Tag Archives: acupuncture

Placebo and Qi

An article in the September 3-9, 2018 issue of Time magazine, “Placebo’s New Power,” describes instances of people knowingly taking placebos and getting relief.  These “honest placebos” were administered in a study of irritable bowel syndrome (IBS) patients.  One patient, whose IBS symptoms improved dramatically during the study, later found her symptoms recurred.  She decided to continue the placebo treatments at the researcher’s private clinic and achieved remission again.

Overall, results were so encouraging in this Beth Israel Deaconess Medical Center study that the National Institute of Health has awarded the research team a $2.5 million grant to replicate the study.

Placebos have been around since time immemorial, used to advantage in numerous conditions.  Their use is predicated on the belief that a patient’s faith in the treatment has a healing effect.  Formal pharmaceutical studies in Western medicine measure a presumed new drug’s effects against placebo to determine whether it will work on a large scale.  In Western medicine, generally, the “placebo effect” is disparaged, as though there is something “un-scientific” about it.

The Time article speculates about why people who know they are taking fake pills get better.  It notes patients appreciate doctors who validate their suffering.  They fare better with doctors they perceive as warm and competent.  We are told that confidence in “medical industry leaders” in the US has plunged to 34%, from 73% in 1966.

To me, this is another example of Western medicine taking credit for applying common sense.  Not once does the article mention such old-fashioned terms as “bedside manner,” which cannot be measured or billed for in the codified, prioritized list of “evidence-based” protocols that wants to squeeze patients into convenient, binary-based boxes.

In Western medicine, the patient is seen as a relatively passive recipient of medical care.  The doctor, treatments, and pills act upon the patient, with the external agent believed to effect the healing.

In contrast, Oriental medicine perceives the body is its own healing agent, with its own homeostatic wisdom, presumed to want healing, with the practitioner a partner and participant in the process.  Belief in the treatment, and in the practitioner’s competence, are valuable and acknowledged aids in the healing process.  Far from being “placebo,” the partnership between patient and clinician becomes an integral component of the treatment goal.

A fundamental difference between Oriental and Western medicine involves “qi,” (also spelled “chi”) or “life force.” In Oriental philosophy and medicine, “qi” pervades all things, and is crucial to life. When the body’s “qi” is depleted, restricted, or out of balance, it leads to trouble.  Disharmonies begin on a spiritual level, then become increasingly “dense,” manifesting as intellectual, emotional, and finally physical levels.  Practices like acupuncture rely on stimulating or balancing qi along specific energy channels called “meridians.”

There’s a mistaken belief in the West that we know more than we do about the body.  While we point to specific brain chemicals, such as neurotransmitters serotonin or acetylcholine, these are only two of perhaps thousands of brain messengers that interact in a constant dynamic.  The brain is only one organ in an equally complex body, with signals going back and forth at lightning-fast speed.  Western science presumes the body is like a machine, but the mechanical construct of Western medicine gives no credit to life.

For me to say Western medicine is backwards, that the practice of dehumanizing patients under mechanical models works against health, may sound extreme.  Certainly the most expensive “health care industry” in the world deserves more respect, more funding, and more of our life blood.  But I suspect the opposite, that the commercialization and institutionalization of the “health care industry” has devitalized the system in the name of high-tech, low-yield placebos that only help if you believe they work, and often not even then.

 

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Crazies ‘R’ Us

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One of my alter-egos, Kookie the Shrink, with New-Age, eco-friendly, portable, non-pharmaceutical, public domain feel-good idea that hasn’t been invented yet.

Everyone knows psychiatrists are crazy.  Just ask my deceased mother, who claimed psychiatrists enter the profession to solve their own problems.  Fact is, I only began having problems in medical school.  My problems got worse after psychiatry residency, when I started practicing psychiatry in a “health care industry” so saturated with sanctimonious hypocrisy that I was astounded.  No one seemed to notice or care that externally imposed rules and expectations were making a mockery of the principles I was taught in training.  While everyone in the “health care industry” claims to be acting in the patients’ and public’s best interest, the so-called “healers” have become passive tools in a tidal wave of co-dependency that cripples to control and calls it “care.”

While “health care” professionals across the board have succumbed to this debilitating delusion, I feel particularly betrayed by the leadership in my own chosen specialty, because psychiatrists should know better.  I believe the psychiatric establishment has abdicated its philosophical foundations.  Instead of promoting mental health and self-reliance, it is busy kissing up to the profiteers in government, pharmaceutical and insurance industries, and seeking ever new ways to bind patients and the public to its mind-numbing agenda.

Two concurrent trends show how the psychiatric establishment–which depends on pharmaceutical advertising for its numerous professional publications—is desperately seeking relevance in a drug-pushing world.

The first trend, toward “medication-assisted treatment” for “opioid use disorder,” has been heavily embraced by the psychiatric establishment and the mainstream media.  The Friday, August 11, 2017 issue of USA Today claims “Opioids to be declared a national emergency.”  Here, we learn that President Donald Trump “’is drawing documents now’ to officially label the crisis as a national emergency.”  Such a designation would trigger specific tools for federal and state governments, including grants from the Public Health Emergencies Fund, a suspension of some of the patient privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and waive Medicaid restrictions on federal funding for mental health hospital admissions.

The second trend is the ongoing fight by the American Psychiatric Association (APA) and its state-level affiliates to stop the push by psychologists for prescription privileges.  This is an ongoing turf battle, with bills for psychologist prescribing introduced in multiple state legislatures every year.

The common denominator in these trends is that they are turf battles over drugs.  They have nothing to do with caring for patients, mental health, or the mind’s intrinsic self-healing potential.  The professional contestants, however, all claim they have patients’ best interests in mind.

Contributing factors abound.  In psychiatry, the shift from psychotherapy to medication management has been particularly devastating to professional self-esteem.  Psychiatry, now more than ever, seeks to align with the “scientific” foundations of medicine. Meanwhile, insurance and government have delegated “talk therapy” to less expensive psychologists and social workers.  What used to be 45-minute psychiatric consultations have become 15-minute “med checks.” Freud has been replaced by Prozac.

This follows a general cultural trend toward quick-fix solutions, with pills becoming the treatment of choice in all specialties except surgery.  The rise in illegal drug use can’t compare with the explosion of drugs for medical conditions, vaccines, and pseudo-conditions.  Over-medication is a major cause of accidents, drug interactions, and overdoses.  Unintentional injuries from falls and overdoses from prescription and illegal drugs are now the fourth leading cause of death in the US, according to one study.  Another study cites medical error the third leading cause in hospitalized patients.

The “opioid crisis” is attributed in part to Purdue Pharma’s misrepresenting OxyContin in 1997, when it was introduced, as having low abuse potential.  That same year, the FDA approved direct-to-consumer advertising. Pharmaceutical DTC advertising took off at the turn of the century.

That prescription painkillers fall in a different category from heroin—which cannot be prescribed in the US—bears mention, but they are linked by their black market affiliation.  OxyContin’s introduction on the market, and its aggressive marketing campaign to specialists and family practitioners brought Purdue Pharma $45 million in sales the first year.  That increased to $3.1 billion by 2010, or 30 percent of the prescription painkiller market.  In 2007, Purdue pleaded guilty in a federal lawsuit claiming it intended to mislead doctors and patients about its addictive properties.  It paid $600 million in fines.  The state of Kentucky, the state most ravaged by prescription painkiller and heroin use, has made 12 claims against Purdue, including false advertising, Medicaid fraud, unjust enrichment, and punitive damages.  OxyContin costs up to $1/mg on the street, or up to $80 for an 80 mg tablet.

Other reports say fentanyl, a prescription opioid that can be synthesized by drug traffickers, dramatically increases the risk of fatal overdoses.  Its deadliest component, carfentanil, is five thousand times stronger than heroin.  Add this to the fact that multiple common drugs and alcohol also depress the respiratory center, with a cumulative effect.  Benzodiazepines, like Xanax, are often taken along with opiates.

The “opioid crisis,” is now being traced to pharmaceutical companies and to the FDA, according to The Guardian’s latest report.  (www.theguardian.com/commentisfree/2017/aug/13/dont-blame-addicts-for-americas-opoid-crisis-real-culprits)

The collusion between the psychiatric community and the pharmaceutical industry to push drugs on a gullible public smacks of a cronyism that few seem to recognize.  The FDA-approved “medication-assisted” treatment for opioid use disorder contains two opioids—methadone and buprenorphine—which are also abused.  However, the psychiatric establishment, which has sub-specialties in addiction, has a piss-poor success record with addiction treatment and virtually ignores Alcoholics Anonymous and its spin-offs, like Narcotics Anonymous.  These are peer run, free, and have a better track record than the “experts” can claim, despite their education and degrees.  The APA also ignores non-pharmaceutical treatments like acupuncture, which even the NIH has admitted has utility in chronic pain.  Auricular acupuncture for substance abuse has a long and under-appreciated track record.

Where does psychiatric officialdom stand on the mental health advantages of low-stress lifestyles, nutrition, physical therapy, and exercise?  Ask, and let me know what you find out.

Crazies ‘R’ Us indeed.  The psychiatrists need to get off the drugs and learn to use their minds to heal themselves first.

 

The Mind-Body Connection

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From “The Foot Book: Healing the Body Through Reflexology,” by Devaki Berkson, 1977

Anyone who has a neck has a mind-body connection, assuming the mind is in the brain, which has not been proven.  In fact, with the medical mucky-mucks pontificating about “evidence-based” medicine, I have to ask what evidence do we have that the mind exists at all?  In fact, what evidence do we have that life exists?  We can’t measure either of these on our fancy instruments.

Albert Einstein, who sought in vain for a unified field theory to link the different universal forces, like gravity, and strong and weak nuclear forces, took life for granted, as Western medicine and science do.  Oriental philosophy does somewhat better, with its acceptance of “qi” or “chi,” loosely translated as “life force.”  Philosophically, I prefer the Oriental paradigm, which assumes a living cosmos, emanating from the inside out, like a holograph.  Embryos grow from the inside out, as do plants from seeds.

While people know the brain is in the head, they forget that nerves extend from the brain to almost every cell in the body, in a feedback loop that transmits information and directions back and forth with dazzling complexity.   Chemical messengers and neurotransmitters number in the thousands.   Only a few have been studied, and even these are poorly understood.

The so-called “scientific method,” a construct of the mechanized Western model, assumes cause and effect, yet it requires limiting any “scientific study” to one variable. This creates an artificial situation which attempts to control for confounding factors and leads to skewed results.  Alternatively, the Oriental model, which sees disease, for instance, as a pattern of dis-harmonies, is inclusive.  It presumes there are no single causes and that dis-harmonies create patterns of dis-equilibrium. Disciplines like acupuncture strive to re-balance “qi” to improve health and quality of life.

Ear acupuncture and reflexology are based on the idea that there are correspondences between points on the ears, hands, and feet and the various organs and structures in the body.

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Acupuncture does not lend itself to the “scientific method.”  Because it is holistic, it cannot be reduced to “cause and effect” studies.  Also, studies into acupuncture can’t be double-blinded, as the acupuncturist presumably knows which points are the “real ones.”

However, as East and West develop more ties, acupuncture is receiving more attention and acceptance, especially for such conditions as pain and substance abuse.

Reflexology, which is a specific form of massage, does not get as much attention, but it has the advantage that anyone can do it.  I make no claims about its healing properties, but I can vouch for the fact that foot and hand massage feel good and constitute a safe form of touching in a skin-starved society.