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Strategy Ideas for Skeptics
By Bob Lloyd
Posted on: 12/5/2009
How do we get people to reject Woo? Bob Lloyd has some suggestions.
On this site, we’re probably all agreed that the irrationality in alternative medicine, in food, in religion and in paranormal claims needs to be countered. But the question is, what’s the most effective strategy?
In matters of faith, a direct challenge often produces a strong defensive reaction, a closing of the mind, a refusal to countenance anything critical of the articles of belief. Challenging someone to justify their belief in a god is often a quick way of ending the conversation. For a discussion, the conversation needs to continue.
Some forms of alternative medicine are also based on irrational belief. For example, Reiki postulates a healing energy and practitioners subscribe to the belief that it is real. They have no evidence or reasoned basis for believing that it is, yet their practice, often their livelihoods, depend on continuing to believe it.
And yet all of the people involved in any form of Woo also live and work in the real world. They can suspend their normal rationality to the extent required by their Woo beliefs only up to the point where the real physical world conflicts with it. For example, they can continue believing in a therapy until sufficient evidence accumulates that it is pointless. But while they experience the placebo effect, and don’t know what it is, they will not gather that negative evidence.
So amongst the people involved in Woo, there is a spectrum of belief. Some are total converts, believing in crystals, magnets, Reiki, homeopathy, healing touch and pretty much anything else that passes by. These are the ultimate consumers of Woo: gullible and credulous to a fault. At the other end are those who, because they are desperate for pain relief, or treatment for a chronic illness, are willing to suspend their normal rationality in the hope of coming across something that might help them. These are reluctant consumers of Woo, willing to try it because they see little or no alternative. In between, there is a full range of skepticism and belief.
So any strategy to increase skepticism, to reduce the influence of Woo, has to take these different groups and their interests into account. A bald statement of facts will affect only those that are already on the skeptical end of the spectrum but will leave the rest untouched.
Let’s consider the interests of each of these groups of people and the type of arguments that are most likely to be strategically effective in each of the major branches of Woo.
Complementary and Alternative Medicine
There are two groups here that have somewhat different motivations and interests: patients and practitioners, or more accurately buyers and sellers. Sometimes, those people who have consistently bought the products and believed what they were told will move over the counter, attend courses and buy certificates, and then set up businesses selling as well, so there is some overlap. But let’s consider the interests of each group separately.
The customer often comes to Woo from a position of frustration with the existing medical provision and will perhaps have experienced some form of chronic ailment for which conventional treatment was ineffective. It may be chronic back or muscle pain, skin complaints, perceived allergies or a general feeling of being unwell. GPs will have recommended various palliatives and medication which will have had minimal effect. They may have been given the impression that their complaint was trivial or hopeless.
In these circumstances, the natural placebo effect — which is based on conditioning and the expectation that the doctor will be able to cure them — will be ineffective. They no longer expect the doctor to be able to help and therefore will get no placebo effect from the consultation. That release of endorphins and other opioids which are released on the expectation of pain relief won’t happen and so the patient does not feel better. Their placebo effect which accompanies every consultation is broken.
A shift in the focus of the expectation, on the other hand, will be able to produce a new placebo effect, and a recommendation from another Woo consumer or advertisements promising quick improvements will readily convince them to give it a try. Their entry into Woo provides a quick placebo response which convinces them that it works.
Once they have made this initial step, the placebo effect can be reinforced by the addition of other alternative placebo providers. Their sense of well-being is accentuated by the continual reinforcement of belief in Woo products.
For these people, anyone undermining the belief in the efficacy of Woo products will seem to them to be denying that they feel better. Since they do not generally understand the placebo effect, they can see no basis for rejecting the fact that they feel better and therefore are better. Although they will readily acknowledge that some types of Woo don’t work (for example, crystals or magnets), they will defend the type on which their own placebo effect is based. They will reject homeopathy, but vigorously defend their chiropractor. Or they will reject healing touch, but insist on the efficacy of homeopathy. They have customised their own placebo provider.
Any strategy aimed at helping them get away from Woo will have to involve a recognition both that the Woo product is worthless, but also crucially that their ailment may not yet have an effective treatment. This is a negative message because if the customer experiences the placebo effect and that stops because of loss of expectation, the patient may initially feel worse off.
Reorientating that expectation back to conventional medicine based on the tested nature of scientific knowledge and its growth is an important part of the process of drawing them away from Woo. A little scientific knowledge goes a long way and also gives customers a better sense of involvement in their treatment. Medical treatments do get better over time based on accumulated knowledge. But it’s a tricky message to give because the pharmaceutical industry makes its big money from managing symptoms rather than effecting cures. In any case, no-one likes to be proved that they backed a non-runner like Woo alternatives.
For sellers of alternative medicine, the situation is more complex. Not only have they backed a placebo-based product, but often they are trying to earn a living selling them. They have financial interests in maintaining not just their customer base but also their continued commitment to the products. They will be much less able to sell products they don’t believe in. Their business motivation requires a continuous reinforcement of the belief in the product.
Partly, these sellers are convinced by the anecdotal accounts of their customers who insist they have spent their money well. This belief in the reports of their customers shores up their confidence that they are providing a valuable service. In addition, they will have paid for courses — perhaps some even from universities — which provide them with an official stamp of approval for the skills they claim to possess. Challenging these beliefs is therefore very much more difficult than in the case of customers.
However, because they are operating as businesses, they are aware of consumer protection legislation, professional standards, government regulation, health and safety, and they will be sensitive to the need to establish their official status. Their certificates will provide them with some personal confidence and status, but they will also draw strength in their Woo beliefs from the existence of an established market along with associations and institutions that promote the same message. Any strategy to counter Woo will have to address all the leading sources of their beliefs.
Because they are conducting businesses, they will have a heightened awareness of the issue of evidence, of which claims can be made legally and what restrictions there are on advertising and promotion. That means they will already be primed to consider skeptical messages phrased in an appropriate way. Some will simply come into conflict with legislation or regulatory controls, as in the case of chiropractors in the UK reported to their own associations for claiming to treat childhood colic, for example. These members now face investigation from the very body which they joined to defend their interests. The raising of doubts about efficacy therefore has an institutional aspect.
Often the response from skeptics has been to seek further regulation of alternative medicine but this paradoxically serves to provide an official stamp of approval — a regulated alt-med business seems as though it is factually supported when it isn’t. Regulators of Woo businesses rely on believers to assess evidence — foxes in charge of the chicken coop. Regulation should therefore only be available to those with a rigorous scientific basis. Alt-med doesn’t qualify for consideration as a regulated profession until it meets the evidence-based quality standards on which real regulation is based.
Similarly, where courses are promoted through universities, whether taught by them or simply validated by them, investigation of the content of the courses can expose the administrations to embarrassment. In the UK, the activities of Dr. David Colquhoun have led to the closure of homeopathy degree courses and the suspension of recruitment to a number of CAM courses.
But despite the existence of consumer legislation, the sellers of Woo can avoid any charge of fraud simply by maintaining a stated belief in the product. For the occurrence of fraud, there has to be an intention to deceive for gain. For that reason alone, there is a strong incentive for sellers of Woo to avoid any consideration of the facts. Ignorance of human biology both helps to maintain their own belief and provides a legal cover. They will therefore draw their source of information from people who share their belief, independent of any scientific scrutiny.
To justify this rejection of scientific evidence, they need a theory which undermines scientific credibility. This is the rationale for claiming that alternative medicine cannot be assessed by normal clinical evaluation: the controlled double-blind trial. Turning away from clinical medicine is an essential component of maintaining their own faith in their products.
The vast irrational literature on alternative medicine provides the reassurance that conventional medicine can be left on one side, and that consequently, medical science can be ignored.
Strategically, the difficulty for skeptics is the sheer size of the market, the flood of irrational material in the form of businesses, books, videos, websites and forums, all of which reinforce the message to Woo sellers to avoid the evidence. They are steered towards alternative sources where they are given a reinforcing message. Breaking into this milieu to provide a rational response is difficult as it is a defensive and closed community.
For those people running businesses based on Woo, they need to have viable alternatives before they will consider the importance of evidence. They will not consider any ideas that threaten their businesses. They will not acknowledge that their business is based on nonsense since they get regular feedback that their customers feel better. To them that is reliable evidence, even though we know they are placebo-based anecdotal accounts. They need to be informed about the placebo effect but crucially, need to be guided towards more evidence-based practice. In many cases, none of what they do will be evidence-based and they should be encouraged to retrain into one of the caring professions. In the meantime, they should be encouraged to moderate their claims pending a review of the available evidence.
Many Woo sellers entered the business with the best intent in the world, wanting to help people who were suffering. They were led into a field in which the irrationality was obscured by slick marketing, glib mystical phrases and an apparently welcoming market. They were offered good career prospects with the likelihood of running their own businesses. To reorient them towards evidence-based caring will involve a recognition that their previous qualifications were worthless, but that their intentions were honourable. They have been misled themselves and in most cases were not intentionally misleading others. Hopefully, eventually someone will sue the institutions awarding them.
Of crucial importance in the sales of food Woo is confusion about human biology. To sell anything to do with human nutrition, the customer needs to suspect that something is wrong, whether it is that they lack some important nutrients, are suffering from a build-up of toxins, that their diet is out of balance or that they need to change their physical appearance in some way. In every case, anxiety is a crucial component.
The second important component is customer ignorance. The claim that there is a build-up of toxins in the body is easily countered by the factual statement that there isn’t. The functions of the liver and kidneys, once understood, convince the potential customer that the seller’s claims are nonsense. But this requires the customer to know some basic information about human biology.
Swamping that factual information is a sea of misinformation, directed at the customer. The anxiety about appearance is exacerbated by claims that their nutrition is responsible and since we all buy the food we eat, we are all drawn to the market for food supplements, detox and diets.
One problem for skeptics countering the food Woo is that some of the medical claims made about diet are certainly true. People on western diets clearly are eating too much processed food of questionable nutritional value, they are becoming more obese, sometimes dangerously so, there is an increase in diabetes and so on. The food Woo marketers build on this information by combining good advice with poor advice. The good advice such as eating a balanced diet and exercising is combined with poor advice linked to their unnecessary products, whether supplements, diet plans or detox.
It is important to dissociate these messages again. Whereas the good advice follows from the evidence, the marketing add-on does not. Food Woo often grossly distorts the nature of risk, the level of contaminants and the ability of the human body to respond to a variety of chemicals in the environment. Reassurance based on scientific information is important to undermine the psychological attraction of food Woo.
For the sellers of food Woo, there is much less belief involved than is the case in alternative medicine. Most food Woo sellers are simply in business to exploit the market to make money. Scientific information is used, if at all, to create consumer uncertainty and anxiety. Papers are routinely quoted out of context to raise the spectre of poisoning and the fear of additives and preservatives. There is little, if any, commitment to a set of beliefs beyond the idea that detox and supplements are needed.
Both of these ideas are easily dismissed by scientific information but the truth of this is irrelevant to the marketers. The volume of the message is so loud that science isn’t heard. Because of the scale of the business, consumer and regulatory bodies cannot control the output. Many herbal medicines are sold as dietary products to avoid scrutiny.
Tell a religious believer that their god doesn’t exist and they will feel insulted. To a rational person, it’s hard to see the cause of the offence until we realise that they associate key parts of their personality to their belief in the factual existence of that god. Consequently, a simple rational attack on the nature of the belief is often ineffective in getting believers to question their faith. Whatever willingness they might have had to consider the question of evidence evaporated when they felt their ego threatened.
The sellers of religion, the religious institutions, are often protected by state legislation and financial power. They have secure ideological positions in many educational bodies, representation in the institutions of government, advisory positions and a network of believers in influential posts. For this reason, very many children are indoctrinated into the religious beliefs of their parents, pre-empting their opportunity to consider the issues rationally and to make their own choices.
So the question of skeptic strategy when confronting religious beliefs really falls to two areas: religion and the state, and religion and the individual.
The separation of church and state is a principle often quoted in democracies and many pay lip service to the idea. Protecting children in state schools from religious indoctrination means abolishing acts of worship in school assemblies, the removal of crucifixes from classrooms and stopping the practice of schools pushing religious belief as the basis of morality.
But it goes further. Whenever there are moral issues discussed in the media, inevitably a religious figure is invited to comment. They have no specific expertise in the subject simply because of their faith in a god, but they are given moral credibility because they claim it. By challenging the religious basis of morality, we simultaneously undermine the credentials of religious figures who pronounce on moral issues. Restoring moral responsibility to all people independent of religion is an important task for skeptics.
But the strategic area is broader still. Religions make factual claims about the world and these are subject to disproof. This provides a means of drawing the devout towards a reduction of their religious claims as they see the need to accommodate growing scientific evidence. Very many Christians accept evolution as a fact, and it is therefore possible to engage them in other questions such as how souls evolved and what the word might mean. The soul as nothing more than self-consciousness is a useful rational approach to the question.
Similarly in discussing moral values and ethical actions, we can show easily that morality does not depend on religious beliefs. People are moral without a belief in god. This weakening of the dependence on a god can help people adopt a more rational basis for their own actions, and opens up to argument notions of sin. By showing how the more socially acceptable religious values are really secular values, religion becomes less significant and this also reduces the hostility that many believers have towards atheism, but without weakening the stand of atheists. A stronger position can be taken which demonstrates the contradictions in dogmatic religious thought, for example in the catholic condemnation of the use of condoms in the fight against AIDS.
As a strategy this approach has the advantage of taking the conflict out of the move towards rationality. People can become more rational about morals and ethical issues and accept that atheists have a morality without they themselves giving up their faith. As rationality gets a stronger grip, the adherence to irrational beliefs becomes less important. The more personal the religious beliefs and less institutional, the easier it becomes for a rational approach to become the dominant one.
Where does that leave us?
We could usefully do the following:
A. Sellers of alt-med Woo
B. Consumers of alt-med Woo
- Make complaints to professional associations where unjustified claims are made by their members. At the very least, the members concerned will be notified.
- Publicise the nature of the credentials of Woo sellers, showing for example that they can be bought, that they are not based on evidenced material, that they are not examined.
- In the case of universities, name and shame those institutions awarding or validating degrees and other qualifications in branches of Woo, urging the administrations to uphold publicly their academic standards and enlisting the support of people working in those universities.
- Make use of the advertising standards authorities and consumer protection groups to question suspect claims. The more questions and complaints, the more focus is placed on those Woo sellers who are making those claims.
- Publicising the real facts associated with, for example, clinical trials and available evidence through links to PubMed, the Cochrane Collaboration, and others.
- Focus on specific branches of Woo such as Reiki at particular times (Woo of the month?) in order to leave critical views on forums, sending emails questioning claims and write articles and comments in the online press.
- Question the actions of regulators who have failed to regulate. For example, where official bodies such as chiropractor bodies fail to act against questionable claims by their members. The more traffic they have to respond to, the more likely they are to take the issue seriously.
C. Food Woo consumers
- Clear, accessible, available material explaining the placebo effect, the scientific method, the problem with anecdotal accounts, the nature of clinical trials and the lack of control over the Woo alternatives.
- Use every opportunity to stress the positive benefits of conventional medicine, the fact that it can correct itself and that it progresses. Stress that illnesses that don’t currently have treatment may well have effective treatments in the future. Alt-med can’t progress.
- Building on the skepticism which most Woo consumers display to certain branches, make the link between different branches of Woo by using the same basis for questioning them. Contrast the belief in Woo with the way consumers normally approach things they buy.
- Show the contradictions between what we know works, and what Woo sellers claim. Show how credibility is stretched but in a way that doesn’t belittle naïve belief.
- Make available information about human biology at appropriate points, for example in comments on forums. The better people understand human biology, the less of a hold Woo theory will have.
- Enter the fray on alt-med forums and websites. Post comments, questions, links. Be genuine and not snide, sarcastic or abusive. For example, ask how the therapy actually works or how it remains consistent with specific aspects of human biology.
- Post informative articles on other sites then post links to them on alt-med forums.
D. Food Woo sellers
- Make a clear distinction between the good advice (balanced diet, exercise) and the bad advice (detox and supplements), using the opportunity to question the biological understanding behind the claims.
- Demand to know the details about the specific toxins, the levels, the effects, the evidence, and the specific detoxifying agents and their mode of action. Contrast detox with treatment for poisoning and question why such detailed investigation is required in treating the latter.
- Look for and question any mention of risk, and ask how it is assessed. Expose how anxiety is a core component in selling food Woo.
E. Religious Woo
- Report detox merchants to advertising and consumer standards authorities saying that their claims are unjustified. The more complaints, the more likely they are to take them seriously.
- Leave comments on food Woo sites questioning the claims and asking for the evidence. Again, be genuine. You want to see how their claims stack up against known human biology.
- Draw out the distinction between factual claims and beliefs and show that the factual claims of religions have been progressively shown to be wrong.
- Explore concepts like souls and sin and relate them to introspection, self-awareness and guilt.
Show how valid moral and ethical decisions are made by atheists and that they stand responsible for them. Give clear examples of how atheists arrive at moral positions without the need for religion.
- Object to the involvement of religious organisations in the education of children and question why they need to have access to them.
- Challenge the credentials of religious figures claiming expertise in ethical debates, for example about stem cells. Show how religious dogma restricts ethical thinking in ways that are not beneficial to society.
There are many opportunities to voice a skeptical message but we need to be outgoing, to engage with those who are still wrapped up in Woo beliefs. We need to act on those agencies spreading misinformation and pseudoscience, and sometimes that may involve using the existing consumer protection legislation. It’s a very broad front and the Woo propaganda is loud and ubiquitous, but the quacklash is coming and the more we chip away at the irrational nonsense behind these ideas, the easier we make it for other skeptical rational people to voice their opinions, without fear that peer-pressure will bully them into silent acquiescence. Every small contribution to challenging these ideas has an effect. Every seed of doubt put into the minds of Woo believers, will encourage them to be more open to the evidence and to assess the validity of claims made.
I hope these ideas will encourage a discussion of how to be most effective in getting across the skeptical, rational viewpoint. You are all invited to take it to bits and I am sure you will come up with something better.
Bob Lloyd is the author of Leaving the Land of Woo, which Michelle Shires has reviewed for SFN.
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