“The Certainty Principle” (Alternative medicine diagnoses)

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One of the main causes of stress is the unknown. When staring a new job, an employee will wonder what the boss will be like, what the expecations are, and how cool they keep the break room fridge. But as the worker learns these answers, he or she settles into a routine and the fear of the unknown dissipates.

But until an answer is given, the stress continues. More stressful than the unknown at a new job is the angst over a serious health issue. That’s why the seeming ability of alt-med practitioners to offer a definitive diagnosis and a treatment plan can seem attractive. Their answers are often painless, quick, and inexpensive, making it more appealing. But the biggest hook is certainty.

However, Dr. Harriett Hall wrote in the Skeptical Inquirer that uncertainty is a legitimate, important part of many medical diagnoses. She recalled from her days as a practicing physician how patients would clamor for more testing when a thorough checkup and exam failed to find the cause of their malady.

She recalled, “They wanted an answer and thought if we just did more tests, the answer would become evident. I had to explain to them that we had done all the indicated tests and that further indiscriminate testing would only muddy the waters.”

Moreover, when the chance of a disease is minuscule, a test is much more likely to produce a false positive than a true one. Testing for 100 different ailments might suggest the patient has one or two of the conditions, but these would likely be false results, which, Hall explained,  “would only lead to further fruitless diagnostic efforts, including possibly dangerous invasive procedures.”

Sometimes, conditions resolve on their own. The cyclical nature of many illnesses is why many alt-med practices seem to work. By the time one is seeking an applied kinesiologist or a Reiki practitioner, the condition has likely been bugging the patient for some time, so they resort to alt-med. When the symptom then runs its course, alt-med gets the credit and another glowing anecdote in lieu of data.

This desire for certainty fuels alt-med. If a medical doctor tells someone that their leg cramps are a common ailment of unknown origin and will likely resolve, that can leave the patient unsatisfied. The diagnosis may include pain relief pills or leg exercises, but this lacks the reassurance of a quick fix.

Conversely, peddlers of craniosacral therapy, Joy Touch, and iridology will insist they know the precise cause, the specific cure, and how to guard against its recurrence, the latter involving regular visits to their office. This leaves the patient with an artificial reassurance.

Depending on which branch of alternative medicine the provider practices, the focus will be on a different body part that is allegedly the center of heath – the spine for chiropractic, the feet for reflexology, the hand for Therapeutic Touch, the skull for craniosacral therapy – and so on. Tellingly, when such practitioners gather for a group talk or forum, they never challenge each other even though they can’t all be right. If an acupuncturist claims the movement of qi through meridians determines everyone’s health, this is at odds with the iridologist’s insistence that every illness is caused by a disturbance within the eye. Yet all the practitioners and audience members nod and somehow merrily agree.

Many of those audience members may not even have an ailment. The craving for certainty causes some patients to embrace an unproven treatment for a disease or condition never shown to exist. This includes chronic Lyme disease, adrenal fatigue, and Leaky Gut Syndrome. These are imaginary illnesses, but a desperate patient finally has a name to associate with a real or perceived medical misfortune. They now know what they are suffering from and a kindly alt-med practitioner has the cure. The practitioner offers them sympathy and an attentive ear, plus a diagnosis and treatment plan that sounds sciencey but has no medical basis.

And while replicable double-blind studies remain the benchmark of medical efficacy, they have trouble matching personal experience. A person who would never read or understand a 60-page paper can most assuredly know that a technique worked for them. But as Hall wrote, “You had a symptom, you tried a remedy, and your symptom went away. It might have gone away without any treatment, it might have gone away because of the treatment, or it might have gone away despite the treatment. Before antibiotics, there were people who survived pneumonia. Spontaneous remissions occur.”

Compare that mindset to that of alt-med darling Andrew Weil. Hall wrote that Weil ran “tests of osteopathic manipulation for ear infections, and when the experiments showed no effect, he said, ‘I’m sure there’s an effect there. We couldn’t capture it in the way we set up the experiment.’”

Such a conclusion is silly, to be certain.

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