A discussion interruptus.

So… what is True?

One of the advantages of having a blog is that I don’t have to submit to a debate.  There might be one in the comments when I’m done, but the post is mine and mine alone, so I can just tell it like I see it.

So, what is true? The person who made the comment states that for her Acupuncture and Bowen therapy are true.  What I assume she means is that she’s had positive experiences with both, they both appeared to help with the problems she took to them and as a result she believes them to work. And if they worked for her she considers them to be true, at least for her.

The dictionary definition of true is: 1) in accordance with fact or reality  2) accurate or exact and a couple of others that don’t relate to this discussion. (This is the dictionary that comes on the Macintosh, but I suspect other dictionaries will fundamentally agree.)

So if acupuncture is true I take that to mean that it does what it claims to do, i.e. treats a large range of conditions based on the use of needles placed at specified acupuncture points on various meridians of the body.  The first thing I notice is that acupuncture being “true” is very different than one person having a good experience with it.  The second thing I notice is that she is only claiming it’s true for her.  (I’ll leave Bowen therapy out of it for a moment for simplicity’s sake).

The idea that acupuncture is true for her suggests that it’s not true for someone else.  It suggests a kind of personal reality where truth depends entirely on the viewer.  If you get an acupuncture treatment and feel better, acupuncture is true for you.  If I get an acupuncture treatment and don’t feel better, acupuncture is false for me.  It truth is completely relative it has no meaning except in the personal sense.  If it is not something we can study, test and agree on, it doesn’t really exist except as a subjective experience.

If I’m told that ice will melt if heated sufficiently, it is a true statement. It can be tested.  Reasons and explanation can be provided.  It can be measured.  It’s not a personal subjective judgement. And most people will agree with that.

So why is acupuncture something that can have multiple states of true depending on the observer?  (I know that Deepak Chopra could come up with a quantum explanation, but let’s not go there.)  I don’t think it can.  But here’s where any debate will break down.  If you think that truth is a subjective matter, we can never discuss these issues.  Because these issues are about working out what is so, what reality tells us.  If you are the creator of your own reality, and you can have reality look like anything you want, you are not really available for a discussion about what is true.  True is whatever you say it is.

For me there is more to truth than personal opinion.  So I’m going to continue on the basis that there is actually something to talk about here.

Finding out if something is true is not always easy. It’s not an intuitive thing.  For almost two thousand years one of the most trusted and widely used medicinal treatments in the west was blood letting.  The truth of it was not doubted.  It lived on and on, and many, if not most, people believed it to be true. It was almost always detrimental to the patient’s health but it wasn’t until 1624 that it was prove to not work and it didn’t fall out of common usage until the mid 1800’s. The personal belief that many had that it was true did not make it safe or efficacious.

If you don’t accept the supremacy of subjective reality you might want to know if acupuncture really does what it claims.

Anecdotal evidence for blood letting was overwhelmingly positive for nearly 2000 years and yet blood letting was false.  Your own or my own personal experience of acupuncture are anecdotes. Because they are personal they can be quite compelling, but they are anecdotes.  I got no results, but since the result I was looking for was pain relief, and pain relief is very subjective, I could have been in denial about the benefit I actually got.  And you could have had a placebo response, a willingness to find the improvement you expected and you may have had improvement for reasons utterly unrelated to the acupuncture.  In any case, all we have is anecdotes.

In order to find out what it true it’s important to test the treatment.  And acupuncture has been tested. The most telling results have been those that show that the results obtained when a train acupuncturist places needles in the specified points are exactly equal to someone else putting them in random points and that using toothpicks instead of needles without puncturing the skin works just as well as “proper” acupuncture.  There is still some debate about whether there may be some benefit to acupuncture or not, but the best that can be said is that it isn’t very true.

The commenter may very much like acupuncture and may be offended when it is criticised, but that doesn’t make it true.  It makes it something she likes which is something very different.

And, for the record, criticising Acupuncture or any alt-med is not putting down others.  It is questioning questionable claim.  It is saying that science and evidence matter, that there are some treatments than are better than other treatments and it’s worth finding out what they are.

[Sorry that this is so long.]

 

 

6 Responses to “Alt-med and the meaning of true.”

  1. Hmmm….I didn’t say acupuncture is true. I said I have claims that are true for me. Most of the the treatments I had over the years were effective in reducing pain and restoring mobility.
    You can debunk acupuncture, if you feel a need to, but that doesn’t take away from its efficacy for me.

  2. Robyn Daly says:

    I have found personally that acupuncture can work for back pain, but it has never worked for anything else it was recommended for. In fact, after some acupuncture treatments for back pain I got off the table quite “high” and had to walk around the block for a while until I felt safe to drive. 🙂 I score very low on suggestibility indices so I don’t think it was placebo effect, especially since the treatments I’ve tried have only worked for pain and nothing else.

    However, “sham” treatments seem to work as well as traditional, so it’s probably the stimulation of nerve endings rather than “chi” which produces the effect.

    http://www.webmd.com/rheumatoid-arthritis/guide/arthritis-acupuncture
    http://www.spine-health.com/news/20100519/acupuncture-pain-treatment
    http://www.ncbi.nlm.nih.gov/pubmed/19278378
    http://www.medicalnewstoday.com/articles/187292.php
    http://www.mayoclinic.com/health/acupuncture-for-back-pain/an02055

    Interestingly, it’s been of no use to me for the neuropathic pain that I am left with as a result of chemotherapy, but which can be somewhat controlled by a low daily dose of venlafaxine. I imagine that this is probably because neuropathy is not the same as pain from actual tissue damage.

  3. Daniel says:

    My intention in this post was to discuss the fact that there is a big difference between a treatment working for me and a treatment that actually works. They are not incompatible, but the fact that I’m convinced that the treatment works does not mean it works – it only means that I got what seemed to be a good result. I wouldn’t discourage anyone from getting a treatment that seems to help. However, there are many treatments available for any one problem. I turn to science to give me the low down on which is most likely to really help.

    • I think that part of the difficulty in talking about “true” on a subject such as acupuncture is to insure that the parties involved in the discussion are talking about the same thing. Pain relief is very subjective and thus it pretty much has to be taken as “true” that someone has experienced pain relief if they say that they have. The alternative is to call them a liar which seldom comes out well. Wouldn’t it be wise though to find out what caused the pain? Acupuncture might make the pain in my ankle go away, but if the pain was caused by a hairline fracture, then walking on the ankle is not a good idea, pain or no pain.

      • That goes to the question of diagnosis, which is valid but is another question. What I was wondering about is what does ‘true’ or ‘it works’ or ‘it’s effective’ actually mean? Many people have the experience of, say, acupuncture working for them, and hearing from people they trust that it works for them too. It isn’t a matter of lying at all, but could it be that we as a species vastly underestimate our ability to self deceive? If we believe we are better we feel better. But are we really better. There have been good studies done with Saw Palmetto where the participants who took the herb reported clear improvements. However, there are objective measurements for prostate problems and those same participants showed no improvement in objective measures. So were they better? Did Saw Palmetto work? If a tree falls in the forest?

        I think that randomised double blind trials are the best way to sort this out – is a treatment actually better than a placebo. Others feel that their own subjective experience and that of their friends trumps the science. That’s a pretty big chasm. On one side of that chasm sits alt-med (for the most part).

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