From Abracadabra to Zombies

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reader comments: faith

19 May 1999 
While perusing your marvelous website--many, many thanks, by the way--I came across this recent segment:

'Dr. Sloan and his team acknowledge that faith can help patients deal with illness, but caution that "linking religious activities and better health can be harmful to patients, who already must confront age-old folk wisdom that illness is due to their own moral failure.''' I have long been curious about the true health value of faith.

So I thought you might be interested in the following:

Two quoted sections from the Skeptic Magazine Hotline. The first is part of a response by Steven B. Harris, M.D., a member of the Skeptics Society advisory board, to an article by Michael Shermer on the death of Susan Strasberg and her use of "alternative" medicine. Dr. Harris deals regularly with cancer patients. His position seems to reflect an increasingly accepted (by non believers) view of on the role of faith. .

"...Breast cancer is a long, drawn-out thing. You can spend 5 or 10 or 15 years in a constant agony of anxiety about having a fatal disease, or you can find a lie and be happy for the same time. Which is better? That's the conundrum facing all skeptics. Lies allay anxiety-- and too much anxiety, particularly about the future and death and pain, which are inevitable, is one of the things that makes life not worth living. Skepticism aims to find out the truth in all things. The lie which skeptics tell themselves is that the truth always, in the end, makes things better. Always. That lie is to relieve the anxiety THEY have that sometimes, occasionally, what they're doing AS skeptics, is not the kindest thing they can be doing. It's recursive and VERY ironic."

That was the setup for this--to me--startling view from Dr. William Jarvis, who Shermer calls "arguably one of the world's leading experts on alternative medicine (from a scientific perspective)". Dr. Jarvis was responding to a longer version of the above quote.

"The idea that cancer patients who delude themselves by attending miracle healers (whether of the psychic variety or otherwise) have a better quality of life than those who submit to standard therapies with their side-effects is not doubted by many (most?) in the medical community. However, the only test of the idea that I am aware of, found this not to be the case.

Cassileth et al obtained the cooperation of Virginia Livingston-Wheeler, MD, who operated a fringe cancer clinic in San Diego circa 1990. Seventy-eight pairs of patients were matched according to sex, race, age, diagnosis, and time from the diagnosis of metastatic or recurrent disease, who were enrolled over a period of 3.5 years. All patients were followed until death. Livingston-Wheeler patients were given her dubious "vaccine," BCG injections, vegetarian diet, and coffee enemas. They All but six of the control patients were on chemotherapy. The patients' quality of life was assessed using the Functional Living Index-Cancer. Researchers expected to find a higher quality of life among the optimistic, deluded VLW patients, but it didn't turn out that way. The VLW patients scored consistently lower than those treated by standard methods. (New Engl J Med, 1991;324:1180-5).

This surprising finding was consistent with two other studies that demonstrated how faulty subjective experience can be when attempting to evaluate a cancer treatment program. The Bristol Cancer Self-help Center (BCHC) in the UK offered patients a stringent diet (partially raw and partially cooked veggies, with soya proteins, and pulses), active participation in the healing process, positive thinking, etc. The program directors and staff were so certain that their patients were doing much better than patients treated in the standard way that they asked a team of doctors and researchers to test their program. This was done, and much to the shock and chagrin of the BCHC people, the finding were that metastasis-free survival was significantly poorer among the BCHC patients, and survival of relapsed patients was significantly inferior as well. (The Lancet, 1990; 336:606-10.)

Bernie Siegel, MD, has made himself into a New Age guru by touting the superiority of his ECaPs (Exceptional Cancer Patients). He has written several books, and appeared on the media touting the idea that optimism, love, and social support are life-enhancing. Nevertheless, a ten-year follow-up of the ECaPs program found no benefit. (J Clin Oncology 1993;11:66-9)

reply: One added benefit of doing the book/talkshow/lecture circuit: you don't have to face those dying patients every day.

It is interesting that even health professionals with standard training can be fooled by the subjective clinical experience. This was documented by Roberts, et al, who looked at five different clinical procedures that had come into use based upon clinical reports, but which were later found to be ineffective when subjected to randomize, blinded clinical trials (Clinical Psychology Reviews, 1993;13:375-91). This review documented the deceptive clinical illusions that physicians can experience who rely upon clinical experience without blinded, objective testing.

Alternativist physicians have the same vulnerability, plus the added problems imposed by their nonconformist personalities. They seem to know about the possibilities placebo effects, and other dynamics that can create clinical illusions on an intellectual level, but seem incapable of sorting these factors out experientially.

Or, like Herbert Benson, they don't think it is important to sort these things out because they believe that belief per se is the most powerful healing factor.

(I have accused Benson of having bumped his head on the cornerstone of the Mother Church of Christian Science there in Boston where he works). The "mind over matter" beliefs of the proponents of positive thinking are very often at the root of alternativism.

I believe these people, both patients and practitioners, are wishful thinkers who, as the old song says, "accentuate the positive, eliminate the negative, latch on to the affirmative, and don't mess with Mr. In-Between." They hate science because it attacks their delusions."
John H. Mazetier, Jr.