Recently my sister-in-law gave birth to her second child, prompting discussion amongst the family on whether a contributing factor to it being an “easier birth” was due to her knowing what was going to happen and a little debate as to whether acupuncture during pregnancy was a good idea or not due to the ongoing research on its efficacy. In the end, I think we tended more towards seeing it as contributing to a ‘placebo effect’ of reducing pain during childbirth.
Upon reading a review of the book R. Barker Bausell’s Snake Oil Science: The Truth about Complementary and Alternative Medicine in the New York Times this morning, I was reminded of that discussion and the place that meaning has in experiencing pain. Childbirth is associated with the possibility of danger; fear contributes to this and certainly the depiction in modern media doesn’t really help much.
Another factor in my case is whenever I’m around young mothers, they seem to take particular delight in outlining in graphic detail how long the birth took (‘nearly twenty hours! You know the longest non-stop commercial flight doesn’t take that long! And I could have had Boland Kelder Sav Blanc throughout!’), which I don’t find very encouraging. I think they’ll have to find some other relative to test the ‘acupuncture during childbirth’ claim too, due to that!
The placebo is related to expectations – a psychologically or physically inert substance with no active ingredients which produces an effect if there are expectations that it will work. They are vital for establishing cause-effect relationships between treatment and outcome. As the review in the NY Times says,
[Bausell] makes it crystal clear exactly how the natural history of most painful conditions conspires with the immensely complex neurological and psychological phenomenon known as the placebo effect to make almost any treatment appear to work, so long as the recipient hopes and believes it will.
Problems arise when the ‘feel good effect’ has a price. I mentioned earlier in a blog entry about how some alternative medicine had some potentially unwanted side effects or even none at all – and you may also notice that I mentioned how the ‘inert’ element is important in a placebo. This isn’t the situation with ‘dolphin therapy‘, which was criticised on the WDCS Australia site and now been reported in Science Daily – Dolphin Therapy – A Dangerous Fad.
Lori Marino, senior lecturer in the Neuroscience and Behavioral Biology Program, has teamed with Scott Lilienfeld, professor in the Department of Psychology, in order to educate the public on the dangers of ‘DAT’. I recognise Lilienfeld’s name from the Inquiring Minds website – he teaches a course on Science and Pseudoscience in Psychology (that’s a link to the Psychologists Educating Students To Think Skeptically site – aka ‘PESTS’!) and presented at the Fourth World Skeptics Conference.
“Dolphin-assisted therapy is not a valid treatment for any disorder,” says Marino, a leading dolphin and whale researcher. “We want to get the word out that it’s a lose-lose situation for people and for dolphins.”
While swimming with dolphins may be a fun, novel experience, no scientific evidence exists for any long-term benefit from DAT, Marino says. She adds that people who spend thousands of dollars for DAT don’t just lose out financially – they put themselves, and the dolphin, at risk of injury or infection. And they are supporting an industry that outside of the United States takes dolphins from the wild in a brutal process that often leaves several dolphins dead for every surviving captive.
This has relevance to where I live, as the Monkey Mia resort in the north is a major tourist draw to my state and I wonder why people would put themselves over the health of the very appealing dolphins? Naturally, I find that papers have indeed been published claiming that DAT reduces pain – papers which were researched and found to be methodologically flawed by Marino and Lilienfeld. Maybe the answer is also found in the review from the NY Times that I originally posted, of Bausell’s Snake Oil Science:
Still, Dr. Bausell knows perfectly well that people in pain don’t care what studies say. The only study they care about is the study of themselves. And who can blame them for that?