4 ms·

Yes I found this very amusing. For several reasons: - Within a week he seems to have found that the content of the book was more effective than years of his tr

Yes I found this very amusing. For several reasons: - Within a week he seems to have found that the content of the book was more effective than years of his treatment of atleast one patient - He buries this as deeply within the article as possible - This experience casts light on the crux of my issue with the article, which is that it is very much a "prereplication" book review. The reality is that neither the author of the book or the review have solid empirical evidence one way or the other, in terms of modern style studies. The book review seems to be drawing an overly negative conclusion about the research because of this fact. To me this is a demonstration of an overreliance on empiricism that seems to dog alot of western medicine practitioners in general. I found this line very revealing: >later studies – done in an atmosphere of boredom, by large multi-center consortia – are almost always disappointing. I'm not sure what the phrase "atmosphere of boredom" signifies but it doesn't sound like a faithful attempt to get something to work. If you are doing any of these treatments in an atmosphere of boredom will it actually be effective? Is doing it in an atmosphere of boredom really a valid way of testing it? I haven't read the book but will read it. It does seem to me that the thesis of the book, that trauma causes the mind to disconnect from the body and shapes the body, is something that Chinese medicine / Qi Gong practitioners have known about for thousands of years. I don't have any empirical evidence to back these specific practices but I have mountains of anecdotal evidence that would seemingly be rejected by the author of the review.

GuiA 7y ago
> I'm not sure what the phrase "atmosphere of boredom" signifies but it doesn't sound like a faithful attempt to get something to work. If you are doing any of these treatments in an atmosphere of boredom will it actually be effective? If you have a broken bone, it doesn’t matter how bored the nurse who sets your cast is - as long as they follow established procedure, you have an extremely high chance to make a good recovery. The issue with psychiatry is that it doesn’t really follow that model for many (most?) “conditions”. As the author points out, wild new approaches seem to work when everyone is excited about them, and then fail to do much better than a placebo when scaled out.
- alex504 7y ago
  Clearly a big part of these approaches is the affect of placebo. Placebo is also a big part of the impact of many parts of western medicine. In clinical trials antidepressants barely outperform placebos for instance. You've raised a good point that this makes it even harder to determine how well something is working. Was it 100 percent placebo or did change take place outside of the effect of the placebo? However just because the placebo effect is present doesn't mean we should dismiss it out of hand. The term "scaling out" and a "boring environment" to me requires a treatment as simple as for instance setting a broken bone. A procedure like this is very easy to train someone to perform and there is relatively little in the way of differentiation between patients. An arm is an arm, it's very easy to see the problem as well as to see how a treatment is working. But for instance in the case of acupuncture or qi gong or yoga, it would be very hard to replicate on a large scale. The practitioner matters a huge amount, as does the exact condition of the patient. Is the patient actually trying ot do the yoga? Is the acupuncturist good (most aren't). What kind of yoga is the person doing? Is the yoga or qi gong teacher leading them in the right direction for their particular issue? It isn't nearly as simple as a routine medical procedure. I'm not saying that all of these treatments necessarily are effective. The issue I have is how quickly some are to dismiss treatments as not being backed up by evidence when the evidence will be very hard to come by, and ignoring the nuance involved. Personally my experience has led me to believe that acupuncture done by someone that knows what they are doing will work more than a placebo. The same certainly goes for qi gong in my personal experience.

GuiA 7y ago

> I'm not sure what the phrase "atmosphere of boredom" signifies but it doesn't sound like a faithful attempt to get something to work. If you are doing any of these treatments in an atmosphere of boredom will it actually be effective? If you have a broken bone, it doesn’t matter how bored the nurse who sets your cast is - as long as they follow established procedure, you have an extremely high chance to make a good recovery. The issue with psychiatry is that it doesn’t really follow that model for many (most?) “conditions”. As the author points out, wild new approaches seem to work when everyone is excited about them, and then fail to do much better than a placebo when scaled out.

alex504 7y ago
Clearly a big part of these approaches is the affect of placebo. Placebo is also a big part of the impact of many parts of western medicine. In clinical trials antidepressants barely outperform placebos for instance. You've raised a good point that this makes it even harder to determine how well something is working. Was it 100 percent placebo or did change take place outside of the effect of the placebo? However just because the placebo effect is present doesn't mean we should dismiss it out of hand. The term "scaling out" and a "boring environment" to me requires a treatment as simple as for instance setting a broken bone. A procedure like this is very easy to train someone to perform and there is relatively little in the way of differentiation between patients. An arm is an arm, it's very easy to see the problem as well as to see how a treatment is working. But for instance in the case of acupuncture or qi gong or yoga, it would be very hard to replicate on a large scale. The practitioner matters a huge amount, as does the exact condition of the patient. Is the patient actually trying ot do the yoga? Is the acupuncturist good (most aren't). What kind of yoga is the person doing? Is the yoga or qi gong teacher leading them in the right direction for their particular issue? It isn't nearly as simple as a routine medical procedure. I'm not saying that all of these treatments necessarily are effective. The issue I have is how quickly some are to dismiss treatments as not being backed up by evidence when the evidence will be very hard to come by, and ignoring the nuance involved. Personally my experience has led me to believe that acupuncture done by someone that knows what they are doing will work more than a placebo. The same certainly goes for qi gong in my personal experience.