The show, which airs Saturday nights, recasts major historical events, beginning with the Kennedy assassination, as part of a UFO invasion and coverup, asserting in the opening credits that “History as we know it is a lie.”

The May 24 episode, set during the Vietnam War era, suggested that Sagan’s lifelong quest to find evidence for extraterrestrial intelligence was fueled, in part, by a secret meeting with the director of the top-secret Majestic-12 project. In the Dark Skies version of history, a young Sagan comes face to face with a living space alien, learns that extraterrestrial parasites have been seizing control of humans, and develops a way to identify people who have been infected with one of the parasites.

“How many planets are out there, doctor? How many galaxies, how many worlds?” the Majestic chief asks Sagan as he stares at the alien.

It’s an excuse to get the Sagan impersonator to say “billions and billions.”

“Well, somewhere out there is the planet that thing came from,” the director says. “I need you to search the stars, doctor, to find that planet.”

The encounter is supposed to explain why Sagan became such a proponent for the Search for Extraterrestrial Intelligence (SETI) program.

The show was riddled with errors. It made a reference to the Planetary Society (which wasn't founded until 1981), cited Sagan’s doctoral dissertation at Cornell University (he got his doctorate at the University of Chicago), and credited him with the idea that our radio and television transmitters are sending signals into space (a theory Sagan embraced but did not originate).

But those are minor compared to the way the show’s executive producers, Bryce Zabel and James D. Parriott, shamelessly chose to turn Sagan, who passionately argued that there was no convincing evidence that UFOs were extraterrestrial spacecraft, into a hypocrite and government conspirator.

Even if the show had aired before his death, it is not clear that Sagan, a public figure, could have done anything about the Dark Skies portrayal. To successfully sue, public figures must prove malice, which is extremely difficult. Dead people cannot be libeled.

Sagan’s widow, Ann Druyan, said before the program aired that she was unaware that Sagan was going to be portrayed on the show. She later called the episode “terribly silly,” in part because of the errors.

“When you think of what’s possible with the media, and then see what impoverished and pathetic programs we actually get,” she said, “it’s really dismal.”

Dark Skies was not renewed for NBC’s fall schedule.

Carol Araujo must have been one of the proudest women in Rhode Island last Mother’s Day. She had been named “Mother of the Year” after her thirty-three-year-old autistic daughter, Tammy Galuska, submitted an essay explaining how Mrs. Araujo “sacrificed a year of her life to teach me how to communicate.”

“She has given me a new life. I reached a time in my life where she was the only one who believed that I could learn to communicate. Mere understanding is death to a non-verbal person.” These were the winning words Tammy wrote.

Or did she?

At the age of two, Tammy showed signs of retardation and was eventually diagnosed with Retts Syndrome, a severe brain disorder that only affects girls.

The 154-word essay was created using facilitated communication (FC), a questionable technique in which a helper (or “facilitator”) holds the hand, wrist, or finger of the person and “helps” them point to letters on a board or keys on a computer. Test after test has shown that it is the facilitator, not the handicapped person, who subconsciously determines what letters will be touched.

When WPRI-TV in Providence did a Mother’s Day feature on Mrs. Araujo and Tammy, the reporter showed Mrs. Araujo grasping three of Tammy’s fingers and bringing the young woman’s index finger to a specially designed computer so a key could be pushed. Tammy’s job coach, Andrea Healey, a caseworker with RI ARC, a Pawtucket, Rhode Island, association that helps the handicapped, was the one who held Tammy’s hand when the essay was written.

Testing a person who claims to be communicating through FC is easy: See if the person can identify a simple picture when nobody else in the room (especially the facilitator) knows what it is. In 1994, when I tested four Rhode Island people who supposedly were spelling out messages through FC, all four lost their ability when the facilitator didn't know the correct answer. One of them was Tammy.

Unfortunately, too many people — including reporters, contest judges, and folks who work with the handicapped — aren't even aware of the controversy surrounding FC and wouldn't know how to conduct a proper test.

“Tammy’s touching story moved the hearts of the judges to choose Carol Araujo,” according to a news release from radio station WARV, the chief sponsor of the contest. Station spokesman Emanuel DaCunha later reported that neither the station nor the judges were aware that there was controversy surrounding the technique used to created the essay. The station learned the circumstances of Tammy’s life by talking to Healey, an avid believer in FC.

In an interview, Healey said she is aware of the controversy but believes Tammy is truly communicating even though Tammy has never passed a simple double-blind test.

“Tammy doesn't want to hear a word about validation or anything else like that,” said Healey. “Tammy gets highly insulted when she is put in a position of having to prove anything to people who are skeptical.” Healey’s information about what Tammy is thinking, of course, comes from the FC messages.

Carol Araujo’s unshakable conviction that she has helped her daughter reestablish communication with the world may make her worthy of a Mother of the Year award. But there was a second-place finisher in the contest who lost a richly deserved honor because people don't know a bogus technique when they see it.

Finally, let’s have a moment of silence for the media professionals of the Denver Press Club. Never has a group of journalists worked so hard to lose a Pulitzer Prize.

It seems the press club building has been haunted for at least eighty years by four now-deceased reporters whose interest in poker has persisted long after they officially cashed in their chips.

After putting up with a toilet that seemed to flush by itself and miscellaneous knocking sounds, club officials brought in “psychic Cleo of Spirit Clearings” and her sidekick, Eshaya, on September 23, 1996.

Cleo sensed the presence of the poker players and also claimed to get vibes from (a) the ghost of a woman murdered twenty-five years earlier, (b) a hanged body (one too many changes by copy editors, perhaps), and (c) a reporter standing lookout at the club.

Now, in anybody’s book, being able to produce long-sought proof that an afterlife exists would be the scoop of the century — if not the millennium.

But how did the reporters of the Denver Press Club react?

According to the January 18 Editor & Publisher (pp. 8-9), they asked Cleo and Eshaya to get rid of the ghosts! (Colorado’s crooked politicians must love being covered by a press corps that destroys the evidence.)

Fortunately, although the spirit of the murdered woman was sent “home” to her final rest, the poker players and their lookout refused to shuffle off, according to the E&P article.

Thus, the journalists in Denver still have a chance to redeem themselves.

With the spirits still floating around, and with the press club “documenting” the ghosts with fuzzy infrared photographs (available on the Internet at http://www.pressclub.org/ghosts/pictures.htm), perhaps one of the club’s members will recognize the importance of this discovery, call in a team of real scientists with infrared detectors, find proof of the hereafter, and get that Pulitzer for investigative reporting after all.

The Simpsons, Fox’s long-time animated hit series, has a reputation for being smart, innovative, well-written, and very funny. After the final new episode of the season aired Sunday, May 18, the network re-ran The Simpsons’ “alien encounter” show, first broadcast earlier in the year.

Rarely has any half-hour of television been so thoroughly enjoyable for skeptical viewers. Granted, it’s only a half-hour, but The Simpsons is re-run continuously on Fox outlets nationwide, so viewers haven't seen the last of this outstanding episode.

Right from the beginning, it’s obvious this isn't going to be the typical television fare.

An animated Leonard Nimoy sits at a table that sports a skull and flickering candles. Books line shelves behind him as he introduces the “documentary” we are about to view.

It really is Nimoy’s voice. As host of the notorious, syndicated In Search Of series, Nimoy is considerably more familiar to most viewers than is Occam’s Razor.

Not tonight, Spock. “The following story of an alien encounter is true,” he says. “And by ‘true' I mean it’s false. It’s all a bunch of lies. (Pause) But they're such entertaining lies.”

Cut to Homer Simpson, hapless and corpulent employee of the Springfield Nuclear Power Plant, slamming down Duff beers on Friday night at Moe’s, his favorite tavern.

Being a responsible bartender, Moe makes Homer take a Breathalyzer test before allowing him to leave at 1 a.m. Homer’s breath sends the machine to its highest level (“Boris Yeltsin”) and Moe makes his patron walk home.

As Homer cuts through some eerie woods, the mood is heightened by the piercing strings of the Psycho movie theme. Turns out only to be the Springfield Philharmonic Orchestra tuning up as its members return home via a city bus.

But, sure enough, soon a green, glowing, classic “alien” — small, hairless, big head, big eyes — sweeps toward Homer through the trees. Homer flees in terror, tracing what looks to be a crop-circle “Yaaaah” in his wake.

Back home, he awakens his wife, Marge, who asks if Homer had been drinking. “No! Well, ten beers,” he replies.

At breakfast the next morning, Homer is confronted by his brainy daughter, Lisa, who is reading Junior Skeptic magazine, surely a television first.

Lisa informs Homer the odds against actually contacting an extraterrestrial life form are 175 million to one. “The people who claim they see aliens are always pathetic low-lifes with boring jobs,” she says. “Oh, and you, Dad.”

At work, Homer relates his experience to fellow employees. “Then they put me on a cold, metal table and prodded me with humiliating probes. No, wait, that was my physical.”

The scene shifts, and suddenly The Simpsons has turned into The X-Files, complete with theme and an animated Scully and Mulder, with the actual voices of X-Files leads Gillian Anderson and David Duchovny.

We're at FBI headquarters, and the pair has heard about Homer. “Another unsubstantiated UFO sighting in the heartland of America,” Mulder says. “We've got to get there right away.”

Scully says she has information that a shipment of drugs and illegal weapons is coming into New Jersey that night. “I hardly think the FBI is concerned with a matter like that,” Mulder scoffs.

Their interview with Homer is less than successful. His first stupid answer blows up their lie detector. When they return to Moe’s to re-create the night, Homer gets drunk, says he was discussing philosophy before the alien encounter, makes a pass at Scully, and falls off his barstool.

They return to the woods at dark. No alien, so Mulder takes advantage of the situation to make a pompous speech asking if we are alone in the universe and wondering about “the unsolved mysteries of Unsolved Mysteries.”

The effect is dramatic with the darkening sky and a flashing meteor behind Mulder. Unfortunately for the effect, also behind Mulder are bartender Moe and two coworkers carrying Shamu, the killer whale.

Moe thinks the FBI is after him for kidnapping the mighty mammal from Sea World to use for some unspecified purpose in his tavern. “Who would have thought a whale would be so heavy?” he asks, rhetorically.

Ridiculed by his neighbors, Homer retreats to his own kitchen where he has a touching encounter with his ne'er-do-well son Bart. The Simpson “men” decide they'll camp out in the woods and look for the alien the following night, which happens to be the next Friday.

And the alien appears again, just as before, saying, “I bring you peace.” Homer tries to approach the ET but sets his foot ablaze in the campfire.

No problem. Bart has the alien’s appearance on videotape. It’s shown the next day on television news, so of course it is accepted as real and most of Springfield shows up at Homer’s house to voice support and ask penetrating questions like, “Is the alien Santa Claus?”

Back to Nimoy, who ends the documentary. “From this simple man came proof that we are not alone in the universe,” is his benediction.

Unfortunately for Nimoy, and the “proof,” only twenty minutes have elapsed in the thirty-minute show, a fact he is made aware of by a stagehand. “I've, uh, got to get something out of my car,” Nimoy says. The next sound we hear is him driving away.

The “real” ending is yet to come. The next Friday there is a carnival atmosphere in the Springfield woods, complete with T-shirt vendors, food booths, and a band playing the five-note Close Encounters of the Third Kind anthem. Even Nimoy shows up.

The alien appears, bestowing love upon the crowd. “It’s bringing love. . . . Break its legs,” is the mob’s reaction.

But Lisa Simpson spoils all the fun. She steps in and shines her flashlight on the alien, which turns out to be just old Montgomery Burns, owner of the Springfield Nuclear Power Plant.

Burns’s toady assistant, Smithers, explains that every Friday night the wealthy megalomaniac undergoes a series of treatments “designed to cheat death for another week.”

After an assembly line of chiropractic work, pain-killing shots, and eyedrops, Burns, the opposite of his misanthropic self for a few hours, usually wanders off through the woods. “It leaves me twisted and disoriented,” Burns explains. “It also leaves me as impotent as a Nevada boxing commissioner.”

What about the glowing? “A lifetime of working at a nuclear power plant has left me with a healthy green glow,” he says.

But the shots are wearing off and Burns is returning to “normal,” vowing to make life miserable for Springfield until a physician jabs another needle into his arm, causing Burns to begin singing “Good Morning Starshine” from the musical Hair.

Nimoy steps up, puts his arm around Burns, joins in, and the show closes with the crowd, now including Scully and Mulder, finishing the song. There’s a brief cut back to the absent Nimoy’s set where the stagehand wraps up the “documentary.”

It would be difficult to find another half-hour on network television in the past decade where any branch of pseudoscience was so thoroughly, and effectively, trashed.

Series creator Matt Groening and his staff of animators deserve some real appreciation from skeptics for this one. Next time some alien encounter is presented as fact I'd imagine at least a few viewers are going to remember old Monty Burns and start laughing.

But were The Simpsons’ creators just being funny? I suspect the late-night kitchen encounter between Homer and Bart provides a clue.

Homer is agonizing over whether he and Bart should return to the woods to try to film the alien. He wonders if it’s “the real thing.”

“If it isn't, we can fake it and sell it to the Fox network. They'll buy anything,” Bart replies.

“Now son,” Homer admonishes. “They do a lot of quality programming.”

Father and son look at each other and think about that one. Then both burst out laughing for a full five seconds.

The joke is, this time, Fox did exactly that.

By now, however, the Arnold sighting has been forgotten by all but the long-time saucer fans. Sightings alone fail to excite the masses, at least in North America: to be newsworthy these days, a saucer must either abduct and molest somebody, or better yet, crash. (In other countries, UFOs can still make big headlines by merely flying around.)

Today, the early days of the saucer era are primarily remembered not for Arnold’s sighting, but for Roswell, where a UFO is supposed to have crashed just eight days after Arnold discovered (or invented) them. As expected, UFO promoters held a big bash in early July to celebrate the happy occasion. Hotel rooms in Roswell and the vicinity were booked solid for the Roswell UFO Encounter 97 festival, which, for a modest fifty dollars per person, promised an all-night rock concert. There was an alien film festival, an extraterrestrial costume party, and tours of several of the sites claimed to be the “true crash site.” Television reports of alien events seemed nonstop, with coverage across the board from the trash-titillators to the “serious” news organizations.

According to the Albuquerque Journal (April 17), a number of prominent sponsors backed out of the festival after the mass suicide of the UFO cult Heaven’s Gate in March because they were reluctant to be identified in any way with something that reeks, however faintly, with the stench of death. Roswell promoters had to scramble to put on a scaled-down concert.

But even that proved elusive. One would-be promoter of the cosmic event before the major sponsors pulled out said his lawyer had informed him that he didn't need a permit to put on his ET entertainment extravaganza. The County Attorney, however, insisted that he did and threatened him with jail and fines. The Roswell promoters, tireless in getting to the bottom of unfathomable mysteries, were thwarted by their own failure to apply to the county for a permit. The few bands who came to Roswell ended up holding a Sunday afternoon jam session in the parking lot of the Roswell Inn Hotel, hoping to raise just enough money to get home. In January 1997, the attendance at the festival was projected to be 150,000. By March, that estimate had fallen to 60,000. The actual figure seems to have been closer to 30,000 (see the UFO Encounter 97 Web site at http://www.rt66.com/%7Eroswell/). (Webmaster’s note: this web site appears to be down for good)

Despite all the excitement over Roswell festivities and the financial returns therefrom, all does not sit well with the crash story today. Philip J. Klass reports in his Skeptics UFO Newsletter (May 1997) that Jim Ragsdale, one of the supposed “crash recovery” witnesses whose account is currently touted as among the most credible, has contradicted himself yet again by moving the crash site dozens of miles from where he first had it. Some charge that this was done to make it easier for Pilgrims wishing to visit the historic site. Stanton Friedman, the “flying saucer physicist,” says that he trusts Ragsdale’s account, but he did not specify which version of Ragsdale’s shifting story he believes. Presumably, he believes all of them simultaneously.

Meanwhile, the account of former mortician Glen Dennis, once touted by Friedman and others as among the “best evidence” for Roswell, is rapidly losing credibility among Roswell researchers who have been trying to substantiate it. Even arch-Roswell-promoter Kevin Randle is backing away from Dennis. Klass further reports that Kent Jeffrey, who only recently was organizing the International Roswell Initiative to uncover the supposed coverup, has publicly disavowed the whole crashed-saucer story (see the Roswell Initiative Web page at roswell.org for a full explanation of why Jeffrey changed his mind), as has onetime supporter Karl Pflock.

But if the truth isn't to be found at Roswell, it’s still “out there” somewhere, and the Center for the Study of Extraterrestrial Intelligence, CSETI (not to be confused with scientific SETI organizations), is determined to find it. Steven Greer, M.D., the head of that organization, was in Washington, D.C., in April to call for congressional hearings into the alleged government coverup. This is a group that claims on its Web page (cseti.com) to have “successfully established contact with extraterrestrial spacecraft in the United States, England, Mexico, and Belgium.” They shine a beacon or strobe at lights in the sky believed to be UFOs; if the object flashes or twinkles in apparent response, that’s “contact.” Sometimes, they report, UFOs that wish to hide zoom up high into the sky and blend in with the stars. Somehow, this technique has succeeded in fooling all of the world’s astronomers, who have not yet spotted the interlopers amid their charts. The CSETI Web page also plays weird sounds of unspecified origin suggestive of the giant insects of classic bad sci-fi films. I have been told that these are sounds purportedly recorded during UFO sightings, sometimes from inside crop circles.

While in Washington, CSETI held several briefings for the press and congressional aides, parading a group of witnesses who claimed to be able to offer dramatic testimony of UFO encounters — if the government would release them from supposed vows of silence. That prosecution of anyone on charges of “revealing UFO secrets” would be virtually impossible, since the very attempt to prosecute them would be the story of the millennium, seems not to have occurred to anyone. A Boston Globe story reported that “Greer, [former astronaut Edgar] Mitchell, and a panel of ‘witnesses’ asserted that several extraterrestrial civilizations — working together from bases within the solar system and possibly from temporary outposts under water on Earth — regularly visit the planet and are prepared for wide-scale contact with humans.”

After finishing up its business in Washington, CSETI announced that its next project was its June “Advanced Researchers’ Training and Retreat in Crestone, Colorado, where UFOs are regularly seen” (see News and Comment story, “San Luis Valley Crystal Skull,” this issue). But rather than coming to Washington to tell the press stories of past UFO encounters, why didn't they just invite them out to Crestone, to see for themselves? Unless, that is, what CSETI is calling “UFOs” others might call “satellites” and “airplanes.”

So-called “alternative” therapies, mostly derived from ancient healing traditions and superstitions, have a strong appeal for people who feel left behind by the explosive growth of scientific knowledge. Paradoxically, however, their nostalgia for a time when things seemed simpler and more natural is mixed with respect for the power of modern science (Toumey 1996). They want to believe that “natural” healing practices can be explained by science. Purveyors of alternative medicine have, therefore, been quick to invoke the language and symbols of science. Not surprisingly, the mechanisms proposed to account for the alleged efficacy of such methods as touch therapy, psychic healing, and homeopathy involve serious misrepresentations of modern physics.

The No-Medicine Medicine

Homeopathy, founded by a German physician, Samuel Hahnemann (1755-1843), is a relative newcomer. Homeopathy is based on the so-called “law of similars” (similia similibus curantur), which asserts that substances that produce a certain set of symptoms in a healthy person can cure those same symptoms in someone who is sick. Although there are related notions in Chinese medicine, Hahnemann seems to have arrived at the idea independently. Hahnemann spent much of his life testing natural substances to find out what symptoms they produced and prescribing them for people who exhibited the same symptoms. Although the purely anecdotal evidence on which he based his conclusions would not be taken seriously today, homeopathy as currently practiced still relies almost entirely on Hahnemann’s listing of substances and their indications for use.

Natural substances, of course, are often acutely toxic. Troubled by the side effects that often accompanied his medications, Hahnemann experimented with diluting them. After each successive dilution, he subjected the solution to vigorous shaking, or “succussion.” He made the remarkable discovery that although dilution eliminated the side effects, it did not diminish the effectiveness of the medications. This is rather grandly known as “the law of infinitesimals.”

Hahnemann actually made a third “discovery,” which his followers no longer mention. “The sole true and fundamental cause that produces all the countless forms of disease,” he writes in his Organon, “is psora.” Psora is more commonly known as “itch.” This principle does not seem to involve any laws of physics and is in any case ignored by modern followers of Hahnemann.

By means of successive dilutions, extremely dilute solutions can be achieved rather easily. The dilution limit is reached when the volume of solvent is unlikely to contain a single molecule of the solute. Hahnemann could not have known that in his preparations he was, in fact, exceeding the dilution limit. Although he was contemporary with the physicist Amadeo Avogadro (1776-1856), Hahnemann’s Organon der Rationellen Heilkunde was published in 1810, one year before Avogadro advanced his famous hypothesis, and many years before other physicists actually determined Avogadro’s number. (Avogadro showed that there is a large but finite and specific number of atoms or molecules in a mole of substance, specifically 6.022 x 10²³. A mole is the molecular weight of a substance expressed in grams. Thus, a mole of water, H2O, molecular weight 2 + 16 = 18, is 18 grams. So there are 6.022 x 10²³ water molecules in 18 grams of water.)

Modern day followers of Hahnemann, however, are perfectly aware of Avogadro’s number. Nevertheless, they regularly exceed the dilution limit — often to an astonishing extent. I recently examined the dilutions listed on the labels of dozens of standard homeopathic remedies sold over the counter in health stores, and increasingly in drug stores, as remedies for everything from nervousness to flu. These remedies are normally in the form of lactose tablets on which a single drop of the “diluted” medication has been placed. The “solvent” is usually a water/alcohol mixture. The lowest dilution I found listed on any of these bottles was 6X, but most of the dilutions were 30X or even, in the case of oscillococcinum, an astounding 200C. (Oscillococcinum, which is derived from duck liver, is the standard homeopathic remedy for flu. As we will see, however, its widespread use poses little threat to the duck population.)

What do these notations mean? The notation 6X means that the active substance is diluted 1:10 in a water-alcohol mixture and succussed. This procedure (diluting and succussing) is repeated sequentially six times. The concentration of the active substance is then one part in ten raised to the sixth power (10⁶), or one part per million. An analysis of the pills would be expected to find numerous impurities at the parts-per-million level.

The notation 30X means the 1:10 dilution, followed by succussion, is repeated thirty times. That results in one part in 10³⁰, or 1 followed by thirty zeroes. I don't know what the name for that number is, but let me put it this way: you would need to take some two billion pills, a total of about a thousand tons of lactose, to expect to get even one molecule of the medication. In other words, the pills contain nothing but lactose and the inevitable impurities. This is literally no-medicine medicine.

And what of 200C? That means the active substance is sequentially diluted 1:100 and succussed two hundred times. That would leave you with only one molecule of the active substance to every one hundred to the two hundredth power molecules of solvent, or 1 followed by four hundred zeroes (10⁴⁰⁰). But the total number of atoms in the entire universe is estimated to be about one googol, which is 1 followed by a mere one hundred zeroes.

This is the point at which we are all supposed to realize how ridiculous this is and share a good laugh. But homeopaths don't laugh. They've done the same calculation. And while they agree that not a single molecule of the active substance could remain, they contend it doesn't matter, the water/alcohol mixture somehow remembers that the substance was once there. The process of succussion is presumed to charge the entire volume of the liquid with the same memory. Is there any evidence for such a memory?

Smart Water?

Homeopaths have been administering this sort of no-medicine medicine for two centuries. Most scientists, however, first became aware of their extraordinary claims when Nature published a paper by French epidemiologist/homeopathist Jacques Benveniste and several colleagues, in which he reported that an antibody solution continued to evoke a biological response even if it was diluted to 30X — far beyond the dilution limit (Davenas et al. 1988). Benveniste interpreted this as evidence that the water somehow “remembered” the antibody.

In reaching that conclusion, Benveniste turned conventional scientific logic on its head. A large part of experimental science consists of devising tests to insure that an experimental outcome is not the result of some subtle artifact of the conduct or design of the experiment. “Infinite dilution” is one such procedure used by chemists. The effect of some reagent, for example, is plotted as a function of concentration. If at low concentrations, the plot does not extrapolate through the origin, it is taken as proof that the observed effect is due to something other than the reagent. By Benveniste’s logic, it’s evidence that the reagent leaves some sort of imprint on the solution that continues to produce the effect.

Attention had been called to Benveniste’s article by the editor of Nature, John Maddox, who pointed out in an editorial that Benveniste had to be wrong (Maddox 1988). Because the reviewer could not point to any actual mistake, Nature had agreed to publish the article in the spirit of open scientific exchange. Reviewers, of course, have no way of knowing if the author faithfully reports the results of the measurement, or whether the instruments employed are faulty. Nevertheless, the existence of this one paper published in a respected journal has been widely trumpeted by the homeopathic community as proof that homeopathy has a legitimate scientific basis.

The Maddox editorial encouraged other scientists to repeat the Benveniste experiments. An attempt to replicate the work as precisely as possible was reported by Foreman and colleagues in Nature in 1993 (Foreman et. al. 1993). The authors found that “no aspect of the data is consistent with [Benveniste’s] claim.” I am aware of no work that replicates Benveniste’s findings. Why was Foreman’s water dumber than Benveniste’s? We will return to that question.

Quite apart from the matter of how the water/alcohol mixture remembers, there are obvious questions that cry out to be asked: 1) Why does the water/alcohol mixture remember the healing powers of an active substance, but forget the side effects? 2) What happens when the drop of solution evaporates, as it must, from the lactose tablet? Is the memory transferred to the lactose? 3) Does the water remember other substances as well? Depending on its history, the water might have been in contact with a staggering number of different substances.

A number of mechanisms have been proposed to account for this miraculous memory. These mechanisms are discussed by Wayne Jonas in his recent book, Healing with Homeopathy, coauthored by Jennifer Jacobs (Jonas and Jacobs 1996). Jonas is the Director of the Office of Alternative Medicine of the National Institutes of Health and is identified on the book jacket as one of “America’s leading researchers of homeopathic medicine.” Jonas appears, at the very outset, to acknowledge the possibility that the effect of homeopathic medicine may “turn out to be only a placebo effect.” But as we will see, in alternative medicine circles the placebo effect can be the weirdest explanation of all.

If it is not a placebo effect, Jonas says, the “information” from the active substance must be stored in some way in the water/alcohol solution, perhaps in the structure of the liquid mixture. There has been an abundance of speculation about what sort of “structure” this might be: clusters of water molecules arranged in specific patterns (Anagnostatos 1994); arrangements of isotopes such as deuterium or oxygen-18 (Berezin 1990); or “coherent vibration” of the water molecules (Rubik 1990). I could not find a single piece of evidence supporting any of these speculations, and there are sound scientific reasons for rejecting each of them. Jonas refers to structural studies showing regions of local order in liquids. A “snapshot” of the structure of a water/alcohol mixture will of course show regions of local order, but these are transient; they cannot persist beyond the briefest of relaxation times depending on the temperature. That not even local order can persist is the definition of a liquid. The problem, of course, is entropy. The second law of thermodynamics is the most firmly established of all natural laws, but even if you could somehow repeal the second law, you would still confront the question of how this stored information can be communicated to the body.

The Illusive Biophoton

One possibility, according to Jonas, is that information is transferred by “bioelectromagnetic energy.” Here he cites, as “some of the most carefully executed work in this area,” studies of the effect of serially agitated dilutions of frog thyroxine on highland frogs that are in the climbing stage of metamorphosis (Endler et al. 1994). Thyroxine is reported to increase the climbing rate of the frogs — and the response continues even after the thyroxine dilutions are taken far beyond the dilution limit. In other words, when it is certain that there is no thyroxine.

That would appear to be clear evidence that something other than thyroxine is responsible for the stimulation of the frogs. In this case, for example, it might be the alcohol that is producing the climbing response, or some impurity, or the frogs might be stimulated by the act of administering the medication, or there might be subconscious bias on the part of the experimenter in deciding whether the frogs are stimulated. Once again, however, scientific logic is turned on its head; the results are interpreted as evidence that an imprint of thyroxine has somehow been left in the water.

But even if the water contains information about thyroxine, how is this information communicated to the frogs? Rather than administering the water/alcohol solution directly to the frog, the researchers tried putting the solution in a sealed glass test tube and placing it in the water with the frogs. The frogs still responded. Why am I not surprised?

What conclusion did the researchers come to? They concluded that information that once resided in the molecular structure of the active substance, and which was then somehow transferred to the succussed water, must have been transmitted to the frogs via a “radiant” effect, perhaps an illusive “biophoton.” No evidence of such radiation has been reported. Benveniste, however, now claims that a 50Hz magnetic field can erase the memory of his antibody solutions (Benveniste 1993), which might explain why other researchers do not find a memory. This electromagnetic link led Benveniste to the further discovery that he can “potentize” your water over a telephone line.

One possibility, according to Jonas, is that information does not pass from the solution to the frog — or from a medication to a human patient — but the other way. The unhealthy state of the patient might be “released through the remedy.” “Such speculative theories,” Jonas admits, “need further experimental work to confirm or disprove them.”

The Case Against Butterflies

Jonas also speculates that chaos theory might offer insight into the effect of homeopathic remedies on the body’s self-healing mechanisms: One concept in chaos theory is that very small changes in a variable may cause a system to jump to a very different pattern of activity, such as a small shift in wind direction drastically affecting climatic patterns of temperature and precipitation. Under this way of thinking, the homeopathic remedy can be seen as a small variable that alters the symptom pattern of an illness. (Jonas and Jacobs 1996, 89)

This dreadful shibboleth betrays a total misunderstanding of what chaos is about. “Chaos” refers to complex systems that are so sensitive to initial conditions that it is not possible to predict how they will behave. Thus, while the flapping of a butterfly’s wings might conceivably trigger a hurricane, killing butterflies is unlikely to reduce the incidence of hurricanes. As for homeopathic remedies that exceed the dilution limit, a better analogy might be to the flapping of a caterpillar’s wings.

Psychic Healing

But if none of these mechanisms work, Jonas says, “highly speculative and imaginary [sic] explanations may be necessary.” What he has in mind is the placebo effect. “Belief in a therapy,” Jonas explains, “may be an important factor in healing.” Who would disagree? If it is a placebo effect at work in homeopathy, all of the pseudoscientific trappings of similia similibus curantur and the law of infinitesimals merely serve as props to deceive people into believing that sugar pills are medicine. But “placebo effect,” as used by Jonas and other proponents of alternative medicine, turns out to be the strangest beast of all. It is suffused with the New Age notion of a universal consciousness. The placebo effect becomes psychic healing. Again from Jonas:

Some theorists suggest that intentionality and consciousness must be brought to any explanation of how nonlocal, and nonspecific quantum potentials might be “collapsed” into so-called informational coherence patterns (molecules), which then have specific effects. Once these previously unstable and nonlocalizable coherence patterns (such as thoughts and beliefs) nudge potential effects into existence (by an intention to heal in the person or practitioner), they are then seen by the body as locally acting, stable, “molecular” structures that produce specific biological signals and have predictable effects in the person. (Jonas and Jacobs 1996, 90)

This all sounds very much like Deepak Chopra (1989 and 1993), who asserts that: “Beliefs, thoughts, and emotions create the chemical reactions that uphold life in every cell.” The notion that by thought alone the medicines needed to cure illness can be created within the body comes from Ayurveda, the traditional religious medicine of India that dates back thousands of years. Chopra has, in any case, created vast personal wealth by simply invoking “quantum healing” in book after book. His books reveal no hint that he has any concept of quantum mechanics.

Nevertheless, there are quantum mystics, including a few physicists, who interpret the wave function as some kind of vibration of a holistic ether that pervades the universe. Wave function collapse, they believe, happens throughout the universe instantaneously as a result of some cosmic consciousness. That, of course, would violate causality in the relativistic sense, and it would also violate quantum field theory (Eberhard and Ross 1989).

Biofield Therapeutics (Touch Therapy)

Alternative medicine consists of a wide spectrum of unrelated treatments ranging from the barely plausible to the totally preposterous. At the preposterous end, I place those therapies that have no direct physical consequences of any sort, such as homeopathy and psychic healing. One must also include “biofield therapeutics” or “touch therapy,” though in fact it would be more accurate to call it “no-touch therapy,” since the practitioner’s hands do not actually make contact with the patient. Instead, it is claimed that the patient’s “energy field,” “qi,” or “aura,” is “smoothed” by the hands of the therapist or shifted from one place to another to achieve balance. The energy field is said to extend several inches outside the body, and the patient’s field interacts with the field of the practitioner.

The nature of this supposed energy field is obscure, but proponents often link it in some way with relativity and the equivalence of matter and energy. It has also been suggested that the body’s energy field is electromagnetic. Quantum mechanics, despite its popularity in many alternative medicine circles, rarely seems to be invoked in touch therapy. Indeed, B. Brennan, author of Hands of Light (1987), writes: “I am unable to explain these experiences without using the old classical physics framework.” I confess that classical physics does not make it any easier for me to explain. Practitioners claim to be able to “feel” the energy field and often employ hand-held pendulums to locate the “chakras,” or vortices, in the field that must be smoothed out to promote healing. It would seem to be a simple matter to examine a field that can be felt tactually, or that affects the motion of a pendulum, but so far no one has claimed to detect the energy field with any instrument that is not hand-held. This is quite remarkable since there are said to be tens of thousands in the United States who have been trained in some form of this therapy. In the United Kingdom there are 8,500 registered touch therapists (Benor 1993).

The public is spending billions of dollars annually on sugar pills to cure their sniffles, hand waving to speed recovery from operations, and good thoughts to ward off illness, all with assurances that it’s based on science. Society has been set up for this fleecing in part by the media’s sensationalized coverage of modern science. Popular discussions of relativity, quantum mechanics, and chaos often leave people with the impression that common sense cannot be relied on — anything is possible. Scientists themselves often feed the public’s appetite for the “weirdness” of modern science in an effort to stimulate interest — or simply because scientists, too, can be beguiled by the mysterious.

References

• Anagnostatos, G. S. 1994. In Ultra High Dilution: Physiology and Physics, edited by J. Schulte and P. C. Endler. Dordrecht: Kluwer.
• Benor, D. J. Frontier Perspectives 3: 33.
• Benveniste, J. 1993. Frontier Perspectives 3: 13.
• Berezin, A. A. 1990. Medical Hypothesis 31: 43.
• Brennan, B. 1987. Hands of Light. New York: Bantam.
• Chopra, D. 1989. Quantum Healing. New York: Bantam.
• —. 1993. Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old. New York: Random House.
• Davenas, E., et al. 1988. Nature 333: 816. The “Benveniste” paper.
• Eberhard, P. H., and R. R. Ross. 1989. Foundations of Physics Letters 2: 127.
• Endler, P. C., et al. 1994. FASEB Journal 8: 2313.
• Foreman, J. C., et al. 1993. Nature 336: 525.
• Jonas, W. B., and J. Jacobs. 1996. Healing with Homeopathy. Warner.
• Maddox J. 1988. Nature 333: 287.
• Rubik, B. 1990. Berlin Journal of Research in Homeopathy 1: 27.
• Toumey, C. P. 1996. Conjuring Science. New Brunswick, N.J.: Rutgers.

“Nothing is more dangerous than active ignorance.”

—Goethe

Those who sell therapies of any kind have an obligation to prove, first, that their treatments are safe and, second, that they are effective. The latter is often the more difficult task because there are many subtle ways that honest and intelligent people (both patients and therapists) can be led to think that a treatment has cured someone when it has not. This is true whether we are assessing new treatments in scientific medicine, old nostrums in folk medicine, fringe treatments in “alternative medicine,” or the frankly magical panaceas of faith healers.

To distinguish causal from fortuitous improvements that might follow any intervention, a set of objective procedures has evolved for testing putative remedies. Unless a technique, ritual, drug, or surgical procedure can meet these requirements, it is ethically questionable to offer it to the public, especially if money is to change hands. Since most “alternative” therapies (i.e., ones not accepted by scientific biomedicine) fall into this category, one must ask why so many customers who would not purchase a toaster without consulting Consumer Reports shell out, with trusting naivetë, large sums for unproven, possibly dangerous, health remedies.

For many years, critics have been raising telling doubts about fringe medical practices, but the popularity of such nostrums seems undiminished. We must wonder why entrepreneurs’ claims in this area should remain so refractory to contrary data. If an “alternative” or “complementary” therapy:

1. is implausible on a priori grounds (because its implied mechanisms or putative effects contradict well-established laws, principles, or empirical findings in physics, chemistry, or biology),
2. lacks a scientifically acceptable rationale of its own,
3. has insufficient supporting evidence derived from adequately controlled outcome research (i.e., double-blind, randomized, placebo-controlled clinical trials),
4. has failed in well-controlled clinical studies done by impartial evaluators and has been unable to rule out competing explanations for why it might seem to work in uncontrolled settings, and,
5. should seem improbable, even to the lay person, on “commonsense” grounds, why would so many well-educated people continue to sell and purchase such a treatment?

The answer, I believe, lies in a combination of vigorous marketing of unsubstantiated claims by “alternative” healers (Beyerstein and Sampson 1996), the poor level of scientific knowledge in the public at large (Kiernan 1995), and the “will to believe” so prevalent among seekers attracted to the New Age movement (Basil 1988; Gross and Levitt 1994).

The appeal of nonscientific medicine is largely a holdover from popular “counterculture” sentiments of the 1960s and 1970s. Remnants of the rebellious, “back-to-nature” leanings of that era survive as nostalgic yearnings for a return to nineteenth-century-style democratized health care (now wrapped in the banner of patients’ rights) and a dislike of bureaucratic, technologic, and specialized treatment of disease (Cassileth and Brown 1988). Likewise, the allure of the “holistic” dogmas of alternative medicine is a descendant of the fascination with Eastern mysticism that emerged in the sixties and seventies. Although the philosophy and the science that underlie these holistic teachings have been severely criticized (Brandon 1985), they retain a strong appeal for those committed to belief in “mind-over-matter” cures, a systemic rather than localized view of pathology, and the all-powerful ability of nutrition to restore health (conceived of as whole-body “balance”).

Many dubious health products remain on the market primarily because satisfied customers offer testimonials to their worth. Essentially, they are saying, “I tried it and I got better, so it must be effective.” But even when symptoms do improve following a treatment, this, by itself, cannot prove that the therapy was responsible.

The Illness-Disease Distinction

Although the terms disease and illness are often used interchangeably, for present purposes it is worth distinguishing between the two. I shall use disease to refer to a pathological state of the organism due to infection, tissue degeneration, trauma, toxic exposure, carcinogenesis, etc. By illness I mean the feelings of malaise, pain, disorientation, dysfunctionality, or other complaints that might accompany a disease. Our subjective reaction to the raw sensations we call symptoms is molded by cultural and psychological factors such as beliefs, suggestions, expectations, demand characteristics, self-serving biases, and self-deception. The experience of illness is also affected (often unconsciously) by a host of social and psychological payoffs that accrue to those admitted to the “sick role” by society’s gatekeepers (i.e., health professionals). For certain individuals, the privileged status and benefits of the sick role are sufficient to perpetuate the experience of illness after a disease has healed, or even to create feelings of illness in the absence of disease (Alcock 1986).

Unless we can tease apart the many factors that contribute to the perception of being ill, personal testimonials offer no basis on which to judge whether a putative therapy has, in fact, cured a disease. That is why controlled clinical trials with objective physical measures are essential in evaluating therapies of any kind.

Correlation Does Not Imply Causation

Mistaking correlation for causation is the basis of most superstitious beliefs, including many in the area of alternative medicine. We have a tendency to assume that when things occur together, they must be causally connected, although obviously they need not be. For example, there is a high correlation between the consumption of diet soft drinks and obesity. Does this mean that artificial sweeteners cause people to become overweight? When we count on personal experience to test the worth of medical treatments, many factors are varying simultaneously, making it extremely difficult to determine what is cause and effect. Personal endorsements supply the bulk of the support for unorthodox health products, but they are a weak currency because of what Gilovich (1997) has called the “compared to what?” problem. Without comparison to a similar group of sufferers, treated identically except that the allegedly curative element is withheld, individual recipients can never know whether they would have recovered just as well without it.

Ten Errors and Biases

The question is, then: Why might therapists and their clients who rely on anecdotal evidence and uncontrolled observations erroneously conclude that inert therapies work? There are at least ten good reasons.

The disease may have run its natural course.

Many diseases are self-limiting — providing the condition is not chronic or fatal, the body’s own recuperative processes usually restore the sufferer to health. Thus, before a therapy can be acknowledged as curative, its proponents must show that the number of patients listed as improved exceeds the proportion expected to recover without any treatment at all (or that they recover reliably faster than if left untreated). Unless an unconventional therapist releases detailed records of successes and failures over a sufficiently large number of patients with the same complaint, he or she cannot claim to have exceeded the published norms for unaided recovery.

Many diseases are cyclical.

Arthritis, multiple sclerosis, allergies, and gastrointestinal complaints are examples of diseases that normally “have their ups and downs.” Naturally, sufferers tend to seek therapy during the downturn of any given cycle. In this way, a bogus treatment will have repeated opportunities to coincide with upturns that would have happened anyway. Again, in the absence of appropriate control groups, consumers and vendors alike are prone to misinterpret improvement due to normal cyclical variation as a valid therapeutic effect.

Spontaneous remission.

Anecdotally reported cures can be due to rare but possible “spontaneous remissions.” Even with cancers that are nearly always lethal, tumors occasionally disappear without further treatment. One experienced oncologist reports that he has seen twelve such events in about six thousand cases he has treated (Silverman 1987). Alternative therapies can receive unearned acclaim for remissions of this sort because many desperate patients turn to them when they feel that they have nothing left to lose. When the “alternatives” assert that they have snatched many hopeless individuals from death’s door, they rarely reveal what percentage of their apparently terminal clientele such happy exceptions represent. What is needed is statistical evidence that their “cure rates” exceed the known spontaneous remission rate and the placebo response rate (see below) for the conditions they treat.

The exact mechanisms responsible for spontaneous remissions are not well understood, but much research is being devoted to revealing and possibly harnessing processes in the immune system or elsewhere that are responsible for these unexpected turnarounds. The relatively new field of psychoneuroimmunology studies how psychological variables affect the nervous, glandular, and immune systems in ways that might affect susceptibility to and recovery from disease (Ader and Cohen 1993; Mestel 1994). If thoughts, emotions, desires, beliefs, etc., are physical states of the brain, there is nothing inherently mystical in the notion that these neural processes could affect glandular, immune, and other cellular processes throughout the body. Via the limbic system of the brain, the hypothalamic pituitary axis, and the autonomic nervous system, psychological variables can have widespread physiological effects that can have positive or negative impacts upon health. While research has confirmed that such effects exist, it must be remembered that they are fairly small, accounting for perhaps a few percent of the variance in disease statistics.

The placebo effect.

A major reason why bogus remedies are credited with subjective, and occasionally objective, improvements is the ubiquitous placebo effect (Roberts, Kewman, and Hovell 1993; Ulett 1996). The history of medicine is strewn with examples of what, with hindsight, seem like crackpot procedures that were once enthusiastically endorsed by physicians and patients alike (Skrabanek and McCormick 1990; Barrett and Jarvis 1993). Misattributions of this sort arise from the false assumption that a change in symptoms following a treatment must have been a specific consequence of that procedure. Through a combination of suggestion, belief, expectancy, cognitive reinterpretation, and diversion of attention, patients given biologically useless treatments can often experience measurable relief. Some placebo responses produce actual changes in the physical condition; others are subjective changes that make patients feel better although there has been no objective change in the underlying pathology.

Through repeated contact with valid therapeutic procedures, we all develop, much like Pavlov’s dogs, conditioned responses in various physiological systems. Later, these responses can be triggered by the setting, rituals, paraphernalia, and verbal cues that signal the act of “being treated.” Among other things, placebos can cause release of the body’s own morphinelike pain killers, the endorphins (Ulett 1996, ch. 3). Because these learned responses can be palliative, even when a treatment itself is physiologically unrelated to the source of the complaint, putative therapies must be tested against a placebo control group — similar patients who receive a sham treatment that resembles the “real” one except that the suspected active ingredient is withheld.

It is essential that the patients in such tests be randomly assigned to their respective groups and that they be “blind” with respect to their active versus placebo status. Because the power of what psychologists call expectancy and compliance effects (see below) is so strong, the therapists must also be blind as to individual patients’ group membership. Hence the term double blind — the gold standard of outcome research. Such precautions are required because barely perceptible cues, unintentionally conveyed by treatment providers who are not blinded, can bias test results. Likewise, those who assess the treatment’s effects must also be blind, for there is a large literature on “experimenter bias” showing that honest and well-trained professionals can unconsciously “read in” the outcomes they expect when they attempt to assess complex phenomena (Rosenthal 1966; Chapman and Chapman 1967).

When the clinical trial is completed, the blinds can be broken to allow statistical comparison of active, placebo, and no-treatment groups. Only if the improvements observed in the active treatment group exceed those in the two control groups by a statistically significant amount can the therapy claim legitimacy.

Some allegedly cured symptoms are psychosomatic to begin with.

A constant difficulty in trying to measure therapeutic effectiveness is that many physical complaints can both arise from psychosocial distress and be alleviated by support and reassurance. At first glance, these symptoms (at various times called “psychosomatic,” “hysterical,” or “neurasthenic”) resemble those of recognized medical syndromes (Shorter 1992; Merskey 1995). Although there are many “secondary gains” (psychological, social, and economic) that accrue to those who slip into “the sick role” in this way, we need not accuse them of conscious malingering to point out that their symptoms are nonetheless maintained by subtle psychosocial processes.

“Alternative” healers cater to these members of the “worried well” who are mistakenly convinced that they are ill. Their complaints are instances of somatization, the tendency to express psychological concerns in a language of symptoms like those of organic diseases (Alcock 1986; Shorter 1992). The “alternatives” offer comfort to these individuals who for psychological reasons need others to believe there are organic etiologies for their symptoms. Often with the aid of pseudoscientific diagnostic devices, fringe practitioners reinforce the somatizer’s conviction that the cold-hearted, narrow-minded medical establishment, which can find nothing physically amiss, is both incompetent and unfair in refusing to acknowledge a very real organic condition. A large portion of those diagnosed with “chronic fatigue,” “environmental sensitivity syndrome,” and various stress disorders (not to mention many suing because of the allegedly harmful effects of silicone breast implants) look very much like classic somatizers (Stewart 1990; Huber 1991; Rosenbaum 1997). When, through the role-governed rituals of “delivering treatment,” fringe therapists supply the reassurance, sense of belonging, and existential support their clients seek, this is obviously worthwhile, but all this need not be foreign to scientific practitioners who have much more to offer besides. The downside is that catering to the desire for medical diagnoses for psychological complaints promotes pseudoscientific and magical thinking while unduly inflating the success rates of medical quacks. Saddest of all, it perpetuates the anachronistic feeling that there is something shameful or illegitimate about psychological problems.

Symptomatic relief versus cure.

Short of an outright cure, alleviating pain and discomfort is what sick people value most. Many allegedly curative treatments offered by alternative practitioners, while unable to affect the disease process itself, do make the illness more bearable, but for psychological reasons. Pain is one example. Much research shows that pain is partly a sensation like seeing or hearing and partly an emotion (Melzack 1973). It has been found repeatedly that successfully reducing the emotional component of pain leaves the sensory portion surprisingly tolerable. Thus, suffering can often be reduced by psychological means, even if the underlying pathology is untouched. Anything that can allay anxiety, redirect attention, reduce arousal, foster a sense of control, or lead to cognitive reinterpretation of symptoms can alleviate the agony component of pain. Modern pain clinics put these strategies to good use every day (Smith, Merskey, and Gross 1980). Whenever patients suffer less, this is all to the good, but we must be careful that purely symptomatic relief does not divert people from proven remedies until it is too late for them to be effective.

Many consumers of alternative therapies hedge their bets.

In an attempt to appeal to a wider clientele, many unorthodox healers have begun to refer to themselves as “complementary” rather than “alternative.” Instead of ministering primarily to the ideologically committed or those who have been told there is nothing more that conventional medicine can do for them, the “alternatives” have begun to advertise that they can enhance conventional biomedical treatments. They accept that orthodox practitioners can alleviate specific symptoms but contend that alternative medicine treats the real causes of disease — dubious dietary imbalances or environmental sensitivities, disrupted energy fields, or even unresolved conflicts from previous incarnations. If improvement follows the combined delivery of “complementary” and scientifically based treatments, the fringe practice often gets a disproportionate share of the credit.

Misdiagnosis (by self or by a physician).

In this era of media obsession with health, many people can be induced to think they have diseases they do not have. When these healthy folk receive the oddly unwelcome news from orthodox physicians that they have no organic signs of disease, they often gravitate to alternative practitioners who can almost always find some kind of “imbalance” to treat. If “recovery” follows, another convert is born.

Of course, scientifically trained physicians are not infallible, and a mistaken diagnosis, followed by a trip to a shrine or an alternative healer, can lead to a glowing testimonial for curing a grave condition that never existed. Other times, the diagnosis may be correct but the time course, which is inherently hard to predict, might prove inaccurate. If a patient with a terminal condition undergoes alternative treatments and succumbs later than the conventional doctor predicted, the alternative procedure may receive credit for prolonging life when, in fact, there was merely an unduly pessimistic prognosis — survival was longer than the expected norm, but within the range of normal statistical variation for the disease.

Derivative benefits.

Alternative healers often have forceful, charismatic personalities (O'Connor 1987). To the extent that patients are swept up by the messianic aspects of alternative medicine, psychological uplift may ensue. If an enthusiastic, upbeat healer manages to elevate the patient’s mood and expectations, this optimism can lead to greater compliance with, and hence effectiveness of, any orthodox treatments he or she may also be receiving. This expectant attitude can also motivate people to eat and sleep better and to exercise and socialize more. These, by themselves, could help speed natural recovery.

Psychological spinoffs of this sort can also reduce stress, which has been shown to have deleterious effects on the immune system (Mestel 1994). Removing this added burden may speed healing, even if it is not a specific effect of the therapy. As with purely symptomatic relief, this is far from a bad thing, unless it diverts the patient from more effective treatments, or the charges are exorbitant.

Psychological distortion of reality.

Distortion of reality in the service of strong belief is a common occurrence (Alcock 1995). Even when they derive no objective improvements, devotees who have a strong psychological investment in alternative medicine can convince themselves they have been helped. According to cognitive dissonance theory (Festinger 1957), when experiences contradict existing attitudes, feelings, or knowledge, mental distress is produced. We tend to alleviate this discord by reinterpreting (distorting) the offending information. To have received no relief after committing time, money, and “face” to an alternate course of treatment (and perhaps to the worldview of which it is a part) would create such a state of internal disharmony. Because it would be too psychologically disconcerting to admit to oneself or to others that it has all been a waste, there would be strong psychological pressure to find some redeeming value in the treatment.

Many other self-serving biases help maintain self-esteem and smooth social functioning (Beyerstein and Hadaway 1991). Because core beliefs tend to be vigorously defended by warping perception and memory, fringe practitioners and their clients are prone to misinterpret cues and remember things as they wish they had happened. Similarly, they may be selective in what they recall, overestimating their apparent successes while ignoring, downplaying, or explaining away their failures. The scientific method evolved in large part to reduce the impact of this human penchant for jumping to congenial conclusions.

An illusory feeling that one’s symptoms have improved could also be due to a number of so called demand characteristics found in any therapeutic setting. In all societies, there exists the “norm of reciprocity,” an implicit rule that obliges people to respond in kind when someone does them a good turn. Therapists, for the most part, sincerely believe they are helping their patients and it is only natural that patients would want to please them in return. Without patients necessarily realizing it, such obligations are sufficient to inflate their perception of how much benefit they have received. Thus, controls for compliance effects must also be built into proper clinical trials (Adair 1973).

Finally, the job of distinguishing real from spurious causal relationships requires not only controlled observations, but also systematized abstractions from large bodies of data. Psychologists interested in judgmental biases have identified many sources of error that plague people who rely on informal reasoning processes to analyze complex events (Gilovich 1991, 1997; Schick and Vaughn 1995). Dean and colleagues (1992) showed, using examples from another popular pseudoscience, handwriting analysis, that without sophisticated statistical aids, human cognitive abilities are simply not up to the task of sifting valid relationships out of masses of interacting data. Similar difficulties would have confronted the pioneers of pre-scientific medicine and their followers, and for that reason, we cannot accept their anecdotal reports as support for their assertions.

Summary

For the reasons I have presented, individual testimonials count for very little in evaluating therapies. Because so many false leads can convince intelligent, honest people that cures have been achieved when they have not, it is essential that any putative treatment be tested under conditions that control for placebo responses, compliance effects, and judgmental errors.

Before anyone agrees to undergo any kind of treatment, he or she should be confident that it has been validated in properly controlled clinical trials. To reduce the probability that supporting evidence has been contaminated by the foregoing biases and errors, consumers should insist that supporting evidence be published in peer-reviewed scientific journals. Any practitioner who cannot supply this kind of backing for his or her procedures is immediately suspect. Potential clients should be wary if, instead, the “evidence” consists merely of testimonials, self-published pamphlets or books, or items from the popular media. Even if supporting articles appear to have come from legitimate scientific periodicals, consumers should check to see that the journals in question are published by reputable scientific organizations. Papers extolling pseudoscience often appear in official-looking periodicals that turn out to be owned by groups with inadequate scientific credentials but with a financial stake in the questionable products. Similarly, one should discount articles from the “vanity press” — journals that accept virtually all submissions and charge the authors for publication. And finally, because any single positive outcome — even from a carefully done experiment published in a reputable journal — could always be a fluke, replication by independent research groups is the ultimate standard of proof.

If the practitioner claims persecution, is ignorant of or openly hostile to mainstream science, cannot supply a reasonable scientific rationale for his or her methods, and promises results that go well beyond those claimed by orthodox biomedicine, there is strong reason to suspect that one is dealing with a quack. Appeals to other ways of knowing or mysterious sounding “planes,” “energies,” “forces,” or “vibrations” are other telltale signs, as is any claim to treat the whole person rather than localized pathology.

To people who are unwell, any promise of a cure is especially beguiling. As a result, false hope easily supplants common sense. In this vulnerable state, the need for hard-nosed appraisal is all the more necessary, but so often we see instead an eagerness to abandon any remaining vestiges of skepticism. Erstwhile savvy consumers, felled by disease, often insist upon less evidence to support the claims of alternative healers than they would previously have demanded from someone hawking a used car. Caveat emptor!

References

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