Book Reviews, Health Care

Loving Placebo

Modern medicine’s attempts to reduce wellness to biology have created a gulf between the patient’s mind and body. In “Elderhood,” Louise Aronson attributes this to medical specialization and a focus on record-keeping that prevents the doctor from addressing the whole patient. In “Mind Fixers” Anne Harrington paints psychiatry in even darker colors, revealing how hubris, greed and pseudo-scientific diagnoses have eroded our ability to manage our mental health.

Unrecognized in that analysis is a root cause: a social epidemic of failures to care and care for. Doctors and psychologists are both confronted with patients whose interlocking complaints arise from lifestyles driven by anxiety and restricted choice.

The parent working two minimum-wage jobs can’t sleep, and eventually reason collapses in exhaustion, loosing the reins on emotions that run amok. Stress suppresses the activity of the immune cells that eliminate cancer. To control tumor growth, chemotherapy is prescribed, disrupting routine and raising anxiety even higher. Anger and fear surge, driving wedges into relationships. Isolation breeds depression, weakening the self-esteem that guards against dependency on pain medications.

So where is the clinician to start? Confronted with this tangled knot, it is perhaps necessary to specialize, to prescribe the popular drug, to see the patient as a machine to be repaired. For in fact the alternative – to truly care – is to confront suffering that cannot be relieved.

Or at least not in modern medicine’s cost model. Doctors and psychiatrists charging $200/hr. cannot undo all the harm wrought in lives lived at $8/hr.

This is the ground truth that drives Melanie Warner’s “The Magic Feather” to its conclusion. A firm subscriber to scientific materialism, Warner surveys the studies of integrative health and concludes that it would all go away if only doctors could allocate the time to build rapport with their patients.

Warner’s survey starts at the fringes of alternative health and works its way toward Freud’s hysterical conversion: physical disorders born rooted in psychological stress (teeth grinding is a familiar example).

Energy healing and aura manipulation is eventually categorized as synesthesia – the blending together of the senses that brings colors with sound. Practitioners are self-deluded. Shading over toward physical therapy, acupuncture is dismissed by reference to studies that show random needle pricks are no less effective than carefully defined treatments, a conclusion reinforced by scholarly work that reads the original manuscripts not as energy healing but as blood-letting. From there Warner attacks chiropractic, resuscitating the debunked cure-all claims of its founder before observing that manipulations have no permanent physiological effect. (I might suggest, however, that manipulation could reestablish awareness of muscles, and thus allow re-adjustment that brings relief. Physical therapists do something similar to stroke patients, pounding on muscles that have gone silent in the brain.)

To her credit, Warner recognizes that these treatments bring real relief to patients – relief that often appears miraculous. This leads to an analysis of research on placebo – the activation of a patient’s natural healing powers through simple acts of caring. This is not an effect unique to alternative health – many studies conclude that a medical cure is dependent upon the patient’s belief that healing will occur. This is substantiated by the opposite effect: Warner introduces us to the European discipline of psychosomatic (mind-body) illness (a discipline discredited in America by the prejudicial “it’s all in your head”). Therapy begins with a relocation to peaceful surroundings in which the patient can rebuild healthful communication between the mind and body.

Warner synthesizes her studies to conclude that only medicine can make real physical changes in the body. Her hope to inspire doctors to see the whole patient, however, is undermined by results from Harvard Medical School that show a decrease in empathy as students advance toward mastery of clinical procedures. That might be expected: medical students are adopting jargon and a station in life that makes it ever more difficult to relate to those most in need of their care.

Warner affirms that alternative healthcare will survive until doctors learn to build rapport with patients. As an intuitive healer, that suits me just fine, for I see in medical knowledge elements that inhibit that outcome.

Unfortunately in slighting the integrity of alternative health practices Warner leads consumers astray, and therefore deserves a rebuttal. I wish that she had focused less on high-profile practitioners that surround themselves in cultish authority. Humble practitioners may walk blind into a therapy and find themselves manipulating auras in ways that are only validated after-the-fact by client disclosure. That is my experience of Reiki. I cannot state authoritatively why that force refuses to submit to scientific examination but given how all scientific insight is channeled for military use – well, it’s not hard to guess why love would be reticent to have its secrets revealed.

Jesus said to those cured in his presence: “Your faith has healed you.” I wish Warner would give it an honest college try, and perhaps demonstrate to herself the foolishness of a standard of reproducible proof. After all, we are each unique, and love must adapt itself accordingly.

1 thought on “Loving Placebo”

  1. Upon sharing the gist of Warner’s criticism of chiropractic with a practitioner, he mentioned that fMRI, hormone concentrations and blood flow analysis all substantiate the positive material effects of his discipline. Warner focused almost exclusively on the physical alignment of the spine.

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