We hear so much about what alternatives to medicine are not doing, it’s perhaps worth pondering what they might be doing.

Beyond producing a placebo effect, which I stress is nothing to sniff at, it seems we can articulate other accompanying features we would do well to understand. One usually thinks of prescription writing conventional doctors upon hearing expressions like “we expect a pill for every ill”. This is not without good cause. As we saw medicine leap forward and family consulting rooms multiply, the gap between symptom severity and seeking attention quite naturally narrowed.

Yet whatever was going on in our minds that modified our part in closing that gap is a restless beast indeed. Part worry, part suspicion, part urgency, part ignorance, part arrogance, part fear, part expectation, part assumed knowledge and more, it can play a role in convincing us we’re ill – or far more ill than we are. Doctors now know that pandering to this aspect can lead to over-prescription, self medication and hypochondriacs. As a result the medical profession has learned how to manage certain traits with placebo and/or skilled bedside manner.

However, the industry to far and away exploit the sole notion of people needing attention for absolutely no reason is the so-called Wellness Industry. It is aptly named, proffering entirely useless or arguably harmful potions, rituals, observances, gizmos, pokes, prods, states of mind and more, to the entirely well.

But why? As one woman informed ABC’s Lateline some time back as they examined the scams used by chiropractors, It’s “…maintenance… making sure everything’s working properly, making sure everything’s working at its best”.

Sure enough the chiropractor asked her to bend to the left, then right. “How that going for you?”, he asked in the tone real doctors might use when examining an actual problem. The woman gets a check up every 4 to 6 weeks. The question we need to ask is about the driving force for her to ask someone if she is in good health. Is it a type of hypochondria? Is it a type of “self medication” in which one seeks out excessive treatment? Is not this chiropractor simply pandering to a psychological state, when his best advice would be to encourage less dependence?

I’m sure she felt better after paying, because just like with Cold Reading all the action occurs within the patients mind. In this case a complex array of cues, sciency stuff, repetition, anatomy posters and models, machines that go “Bing!”, tones of voice and even payment lead up to a nice squirt of dopamine upon completion. The woman is simply conditioned to associate the entire hanky panky with feeling good and thus, better health.

Of course take away this experience without the woman’s consent, and the more time that passes the more anxiety will mess with critical thinking and the usual creaks and twangs she’d ignore become directly attributable to not making it to her “maintenance”. This is the truly brilliant aspect of Wellness Scams. Even when their “patients” are well away from them the urge to return is steadily growing.

People don’t need chiropractic rituals as “maintenance” of health. Thus to continue to exploit this woman is unethical abuse simply for monetary gain. Get them hooked on this notion and it’s easy money. When challenged for evidence of efficacy these visits are trotted out, as if volume of attendance equates to success.

This is why chiropractors, shady nutritionists, reflexologists, reiki magicians, homeopaths, traditional therapists/masseurs work so hard at reinforcing “hits” between their scam and the patient verbalising an association. In the case of New Age diagnostics – often combined with a “therapy” (say iridology and vitamin therapy) – it’s quite simple to create a syndrome that just might be about to run amok.

“Hmmm. We’d better double the selenium, calcium and vitamin E and get you to come in at least twice a week. Let’s see if we can’t nip this in the bud, shall we?”.

It is actually a welcome trait seeing individuals wanting to take more charge of their own health. Certainly that plays a role in the viability of ongoing pseudosciences that masquerade as health services. Perhaps combined with the highly visual and ritualised capers pretending to offer health people are feeling in more control of their health than with brief doctors consultations. It may be that in our present uncertain world of such frequent change to once permanent features, that one seeks out modes of reassurance.

What is certainly a concern is that as people seem intent on taking more control over, and playing more active roles in their own health management, there are charlatans highly skilled at taking advantage of human needs. Nothing is too  difficult for them, nothing cannot be understood, all can be managed and all will be well.

At the top of the scam pyramid reign chiropractors, at once tuning, “diagnosing” and “curing” entirely made up syndromes that engender fear, anxiety, poor decision making and dependence upon ritual in innocent people. So good are chiropractors at this that pregnant patients, fed lies about the needs of newborns, express an impatience for delivery. All so that their neonate can begin chiropractic and thus, start to overcome the abnormalities they believe all children are born with.

Chiropractors run workshops on increasing income. The malleable state of women in a state of hormone flux either side of gestation is well understood. Not for the “patients” benefit. For the benefit of profit born of maternal anxiety and parental fear. It becomes a matter of urgency. The longer left, the more “abnormal” the child will be. Antivaxxers make use of the maternal instinct also, as do renegade home birth groups.

It’s a trait that has served our species well. If mum receives bogus input suggesting the foetus or bub is under threat, no harm comes to either if mum acts upon it. But if mum hangs around to weigh up the risks or ignores constant cues for some time and the risk is real, the chance of this remaining as a successful evolutionary trait is zero. The strength of this trait is notable in that addiction to harmful substances can overrun it. Yet this is following changes in the reward-pleasure centre of the brain, that then initiate neuronal projections into the frontal lobe that serve to inhibit reasoning, decision making, self control and inhibition of behaviour.

Antivaccination lobbyist, AVN member, anti-medicine advocate, homeopathic immunisation promoter and chiropractor Simon Floreani who has children making up 60% of his client base once told Today Tonight:

Babies often come directly from the hospital. They’re referred from the obstetricians, the doctors, the pediatricians, the nurses because chiropractic care’s so safe for them. Many of the current medical procedures just don’t work and parents aren’t silly. They’re looking for good alternatives from people that care and are prepared to look into diet and lifestyle.

As one time Skeptic of the year, Loretta Marron contends, “what they are is faith healers”. Traditional chiropractor John Reggars insists it’s a case of self limiting conditions or perceived changes. From an evidence viewpoint there’s nothing to support chiropractic – even with sore backs.

Update: In fact studies of infant crying and chiropractic therapy suggest treatment reduces crying have a high risk of performance bias. Indeed as parents are the assessors the results may be shared by parental belief. This Cochrane review of infantile colic and chiropractic notes (p.2);

It’s important to realise that this review concluded the above based on “most studies”. It has consulted this RCT by Miller, Newell and Bolton (see p.25 of Cochrane review), and still found data to be inadequate to reach definitive conclusions.

Thus potentially, if parents think the infants are getting treatment they may be reporting improvement even if there is none. Conversely if they believe the child is not being treated when it is, they may report adversely. /Update

The Courier Mail reported recently:

SCIENTISTS spent $374,000 recently asking people to inhale lemon and lavender scents to see if it helped their wounds to heal. It didn’t.

The National Centre for Complementary and Alternative Medicine in the US also outlaid $700,000 to show that magnets are no help in treating arthritis, carpal tunnel syndrome or migraines.

The centre spent $390,000 to find that old Indian herbal remedies do not control type 2 diabetes and $406,000 to prove coffee enemas do not cure pancreatic cancer.

It’s the same story around the globe. One by one, weirdo treatments are being exposed as bunkum.

Why are people so gullible, handing over their hard-earned cash for unproven alternative therapies?

Why do usually sane people get sucked in by pseudo-scientific fiddle-faddle such as homeopathy, reiki, reflexology, naturopathy, aromatherapy, iridology and crystals? […]

Chiropractors have now been discredited by every reputable medical organisation from the Royal Society down, yet people still spend up on these bone-crunchers and state and federal governments seem unwilling to shut them down.

Recently I reported on two experts on alternative medicine who reviewed all the evidence and concluded chiropractic was “worthless”.

Professor Edzard Ernst and Peter Canter found no convincing data to support claims the technique was effective.

With the possible exception of the relief of some back pain – where spinal manipulation is as good but no better than conventional treatments – the technique is worthless, the review in the Journal of the Royal Society of Medicine concluded.

Another impacting feature is the “legitimising” tricks buffering complete rubbish. “Diplomas” in homeopathy. “Degrees” in chiropractic. The meaningless but very powerful use of the term Doctor. Flashy titles given to Boards or National Bodies. Misleading titles such as The Australian Vaccination Network that supports zero vaccines calling them “instruments of death”. “Pro-choice” groups. All this is strictly designed to mislead from the outset.

Yet I’m not sure asking only about gullibility is enough. Gullibility persists often due to a conscious decision to not examine criticism of what has become a comforting belief or set of beliefs. More so we are hard wired to seek out information that confirms what we think we know as fact and associate with people who reinforce our beliefs. Even internalising contradictory information about our beliefs can in time lead to reinterpretation that reinforces the opposite of the information we took in. Cognitive bias is a powerful master.

An admirable foe to conventional medicine who pops up here, Meryl Dorey, completely dismisses the findings above. Yet, when criticising vaccines she relies upon respect for the same scientific approach. “The gold standard of scientific research”, she argues, is the Randomised Controlled Trial. As RCT’s mow down alternatives to medicine Meryl insists that until vaccines are subject to RCT’s they cannot be regarded as “properly tested”. Although Meryl is beyond reason (as evidenced by this level of ignorance about how RCTs work) it’s a fine example of how belief can eliminate respect for evidence.

Perhaps we should be asking more about what leads people to internalise so much misinformation about the world we live in and the basics about how it works. So much of the market sustaining disproved alternatives to medicine also accept without question that our environment is highly toxic, it pollutes our health and natural new age “cures” are needed. They also believe conventional medicine, hiding the truth about “natural cures”, is irrevocably corrupt, peddles poison as medication and is ironically creating a world of sickness from which it profits.

Much of this is provided to them from so-called “alternative practitioners”. Detox’ is necessary. No, it’s quite dangerous. Medicines treat the symptoms not the cause. Quite true, I hasten to add in many cases. I’m just not sure why this is assumed to be a blanket flaw. Figures on medical mishaps draw concern. Yes real doctors are accountable and mishaps are still a small percentage. Adverse reactions from drugs prove medicine is lethal. Quite wrong. Primarily ADR’s underscore patient error, and again given the millions of scripts dispensed is another small symptom of accountability.

The truth is, Conventional Medicine is not peddling sickness and keeping you ill for profit. But Alternatives to Medicine are profiting from the false belief you need maintenance and from keeping you splendidly ignorant.

This continued misinformation about real medicine takes up an exorbitant amount of the message coming from the supposed “complimentary”, “alternative” or “integrative” chapters. From antivaccination messages to the vast bulk of alternatives to medicine the claim of “efficacy” is buoyed upon a childish notion. “We are good, because they are bad”. The more “bad” squeezed in the less the need for evidence to show Theta Healing could possibly work or that oscillococcinum isn’t plain nonsense.

Still this doesn’t explain everything and I don’t imagine I could. What causes one mother to accept antivaccination hogwash in a maternal embrace and another to sink her teeth into its carotid artery, so to speak? Personal experience can shape belief but even here outside forces tend to be the final decider. Certainly scientific literacy and the awareness that one must trust experts in certain fields is crucial to good decision making.

Alternatively, having “researched” every crackpot self affirming, disreputable source whilst avoiding reputable – indeed any source – material is intellectual sabotage. Likewise being affluent and highly skilled in one area doesn’t immediately make a person “educated” as the media insist on telling us.

At best one could argue that so many scams continue to attract patronage because they offer an emotional and psychological package of oneself taking control. Lengthy consultation sessions provide for bonding and a sense of loyalty.

Much of the practice or ritualised session is designed to instil reliance and dependence upon the so-called practitioner. Bogus symptoms and syndromes are tacked on whilst alienation from conventional medicine evoking feelings of betrayal and self-superiority sinks in. Reading material and other patrons readily reinforce this.

Some charlatans often claim their Wonder Woo is suppressed by Big Pharma, as was the case with Francine Scrayen, Dr. Death Sartori charged in multiple countries and QLD MMS wielding cancer curing, scam artist Jillian Newlands. Although most often this is announced to the very desperate and the most ill.

Ultimately it appears that if we are to push down this bubble of bogus practices we need to understand just why so many of us are seeking attention to our state of being. It is not last ditch desperation or even seeking treatment for obvious illness. People need attention and in seeking it they are being sold dependence.

Dependence upon forces, rituals, cleanses and superstitions they previously never knew existed. That so much of this comes with ready packaged insults toward conventional medicine instills distrust of the very regulators who must act for the public good.

Perhaps as more and more scams are shown to be clinically useless, those that have depended upon them need to be educated in how they’ve been manipulated.