse hook people up to the plug?
Well, for one thing the quack would make less money.
I’m sure that’s more effective on people than feeding them sugar beets. Though that did seem to do the trick for a couple of our cows. After they’d been righted by the rescue services.
“In a spirit of collegiality I offered to run a transferable skills course myself. I even offered to do it for nothing (rather than the rumoured £700 per day charged by the life style consultants). I proposed a course in ‘How to read critically’ (subtitle ‘How to detect bullshit’).”
Why not do the course for us one evening or week end? Last week I went to a Patrick Holford seminar that cost £15. I am sure your pulling power is at least as great as Mr Holford’s, especially if you did the lecture in partnership with Ben Goldacre.
Possibly the entrance fee could be donated to a worthy cause such as “Sense About Science” or the South African “Treatment Action Campaign”?
wrt “Quackery in training courses
I was certainly surprised to find out that UCL’s own HR department was offering a course that promised to teach you the “core principles” of Brain Gym and Neurolinguistic Programming, both totally discredited bits of psycho-babble,…”
By whom is Neurolinguistic Programming discredited, totally or otherwise?
pajamapaati
There was one reference in the original article
Dr Steven Novella appears unimpressed by NLP.
Thanks for that link Claire. The link to Beyerstein’s work (Simon Fraser U) are broken so I’m trying to find pdfs of them.
The link in your original article was syntactically incorrect:
Click to access 02SciencevsPseudoscience.pdf
Making the obvious correction to
Click to access 02SciencevsPseudoscience.pdf
gives a 404 / not found error, and trimming the URI back to
http://www.sfu.ca/~beyerste
also gives a 404 / not found, suggesting either that user beyerste is no longer at Simon Fraser University, or that they’ve reorganised their web server so user’s home pages are no longer found under ~username.
SFU’s front page has a jolly picture of Messrs Blair, Bush & entourage striding purposefully through the woods, and a search box. Searching for ‘beyerste’ returns a reference to Dr. Barry Beyerste as the supervisor of of an MA Psychology student’s 1989 MA thesis on “The effect of EMG biofeedback on cerebral palsy muscle activity”. Is this the chap? Googling for ‘beyerste neuro linguistic programming’ turns up a promise of a cached copy of the paper you mention, but which unfortunately leads to a ‘not found’.
Googling for SciencevsPseudoscience.pdf turns up many pages, none of which seems to be the paper we’re after.
Perhaps you have a copy you could email me?
I trust it contains more substance than the assertion that Neurolinguistic Programming is a panacea harbored[sic] by the human potential movement and fringe areas of psychology, which you quote? Some actual work examining what it claims to do and measuring how it actually performs in achieving its stated goals, for example?
Yes of course I had tried all of those tricks. Sadly Dr Beyerstein died prematurely last year, which no doubt accounts for it. When I get copies of some of his papers, I’ll post links here.
It’s funny that you should mention Blair and Bush. Surely NLP is just another example of the woolly wishful pseudo-scientific thinking that Bush and Blair were so good at?
You ask, very properly, for
That is exactly what I ask for, but of course it is not my job to produce it, but the job of those who advocate NLP. You seem eager to defend NLP, so perhaps you can give us some good reason to believe it is more than profitable psycho-babble?
Working backwards:
I don’t know how profitable NLP is but suspect that, for some, it is very; and that that, rather than the pursuit of excellence, is what motivates them to set up in business as “NLP” therapists, trainers or whatever.
I’d certainly agree that those who /advocate/ NLP should produce evidence of its claimed achievements. Likewise I’d expect those who dismiss it as pop-psychology and lump it in with Scientology as “questionable panaceas” to produce evidence for so doing.
As I understand it one can not help but produce evidence of what one acheives using NLP: a basic principle is that to acheive any goal or outcome it has to be specified in sensory-specific terms that can be observed by anyone with the appropriate sensory apparatus[1]. One then applies whatever practical, technical resources one has available and judges suitable for acheiving the goal, checking to know when one has acheived it, and employing other appropriate resources when what one’s doing isn’t working.
If you leave out the knee-jerk-producing term ‘NLP’ does this seem familiar, or at least reasonable?
Personally I got interested in NLP many years ago and did some training with the (then) UK Training Centre for NLP. They had some good – one great – trainers and I learned a great deal from it, but also failed to learn a godd deal more that I think I should have. It was a Diploma course and I really didn’t think I should have qualified for the Diploma, but they awarded it to me. Now partly I may have a tendency to think I’m not as clever as perhaps I am (when I had a viva for my degree I assumed it was to decide whether I should fail or not: it turned out I got a 2:1). But also I had never been in an educational setting outside ‘proper’ school/uni/tech: I think they probably awarded the diploma to everyone who’d paid the course fee. Ho-hum, welcome to the private sector (or at least, part of it).
Anyway, what I learned from the course was the principles such as I descibed above, transformational grammar[3] (never again be spun by spin!) and probably some other stuff I can’t think of right now.
What I wasn’t good at – and which street NLP is full of – is techniques such as eye-accessing cues, anchoring, the ‘swish’, modalities and what-have-you. Many if not all of these are adopted[2] from other fields, and in particular from psychotherapeutic fields such as Fritz Perls’, Virginia Satir’s and Milton Erickson’s work, since Bandler and Grinder studied these people in originating NLP.
I think what happens is that some people do an NLP course, learn a bunch of techniques and set themselves up as NLP therapists, business consultants or whatever. (I recall being uncomfortable that some people on our course were doing that, with less than a year’s training and no experience.) They may have some competence in applying the techniques they know, but even if they don’t they may still make a comfortable living from their work because of the phenomena Ben Goldacre has so eloquently described in his book (and which I daresay you too have DC – I’m just more familiar with BG’s work). And no doubt these practitioners will get good feedback from enough of their clients that they may honestly believe themselves to be competent.
Then if you take these people as examples of NLP practitioners to do a proper scientific comparison with other approaches you – unsurprisingly – find that they’re not so good; and may be seduced into thinking that NLP itself is therefore rubbish. (Equally, of course, one could find a bunch of “qualified” but incompetent medical doctors, and generalise from their performance that medical practice is rubbish!)
I suspect that this accounts in large part for NLP having such a bad press. Perhaps another, related, reason is that it’s easy to see NLP being ‘taught’ as just some of the techniques (or maybe only even one technique) without the methodological principles underpinning it, and therefore see it as the mechanical and unsystematic use of rather limited tricks. Also, NLP has – like most other fields – developed its own vocabulary (“meta-model”, “modelling”, “sub-modalities”, “reframing”, “presuppositions” etc) which can cause – or be used for – obfuscation when used with those unfamiliar with them. Since one of NLP’s presuppositions (there I go!) is that “the meaning of the communication is the response it elicits” then a real NLPer who wishes to convey something clearly is unlikely to use such terms with non-NLPers.
Lastly – and related to the above – I think some of the people who get into NLP are of the crystal healing[4] persuasion. Now in principle if you want to do crystal healing in an NLP way that’s OK: NLP has several presuppositions (I think they’re described in the wikipedia article) but no prejudices. So if you’re attuned to the changes produced by your intervention in sensory-specific terms (i.e. that a passing Martian could validate) then you do your crystal healing: if it works (ask your Martian) then OK, otherwise do something different. I’m not sure everybody in the NLP game has got the latter bit.
In fact I’m damn’ sure they haven’t: I (bitterly) suspect that they just regard it as another module in the fashionably-eclectic rag-bag of stuff they do which doesn’t actually have to work in real, verifiable evidence-based, terms because they get a warm fuzzy feeling (and more or less loadsa dosh) for doing it and the warm fuzzy feeling rubs off on their clients long enough for them to disappear down the street and their cheques to get cashed. I further bitterly suspect that that’s the sort of ‘NLP’ that’s peddled alongside ‘nutrition’ and suchlike.
Ironically I think if NLP has a particular failing it is in failing to teach many of its students to think properly, in a systemetic, evidence-based way; and in the failure to communicate that it’s the systematic thinking, not the bag’o’tricks, that is essentially NLP.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
And getting at last to the beginning of your response: I read Beyerstein’s daughter’s obituary page for her father, and some of the comments on it, and was touched; he seems to have been one of the nice, good guys. And 60 is too young.
And no credit to Simon Frazer University for simply unperson-ing him: they could at least have put up a page informing visitors that he’d died. Maybe even expressed some appreciation for his work etc – and left it there so it would live on after him.
– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –
[1] such as having vision, if the evidence is visual: nothing esoteric or ethereal.
[2] or stolen if you prefer: if scientist B uses a technique pioneered by scientist A is that stealing?
[3] or NLP’s version of transformational grammar: I’m not familiar with the work of Chomsky et al on the subject. If anyone is offended by NLP’s use of the name that’s tough 🙂 But seriously, “Structure of Magic” does make it clear that NLP takes _some_ of transformational grammar which it applies for its own purposes.
[4] which I use as as shorthand for all sorts of CAM nonsense.
Thanks -it seems that we have some convergence of views.
I’ve been sent a copy of Beyerstein’s 1995 review, but he doesn’t analyse NLP in any detail. I’ll try to collect more of his stuff. As you say, SFU hasn’t done him justice. He seems to have been someone that I’d have loved to know.
I tend to take note when people with credentials in neuroscience, such as Dr Novella, are dubious about things like NLP. That said, as I usually come across it in a HR context, I (perhaps wrongly) don’t get too worked up – management training and business coaching are famously prone to overstate claims for strategies for success. I think I’m probably in agreement with people like Derren Brown, who finds that there are some practical, commonsense aspects to NLP worth bearing in mind, surrounded, unfortunately, by a lot of pseudoscience. Where I do get bothered is when people with no relevant training or qualification claim to be able to alleviate named medical conditions and do things like retrain immune systems, e.g. here .
I never thought I would be arguing (however half-heartedly) for something that may well be woo but here goes anyway.
I would like to comment on the NLP thread of this multi-threaded conversation.
All I can say is that if NLP does not work then Derren Brown is a real magician with a Ph.D in Magic from Hogwarts.
He did his stuff on a Professor of Psychiatry who said he was probably the best exponent of NLP he had ever seen.
I have only ever been able to work out how he did it once – when he programmed the architect guy to wander around a supermarket looking for vinegar.
Pace Claire: Organisations which use NLP as part of sales training have found improvements in the performance of their sales force. As an involved individual I have actually quantified this. However, having thought about it, I do not think it is much different to a well-recognised sales methodology like the Huthwaite Group’s SPIN. Most sales forces seem to improve performance post ANY sort of training – which is probably just the result of them refocusing their attention and thinking about what they are doing (for once).
I never for a second realised that NLP might be taught as a therapeutic technique nor that there was such a thing as an NLP therapist. Other than directing a discussion I do not see the applicability of this – other than (I suppose) it is good to talk.
So it probably has some uses when stripped of its woosterishness quotient. It is probably useful when somebody needs a mechanism for structuring a “formal” conversation (like a sales presentation) but not for much else. Like a lot of this stuff something with a small grain of something to it gets blown out of all proportion into a business opportunity with its own language, rules, acolytes and naked emperors.
In terms of the pseudoscience/therapy bit of NLP I am happy to go along with Steven Novella, seeing as he is a clinical neurologist at Yale and I am a wage drone. He seems right about everything else on his site and anyone who has a pop at ID dingbats gets my vote.
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David Colquhoun // Nov 26, 2008 at 10:45 am
I’ve been sent a copy of Beyerstein’s 1995 review, but he doesn’t analyse NLP in any detail. I’ll try to collect more of his stuff. As you say, SFU hasn’t done him justice. He seems to have been someone that I’d have loved to know.
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I did find copies of his home page and some of his writings on the internet archive (“wayback machine”). I haven’t found anything directly about NLP though, only passing references to it, lumping it in with Scientology etc.
The science v. pseudoscience paper is excellent though: on a par with Ben Goldacre’s book. And of course your own site (which I got to from BG’s recommendation in his book).
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Claire // Nov 25, 2008 at 9:52 am
Dr Steven Novella appears unimpressed by NLP.
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Claire // Nov 26, 2008 at 1:51 pm
I tend to take note when people with credentials in neuroscience, such as Dr Novella, are dubious about things like NLP.
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John Hooper // Nov 26, 2008 at 5:02 pm
In terms of the pseudoscience/therapy bit of NLP I am happy to go along with Steven Novella, seeing as he is a clinical neurologist at Yale
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So Novella is An Authority Figure. Maybe he even has a white coat.
Goldacre in his book (as I recall – I’ve lent my copy to a friend) makes the point that science is about what people say and do, not who they are and what letters they have after their name. Both Goldacre (IIRC) and Beyerstein, in his paper, also caution against people making claims in fields in which they have no expertise.
Novella describes himself as a clinical neurologist. Since he quotes Wikipedia on NLP in the article to which Claire refers (http://www.theness.com/neurologicablog/?p=228) I’ll refer to Wikipedia’s entry on “neurologist”:
http://en.wikipedia.org/wiki/Neurologist
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Neurology (from Greek ??????, neuron, “nerve”; and -?????, -logia) is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. Physicians who specialize in neurology are called neurologists, and are trained to investigate, or diagnose and treat, neurological disorders. Pediatric neurologists treat neurological disease in children. Neurologists may also be involved in clinical research, clinical trials, as well as basic research and translational research. In the United Kingdom, contributions to the field of neurology stem from various professions; saliently, several biomedical research scientists are choosing to specialize in the technical/laboratory aspects of one of neurology’s subdisciplines.
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So this is nothing to do with, say, learning to spell or to remember telephone numbers, curing phobias or allergies, modelling musical or athletic abilities or resolving relationship problems.
My son is doing an apprenticeship in motor mechanics. He is learning about engines, fuel systems, exhausts, suspension, brakes, tyres, batteries, alternators, bodywork etc. However he can’t drive. If you want diagnosis and treatment of all categories of mechanical malfunction, he’ll be your man. If you want to learn to drive, or to improve your driving, he can’t help you there or speak with any authority on the subject.
Claire says that “Novella appears unimpressed by NLP”. I can’t make out whether he genuinely doesn’t understand it or has taken a personal dislike to it. The straw man he constructs of it suggests the latter, and he does quote the Wikipedia article on NLP which, although IMO confusedly written, does I think contain enough information for him to know better. Still he covers a number of fields with his skeptic’s hat on so maybe he has simply missed the point of NLP: from what I read here he’s not the only one to do so. That’s ultimately a criticism of NLP rather than people who have received a garbled representation of it: one of NLP’s ‘presuppositions’ is that the _meaning_ of a communication is the _response_ it elicits, so if NLP’s communication of what it’s about elicits an impression that it’s about half-arsed mimicry, or talking about emotional problems in an unfocussed way, or acheiving magical changes in physiology, then it needs to communicate what it’s about differently.
That is, it needs to do so if it wants to be accepted in the scientific community. As I understand it at the outset NLP practitioners such as Bandler had a scathing disregard for conventional medicine and academic psychology and psychiatry as applied to psychotherapy, and for much of independent psychotherapy also – with notable exceptions such as the work of Virginia Satir, Fritz Perls and Milton Erickson. Beyerstein himself points out that even in 2002, around 30 years after Bandler and Grinder’s seminal work, mainstream psychotherapy’s acheivements are still ‘modest'[1]. I think some of the early NLP pioneers saw themselves as pioneering radically new, highly effective approaches to psychotherapy whilst establishment practitioners were plodding along with extremely time-consuming, expensive and largely ineffective talking approaches and, in the medical establishment, drug-based treatment and even electroshock. Even lobotomy had (then) only recently been discontinued in the USA.
To put it into a social context remember too that this was the early ’70s, still the pre-Reagan/Thatcher era, in which the ‘counterculture’ was challenging the establishment in many areas. And Bandler – by far the most up-front NLPer of those days – was an abused child from a deprived family in a rough neighbourhood, with an enormous chip on his shoulder[2]. He seems always to have been a maverick, and I don’t think he was ever interested in NLP being ‘respectable’ and accepted by the scientific community.
On the other hand there are NLP practicioners (with much lower profiles than Bandler) who have always taken a highly conscientious approach to their work. Some of them seem genuinely to want to see it properly tested by rigorous scientific methods and have set up an organisation to get proper research done into NLP http://www.nlprandr.net/
I quote:
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Anyone with even a little training in NLP knows from personal experience and client feedback how rapid and effective it can be. And we also know how often we are asked by skeptics, “What is the scientific evidence for NLP?” The simple answer is, “There isn’t any.” As a result, NLP is often dismissed as a “cult,” or another “pop psychology” or “new age scam,” particularly by many in the helping profession, and hundreds of thousands of clients who could have been helped have no opportunity to find out how effective NLP is. Moreover, because these techniques are not being fully investigated, the contributions that they might provide for practitioners in the fields of therapy, education, business, medicine, and other fields are not being realized.
…
Some have explicitly declared that, “NLP is not a proper subject for rigorous research.” Personally, with a “hard science” background in chemistry, I think that anything worthwhile can be researched. Research in its broadest and fundamental sense is simply a way to separate imagination from reality. Furthermore, with NLP’s strong emphasis on sensory-based evidence procedures, detailed patterns of intervention, quick results, and rigorous behavioral testing of those results, I think NLP is much more easily researched than most other therapeutic approaches.
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I think at this point I should finish this essay ([3]) with a quote from Barry Beyerstein’ “Skeptics tool box”
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Some skeptics can be dogmatic too (don’t be one of them!)
The skeptic who refuses to give a claimant a fair hearing (if he or she is making an honest attempt to present the evidence for the claim) is just as bad as the gullible fool who uncritically accepts every tall tale that comes down the pike.
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. . . . . . . . . . . . . . . . . . . . . . .
[1] “Scientific understanding of how best to alleviate emotional distress and other problems of living has been steadily accumulating, but those who specialize in talk therapy still have much to be modest about.”
“Fringe Psychotherapies: The Public at Risk” – Barry L Beyerstein; section “Psychotherapeutic Fictions”
Keynote address to 2002 Annual Convention of the Canadian Psychological Association.
[2] I think Bandler even claimed at one time (possibly in a videotape I saw a couple of decades ago of him doing seminar work) to be a Vietnam veteran (and to have used NLP to deal with the horrors he encountered there). However I can’t find this claim in the Wikipedia article on him or Jon Ronson’s Guardian article about him (http://www.guardian.co.uk/lifeandstyle/2006/may/20/weekend.jonronson1).
[3] means a grin. I would say colon hyphen right-parens but it would come out as a ghastly weenie emoticon like 🙂
David: it’s your website, but can you turn them off? Colon, hyphen, right-parens.
Phew. I call that a fair hearing.
OK I’ll admit that I don’t know much about NLP myself, I am merely quoting other people whose views I have come to respect.
Perhaps what condemns NLP most in my eyes is the company it keeps. It is hard to take seriously anything that pops up in the company of Brain Gym and the Carol Caplin type of lifestyle industry.
“curing phobias or allergies” [pajamapaati]
Do you believe NLP can cure allergies, pajamapaati? If so, how is it that conventional medicine has completely failed to take note of this? And isn’t it reasonable, for such an extraordinary claim, to ask for evidence? Allergies (incl. severe) are something my family has experience of – I really, really do wish they were ‘all in the mind’, as the NLP allergy technique suggests. I am of course aware that things like stress, anxiety and strong emotions can affect allergic diseases, but they are not the whole story.
Regarding people who might know more than I, I think it’s reasonable to take note of their views. “Take note”, mind, not blindly accept.
I was reminded of the Jon Ronson Guardian article a short time ago. I found it fascinating though uneasy-making in the suggestions of ‘group-think’ I picked up. I also wondered, at the conclusion, where Ronson reports being freed from a paranoid fantasy concerning his child stepping out under a bus, if there isn’t some kind of submission to the authority exuded by a charismatic and confident figure going on?
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Claire // Nov 29, 2008 at 6:23 pm
“curing phobias or allergies” [pajamapaati]
Do you believe NLP can cure allergies, pajamapaati?
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I don’t “beleive” it, but I think, based on what I’ve heard and read, that it’s possible.
For a start I’ve had the immense good fortune to do a weekend workshop with Robert Dilts and seen him work, and I know that what he does is not magic: it’s skilful, structured, committed hard work based on a systematic rational understanding of what he’s aiming to acheive, what the present situation is and what resources he can employ to get to his goal. (Whether that goal is teaching a couple of dozen novices some aspect of NLP, or helping an individual whose present adult life is being marred by traumatic abuse she received as a child.) I don’t describe myself as an NLPer: I lack a bunch of practical skills that people like Dilts have. I am an engineer: I’ve worked in electronics, computer networking and now plumbing & heating. My job involves a fair amount of problem solving, whether it’s fixing a TV, working out why one computer can’t talk to another across the internet or getting your central heating system working. So I think I recognise the way that someone like Dilts is working, even if I don’t have the knowledge, skills and experience to do what he does.
Dilts was, I think, the first person to seriously explore the application of NLP to health issues. (He worked with his mother when she was suffering from terminal cancer, as a result of which she recovered and lived a fulfilled and healthy life for another 10 years or so.) He applied an established NLP technique for curing phobias (almost a beginner exercise in NLP) to allergies after an immunologist remarked that allergies were like phobias of the immune system. The book “Beliefs: Pathways to Health and Well-Being” by Robert Dilts, Tim Hallbom and Suzi Smith (ISBN 1-55552-02904) is, I think, a good description of these approaches and NLP’s claims in this field.
I think that it is credible that radical changes of health could be produced by psychological changes in the person. In the case of cancer for instance I understand that some people who are diagnosed as terminally ill do go on to make ‘miracle’ recoveries, so such absolute remissions themselves are possible: we just don’t know how they occur, or if it’s possible to harness or invoke whatever process causes them to occur. In the case of allergies I understand the NLP/Allergy people claim there are cases of people with multiple personalities exhibiting allegies in one personality and not another. Whatever you think of multiple personalities[1] if a person can react allergically at one point and not at another that very much suggests it’s not immutable, unlike, say, a broken arm.
Also in one of Beyerstien’s articles (I think – I can’t lay my hands on it now) there’s a list of physiological processes which can be affected by mental processes.
So I think it’s plausible that an NLP-type approach to allergy could work, and I consider Robert Dilts – who claims that it does – to be a competent, honest, conscientious and thoughtful person, and therefore I think it’s possible the NLP approach does work.
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If so, how is it that conventional medicine has completely failed to take note of this?
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I don’t know: I’m not in conventional medicine. I’d guess that the conventional medics and the NLP-and-health people aren’t talking to each other (yet: the NLP R&R project seems to be trying to rectify that).
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And isn’t it reasonable, for such an extraordinary claim, to ask for evidence?
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Yes, if they want to convince the conventional scientific establishment of their extraordinary (by conventional scientific terms) claims. On the other hand if they just want to get on with helping people as they obviously think they know how, then no, they don’t. As I say it seems that some NLPers are seeking a rapprochement with the scientific establishment.
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Allergies (incl. severe) are something my family has experience of – I really, really do wish they were ‘all in the mind’, as the NLP allergy technique suggests. I am of course aware that things like stress, anxiety and strong emotions can affect allergic diseases, but they are not the whole story.
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I don’t read the NLP approach as suggesting that allergies are all in the mind, any more than terminal cancer is. As I understand it they claim that the human mind and body are integral parts of a whole system, rather than separate almost independent things; and that the body-mind system has powerful resources to heal itself. What I think they are claiming to do is to find out how to mobilise these resources.
I’d have thought allergies were an ideal thing to test the NLP approach to. If NLP is ineffective then it can’t do any harm, can it? The Allergy Alternatives people who you discussed it with were quite clear that they don’t want anyone to discontinue their medications (unless/until advised by their conventional medics), and they don’t knowingly expose people to allergens in the course of their work. And if it does work then you’ve not only got a cure for the allergy but possibly gained a valuable resource for other health problems if, as NLP claims, you have the ability to generalise what you learned from the specific allergy issue to other issues. The only downside would be shelling out some money. I don’t know how Allergy Alternatives charge: if it were me I’d be quite happy to do a no-win, no-fee or money-back guarantee arrangement[2].
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Regarding people who might know more than I, I think it’s reasonable to take note of their views. “Take note”, mind, not blindly accept.
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Indeed: I’m just disappointed that Novella seemed to be spouting off about something that was outside his field and which he hadn’t taken the trouble to understand properly.
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I was reminded of the Jon Ronson Guardian article a short time ago. I found it fascinating though uneasy-making in the suggestions of ‘group-think’ I picked up.
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I think Bandler’s seminars are like that. I know someone who went on one of his hypnotherapy ones and she reported it was pretty full-on. The training sessions I’ve done with other trainers have been quite different.
I also have reservations about Bandler’s “shut the fuck up” approach to dealing with internal voices. I think to some extent that may be stage hyperbole: I’ve seen (on videotape) him working with a very disturbed young man with much more sensitivity than that. However the bottom line is “does it work?”.
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I also wondered, at the conclusion, where Ronson reports being freed from a paranoid fantasy concerning his child stepping out under a bus, if there isn’t some kind of submission to the authority exuded by a charismatic and confident figure going on?
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I think from what Ronson described it – how McKenna “grabs the space in the air where my vision was and mimes chucking it away”, “as the image shoots away … the neurotic feelings associated with it fade, too” and “Three weeks pass. I don’t have a single paranoid fantasy about something bad happening to my wife and son” – it was actually McKenna’s “swish” intervention that did the trick in that case. If it had been the hype of the guru I think it would have worn off in a week or two. It would be interesting to ask him now, though!
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[1] Beyerstein has written an interesting article on the phenomenon, suggesting that they may be brought on by therapeutic suggestion.
[2] Maybe I should get of my backside and get trained up in this sort of work: it can’t be as physically hard work as plumbing and, whilst it’s great to be able to get someone’s heating back on in the winter (my best result was fixing someone’s hot water system just hours before they were due to have a baby, at home, in a birthing pool!) it would be more rewarding still to help people, even just to, say, pack in smoking.
[I’m going to try posting this reply in installments since wordpress seems to be dumping the full text into limbo.]
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Claire // Nov 29, 2008 at 6:23 pm
“curing phobias or allergies” [pajamapaati]
Do you believe NLP can cure allergies, pajamapaati?
“”””””””””””””””””””””””””””””””””
I don’t “beleive” it, but I think, based on what I’ve heard and read, that it’s possible.
For a start I’ve had the immense good fortune to do a weekend workshop with Robert Dilts and seen him work, and I know that what he does is not magic: it’s skilful, structured, committed hard work based on a systematic rational understanding of what he’s aiming to acheive, what the present situation is and what resources he can employ to get to his goal. (Whether that goal is teaching a couple of dozen novices some aspect of NLP, or helping an individual whose present adult life is being marred by traumatic abuse she received as a child.) I don’t describe myself as an NLPer: I lack a bunch of practical skills that people like Dilts have. I am an engineer: I’ve worked in electronics, computer networking and now plumbing & heating. My job involves a fair amount of problem solving, whether it’s fixing a TV, working out why one computer can’t talk to another across the internet or getting your central heating system working. So I think I recognise the way that someone like Dilts is working, even if I don’t have the knowledge, skills and experience to do what he does.
Dilts was, I think, the first person to seriously explore the application of NLP to health issues. (He worked with his mother when she was suffering from terminal cancer, as a result of which she recovered and lived a fulfilled and healthy life for another 10 years or so.) He applied an established NLP technique for curing phobias (almost a beginner exercise in NLP) to allergies after an immunologist remarked that allergies were like phobias of the immune system. The book “Beliefs: Pathways to Health and Well-Being” by Robert Dilts, Tim Hallbom and Suzi Smith (ISBN 1-55552-02904) is, I think, a good description of these approaches and NLP’s claims in this field.
I think that it is credible that radical changes of health could be produced by psychological changes in the person. In the case of cancer for instance I understand that some people who are diagnosed as terminally ill do go on to make ‘miracle’ recoveries, so such absolute remissions themselves are possible: we just don’t know how they occur, or if it’s possible to harness or invoke whatever process causes them to occur. In the case of allergies I understand the NLP/Allergy people claim there are cases of people with multiple personalities exhibiting allegies in one personality and not another. Whatever you think of multiple personalities[1] if a person can react allergically at one point and not at another that very much suggests it’s not immutable, unlike, say, a broken arm.
Also in one of Beyerstien’s articles (I think – I can’t lay my hands on it now) there’s a list of physiological processes which can be affected by mental processes.
So I think it’s plausible that an NLP-type approach to allergy could work, and I consider Robert Dilts – who claims that it does – to be a competent, honest, conscientious and thoughtful person, and therefore I think it’s possible the NLP approach does work.
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If so, how is it that conventional medicine has completely failed to take note of this?
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I don’t know: I’m not in conventional medicine. I’d guess that the conventional medics and the NLP-and-health people aren’t talking to each other (yet: the NLP R&R project seems to be trying to rectify that).
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And isn’t it reasonable, for such an extraordinary claim, to ask for evidence?
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Yes, if they want to convince the conventional scientific establishment of their extraordinary (by conventional scientific terms) claims. On the other hand if they just want to get on with helping people as they obviously think they know how, then no, they don’t. As I say it seems that some NLPers are seeking a rapprochement with the scientific establishment.
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[1] Beyerstein has written an interesting article on the phenomenon, suggesting that they may be brought on by therapeutic suggestion.
“Yes, if they want to convince the conventional scientific establishment of their extraordinary (by conventional scientific terms) claims. On the other hand if they just want to get on with helping people as they obviously think they know how, then no, they don’t”
I’m sorry, pajamapaati, but I’m beginning to suspect that, regarding NLP, you’re a true believer rather than sceptical/objective. People who work in conventional medicine increasingly have to show that their practice is guided by the best available evidence. Before you tell me that not all conventional medicine is evidence-based, yes, I know, but that is not a reason to embrace yet more unproven claims. NLP has been around for quite some time, so rather than confident assertion, conjecture and speculation based on one immunologist’s comment about ‘phobias of the immune system’, I would have expected good quality research to support these. But there isn’t any, as far as I can see. So I remain sceptical. Not “stuck” in scepticism, mind: if good quality evidence is produced, I am prepared to reassess my attitude.
By the by, it’s interesting that the idea that allergies and asthma can be cured by pschological interventions is actually quite an old one: asthmatics particularly used to be regarded has having health problems that were nervous in origin. But medicine has moved on from this position and while the mind-body link is acknowledged by most conventional asthma and allergy doctors as having some relevance, I think the NLP theory pushes this too far.
Regarding your “where’s the harm?” point, one could argue that promoting the idea that allergies can be cured by psychological means (when conventional medicine says they are not curable at present) might mislead people into thinking they’re not worth taking seriously (I’m talking about real, diagnosed allergies, not people who think they might be allergic to wheat or whatever based on something they read in a celebrity magazine). True, most allergy is of relatively minor seriousness, but not all and avoidable tragedies happen .
Regarding the Jon Ronson article, I’m still not convinced that some kind of submission to authority is not at work and that he has been ‘trained’ to let go of his anxiety rather than ‘reprogrammed’. I’m not suggesting the psychologies are the same, but one does see very rapid and enduring changes in behaviour achieved by people expert in working with animals – one I’ve personally witnessed is a highly-strung horse, who previously bucked and plunged in terror at the prospect of being put in a horse-box, happily following a horse-breaker into the box after just 30 minutes work. It looked like magic to us but the horsebreaker, “PJ” insisted it was simpy a matter of gaining the animal’s trust, being confident and in control and so allowing the horse to relax and let go of its anxiety and follow him into the box.
Good grief, Claire – you’re not telling me “PJ” led that horse into a box without good-quality research to base his work on?!! Obviously pseudo-science of the worst kind: pure woo [grin].
But seriously: most of the world doesn’t feel the need to clear their actions with Science before doing what they do. If you ask me to fix your central heating system and then demand I show you a sheaf of peer-reviewed research to justify my approach to the work I’m afraid you’ll stay cold and I’ll find other customers. Now I think I’m pretty good at what I do and, although I don’t know of any good-quality research to back me up on this I’m going to stick my neck out (damn me as a quack if you like) and say that I don’t think the placebo effect works on central heating boilers. As an engineer what I do is based on scientific principles: pseudoscience doesn’t fix broken stuff, or as Feynman put it You can’t kid Nature. It’s just that, like your horse whisperer, I know what I’m doing and get on with it.
Suppose now that instead of fixing central heating boilers and suchlike, I were an NLPer and I fixed people’s psychological, and maybe some physiological problems. Just for the sake of argument (let’s call it a Thought Experiment, as that old quack Einstein did!) let’s suppose that it really were possible to cure people’s psychological and physiological problems, including allergies[2]. (Let’s call this thought-experiment Assumption “A”.) Now you come along and enquire about my services, and ask what research I can show you that my approach works. Now good-quality research, involving dozens or preferably hundreds of people, prominent research experts, research facilities and so on, is expensive. Not by the standards of big pharma, but for me as a one-man-band it’s just out of the question. If someone better-heeled than me has done some research I will conscientiously point you to it, but if that doesn’t satisfy you I’m afraid, ultimately, that’s tough: you’ll just stay cold (or allergic) and I’ll get on with helping others. And I’m sure I wouldn’t be short of other customers, and I’d have the satisfaction of knowing (Assumption “A”) that I’m actually helping my clients, who would otherwise be being ripped off by real quacks. (Maybe I’d even choose to advertise in quack-infested places, simply because I know that’s where I’ll get business.)[3]
So what I’m saying is: the lack of good-quality scientific research evidence isn’t necessarily an indicator that something isn’t actually scientific: it can also mean that it’s financially poor. In the case of NLP you might object that the amount of money being made collectively by all people claiming to be using NLP could easily fund good-quality research, but if we assume that – as with science – not all (or even most) of those who claim to be doing so are actually practicing Real NLP, or care about science, then those who are doing it properly are perhaps a beleagured minority who really can’t fund the necessary resources.
As for your comment about “one immunologist’s comment about ‘phobias of the immune system’”, actually Dilts gives examples of other evidence that contributed to him treating allergies in the way he did. However he didn’t go looking for definitive scientific research before trying this approach. But then neither did John Snow before removing the Soho pump handle. You could read Dilts’ book if you really wanted to know more, but (trying not to get personal here, but this is really what I think) I’m afraid that you’re too much clinging to Science to be open to the possibility that something not (yet) validated by Science could actually be valid. (And – touche – yes I am coming from a rather religious position with regard to NLP, but as I re-evaluate whether it’s woo or not, I find I think it’s probably not.)
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Oops! I edited out the bit that linked to this footnote, but for what it’s worth I’ll leave the note in anyway.
[1] I’m sure one could write a fascinating paper on the sociology and psychology of the NLP movement – from its idealistic beginnings as a radically effective therapy (I’m putting this from the point of view I think they saw it from) through divergence, conflicts of personality, law suits over intellectual property, diversification into sales and HR, to its present fragmented state with Bandler in the red corner offering to take on anyone if they think they’re ‘ard enough, the NLP RandR people in the blue corner trying to address the scientific community’s concerns and become respectable, and off in a world of their own the woo-ish elements peddling an emasculated feel-goody homeopathically attenuated version of NLP along with all their other sciencey bollocks with concern only over how much they can milk from it.
[2] Personally I wouldn’t be happy unless I knew I really was doing this effectively, but part of any real NLP intervention is what’s sometimes called “future pacing” or sometimes just “testing” where one makes sure that one’s intervention really works. Just as I won’t leave your heating system and present you with my bill until I’ve ensured it really is working, and as far as I can tell will continue to do so.
[3] By the way I am not Rob Mesrie – I just followed the links you gave earlier in this thread on DC’s site to your discussion with him!
You’ve missed the point – completely – pajamapaati. PJ made no pseudoscientific claims whatsoever and saw no reason to obfuscate the practical art of animal training with pseudoscience. Poor man predeceased the present horsewhispering thing by some decades; I guess he could be a wealthy man these days, rather than dying in relative poverty, early, of lung cancer (heavy smoking seemed almost ubiquitous in those who worked with horses at that time and place). Furthermore, he would not have dreamed of presuming to treat physical ailments in horses: you need the vet for that.
Can I make an obvious point? Human beings are not central heating systems. Regarding the ‘financial poverty’ argument, lots of CAM promoters use this, usually accompanied by suggestions of vested interests, big pharma etc. There is a US-based NLP research institute (IASH). Has it, say, applied to NCCAM for a grant to conduct research?
I didn’t pick you up on this yesterday but I find your earlier comment extraordinary:
“I think that it is credible that radical changes of health could be produced by psychological changes in the person. In the case of cancer for instance I understand that some people who are diagnosed as terminally ill do go on to make ‘miracle’ recoveries, so such absolute remissions themselves are possible: we just don’t know how they occur, or if it’s possible to harness or invoke whatever process causes them to occur”
Huh? It’s not news to any doctor that diseases, even usually terminal ones, progress differently in different patients and that remissions are possible. It’s a big, and worrying, leap to conjecture that the individual’s psychology is instrumental, given that the converse would be to claim that those who succumb just have a bad attitude. Ugh.
Finally, I’m not sure that your argument that a neurologist is not qualified to comment on behaviour and cognition is cogent: one of the more interesting books I read this year was this one . The author is a neurologist, and discusses, inter alia, how brain physiology, behaviour and cognition are linked.
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Claire // Dec 1, 2008 at 9:35 am
You’ve missed the point – completely – pajamapaati. PJ made no pseudoscientific claims whatsoever and saw no reason to obfuscate the practical art of animal training with pseudoscience.
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I was joking! Although there is a serious point. You say “the practical art of animal training”: why the word ‘art’? I doubt that he was employing the sort of artistic processes that say Mozart, Picasso, Giacometti or Murdoch use: I’d venture a guess that he had learned through observation, hypothesis and experiment what worked to get the results he desired with the animals he worked with. In that respect I’d say he was employing science. Wouldn’t you?
And if he was employing science, how come him doing it without a basis of peer-reviewed etc good-quality research isn’t pseudoscience, but an NLPer or hypnotherapist curing someone’s claustrophobia without ditto _is_ pseudoscience?
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Can I make an obvious point? Human beings are not central heating systems.
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Thanks for pointing that out. Personal foible of mine. Oliver Sachs is writing a book about me: The man who mistook a human being for a central heating system!
Actually I was trying to make a metaphor, or analogy.
I was trying (and evidently failing!) to convey that the _process_ used in fixing a TV, a networking problem, a central heating system, discovering how Cholera spread in Soho, or how to cure allergies, is the same. The content is different but the methodical processes of observation, hypothesising and testing are the same.
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Regarding the ‘financial poverty’ argument, lots of CAM promoters use this, usually accompanied by suggestions of vested interests, big pharma etc.
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Well in the case of the nutrition mob who basically _are_ big pharma I’d agree with Ben G that that’s bollocks. But in the case of Mr Allergy Alternatives with whom you’ve corresponded, and who seems to be basically a one-man-band operation, do you really think he could fund the sort of research that would satisfy your desire for “extraordinary evidence”?
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There is a US-based NLP research institute (IASH). Has it, say, applied to NCCAM for a grant to conduct research?
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I don’t know. As I understand it the organisation NLP RandR was set up by IASH with the object of getting ‘proper’ research done on NLP. The only research work I’ve heard about them pursuing so far (according to their website http://www.nlprandr.org/UniversityofSurreyAbstracts/tabid/213/Default.aspx) is a research proposal submitted to three grant bodies for immediate funding and video taping of NLP treatment of Post Traumatic Stress Disorder. They claim that “the research design exceeds the “gold standard” set by Foa et al 1997 employing videotaping of all sessions. An outside evaluation company in collaboration with an independent psychiatrist (completely unconnected to NLP or the study site) will complete the data collection and a final mixed methods evaluation on participants’ level of symptom reduction and mental health status at termination.”
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I didn’t pick you up on this yesterday but I find your earlier comment extraordinary:
“I think that it is credible that radical changes of health could be produced by psychological changes in the person. In the case of cancer for instance I understand that some people who are diagnosed as terminally ill do go on to make ‘miracle’ recoveries, so such absolute remissions themselves are possible: we just don’t know how they occur, or if it’s possible to harness or invoke whatever process causes them to occur”
Huh? It’s not news to any doctor that diseases, even usually terminal ones, progress differently in different patients and that remissions are possible. …
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OK, good: so we agree on that.
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… It’s a big, and worrying, leap to conjecture that the individual’s psychology is instrumental …
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Good: we agree on that too. I agree that it would be a big leap to make that conjecture, and I didn’t make it. I said “we just don’t know how they occur, or if it’s possible to harness or invoke whatever process causes them to occur”. Taking a scientific approach one might seek to discover what factors are instrumental, and amongst candidate factors one might consider whether people who enjoy spontaneous remissions are their diets, their lifestyles, ethnic backgrounds, particular personality traits, and so on.
Robert Dilts, in the book I’ve mentioned, says he recalls reading a report (which he doesn’t remember the name of) in which a woman investigated people who’d had ‘miraculous’ recoveries from cancer (terminal diagnosis + survival for 10+ years). Some of these people underwent conventional medical treatment, some faith healing, some something else etc – of their choice – but what they all shared was a belief that the treatment they were receiving would cure them. So maybe – MAYBE – belief is an instrumental factor. Maybe not.
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… given that the converse would be to claim that those who succumb just have a bad attitude. Ugh.
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Should one not investigate the possibility of psychological factors being instrumental in remission then, because it would be politically incorrect in somehow blaming people for their illnesses?
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Finally, I’m not sure that your argument that a neurologist is not qualified to comment on behaviour and cognition is cogent: one of the more interesting books I read this year was this one . The author is a neurologist, and discusses, inter alia, how brain physiology, behaviour and cognition are linked.
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You have the advantage of me as I haven’t read that book. Would you say, then, that the regular set of knowledge and skills to be expected from a neurologist (and which wasn’t mentioned in the Wikipedia article) would include the examples I gave such as learning to spell or to remember telephone numbers, curing phobias or allergies, modelling musical or athletic abilities or resolving relationship problems?
This get tedious. Why the word art? Fair point. Skill would have been more accurate. The point being: he wasn’t claiming any kind of science or ‘programming’, just honestly practising a skill. I find your ‘art’ argument tendentious and pointless.
It’s very simple: when you have good evidence for all your speculations, fine, I’ll be delighted to see it. Up until that point, speculation is all it is, in my opinion, so I remain very cautious about dramatic claims relating to health conditions, particularly those of which I have experience. I find the health claims of NLP overstated, so in my view it’s reasonable to ask for good evidence, not anecdotes.
“Should one not investigate the possibility of psychological factors being instrumental in remission then, because it would be politically incorrect in somehow blaming people for their illnesses?”
Words fail me – almost. There are illnesses where lifestyle factors make a contribution, true, but ‘blame the patient’ as a general principle appalls me. And I don’t really buy your “I’m only making a suggestion” shtick.
Your last comment suggests to me that only someone who practises NLP is qualified to comment? Or have I misunderstood? I would, of course, not expect a regular neurologist to have the skills you detail but I’m inclined to suspect he or she would be intellectually equipped to detect pseudoscience and specious arguments.
There appears to be a consistent theme with respect to woosters. it goes something along the lines of:
1) it has been around for ages and there is anecdotal evidence it works.
2) we cannot afford to do proper research into ___________ (insert quackery of choice) – but WE know it works
3) you have to prove it cannot/doesn’t work
Put this in context.
I set up a nice looking surgery (swish office, smart gown, pot plants, good looking nurse) where I use my Black and Decker to drill holes in the back of peoples skulls. I claim this cures _________ (insert self limiting illness of choice).
Probably most woosters would be appalled at this and there would certainly be few of them signing up for it.
With respect to the three points above I can claim (with some justification) that it:
1) was used by the Aztecs (so “ancient wisdom”) and anecdotal evidence from the middle ages suggests it “cured” certain things
2) I can’t afford to do clinical trials but I know it works
3) You say it doesn’t work so you prove it.
This applies equally to NAWD, PJ etc as they have all used these points in defence of their particular brand of quackery.
They would probably be slightly miffed if they were arrested, convicted and banged up because someone said they did it, they looked a bit like the culprit, the police cannot be arsed investigating it anyway and it is up to you to prove yourself innocent (and even if you could you are going away chummy).
Like the police, the burden of evidence is on woosters to show a mechanism, a degree of success and repeatability in any woo medicine (at which stage it would of course no longer be woo).
Very clear and well-expressed, John H. The point about the burden of evidence being on those who promote dubious therapies is crucial but apparently difficult for some to grasp.
One personal observation: for people with conditions which scientific medicine cannot as yet cure, just hope to control, it can actually be quite stressful to have people suggest, however well-meant, that one should be trying x, y or z unproven treatment, otherwise one is closed-minded or lacks the correct psychological attitude to heal. I find this kind of thinking disturbing. Here is a discussion of an extreme manifestation.
Thanks for that Claire. I rather like Respectful Insolence (My only complaint being the “res” rather than “dis”).
I looked at the page you referenced and it brought to mind a post I made on Becky’s excellent anti-jabbophobe site. (I regard Becky along the lines of a personal cess pool emptier – not intended personally obviously Becky – as she deals with the crap I cannot bring myself to handle).
There are many of the rules of quackery displayed in that total energy rubbish:
1) Said quackery cures nearly everything (why limit your market to – say -asthma ?)
2) Appeal to authority (A doctor – with a German name – said that _______________)
3) Use of CAPITALS to spread the good news. This cures CANCER !!
4) Confusion and error – all illnesses start in the brain. Like lung cancer or testicular cancer then; obviously both well known for orginating in the brain and clearly the brain is the first place doctors look for them.
5) Lack of rigour – have a glass of champagne and relax, that will cure cancer
6) Anecdotal evidence – AGAIN. I knew someone who . . . . . .
7) Don’t rely on EBM. It is a big pharma conspiracy designed to subvert energistic medicine. Give up your retro-virals (they are made out of dead monkeys, heavy metals and aborted babies) for beetroot
8) Something to peddle for financial gain.
9) Obfuscation with pseudoscience drivel (quantum, bio-psycho-genealogy, energistics blah blah blah. Do these people have a pseudoscience word generator )
10) Utter b******s and half-truths which cannot have any grounding in reality (illness is caused by previous generations and passed down by genes – err gangrene possibly, or Ebola ?)
As ever Orac does a much better job of skewering the woo.
Looks like the Germans cannot get away from putting “total” in front of any solution.
And Point Number 8 was definitely not intended as a smiley !
Becky F is indeed heroic. Some names which cropped up in pajamapaati’s posts also turn up in this link. I get the impression some NLP-ers are quite into Total Biology.
If it looks like a duck, walks like a duck, hangs around with other ducks and goes QUACK then it is a duck errrrrrrr I meant quack.
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Claire // Dec 2, 2008 at 4:54 pm
Becky F is indeed heroic. Some names which cropped up in pajamapaati’s posts also turn up in this link. I get the impression some NLP-ers are quite into Total Biology.
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Some NLPers? How many? The evidence you produce is that one NLP-er is quite into Total Biology. Extrapolating that to more-than-one-NLPer may or may not be a reasonable guess but it is completely unsupported by any scientific evidence!
As for that one, Isabelle Benarous may have “studied NLP with two of the most eminent NLP creators: John Grinder and Robert Dilts” – but so have I (give or take one of those names!). I could set myself up as a quack therapist (let’s call it, hmmm, how about “Wooster Therapy”?!) and claim to be using (sorry, “integrating”) NLP into my work. Undoubtedly it would be bollocks. Does that make all NLP bollocks? Or, to put it another way …
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John Hooper // Dec 2, 2008 at 5:11 pm
If it looks like a duck, walks like a duck, hangs around with other ducks and goes QUACK then it is a duck errrrrrrr I meant quack.
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… if all ducks are birds, are all birds ducks?
“It’s funny that you should mention Blair and Bush.”
For some reason various alties seem to think that mentioning Blair and/or Bush is some sort of argument that can be used against people who ask for decent quality evidence…
It was a certain David Colquhoun who, earlier in this thread, said “It’s funny that you should mention Blair and Bush.”
Is Colquhoun an “altie” then?
Come off it, pajamapaati. “Get[ting] the impression” is not a statement that I have formed an assessment based on rigorous science. As I suspect you well know – more tendentious, pointless argument. Googling ‘total biology’, ‘biologie totale’ and ‘German new medicine’ does return a fair number of nlp related sites. This GNM practitioner is rather in a huff about NLP practitioners allegedly stealing GNM’s clothes! And although it doesn’t specifically reference the total bull-ology school of thought, this nlp article seems to follow the same kind of thinking:
“Having an imprint laced with unhealthy beliefs can create serious problems for the immune system. Keep in mind that the brain is systemic, meaning that if you’re creating unhealthy beliefs in your life based on unconscious imprints, the brain will attempt to self correct those images or beliefs in the form of an immunological response. Even if the limiting beliefs are repressed or forgotten, the brain is still capable of serving as a catalyst for undesirable health conditions because of its systemic capabilities”
If people like Robert Dilts and John Grinder repudiate total biology and associated theories, they need to say it, loudly, in public and publicly reprimand those who mention their names in this connection.
@pajamapaati: “It was a certain David Colquhoun who, earlier in this thread, said “It’s funny that you should mention Blair and Bush.”
Is Colquhoun an “altie” then?”
If you read very carefully, you will see that DC was not actually the person who brought Blair and Bush into the thread, but was in fact commenting on somebody else’s mention of them.
Can you remember who it was?
PJ
OOOOh. Tying me up in Boolean knots.
All the birds on my pond are ducks so I guess the anecdotal evidence I can present is very strong. Why would I need any proof to the contrary. I KNOW all birds are ducks.
Maybe I should have used the phrase “birds of a feather flock together” because the evidence is pretty clear that if you believe in one lot of hokum you are pretty much guaranteed to believe in any and all other types of hokum.
Having given up all semblance of critical thought and declared yourself an idiot in the first place what does it matter if you pile idiocy upon idiocy.
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Mojo // Dec 3, 2008 at 1:13 pm
If you read very carefully, you will see that DC was not actually the person who brought Blair and Bush into the thread, but was in fact commenting on somebody else’s mention of them.
Can you remember who it was?
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Indeed: I remarked in passing that they appeared on the home page of the website of Simon Fraser University at which the late Dr Barry Beyerstein, who David C brought to our attention, used to work. I didn’t remark further on them: I thought their very presence there said something about SFU, as did its deletion of Beyerstein’s pages from its website after he’d died (about which I did remark).
Your challenge now Mojo, should you choose to accept it, is to spin this back into an insinuation that I _like_ Blair and Bush.
From the papers of Beyerstein’s I’ve managed to retrieve and read so far I suspect he’d be quite interested in the psychology of dogmatic scepticism that seems so prevalent here. I never realised such a phenomenon existed. I feel as if I’ve stumbled into a fundamentalist revival meeting brandishing a copy of Dawkins!
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Claire // Dec 3, 2008 at 9:38 am
Come off it, pajamapaati. “Get[ting] the impression” is not a statement that I have formed an assessment based on rigorous science.
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Sorry: having done NLP I try to say exactly what I mean without generalising or otherwise distorting it, and I’m sometimes a bit picky with what others say.
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Googling ‘total biology’, ‘biologie totale’ and ‘German new medicine’ does return a fair number of nlp related sites. …
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Indeed. I think we’ve already established that there are ‘quacks’ who are NLPers. I am about to suggest, not for the first time, but probably for the last time (because I’m fed up doing so) that there are some NLPers who are not quacks. Please look away now if this conflicts with personal dogma.
OK, ready? Here we go:
I suggest there are some NLPers who are not quacks.
OK. Done.
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If people like Robert Dilts and John Grinder repudiate total biology and associated theories, they need to say it, loudly, in public and publicly reprimand those who mention their names in this connection.
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Why “total biology and associated theories”? Why not homeopathy, crystal healing or voodoo? None of these claims any connection with NLP. Or are you suggesting that Dilts and Grinder should somehow monitor everyone who has ever trained with them over the last 30+ years and tell them off if they’re doing something they don’t approve of?
“Why not homeopathy, crystal healing or voodoo? None of these claims any connection with NLP.” [pajamapaati]
Why not, indeed? The company NLP keeps is worrying.
fyi pjp, there is some peer-reviewed research on the relationship between survival in cancer and psychological attitude. I can readily understand why cancer survivors might attribute this to their psychology, though I will also add that the 3 cancer survivors (all doing great after >5 years, thanks to modern medicine) in my family find the ‘positive outlook’ thing intensely annoying and patronising. That is why it is so important to conduct proper studies to ascertain if ‘survivor bias’ is skewing popular perceptions about psychology and cancer survival.
And finally, if Messrs Grinder and Dilts are concerned about the integrity of their product, all they need do is make clear public statements dissociating themselves from the various quackeries which NLP practioners include in their therapy offering. Which is what I said earlier but which you seem unable to grasp.
AH yes, one of the papers discussed there is “Psychotherapy and Survival in Cancer: The Conflict Between Hope and Evidence”, by Coyne, Stefanek & Palmer (2007) [download the paper]. It came up in an earlier posting about spiritual healing.
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David Colquhoun // Dec 4, 2008 at 12:46 pm
AH yes, one of the papers discussed there is “Psychotherapy and Survival in Cancer: The Conflict Between Hope and Evidence”, by Coyne, Stefanek & Palmer (2007)
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Fascinating paper. The discussion of the strengths and weaknesses of the studies Coyne, Stefanek & Palmer review, along with what I’ve recently read in Ben G’s book about designing experiments to test (particularly) medical science, illustrate how hard – and important – it is to do good science in this area.
However one thing bothers me, which is embodied in the title of the paper “Psychotherapy and Survival in Cancer”. Coyne, Stefanek & Palmer lump together the interventions in all these studies as “psychotherapy”:
“a 1-year, structured group intervention … focusing on discussions of coping with cancer and encouragement to express feelings.”
– Spiegel et al. (1989)
“a 6-week, 90-min, structured group intervention … a mixture of four components: education about melanoma and health behaviors; stress management; enhancement of coping skills; and psychological support from the group participants and leaders.”
– Fawzy et al. (1993) and Fawzy et al. (2003)
“patient and family education about cancer… Intervention nurses … were available to participants on a 24-hr basis through a paging system. Intervention was delivered through three home visits and four telephone contacts over a 4-week period.”
– McCorkle et al. (2000)
“inpatient individual psychotherapy”
– Kuchler et al. (1999)
“one of three interventions designed to increase adherence with medication taking and appointment keeping: (a) an educational package concerning hematologic malignancies, treatment and side effects, and the patient’s responsibility for adherence and self-care, followed by a home visit; (b) a nurse-assisted slide presentation with a hospital-based adherence-shaping procedure; or (c) a combination of interactive slide show, home visit, and adherence shaping.”
– J. L. Richardson et al. (1990)
(which Coyne, Stefanek & Palmer concede had “no explicit psychotherapeutic component, and it is unclear how educational contact with the nurse could be reasonably construed as psychotherapy”.)
“A single counselor provided individual psychotherapy several times weekly, often at bedside. Therapy emphasized reducing denial while preserving hope, completing unfinished business, and taking an active role in treatment decisions, but “above all else, simply listening, understanding, and sometimes only sitting quietly with the patient””
– Linn et al. (1982)
“three psychosocial interventions… One of the intervention groups was led by a social worker and met for 6 months, and another met for 3 months with a social worker and for an additional 6 months without a professional leader. The third intervention group … was intended to
meet for 6 months without professional leadership. However, this group suffered high attrition, and 21 new, nonrandomized patients assigned to it participated for only 3 months. … Few details are provided concerning the structure, process, or conduct of the groups except that the professional leaders “were not instructed in any specific techniques” but used a supportive and educational style to foster open sharing. In survival analyses, all intervention groups were combined and compared with the control condition.”
– Ilnyckyj, Farber, Cheang, and Weinerman (1994)
“The intervention … consisted of eight weekly sessions of cognitive–behavioral therapy supplemented by a family night and three monthly sessions… Patients were further provided with a workbook, handouts, homework, and a relaxation tape.”
– Edelman, Lemon, Bell, and Kidman (1999)
“… professionally led supportive–expressive and cognitive–behavioral psychotherapy… The supportive–expressive component … incorporated mutual support, encouragement to process emotion, and confronting the likelihood of death. The cognitive–behavioral component consisted of standard cognitive–behavioral homework assignments provided in workbook format.”
– Cunningham et al. (1998)
“weekly supportive–expressive therapy”
– Goodwin et al. (2001)
“weekly group therapy (cognitive–existential group therapy)”
– Kissane et al. (2004)
(I find some of these studies distressing for the seeming feebleness of the “interventions” offered to people in the last days of their lives.)
Suppose the title had been “Medicine and Survival in Cancer” and had reviewed studies of the possible efficacy of medicine in improving the outcomes for people with cancer? A meta-study which indiscriminately lumped together chemotherapy, radiotherapy and surgery, or included morphine (or asprin!) in chemotherapeutic medications, would, I suspect, not garner a great deal of respect!
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Claire // Dec 4, 2008 at 12:07 pm
fyi pjp, there is some peer-reviewed research on the relationship between survival in cancer and psychological attitude.
“”””””””””””””””””””””””””””””””””
Noted.[1]
OK, so what do we learn from these two studies? From the first, that the sort of therapeutic interventions whose effectiveness even in dealing with ordinary emotional distress is, at best, “modest” (to use Beyerstein’s aptly-chosen word), have no significant bearing on people’s survival from cancer. From the second, that “attitude”[2] doesn’t affect outcome[3]. Does either study show that there is no link between any mental processes and health in general and cancer in particular?
In the case of health in general, what is the accepted explanation for the placebo effect, if not mental processes – response expectancy or whatever you want to call it? Could these have an effect in the case of cancer? Do we know enough about how these effects occur to say for sure?
With reference to Dilts et al’s claims, neither of these studies attempts to test the techniques involving the identifying and changing of people’s beliefs[4] – almost by definition not something one can do by act of will – described by Dilts, Hallbom and Smith a couple of decades ago, so we don’t scientifically know whether they work or not.
________________________________________________________________________________________
[1] Claire, are you not worried by the company your science keeps?! The web site you link to, http://www.medicinenet.com/, has links to “Find a Therapist” (picture of ugly middle-aged man: choose from “psychologists, psychiatrists, therapists and counselors”) and “Find an alternative therapist” (picture of attractive young woman: choose from “Acupuncturists, Audiologists, Chiropractors, Dentists, Dietitians, Dermatologists, Massage Therapists, Maternity Nurses, MD’s, Midwives, Naturopaths, Nutritionists, Ob/Gyns, Occupational Therapists, Osteopaths, Pediatricians, Physical Therapists, Podiatrists, Respiratory Therapists and Speech Therapists”). Not to mention the chance to win a Wii Fit.
There’s a report with less op-ed and more info about the study, and discussion by experts in the field, at:
http://www.nationalreviewofmedicine.com/issue/2007/11_15-30/4_patients_practice04_19.html
[2] as assessed by five questions that measure emotional well-being on the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire often used to measure quality of life in cancer.
[3] for people with head and neck cancer
[4] Dilts and others point out that we use the word “belief” for everything from mutable opinions regarding, say, whether it will rain tomorrow, through political, to religious beliefs; and that there are beliefs (such as that the sun will rise in the morning and set at evening) that we believe so firmly that we do not even identify them as beliefs (unless invited to do so). Dilts claims that we acquire some beliefs about our identities through powerful experiences in our early lives, for example through seeing father hitting mother a young boy generalises that hitting women is an integral part of what being male is about. He says that these beliefs about identity tend to be out of our conscious awareness, that they can be instrumental in matters of our health (and other life issues) and can be changed by specific methods. Unlike the 1001 pop-psychs with their pet theories[5] he describes in specific, objective terms the way he obtains evidence from people he’s working with that lead him to his ideas, so that we can make reasonable judgements for ourselves regarding his claims, and how he knows (and we can tell) whether a claimed intervention works.
[5] I liked Angus Deayton’s quip: “Men are from Mars, Women are from Venus and pop psychology is from Uranus”
“Claire, are you not worried by the company your science keeps?! The web site you link to, http://www.medicinenet.com/, has links to “Find a Therapist” (picture of ugly middle-aged man: choose from “psychologists, psychiatrists, therapists and counselors”) and “Find an alternative therapist” …”
Yawn. Clutching at straws. Again. Medicine.net is a news service and – regrettably – you will find links to alternative therapies etc on many medical news sites, including Medicine.net’s owner, WebMD. Even Science Based Medicine’s Google Ads sometimes link to dubious sounding sites. I don’t see how you can deduce from this that the science or scientists being reported are associated with quackery. I was talking specifically about NLP practitioners who also practice various other alternative therapies, which is something completely different.
Robert Dilts. Hmmm. Strange how he doesn’t mention having discussed his hunch-based allergy process with, say, the AAAAI or ACAAI, the two major professional medical associations in the US in this field. I’ve learned, inter alia, from his article that the immune system “thinks” and “panics”…
His theory, it seems to me, is based on an overworked analogy arising from the remark of one immunologist. Many NLP sites quote Dr Levi’s remark and his scientific status as if this provides “the proof” for their claims regarding allergy – though none of them report any views of his on whether allergies could be actually be cured by mind techniques like NLP.
I find it a bit of a stretch: it’s perhaps reasonable to liken a hyper-response of the immune system to a phobia, an exaggerated psychological fear response, for purposes of explanation. It does not seem at all robust then to proceed to offer a therapy based on this analogy in the absence of stringent, independent, peer-reviewed evidence for one’s hypothesis. Inductive reasoning and argument by analogy don’t substitute for evidence.
Dilts says his ideas about allergies weren’t derived solely from Dr Levi’s remark but, even if they were, what’s wrong with hunches – whether derived from water overflowing from your bath, an apple falling on your head or a conversation with an expert in another field? Surely the crux, distinguishing science from pseudo-science, is whether you bother with the tedious business of testing your hunch before setting out to use it in practice. I rather suspect Mr Dilts does.
Hi Pajamapaati
You wanted evidence of neurolinguistic programming being discredited (though with such a name it should be obvious that its pseudoscience).
Here:
Norcross, JC, Garofalo.A, Koocher.G. (2006) Discredited Psychological Treatments and Tests; A Delphi Poll. Professional Psychology; Research and Practice. vol37. No 5. 515-522
In that study NLP is listed as more discredited than TFT, and other energy therapies, and more discredited than a lot of the more disturbing fringe practices of the 60s.
In fact it has been rated as among a TOP TEN most discredited interventions:
John C. Norcross, Thomas P. Hogan, Gerald P. Koocher (2008) Clinician’s Guide to Evidence-based Practices. Oxford University Press, USA
Here is more information. NLP is pseudoscience in concept and in practice.
http://knol.google.com/k/joe-greenfield/neurolinguistic-programming/2j6nlcky7q5vo/2#
One thing going for it: Its the best example of modern pseudoscience in the 21st century. There are more neuromythologies in NLP than any other subject, and that includes its close cousin, scientology.
So the information is very useful, as long as you use it for detecting babble and babblers to avoid.
Arun
[…] is almost six months now since I posted Quackery creeps into good universities too -but through Human Resources. One example given there was the University of Leicester. This is an excellent university. It […]
NLP is psychological snake oil. My “university” even offers a UCPD in it, much to my disgust, this is of course offered as part of staff development opportunities by Human Resources.
As a psychologist (non snake oil variety) it does anger me how NLP is promoted by HR. Some of the techniques taught seem to make use of the powerful framing effects found by researchers in decision making and also beloved of managers and quality officers describing an alternative reality. For example in response to a strong assertion in a question the technique is to start of by saying black is actually white. Works for politicians on Newsnight but not quite so useful when it is used by NASA managers “there is no problem with the o rings”.
Now that, of course, really requires a quote of Richard Feynman’s famous line in his report on the Challenger disaster:
Dr Aust,
Much as I love Feynmans quote it has long made me wonder why in everyday life reframing is so effective. I have come to the conclusion that unlike the space shuttle, there is not a harsh physical reality to hold the reframers to account. I suspect it all has to do with definition and measurement, in the social sience areas there is always plenty of wriggle room whereas with physical reality, vacumn or high reentry speeds tend to be a little harsher judges. Take for instance the awful degrees in nutritional therapy etc, we can say how anti scientific and anti academic they are but there is no reality check and it is unlikely that the graduates will ever be placed in an enviroment where their lack of knowledge produces truly dramatic and noticible effects. Even if it did it could be explained away by factors other than their education. Likewise success and failure in higher education seem to be defined in semantically flexible ways with reference to process rather than substance. I see little hope of nature providing a harsh test.
Back to HR though, I challenged the purveyors of personality tests (and incidently I do think they can be useful for research) about their validity and suddenly they were no longer diagnostic tools but tools for relection. The same went for emotional intelligence, the “compentancies” all the group were being urged to develop suddenly got turned into tools for reflection when I challenged the discriminant validity of the scales involved. I have been labelled awkward and as preventing staff development opportunities for my troubles. Sigh I think nature can be fooled as long as it is not tested.
31 March 2013. I have, at last, found a copy of the missing Beyerstein paper. It’s here.
I found it here.
My Dear Sir:
I find it patently offensive that you mock that which you do not understand,
with SCENAR Therapy topping the list!
I was instrumental in designing a similar device, specifically the Dual Integrated Lambent Device for Orthopedics, and those of your ilk immediately began to cry foul, doing so because you simply do not understand the true benefits available through the use of this and other
similar devices. This device uses light of varying frequencies to treat many and various musculoskeletal ailments, and it clearly works…..and in fact if you doubt that you can feel free to ask my mother!
You do not realize the extensive clinical trials that we do with these devices, and although it may be said that we are biased in these studies, I scoff at that as much as you scoff at these great healing devices! I can assure you that everybody we treated….100% of them, in
fact!!….received benefit through the use of the Dual Integrated Lambent Device for Orthopedics, based on the use of the Final Universal Kinesiology Quotient on exiting, treated patients.
Not unlike its predecessor the Advanced Neurological Universal Stimulator, the Dual Integrated Lambent Device for Orthopedics uses varying radiofrequency stimulation to create harmony within and between all systems of the body based on a map of the buttocks wherein all body systems are
each represented by, through, and on a corresponding and respective area of said buttocks. As evidenced by direct and definitive readings assessed by and with the Specific Conduction Radiofrequency Oscillating Tactile Universal Modulator, it is undeniable that I am correct in
my assessment of the great benefits afforded mankind by the items and systems discussed herein.
If it were up to you, we wouldn’t even now have the huge benefits afforded us by the Definitive Index of Correlating Kinesiology, the Pathologic Etiology Numeric Identification System, the Balanced & Unilateral Naturopathic Graduating Harmonically Optimum Limited Electrocardiograph, or even the Continuously Oscillating & Radiologically Nuanced Highly Observable Limited Electrocardiogram!
Shame on you, I say!!!
Sincerely,
AmosMoses
Foundation for Universal Conservation of Knowledge & Total Holistic Education
Endowment
@AmosMoses
The language of your comment sounds like pure pseudoscientific gobbledygook.
The matter is easily settled. You say “You do not realize the extensive clinical trials that we do with these devices”. Please give references to where the results of these trials are published.
As far as I can see, none of them are published so why on earth should anyone believe you?
David, that AmosMoses nonsense is a pathetic attempt at humour. Look at the capitalised words, and spell out what they say …
@ Blue Bubble
Pathetic? Pathetic?! PATHETIC, YOU SAY!?!? It’s clear that you are simply jealous that I am more smarterer than you, even though I am self-taught! I am proud to say that there was once a time that I couldn’t even spell scyentist, and now, through much work and dedication, I is one!