SKEPTICAL EYE: I am often asked the following related questions: Why do service providers promote alternative therapies so actively and so confidently? Why do so many people use alternative therapies? Why do mainstream professionals become involved, either as users or practitioners of alternative medicine?
In my view, there are two kinds of alternative service provider. Those who come to genuinely believe that their product or therapy works, usually in the sense of making a person feel better and those who know that they are selling snake oil and are in the business primarily for the money.
Most practitioners probably belong to the first group.
With regard to the first question above, many practitioners promote and provide a particular service because they have seen it work. Or, they have heard it from clients who did as directed and felt better.
There is a plethora of evidence to suggest that our ears and eyes are easily deceived. Despite this, many alternative practitioners preach that we must trust our own experience. Intuition and experience are notoriously poor sources of accurate information in many circumstances. Anecdotes and testimonials constitute a very low level of evidence.
We are strongly inclined to believe that when a particular event follows a particular action that the two are causally related. It is often the case, however, that when two events occur close together they are merely coincident and one does not cause the other.
A practitioner experiencing or witnessing such a connection may be misled into believing that a particular therapy is effective, when, in fact, it is not.
The theory behind a therapy may also attract practitioners if it fits their broader philosophy of life. For example, they may believe that all things natural are good, that the body contains a vitalistic energy that can be "balanced" by the ingestion of particular potions or the performance of certain rituals and so on.
In this context it may seem perfectly sensible to administer homeopathic products, reiki, acupuncture and other questionable and often unproven or disproven therapies.
However, all things natural are not good. Many naturally occurring materials are highly toxic. No vitalistic force has ever been measured and the body is often incapable of healing itself. Try wishing away appendicitis.
Thus, false beliefs may act strongly to encourage and sustain questionable practices.
With regard to the second question posed: why do so many people use alternative therapies? - the same factors described above influence service users.
In conjunction with this, they may believe that by following a particular alternative treatment regime that they will protect themselves from future illness.
A range of alternative therapists actively promote this misguided idea of prevention. The mechanism often cited in support of this claim is that the immune system will be boosted by the particular therapy being employed. There is no evidence to support these claims.
A service user in this context may also be extremely vulnerable, due to bereavement, serious illness that is resistant to mainstream medical treatment, or they may believe the practitioner to be a conduit for some kind of supernatural power. They may feel hopeless and the alternative practitioner may be seen as their last resort.
There is no doubt that the use of alternative therapies is extensive and on the rise. The factors noted above are powerful enticements.
Another factor commonly cited for the move to alternative practises is disillusionment with mainstream professionals and with medicine in general. Medicine is certainly limited in what it can provide, and undoubtedly some practitioners have appalling bedside manners. However, if you are suffering from a significant illness it is the only sensible route to follow, based on the evidence.
The third question: why do mainstream professionals become involved, either as users or practitioners of alternative medicine? relates to the involvement of mainstream practitioners in questionable practises.
A mainstream practitioner providing alternative medicine might be accused of malpractice, in the sense that he or she is providing a therapy for which no sound evidence exists and the service being provided is not sanctioned by the profession concerned.
It has been argued that some of the reasons why mainstream practitioners provide or promote questionable therapies relate to boredom with the humdrum of day-to-day work, feeling unappreciated and the reality of incurable illness and feeling powerless as a consequence.
It is also the case that many mainstream practitioners share some of the kinds of beliefs outlined with regard to the first two questions considered above. Nor are they immune to the deceptions of the senses.
Another factor is the profit motive. Alternative medicine is a multibillion dollar industry worldwide. Alongside this, it is largely uncontrolled and is easily entered by anybody with the motivation to do so.
There are psychologists who have become involved with a variety of esoteric practices such as touch therapy, soul therapy, astrology and recovered memory therapy. Psychiatrists have practised past life therapy and alien abduction therapy. Nurses have engaged in therapeutic touch. Occupational therapists have practised facilitated communication. Physiotherapists have provided craniosacral therapy.
Pharmacists sell unproven products and one of our major health insurers (Bupa) is advertising cover for the unproven treatments of homeopathy and reflexology.
None of the above practices has a scientific evidence base. A third-level education does not immunise anybody against believing nonsense, nor does it necessarily prepare students to think critically or to be appropriately sceptical.
Lest one might think that the medical profession is immune to similar criticism, there have been many cases in the media describing malpractice among its members and doctors who have been struck off the medical register are free to continue to run alternative medicine clinics.
A report from the National Working Group on the regulation of complementary therapists is currently with the Tánaiste. It will be interesting to see what proposals it contains.
Paul O'Donoghue is a clinical psychologist and founder member, of the Irish Skeptics Society.
www.irishskeptics.net.