Kathy Sykes Part 2 - Faith Healing

[The Don]

From the programme blurb

Quote:

Kathy Sykes investigates the power of healers. She discovers that although there is no evidence that healers have any special powers, their patients do appear to recover. It's a mystery that Kathy only finally solves when she discovers that each of us has a powerful self-healing mechanism, that healers have found a way to manipulate.

Apparently, they control the placebo response

[Rolfe]

Poor old Asolepuis started a thread about this series a couple of weeks ago, and every time, it gets gazumped by someone else starting a thread on the programme!

Originally Posted by Rolfe

Just thought I'd bump this thread now in preparation for tomorrow's programme. It seems we are to be treated to a performance by Benny Hinn. I hope she's as balanced with him as she was with the acupuncturists!

It seems from the Radio Times blurb that she's going to demonstrate that the power of the mind can produce amazing healing effects. Only believe, and you will be healed.

Yeah, right.

And then next week she can explain to my woo colleagues just how that works on animals, again?

Rolfe.

Oh well, I did try, Asolepius!

Rolfe.

[sionep]

Originally Posted by The Don

Kathy Sykes investigates the power of healers. She discovers that although there is no evidence that healers have any special powers, their patients do appear to recover. It's a mystery that Kathy only finally solves when she discovers that each of us has a powerful self-healing mechanism, that healers have found a way to manipulate.

I think, that Prof. Sykes is the wrong person to host this show. She discovers that man has a powerful self-healing mechanism. Wow, I thought all children at kindy's know this pretty well. If a kid has a running nose, then pretty much nothing can be done and after2 to 4 days, it then disappears.

[Rolfe]

Yes, but I think this goes beyond that. Sure, the body is very good at healing itself. Looked at in a certain way, all healing is self-healing. You can't heal a wound or cure an infection in a corpse.

Nevertheless, I think what we're about to see is the proposition that given a strong enough suggestion, leading to strong enough faith, people can overcome conditions which would normally be regarded as either incurable, or as not likely to go away any time soon.

I have deep, deep misgivings about this. I think it exploits sick people, because of course if you don't get better it's because you didn't have enough faith. Not my fault, guv. And I don't think there is any objective evidence that these miracle cures really do happen, as opposed to fraud, coincidence, and misreporting. One of the points I keep making is that these woos claim equally good if not better results in animals. Since it stretches any sort of credulity to imagine that the firm belief of the owner is having any effect on the animal's physiological condition, then is this not in fact good evidence for the whole thing being smoke and mirrors - coincidence and wishful thinking, not excluding a smattering of plain lying?

Rolfe.

[NeilC]

Most alternative health "modalities" seem to have, at their heart, the idea that the body will heal itself if only it is "brought back into balance". It makes one wonder why anyone ever dies of cancer....unless they are living a bad life maybe?

I have to listen to this stuff in my ITEC massage classes. Most people buy into it.

[Asolepius]

Originally Posted by Rolfe

Poor old Asolepuis started a thread about this series a couple of weeks ago, and every time, it gets gazumped by someone else starting a thread on the programme!Oh well, I did try, Asolepius!

Rolfe.

Thanks, but I don't maintain a proprietary stance on this topic! We will need a new thread for the last episode, on herbs.

[Zendal Darkman]

Well I'll wait until seeing the program, but ...

Quote:

It's a mystery that Kathy only finally solves when she discovers that each of us has a powerful self-healing mechanism, that healers have found a way to manipulate.

means I will have to remove all "throwable" objects that are within arms length of my sofa. A pity as my daughter was quite interested in last weeks program.

[Blue Bubble]

Originally Posted by ,but does it work?

means I will have to remove all "throwable" objects that are within arms length of my sofa. A pity as my daughter was quite interested in last weeks program.

Yikes, you were going to throw your daughter at the screen ??

[Darat]

Quote:

...snip... It's a mystery that Kathy only finally solves when she discovers that each of us has a powerful self-healing mechanism,....snip...

So she's never had a cut, a bruise, scratch or a cold?

[Rolfe]

And Kathy is the one who discovers this! You know (see acupuncture thread), Kathy the PhD in physics who doesn't have a publication to her name post-doc, and who has somehow managed to net a little sinecure of a chair, as Prof. of "the public engagement with science", whatever that is.

All those physicians, and biochemists, and psychiatrists, all the medical researchers who have looked into this for years, even Ben Goldacre who has looked at much the same information in his Bad Science column, none of these people discovered it, it took KATHY herself to make this groundbreaking discovery.

Yeah, right.

Rolfe.

[brettDbass]

I can almost hear the sound of dozens of TV screens smashing as UK forum members listen to her smugly announce "now, I'm a scientist" for the 59th time in tonight's episode.

[dogbite666]

Well, following last weeks shabby performace Im not even going to bother watching this one.

[The Don]

Originally Posted by brettDbass

I can almost hear the sound of dozens of TV screens smashing as UK forum members listen to her smugly announce "now, I'm a scientist" for the 59th time in tonight's episode.

Well I'm in a hotel room with two TVs tonight so not only will I not be trashing my own telly but I'll have a spare once we've reached the 59th utterance

[John Jackson]

I'll be watching.

Didn't Les (Asolepius) say to watch out for programmes 2 and 3? There may be more moments than in the first programme.

I think that most if not all alternative remedies rely on placebo effects and our bodies' self-repair mechanisms.

[John Jackson]

Well I've just finished watching it and I must say that it was an excellent programme (in contrast to last week's).

I would have liked to have seen something on the placebo effect and its role with organic disease, but the programme concluded that faith healing is all about the placebo effect.

The conclusion that Kathy came to matches my current understanding of the placebo effect so I may be biased, but I thought the programme was educational, and gave a good insight as to how many (not just faith healing) alternative remedies "work" - especially with regard to the practitioner/healer.

I was expecting a lot worse.

[Asolepius]

Sorry folks - I inadvertently started a new thread, please ignore it. Here is my post for what it's worth.

Well, another glaring gap in this episode. Various `spiritual' modalities are well known to be useful in palliative care, but there is no evidence that they can heal, ie cure. I will have to look up the knee arthritis study, because I would have thought it obvious to do some radiology to look at joint damage. The distiction between palliation and cure should have been emphasised.

So Kathy has discovered the placebo effect now has she? Tell me something new. Has she wondered how on earth it could be used in clinical practice? How to use it, doctors will have to lie to their patients? Which is illegal? OK, the homeopath doctors do that anyway.

As for Michael Dixon, my pen is poised for my letter to his dean of medicine. What planet is he on?

I should not be too harsh on Kathy I suppose, as she was a lot more sceptical this time, but really she doesn't see the big picture at all. Why does she not worry about people lying to the sick?

ETA: That last bit about her dad was rather maudlin, as well as misleading. She implied that belief will affect outcome, which is quite untrue.

[Rolfe]

I agree with John, it wasn't nearly as bad as last week. And she only said "I'm a scientist" twice, that I noticed.

But hey, she watched some MRI scans of people who'd had a sham injection, versus people who had had no injection, and wow, look at that effect? And she didn't think to relate that to last week's little needle-stick adventure?

I spent most of the programme muttering, "yeah, but show me an effect on diabetes or heart failure!" I mean, an effect on an objectively measured variable, rather than on perception. Everything we saw was perception only, even the knee surgery story. No actual orthopaedic follow-up to see if the pathology was any different, was that too hard or what?

She simply failed to address the difference between perception and real outcome. Of course for some conditions, perception may be of real importance, especially where pain is involved, or in psychological conditions. Nevertheless it's a huge distinction. What about these people jumping out of their wheelchairs? She never looked any closer at that, which looked awfully staged to me.

And like I said, how about next week coming along and telling me how making the pet owners feel all warm and fuzzy is actually going to benefit the pets, now? And maybe explaining how come, if placebo mainly works the way she implies, it seems (according to every woo I ever heard) to work just as well on animals.

Oh I forgot. I had a patient once with a chronic gut bleed. In the end, I persuaded an abdominal surgeon to open him up to see if we could identify the source of the blood loss. No joy, we found no lesion at all, and in the end closed without doing anything at all constructive. The dog's PCV soared over the next two days, he turned a nice healthy shade of pink, and I sent him home for Christmas. Come a February checkup he was still fine. God only knows how. So hey, that proves it.

(Except this sort of story has been told so often in human medicine - they call it "giving the guts an airing" - that I believe someone did do a formal study on it and found nothing, suggesting reporting bias. Rather unlike that knee surgery tale. Shame. I thought it worked on electronic equipment, too....)

Rolfe.

[Mr. Gruff]

What a surprise! Faith healing is nothing more than placebo.

I was a little disappointed that placebo was presented as a panacea, when in fact the only thing that it appeared to cure in this documentary was psoriasis, which has an autonomic influence anyway.

It is only treating the symptoms, not the diseases. The separation was not clear, and it should have been clarified in order to encourage people to have diseases treated rather than visiting a faith healer in false hope of a cure.

[sesmo_k]

Rolfe, the "give the guts an airing" does anecdotally work on IT equipment at least. Called a pull-push procedure. It works especially well where old circuit boards won't work. Pull them out, push them back in and hey presto... working computer!

Tonights programme wasn't bad. I agree that the last five minutes were unneccessary. She wasn't half as patronising either. I was quite shocked when she said you can get healing on the NHS though! Interesting results from the test with a "real" healer as compared to a fake healer interesting. Does this mean that healers will now have a massive downturn in profits as people turn to their next door neighbour instead?

[Rolfe]

Originally Posted by Asolepius

Has she wondered how on earth it could be used in clinical practice? How to use it, doctors will have to lie to their patients? Which is illegal? OK, the homeopath doctors do that anyway.

Time to give The Central Dilemma of Alternative Medicine a name-check, again.

Rolfe.

[sat556]

Originally Posted by sesmo_k

Interesting results from the test with a "real" healer as compared to a fake healer interesting. Does this mean that healers will now have a massive downturn in profits as people turn to their next door neighbour instead?

No. It means that there will be a massive downturn in profits because many more people will be setting up as healers now we all know we can do it just as 'well'.

I found the program interesting, much better than last week's. I liked the way the woo was dealt with quite quickly at the beginning and then placebo concentrated on for the rest of it. I couldn't quite understand the bit about her dad though, I didn't see the need for it.
I did shudder when I heard 'as a scientist' AGAIN Seems like she is trying to convince herself!

[John A]

Well that was better! Nothing as misleading as last time. I do find the style in which the program has been shot (with the far-away looks, hotel rooms, etc) a little cringe-worthy and I still would have liked way more detail - exactly what were patients told, what was the result of the long-term diagnosis of the sham knee op patients after they were told if it was sham or real, etc, etc. But then the show isn't aimed at the pedant.

Originally Posted by Asolepius

She implied that belief will affect outcome, which is quite untrue.

Doesn't it depend on what's wrong with her father? If it was rehab for a stroke - belief might help there? TV certainly promotes the idea that positive thinking helps patients beat cancer - is there any literature on this? (I know how to use pubmed but I'm being lazy).

Just as an aside, I was surprised that a general anaesthetic wasn't viewed as an unecessary risk for a mere sham surgery!

[Badly Shaved Monkey]

Tonight's programme...

Much better, I thought and genuinely thought-provoking about the real power of placebo, subject to the limitation that it seems to apply when the actual disease is confined to the patient's skull, or the locus of therapy is confined to the patient's skull.

This would accord with something from another thread- help me someone- where it was said that the placebo effect applied to cancer patients does not make them live longer but can improve their quality of life.

So, what it comes down to is that the placebo effect can be powerful in psychosomatic disease and that psychosomatic process are quite important in medicine but are not sufficient to mend a broken leg, cure cancer or treat gangrene.

I still find her breathess presentation "as a scientist" a bit wearing, but I did thnk the content was better.

(Moved over from the other thread)

[Rolfe]

Originally Posted by Badly Shaved Monkey

So, what it comes down to is that the placebo effect can be powerful in psychosomatic disease and that psychosomatic process are quite important in medicine but are not sufficient to mend a broken leg, cure cancer or treat gangrene.

So how come she didn't backpedal a bit and consider if everything she saw last week might have been equally well included this week?

Rolfe.

[Badly Shaved Monkey]

Originally Posted by Rolfe

Except this sort of story has been told so often in human medicine - they call it "giving the guts an airing"

My Dad always called it "ventilating the evil humors" to give it a nice touch of Galen.

By the way, you're right about the animals in this regard. A placebo effect remains useless and possibly even counter-productive if it is working on the owner.

[John A]

Originally Posted by Asolepius

Has she wondered how on earth it could be used in clinical practice? How to use it, doctors will have to lie to their patients?

I think this is an important debate and I'd love to hear others views on this in relation to the NHS. Especially pro-CAM views where the assumption is that CAM has no efficacy greater than placebo.

But perhaps it's a separate thread?

[Badly Shaved Monkey]

Originally Posted by Rolfe

So how come she didn't backpedal a bit and consider if everything she saw last week might have been equally well included this week?

Rolfe.

Well, quite.

I was definitely very forcefully reminded of our excessively self-certain friends the homeopaths when she talked about the power of ritual and a committed practitioner.

[Geckko]

I thought the program finished with a decent point to make about how the clinical effectiveness of modern consultations could be improved by doctors taking a little more time and taking greater care to interact with the patient.

[Interesting Ian]

Originally Posted by sionep

I think, that Prof. Sykes is the wrong person to host this show. She discovers that man has a powerful self-healing mechanism. Wow, I thought all children at kindy's know this pretty well.

Then they know more than skeptics.

[Interesting Ian]

Originally Posted by John A

Well that was better!

It was equally good! Another excellent programme although predictable. And she was equally as sceptical as the first programme.

[Badly Shaved Monkey]

Ah, small fly in the ointment. I was discussing the sham knee surgery with a colleague today and he and I had obtained different impressions of what the sham consisted of. I thought it was non-invasive, he thought it involved actually entering the joint with the arthroscopy instruments but not doing the chewing and chopping inside the joints. The problem with this is that "ventilating the evil humors" from joints is itself almost certainly a significant therapeutic intervention aside from any placebo effect. So it is important to know whether the joint was entered or not. Does anyone know the citation for the study.

An anecdote.
I had a patient with a persistent fluid swelling of one joint. Various features made me fairly sure that this was an immune-mediated arthritis, but that tends to affect several joints. The main differential was a low-grade chronic joint infection. The treatment for IMA is steroids and/or other immunosuppressives, which are thoroughly contraindicated if there is infection. So, I went through a very laborious process of trying to sample the joint to try, as best one can, to prove the negative and declare that there was no infection. I did several procedures to sample joint fluid and finally to take biopsies of the joint lining. At each procedure, a part of what was done was to flush the joint with saline.

And each procedure produced a dramatic clinical benefit in the dog, so when the results came back each time we were less worried about the need to use big drugs to treat him.

Ultimately another joint became involved and with my accumulated evidence I put him on steroids and he got promptly better and the condition eventually resolved and he came off treatment permanently.

Now, the point of this is that dog turned out to have proper immune-mediated arthritis but prolonged clinical remission was achieved on 3 occasions just by flushing the joint. Almost certainly this was because I flushed out the inflammatory mediators and broke a cycle of developing inflammation.

Perhaps you can see why we need a good definition of what the sham was in the knee study discussed in Sykes's programme.

[Asolepius]

Originally Posted by Rolfe

Time to give The Central Dilemma of Alternative Medicine a name-check, again.

Rolfe.

Thanks for this reminder. Fascinating that this page is operated by University College London - which counts the Royal London Homoeopathic Hospital among the jewels in its crown.

[Asolepius]

Originally Posted by John A

Well that was better! Nothing as misleading as last time. I do find the style in which the program has been shot (with the far-away looks, hotel rooms, etc) a little cringe-worthy and I still would have liked way more detail - exactly what were patients told, what was the result of the long-term diagnosis of the sham knee op patients after they were told if it was sham or real, etc, etc. But then the show isn't aimed at the pedant.

Quote:

She implied that belief will affect outcome, which is quite untrue.

Doesn't it depend on what's wrong with her father? If it was rehab for a stroke - belief might help there? TV certainly promotes the idea that positive thinking helps patients beat cancer - is there any literature on this?

There are some meta-analyses, cited in the NICE guidance on palliative care, which clearly show benefits on mood and outlook, but absolutely no effect on morbidity or survival. Positive thinking does not beat cancer, and it is a cruel lie to suggest otherwise.

[Badly Shaved Monkey]

Sorry Asolepius, you missed a typo

"Thanks for this reminder. Fascinating that this page is operated by University College London - which counts the Royal London Homoeopathic Hospital among the jewels in its crown boils on its backside."

[Rolfe]

Originally Posted by Badly Shaved Monkey

Ah, small fly in the ointment. I was discussing the sham knee surgery with a colleague today and he and I had obtained different impressions of what the sham consisted of. I thought it was non-invasive, he thought it involved actually entering the joint with the arthroscopy instruments but not doing the chewing and chopping inside the joints. The problem with this is that "ventilating the evil humors" from joints is itself almost certainly a significant therapeutic intervention aside from any placebo effect. So it is important to know whether the joint was entered or not. Does anyone know the citation for the study.

I'm not sure either. I was just remarking that I didn't know, and I should have paid closer attention. I did get the impression that the joint capsule was opened, and my opinion was the same as yours - that is a significant intervention on its own. However, I'm not sure if I wasn't misled by the sham prodedure (which included film of a real procedure) into thinking that more had been done than was actually the case.

It could be a difficult procedure to blind adequately, without getting very close to doing significant surgery. I'm not sure, but wouldn't it be possible for a patient to tell that an incision was only skin-deep without the joint being entered?

I was also struck by the fact that Kathy only interviewed one of the sham patients in her longer-term follow-up. Who selected this patient? Was he perchance the only one who was still reporting a continuing benefit? Why no complete follow-up with statistical analysis?

Rolfe.

[Capsid]

I got the impression the knee joint was opened but it wasn't clear. I also found this article abstract on the Parkinson's study. I don't have access to the full article unfortunately.

[Rolfe]

Originally Posted by Asolepius

Thanks for this reminder. Fascinating that this page is operated by University College London - which counts the Royal London Homoeopathic Hospital among the jewels in its crown.

To be fair, he does have a good go at that subject too.

Rolfe.

[John Jackson]

Originally Posted by Asolepius

There are some meta-analyses, cited in the NICE guidance on palliative care, which clearly show benefits on mood and outlook, but absolutely no effect on morbidity or survival. Positive thinking does not beat cancer, and it is a cruel lie to suggest otherwise.

I agree. That point should have been made clear in the programme. The feel-good factor of the placebo effect is quite different from its ability to heal. It may be beneficial in reducing pain, stress and anxiety (with their associated benefits), but it won't cure the underlying cause.

Also, at the start of the programme we saw people in wheelchairs walking after being instructed to do so by a faith healer (Benny Hinn). It should have been commented on that this is a standard trick that faith healers use. People who can walk are asked to sit in wheelchairs and are then miraculously cured!

The impression given overstated what the plecbo effect can do. Faith healing is an exploitative con, and that should not have gone unmentioned.

[Badly Shaved Monkey]

Originally Posted by Rolfe

I was also struck by the fact that Kathy only interviewed one of the sham patients in her longer-term follow-up. Who selected this patient? Was he perchance the only one who was still reporting a continuing benefit?

I don't know. Allowing for what I have said in the past about misinterpretation of coincidental reoveries, I would think that man's anecdote was interesting even if he was one of a tiny minority who got dramatically better from prolonged severe pain after sham surgery. BUT, only if the surgery was as shammed as I need it to be, i.e. a skin incision must have been the maximum level of invasion or I don't count it as a sham.

[antihippy]

You can actually feedback the BBC. I've found that they can be quite good at getting back to you - although it does depend on the producer who is involved on the show.