CAM Jerks on PBS

I had read a week or so ago on Science-Based Medicine that PBS has been running what are essentially infomercials for quacks. SBM picked the story up from Salon. I thought my local PBS stations (one in West Virginia, one in Maryland) were immune. I was wrong.

I have a weight bench in the bedroom and I usually watch PBS while I lift. Of course, this is usually weekday evenings, not weekend mornings, so imagine my surprise when I turn on the TV and, instead of the gentle, soothing voice of Jim Lehrer, I see Dr. Mark Hyman peddling his UltraMind Solution.

I didn’t watch long because I read somewhere that it’s bad to vomit while weightlifting. But I wanted to touch on some of the stuff Hyman said. The first, that studies have shown that autism has been linked with diseases of the gut, had me in stitches. The problem is that those studies have been discredited, and considering that Wakefield did his study on a huge sample of 12 people, I don’t know how valid the results could be.

We now know that mercury is toxic.

Actually, we’ve known that mercury was poisonous since at least 1926. However, there are still commercial applications that need mercury, so we still have to use it and be cautious of its environmental effects. But don’t make it sound like mercury poisoning is a new concept.

We use special chemicals that bind with the mercury.

Chelation. He is talking about adults here, so I’m not going to go on a rant about chelating children. He is specifically talking about an adult who lived near a concrete plant. In this case chelation would be appropriate. However, Hyman makes it sound like everyone needs chelation. This is akin to comparing the effects of environmental radiation from someone who lived at Chernobyl to someone born and raised in Nebraska.

Stress shrinks the hippocampus.

This article from Harvard psychologist R.J. McNally refutes this mind myth, giving us a number of studies showing that the atrophy theory is bogus.

Stress lowers serotonin levels in your brain.

I have a problem here. While I can’t find anything reliable that directly relates high stress and low serotonin, it is logical. However, studies have shown that serotonin is released during exercise, and exercise is physically stressful.

But that’s not the real problem. The problem is: so what? People seem to think of serotonin as a miracle, cure-all neurotransmitter, like if they can just get more and more serotonin they would be fine (when, in fact, it makes people ill. It’s called serotonin storm). It’s the same irrational logic that steroid-users present after they’ve shrunk their testicles and grown bitch tits (thank you, Chuck Palahniuk, for such a wonderful term). There can truly be too much of a good thing.

We need stress. We thrive on it. Stop making stress out to be a demon. It is by facing stress that we change, and we face stress as we change. You can point to happiness as the key to a healthy life, but if you’re smiling and laughing in the middle of a firefight, there is something wrong with you.

I’m going to stop here before my head explodes from the stupid. I didn’t link to any of Hyman’s web sites (you’re welcome), but if you want to find this guy, just Google him.

Taking a closer look at child sexual abuse

Each year, approximately 150,000-200,000 children are sexually abused, 70-80% of those cases involve a family member or a friend of the family that the child knows, including older children. It’s an appalling proposition to anyone who wants to work in the treatment of mental disorders. The people that we are supposed to trust, the “in group,” is more likely to do damage than any stranger. Even the most well-balanced counselors and therapists I know get floored by stories of child sexual abuse.

The Journal of Mental Health Counseling published an article by Frazier et al. covering some very good information regarding recovery from CSA. Here are some of the key facts regarding recovery:

• Primary symptoms of CSA include avoidance behaviors (including caregiver phobias), developmental delays, diminished responsiveness to the outside world, lack of interest in a previously-enjoyed activity, and feelings of detachment or estrangement.
• Survivors of CSA may lose developmental achievements. They may start bedwetting behavior, or they may become unable to feed themselves.
• When an abused child views their preabuse life as high-quality, they are more likely to have a positive self-view after the abuse.
• Survivors who believe that others do not view them as responsible for the abuse often feel empowered, leading to a more positive adjustment.
• Abused children who receive emotional support from a non-offending adult are less symptomatic.

Note that the emphasis of this article is on children. Adults who survived CSA are more likely to show symptoms of depression and anxiety, but children respond well to treatment. Frazier et al. recommends using an ecosystem approach in working with child survivors of CSA, and calls for counselors to be aware of transgenerational trauma, or situations in which a child keys into an adult’s behavior surrounding the adult’s experience with sexual abuse. Children are quick to pick up cues from parents. If we can assist these children as early as possible, we may be able to break that cycle.

Of course, CSA is not without its controversies. The biggest of which is probably the diagnosis of Dissociative Identity Disorder.

I’ve been reading bits and pieces of Science and Pseudoscience in Clinical Psychology, and last night I finished a chapter on DID (Lilienfeld & Lynn, 2003). It does a great job of highlighting the controversy surrounding DID.

Briefly, DID is a disorder in which a client presents with two or more distinct “personality states” that alternate in their control over the individual. It is one of the dissociative disorders, disorders which present with disturbances with memory, identity, or perception of the external world. The common belief regarding DID is that the development of separate personalities is caused by child sexual abuse. (note: this is a more recent development. The two famous early cases, those presented in The Three Faces of Eve and Sibyl contain no mention of CSA). The belief is that the child develops the second personality as a way of protecting the primary personality from facing the fact that they are being abused.

The other camp, the place where I hang my hat, claims that DID is the result of therapist cueing. Lilienfeld & Lynn point to a few facts: that a huge number of DID cases come from only a handful of therapists, the flexibility of memory as demonstrated by Elizabeth Loftus, the fact that a majority of the cases of DID begin treatment for other problems and do not report the expression of different personalities until later.

Lilienfeld and Lynn are quick to point out that they are not denying that DID patients experience these symptoms. The question is whether the symptoms are a natural reaction to trauma.

This leads me to a story. In an earlier job, I was treating a female with DID who claimed that her parents performed ritual sexual and satanic abuse. I was an undergraduate student at the time, and I happened to read one of Loftus’ memory studies around that time, and read the FBI statements that there had never been any documented cases of ritual satanic abuse in the US. I was confused, so I went to my boss. He was (and still is) a great counselor and he said “it probably isn’t true, but it is true to her.” This, or course, is a take on the old adage with schizophrenia, never challenge the delusion. Of course, it does beg the question, how do you treat someone who bases their life on events that did not occur?

(Original Photo by D Sharon Pruitt)

Frazier, K.N., West-Olatunji, C.A., St Juste, S., Goodman, R.D. (2009). Transgenerational Trauma and Child Sexual Abuse: Reconceptualizing Cases Involving Young Survivors of CSA Journal of Mental Health Counseling, 31 (1), 22-33

The Verdict is In

I feel like I’m spoiling a perfectly good Darwin Day by blogging about autism yet again, but this is a real vindication. The vaccine court has made a ruling: autism is not caused by vaccines.

However, this hasn’t stopped the hustlers concerned citizens over at Age of Autism, where J.B. Handley had this to say:

1) The honest science has not been done on the vaccine-autism issue, we all know this. We all know vaccinated kids have only been compared to other vaccinated kids, we all know these studies have been designed to generate a certain outcome – an outcome that lets vaccines off the hook. The problem is that this becomes the weight of evidence used in court, no matter how stupid we might think it is.

We do know that there is no link between thimerosal and autism, and we know there is no link between MMR and autism, but Handley is trying to say that vaccinations in general are responsible for the increase in numbers. So if this is so important, why isn’t Handley running a study? Oh, that’s right. Because he’s not qualified to assess these things. And why hasn’t some antivaccine doctor performed the study? Because they don’t want to know the truth. It would cost them too much.

Actually, I don’t even know if anyone keeps numbers on unvaccinated children. If not, a researcher would have to set up an experimental study with children who are given vaccines and children who aren’t. Obviously, there are ethical issues there.

2) The science on our side is very, very incomplete. Do we have some studies that support our position? Yes, we do. But we don’t have a body of evidence that has been printed in scientific journals that would convince a neutral party that we have a clear-cut case.

The “incomplete science” on your side doesn’t stop you from linking to sites selling bullshit supplements that are supposed to “cure Autism,” does it Handley?

Andrew Wakefield A Fraud?

This blog is fairly young as blogs go, and this is my fourth post about the vaccine/autism controversy. Why? Two reasons: When I first started working in human services, I did in-home care for people with mental retardation and developmental delays, part of thew Medicaid Waiver system. I saw first-hand what behavioral interventions can do to enhance quality of life. Second, and I’ve mentioned this before, I fell for it. When I read Robert Kennedy’s article Dangerous Immunity, I initially believed that autism could be caused by mercury poisoning. Then a couple of studies were published which refuted this, and I saw it as a blip on the research radar, not realizing until just last year that this contoversy was still going on.

Now information is coming out claiming that Andrew Wakefield not only took money from anti-vaccine interests before and during his research into the defrauded Autism-MMR link, but that he outright lied about the time of onset in his autism patients to enhance the link with MMR. David Gorski at Science-Based Medicine is covering this story is quite nicely, and over at Pharyngula, PZ Myers mirrors my sentiment from my first post on the issue:

Will this revelation matter? Not one bit. The anti-vaxers have ignored all the evidence that they are wrong so far, so one more demonstration that one of the primary promulgators of this nonsense was an outright fraud won’t change a thing, I’m afraid. This is still a clear-cut case where delusions can kill.

Of course Age of Autism hasn’t said anything about this yet. It doesn’t matter, because they have new explanations now. But I would like to comment on a comment made in an AoA article about Paul Offit:

These “ad hominem” tactics finally failed this election. Perhaps they will start to fail in this realm as well as people wake up to this essential fact:

–People like Offit have an obvious and huge profit motive
–People like JB and other autism parents have nothing to gain other than making their child’s suffering not be for nothing

If that isn’t enough to wake others up, they might as well stay asleep until they develop Alzheimers from all the Flu vaccines they will take unquestioningly.

First off, my grandmother died from Alzheimers, so fuck you. If you want to make shit up to prove your point, become a priest. Second, and I’ve said this before, I’ll bet J.B. Handley and David Kirby make more money off of selling “cures” for autism than most of the skeptics who point out that vaccines don’t cause autism will make off of their vaccine-specific persuits. How much would Handley and Kirby stand to loose if they admitted that autism is not caused by vaccinations?

New study on recovered memories

I tried to read this study, but my access to Psychological Science has a 1-year delay. ScienceDaily has a report on a study which, without going into too much detail, finds that there are two types of women who recover memories of past sexual abuse. The first group recovers memories slowly through suggestive therapy, and the second group recovers memories all at once. The research finds that women who spontaneously recover memories can forget items in memory tests wuite easily, while women who slowly recover memories who were asked to remember a list of words will add related but previously unincluded words. (For instance, if “night” and “bed” were on the original list, they may add “sleep.”)

The researchers stated that the group slowly regained knowledge of childhood abuse are more likely to be creating the story. But I think this study is a little too rigid.

The article presumes that all people who spontaneously forget remember things accurately. It also presumes that memories can be repressed. I’m not sure that either of these things are farfetched, but it’s hard to tell from the press release.

But, just to exhibit the anti-repression side, Here’s Elizabeth Loftus:

Learning Through Litigation

According to Mindhacks, professor of phonetics Francisco Lacerda and the Journal of Speech Language and the Law have been threatened with lawsuits by Nemesysco, a company who is manufacturing machines that they claim can detect lies by analyzing speech patterns. Lacerda wrote an article for the journal highlighting discrepancies between the company’s claims and and what the products are capable of delivering.

 

Vaughn at Mindhacks found a link to the article after it had been taken down from the journal’s website, and you can read it here.

Exploring Placebo

The newest issue of Scientific American Mind has a pretty interesting article on placebos. Although CAM isn’t mentioned specifically, what the highlighted studies suggest has a lot to say about the power of alternative medicine and the overall abilities of the human mind.

The article looks at two different types of placebo; Conditioning placebos, in which real medicine is paired with a second stimulus and the medicine is removed, leaving a second stimulus that provides relief, and Expectation placebos, in which a sham stimulus works because it is similar to a previous effective medications (such as an injection followed by a similar saline injection) or because the patient believes that the sham treatment will work.

The gist of the article is that expectation placebos only seem to work on subjective symptoms, like pain. Conditioning placebos can actually have physiological effects, everything from immunosupression to, in one case, shrinking tumors.

Of course, none of this answers the question of whether placebo treatment is ethical. Consider alternative medicine, for example. Or alternative therapy. One alternative psychotherapy, the emotional freedom technique (EFT), involves tapping on acupressure points on the body while repeating statements that remind one of their problem. Proponents point to horribly-designed studies and argue efficacy. Most likely, the effects are the result of placebo, distraction, and cognitive reprogramming.

So if we can say that placebo is effective, is it ethical to use placebo to treat mental or physical disorders? I say no. First, because the placebo effect is not as reliable as standard treatment. If I were a therapist, I wouldn’t want to hang my success rate on whether someone believes that tapping can solve all of your problems. Second, placebo is unpredictable. If someone believes in the efficacy of a treatment, then becomes unconvinced, it could cause serious problems.

Of course, psychotherapy has its own issues with placebo. With research showing that the therapeutic alliance is more important than any particular therapeutic school of thought, belief plays as much of a role as anything else.

Down but not quite out

I’m trying to quit smoking. I’ve held out okay, but I’ve been coughing like crazy for two days. I thought my lungs were trying to clear themselves, but today it got worse, and my daughter sounds hoarse, so I think I’m actually sick. On top of all of this, I’m craving a smoke like crazy and the only substitute I have is cough drops. Lovely.

If I want to really quit, I should fly out to San Francisco and get acupuncture. Of course, I could also shove needles in my eyes for the same effect.

Stay well, everyone.