There is a crack in everything

...That's how the light gets in.
(Leonard Cohen)

We've been having a discussion, over in Zone 5, on the merits of rigorous scientific analysis.


Graham has been putting his foot down against the infiltration of hard established facts and procedures by all that comes under the label of being alternative. As he argues, in the case of medicine,

“alternative” means in effect a therapy for which there is insufficient evidence- ie no peer-reviewed good-quality clinical trials. If a therapy has been demonstrated to work better than placebo it is no longer “alternative” but merely “medicine”.

Going back over many well-reasoned entries (and some rather heated debates), I find this has been a theme for him for quite a while. This particular strand of discussion started when Permaculture Magazine published an article about the merits of Geomancy (a use of dowsing to help with decision making in gardening/permaculture about site preparation, sowing, plant placement, etc.) :

"I have been in debates of this kind for many years and have many times fallen foul of others for stating these opinions. I have even been told by one permaculture teacher that I “should not express these views” (that fairies dont exist) because I was “upsetting people with good intentions”. I am not questioning the good intentions of people who believe in fairies or geomancy, but I would like to challenge directly the validity of these beliefs, and certainly their relevance for permaculture.

A common response to this is a rejection of science and rational thought as being the source of environmental destruction, and a yearning to revert to earlier animistic beliefs, placing instinct and emotional/sensory feelings above rational thought and enquiry.

This idea is in direct contradiction to what the environmental movement owes to science. It is through science that we know about the likely effects of global warming. It is through long and hard scientific enquiry that we know the true extent of the destruction of the biosphere, the increase in resource consumption, the loss of species and the increase in pollution. It is also through science that we have the benefits of so many aspects of the modern world, unsustainable or otherwise, including computers, magazines and other information technology that help us spread our ideas. We should not take the benefits of science and then reject its methods and demands for rigorous investigation just on a whim of our feelings. Feelings are fickle and not dependable for uncovering the truth.

In that latest entry, "Bad Science - and Good", Graham quotes Ben Goldacre's book Bad Science.

‘Big pharma is evil’, goes the line of reasoning, ‘therefore homeopathy works and the MMR vaccine causes autism’. This is probably not helpful.

He goes on to make some excellent points:

Back to why people still think this stuff works: well, the placebo effect is a fascinating topic in itself, and is explored in the following chapter. If you know nothing of science at all, you might be forgiven for thinking this must be a deeply mysterious subject that maybe proves “mind over matter” or “quantum healing” or something. But in fact, like everything else, it can be studied scientifically. Strange though the results may seem, Goldacre takes us through some of the best experimental data on the subject of the placebo effect, finding for example that two sugar pills may work better than one; that the colour of the pill may effect its efficacy, as will whether it is administered by a man in a white coat with letters after his name.The same may be true for a range of other alternative therapies which people swear blind are curing them- acupuncture being a good example, but also anything from Reiki to Aromatherapy- nice people giving you lots of care and attention in comfortable “healing” environments can work wonders- why wouldnt you feel better afterwards? Far preferable to the perhaps abrupt and peremptory 2-minute consultation you might get in a cold doctors’ surgery- which is precisely why many doctors are indeed willing to refer patients to an alternative practitioner who, for a price, may in reality be more help than they doctor can be- especially if it is for a chronic condition or a condition for which there is no complete cure anyway.

Many kinds of back and knee- pain and similar conditions come under this category- there may indeed by lifestyle causes, or you might just need a nice rest. No reason why a massage wouldnt help you to feel better- but that is a little different from claiming some esoteric cause for presumed healing powers of a therapy. There is no substitute for well-conducted clinical trials to establish the true efficacy of a treatment.

There is also the issue of “regression to the mean”- people often seek help at the peak of distress, after which many illnesses tend to revert to a “mean” or average degree of severity. This is not always the case, but these kinds of conditions are typically the ones people claim have been cured by alternative therapies. Fact is, lots of things just get better by themselves or at least fluctuate and improve, and a bit of TLC can help this along nicely.

Here I absolutely agree. From my own experience with ‘alternative’ therapies, I can say: I don’t think any of them helped ‘cure’ me particularly - (but I never had anything particularly wrong with me in the first place).
On the other hand I strongly feel that I did need the search for health and balance which the process of seeking help entailed, as well as the positive, loving attention received from often quite charismatic people.

Another quote from the 'Bad Science' book:

…the placebo effect is about far more than just a pill: it is about the cultural meaning of the treatment. Pills don't simply manifest themselves in your stomach: they are given in particular ways, they take varying forms, and they are swallowed with expectations, all of which have an impact on a person’s beliefs about their own health, and , in turn, on outcome. Homeopathy is a perfect example of the value in ceremony.

Do we not have a lack of ceremony in our lives?

This process and these people empower and encourage me to look after my own health better.
I have also found that practitioners of ‘alternative’ therapies encourage me in sticking to a value system that is completely different from the mainstream.
Any healthcare practitioner is in a position of power and influence. It is good to have at least some of these have a holistic, caring and reverent outlook on the universe, just as a counter weight to what has become the norm.

So these therapies do fulfill a real need, even if this is often not the one they proclaim to fulfill.

It is important to step back from whatever healing process one is engaged in from time to time, and take a closer look at the particular healer involved, and one's own participation in the process. It is important then to take stock of how much is ceremony, and whether the form this ceremony takes could be got at by other, maybe more appropriate means.
Graham does comment on the huge amounts of money involved, not just in mainstream medicine, but also in the alternative field. There is no doubt that enormous scams are going on within both. It is true that money skews views and makes people cling to beliefs.
I wish all health care providers could be humble as to their claims, and more affordable. This would allow individuals to make their own journey to health — even if there are a few twists and turns along the road.

'Daharja' comments on Graham's blog:

On the issue of midwifery, it is also interesting to note that mainstream practices are often not evidence-based. Cord traction, induction by assumed post-dates, delivery in a supine position and automatic dispensation of pitocin are some obvious examples of mainstream obstetric practices that have been proven dangerous, unnecessary and to increase the likelihood of complications, yet are still routinely practiced.

In other words, just because something is mainstream does not mean there is any sort of science behind it at all - and many so-called ‘alternative’ practices are actually evidence-based traditional ways that have refused to die, simply because they work.

Labels of ‘mainstream’ and ‘alternative’ are often not useful. What all of us need in the field of medicine and health care is evidence, study, analysis, and education. All of these seem to be not as widespread as they should be in our health care culture.

She also makes the point:

Finally, the simplest way of all to care for our health - prevention - is still not taken seriously. Despite massive and irrefutable evidence that lifestyle choices make huge differences to our state of health and wellbeing, our medical system is geared to fixing damage once it occurs, rather than preventing illness in the first place.

And another commenter, 'Matt', rightly adds:

There is a significant problem in that many people can’t or won’t change their lifestyles and demand drug therapy - it will take a long time to change people’s perspectives [and yes, the medical profession are to blame for that dependence in the first place].

Let me stray off-topic for a minute, to mention an article by Curt Cobb on today's Energy Bulletin, in which he argues for a need to look beyond the flood of information readily available today on internet, etc, to aquiring a different type of knowledge:

Putting into the proper context what information we actually do need for something other than aiding and abetting our consumption--for, say, understanding public policy--requires conceptual training that can only come from reading well-written books and articles and engaging with other rigorous minds who challenge our own point of view. That is a much slower training process, and it will never occur at Internet speeds.

Environmental education giant David Orr likes to say that what we lack is "slow" knowledge. It is easy to learn how to take down a whole forest with a chainsaw. That's fast knowledge. But as I wrote in a previous post:

Teaching people the importance of trees in creating and protecting the soil, encouraging biodiversity, preventing runoff, storing carbon and influencing climate is a task that requires time, concentration and reflection. It assumes a body of knowledge about the natural world that most people simply don't have and therefore must acquire. And, it assumes an eye trained to look for subtleties in the natural landscape. Moreover, such learning does not yield the immediate and visible economic benefits of the chainsaw.

But even if we take the time to acquire the slow knowledge we need, we cannot solve the knowledge problem with more information. The world is too complex to comprehend by merely apprehending its parts. And, no human being can see all of the universe or even his or her part of it well enough to give anything but a very fragmentary account. We will always have huge areas of ignorance, particularly about the long-term consequences of the actions we take to reshape the ecosphere to our purposes.

This article stands very well by itself, but I would here like to link it to another of 'Matt's' comments on Graham's blog (especially the last sentence):

As for ‘alternate’ therapies - Graham is absolutely right in that anything that can be proven does become incorporated into mainstream medicine. However, it is important to understand that the nature of double-blind trials is not equally suited to all therapies and not all experiments are equally well designed so there is room for doubt along the way as we receive conflicting results. It’s also important to remember that to fully grasp the results of a paper it’s not always sufficient to have a ‘grasp’ of science but to fully understand the nature of the underlying problem - and we are not all experts in everything.

The difficulty that science has with ‘alternate’ therapies is partly due to a weakness within science itself - in that it can measure small things well [just read the odd PhD abstract for the average level of detail], but there can be great difficulty in areas of overlap and as most areas [particularly with drugs etc] are funded by business, we don’t always have all the data.

I think that is is this perceived weakness that ‘New Agers’ latch on to. They see a conflicting report [for example - just how much wine a day is healthy? The goal posts are constantly changing] and harp on about science not being able to see the whole picture, themselves failing to understand that science IS looking at the bigger picture, by looking at a LOT of little pictures and that this takes time - a lot of time.

What, then, is important for an evaluation of what is good or bad science and which healing methods are valid or unproven – or, indeed, with regard to all types of important decisions we face?

A) Rigorous, scientific, unbiased research is necessary, the more the better.
Even if it is theoretically possible, this will often not happen. Research may be hindered by lack of time, lack of current understanding or lack of resources, indirectly,-- as well as, much more directly, by greed-induced bias.
B) It is important to be conscious of an emotional bias for making decisions. None of us can be free from this.
A simple example would be: "I am conscious of the fact that I am very familiar with brand name x through advertising that I've been exposed to. This suggests to me the feeling that I know and trust this brand. This is a faulty emotional reaction and I will be careful not to base my decision on this when I make my purchase."
C) 'Fast knowledge' can be useful, but 'slow knowledge' only can provide a basis for sustainable decisions. Both on a personal level (That's why life consists of so much trial and error), and on a planetary.
Yes, both Aspirin, and - dare I say it - Homeopathy, will work within the right context - but both can be mis-used as 'quick fixes', if used unquestioned for long periods of time. It takes an onward – never-ending - journey towards true sustainable health, for which these can be only milestones.

What I really wanted to do --- she says, pages and pages later --- was draw your attention to Ran Prieur's blog entry today.

Today I want to write about metaphysics. When I was staying with Rosemoon near Asheville, she mentioned how well homeopathy works on her chickens, which would seem to disprove the objection that homeopathy is all placebo effect. My position is different from the standard pro-homeopathy position, that it works independently of the beliefs of observers, through a kind of objective mechanistic science that we don't quite understand yet. And my position is different from the standard anti-homeopathy position: that it works purely through the ability of the mind to heal the body, which we can't explain but never mind, it's not important, nothing to see here.


I think that "mind" or "awareness" is the fundamental stuff that reality is made of, that the whole universe works like a dream. I'm not sure if there's one dreamer or many dreamers, or if there's anything outside the dream; but in any case, if mind, not matter, is fundamental, then everything is the placebo effect. Even splinting a broken bone is faith healing -- it works through the faith artifact of physical matter, which is extremely powerful because everyone believes in it.
(Update, February 10th: My statement that "mind, not matter, is fundamental" is still stuck in the western industrial-age separation between mind and matter. Suppose that reality is both mind and matter, the same way that light is both a particle and a wave. Depending on the context, sometimes reality behaves like objective physical matter and sometimes it behaves like a dream, but those are both just models we use to make sense of a single unified thing.)


One of the rules of reality creation, which some new age people have trouble grasping, is that it's not solipsistic -- it's collective. I don't know how much of the negotiation is by consensus and how much is by domination of will, but in either case, it's useful to talk about "belief fields" or a transferable placebo effect. Getting back to chickens, they have weak minds, so if you have a strong mind, you can heal them through your belief, especially if your belief is backed up by the beliefs of others.


This could explain why so many giants of alternative medicine, like Wilhelm Reich, have been very strong personalities healing weaker personalities.
...
I've found that I'm highly resistant to suggestion. The nice thing is that I'm immune to most propaganda. Ten thousand TV commercials have failed to give me any desire to buy a new car. But I'm also resistant to good suggestions. Even though I'm a big champion of alternative medical treatments, they rarely work on me. Pretty much the only stuff that works on me is stuff that works on everyone.

I like all the points he is making there (yes, I'm a fan), but the one pertaining to this discussion could be summed up as follows:
The existence of "belief fields" or a transferable placebo effect can not be quite discounted, as they would certainly explain many things in today's world not readily explainable through science or logic. It is not possible to be sure how these "belief fields" work or can be put to use by humans.
This may sound like fuzzy logic, but I am all in favour for keeping a door open for the possibility for there being more out there than we can rationally grasp, and, of course, I am not alone in this.
I remember my Permaculture teacher, Rob Hopkins, giving us a short presentation on Crop Circles. He did not do this in order to assure us of their existence, but to give us an aesthetically beautiful example of the unexplainable in our world.

Until we have All The Answers, it may be more useful to train our minds to --- yes, question everything thoroughly and look at it in its own context as well as in other contexts ---
but also to take an overall view of knowledge and accept that it has accumulative qualities, that it is formed from hard facts as well as layers of first-hand experience, and only time can reveal its true wisdom.

I agree with Graham that it is important to take a stand and draw lines in the sand.
Slow knowledge is nearly impossible to use in arguments in a discussion with a person of the opposite mind. By its very nature slow knowledge allows only like-minded people to share and explore opinions.
So it is necessary to use fast knowledge - hard facts from research articles and from the internet - which prove something, but yet never manage to do justice to the full picture, in order to make a point... and gain a point... and dispute a point.
There comes a time where groups of people get beyond point-scoring and arrive on the same page. That's when facts lose their importance, and people work towards the same goals, out of an intuitive (slow) knowledge of what decisions to take.

Group consensus needs to be challenged from time to time , but maybe not routinely challenged. In all the revolutions of human history, great and small, this happens inevitably.

In the meantime:
'If it works for them, let them carry on.'

Challenge becomes necessary - and often fruitful for both sides- when the assumptions of one group conflict with that of another - or when they become tools of domination over others.

I agree with Graham's taking his stand, and I can respect Alanna for taking hers.
The discussion is necessary, but in the end I say: Let Permaculturists keep their distance from Geomancers, and vice versa!

Let us all be humble as to what we really know.