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Last week I wrote about the theory of homeopathy. Homeopathy is the practice of prescribing specially prepared homeopathic remedies made from extremely dilute natural substances. In many cases, a remedy is used to treat the symptoms that a larger dose of the same substance would cause. For instance, chopping onions may cause redness, burning and tearing of the eyes, and a runny nose. A homeopathic preparation of onion (Allium cepa) is used to treat these conditions, such as when they occur due to a cold or allergies.
Today I want to clarify some points and explore homeopathy’s conundrum. First, since people sometimes confuse the terms, homeopathic is different than holistic, which refers to any treatment that aims to consider and support the whole individual. Acupuncture and naturopathic medicine are examples of holistic systems, though most acupuncturists don’t practice homeopathy, and homeopathy is usually a relatively small fraction of what most naturopathic physicians do.
Second, most of the scientific community believes homeopathy is pseudoscience and no more effective than a placebo. Indeed, there are numerous studies that invalidate homeopathy. Advocates of homeopathy point out that the unfavorable studies involve giving subjects a homeopathic remedy matched to a particular symptom or medical condition without utilizing the specificity that’s essential in effective homeopathic diagnosis. Homeopaths contend that when a remedy is matched not only to the dominant symptoms, but the whole picture of the individual, the rate of success is much higher.
As I said in the last article, I’ve witnessed many cases in which homeopathy did nothing useful – though at least it was entirely harmless and without side effects – and I have also witnessed cases in which it was remarkably effective. Could it have been a placebo effect? Sure. But if it was “merely” a placebo effect, it was a profound placebo effect: a perfect medicine that was entirely beneficial, painless to administer, palatable, with zero downside. One should be asking, “How can we reproduce this?”
Homeopathy is vastly popular around the world. Its use is especially prevalent in France, Italy, India, Switzerland, Mexico, Germany, England, and the U.S. 29% of the EU population uses homeopathy on a daily basis. About half of Germans have used homeopathic medicines and about 70% say they are satisfied with its effects.1 History shows us that sheer number of adherents doesn’t make something correct or morally right, but we’re smarter than ever and have more options.
So, what’s going on here? Why do so many people use it if it’s a sham? Well, there are two possibilities. 1) The thousands of practitioners and roughly 200 million people who use homeopathy on a regular basis are fooling themselves. They think homeopathy is useful but it’s just a placebo and/or wishful thinking. Or 2) There is actual benefit to homeopathy which can’t be substantiated by current science and is not accurately reflected by the research.
Trust me, as a scientist, it’s hard to understand its validity, but I also know what I’ve seen. Are there other systems of medicine with higher rates of success? Probably. To be frank, it is not my go-to modality except for a small number of conditions for which I consistently get good results with homeopathic remedies. However, I’m a mediocre homeopath and I have more training and skill in other forms of medicine.
But when it works, it works. And I have seen cases where several medicines were tried but only the homeopathic one succeeded, including numerous instances in which the patient was highly skeptical of homeopathy. If it were a placebo effect, why would the other medicines not have produced a benefit equal to that of homeopathy? Why would a skeptical patient have a placebo effect when the basis for a placebo response is an expectation of benefit? Should science have the ability to invalidate someone’s subjective experience of benefit?
I don’t have the answers to these questions. I know some incredibly intelligent doctors who practice homeopathy, and I have seen it and them derided by the medical mainstream. Skeptics’ concern, they say, is that people might not get effective medical help because they’re using homeopathics instead. I agree that if someone isn’t getting a benefit from a chosen medical modality, it might be useful to consider other options. I also believe it’s everyone’s right to manage their health in whatever way they wish – even if it hastens their demise. For perspective, it’s important to note that, according to a recent Johns Hopkins study, 250,000 Americans die each year due to medical errors, making mainstream medicine the third leading cause of death after heart disease and cancer. I have seen people killed by mainstream medical treatments. A modality’s safety is no small thing.
While there are plenty of people who are averse to biomedicine, we tend to treat the mainstream with a greater degree of respect than is extended to alternative fields. For instance, when we hear that a particular drug or procedure doesn’t work, most people conclude that this particular intervention wasn’t effective. We don’t say, “Well, biomedicine doesn’t work.” In contrast, when an alternative medicine fails to benefit a certain condition, a common conclusion is that the entire modality is worthless. I can’t tell you how many times I’ve seen an author cite a single failed acupuncture study as proof that acupuncture is bunk. It’s an unfortunate reflection of the tendency for the mainstream to squash its rivals, even when they don’t truly threaten it.
It's important, therefore, that we all keep our eyes wide open and practice critical thinking (and not just when it comes to medicine). Be your own advocate, trust your intuition, listen to your body, and don’t assume that just because someone has a degree they know what’s right for you.
Be well,
Dr. Peter Borten
- https://www.hri-research.org/resources/essentialevidence/use-of-homeopathy-across-the-world/ ; https://en.wikipedia.org/wiki/Regulation_and_prevalence_of_homeopathy ; https://homeopathyeurope.org/
[post_title] => Are We Fooling Ourselves When We Believe in Alternative Medicine?
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Imagine you’re brought to a beautiful place where you’ll be meeting a person with whom you’ll share an incredible, lifelong love – a romantic love or a powerful friendship, or both. If such a person already exists or existed in your life, you can use them for this exercise. Whomever it is, know that they completely love and accept you.
The environment is perfect for you – airy or cozy, with a fire or open windows, vases of flowers, your favorite music, and curtains blowing in the breeze. Maybe it’s a garden, or the top of a mountain, or at the fanciest bowling alley in the world.
Try feeling into this. You’re in this lovely space, about to meet someone who makes you feel both strong and at ease. Imagine you’re facing this person and walking toward them. As you do so, consider your posture. Sit up, lift your head, open your heart, carry yourself as if fully welcoming this fun and inspiring partnership. Take a moment to ride this visualization forward. Feel it in your body, let a smile spread across your face as you imagine coming together and hugging or laughing or dancing because you find each other delightful.
Now, come back to your posture. Feel that straight spine, that open chest, that “lifting” energy?
Our posture is an expression of how we’re carrying our lifeforce and meeting the world. How might life be different if you met each situation with the same posture that you’re meeting this beloved person?
Too often, we collapse, clench, or curl in on ourselves as an unconscious reflection of feeling burdened, apprehensive, untrusting, timid, or vulnerable. Consequently, we feel tired, weak, indecisive, and unconfident.
We also use posture to show dominance and submission, and to indicate prowess. But rather than “posturing” like a puffer fish in an arrogant or animalistic way, I’m suggesting we use posture as a conscious embodiment of who we choose to be and how we choose to relate to life.
In a happy moment, our posture often automatically improves, and it also works the other way around. When you carry yourself with a combination of strength and ease, your mood improves, you relate more positively to the world, and the world responds more willingly to you.
What are your values? What are your gifts? What’s your life purpose? If you have our Dreambook, revisit these sections to remind yourself of what’s most important to you and what you have to share with the world. Who do you want to be?
How do you want to relate to life? With kindness? Openness? Trust? As if it’s an incredible game? As an opportunity to experience a splendiferous palette of flavors, sights, and experiences?
Write a bit about who you choose to be and how to choose to relate to life. Now imagine embodying these intentions and surrender to how your body wishes to reconfigure itself in order to be a cleaner, more accurate and aligned vehicle for this spirit. Throughout the day, bring yourself back to this intention and take just a moment to again reconfigure your body to express this attitude toward life.
Notice how this reconfiguration process changes over time. Sometimes it may be a gross adjustment – your head lifts, your ears come in alignment with your shoulders, your shoulders drop and draw back, your chest opens, your belly relaxes, your jaw unclenches, your breathing deepens. Other times, you may experience it as a subtle unraveling of inner constraint, or as a ripple that emanates through you, bringing all your parts into harmony.
The hardest part is simply remembering to do it.
I’d love to hear what you notice about the positive in negative ways your posture affects you. Feel free to share in the comments section below.
Be well,
Peter
[post_title] => How You Hold Yourself Can Change Everything
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I am often asked, “What’s the difference between acupuncture and dry needling?” So, I thought I’d answer the question for everyone in our community who might be interested, and offer some history and science along the way.
“Dry needling” is a term that has grown tremendously in usage over the past decade because it’s a newly adopted practice by many physical therapists. It essentially consists of inserting acupuncture needles into tight muscles. In many states, acupuncturists have fought physical therapists’ attempts to expand their scope of practice to include this procedure. However, physical therapists outnumber acupuncturists by about seven to one, which means stronger state organizations and greater legal power.
Acupuncturists argue that physical therapists are essentially stealing their medicine and calling it something different. In some states physical therapists can practice dry needling with no training in it; in others they typically complete a 55-hour course. By comparison, a licensed acupuncturist generally receives about 500 hours of instruction in the acupuncture-specific portion of their training.
For a few centuries in the West and a couple millennia in China, observers of the human body have known about nodules that occur in tight muscles and are associated with chronic, complex pain patterns. You might just call them “knots.” In the mid-1900s a doctor named Janet Travell coined the term myofascial trigger point to describe this phenomenon. About 90% of them are found at the locations of acupuncture points, which were mapped out on bronze statues at least 1,000 years B.C.E.
Travell explained that myofascial trigger points are irritable regions in our connective tissue (muscle and fascia) that get stuck in a contracted state. They make muscle fibers taut, reducing muscle strength and range of motion, and causing pain, numbness, and other symptoms that often spread to areas far from where they originate. In many cases, what we perceive to be a visceral problem (heart attack, ulcer, migraine, irritable bowel, urinary tract infection, etc.) is actually the symptom of one or more trigger points. I believe trigger points are responsible for most of the physical pain humans experience.
Travell and her colleague David Simons went on to chart the locations and symptoms of trigger points in every major muscle. Travell became John F. Kennedy’s doctor (the first female presidential physician) and his family credited her with saving Kennedy’s political career by curing his back pain through the release of myofascial trigger points.
Travell (and researchers before her) discovered that it’s possible to release a trigger point through a simple procedure she called “ischemic compression.” It basically entails pressing firmly on the center of a trigger point for about half a minute until it softens. Travell’s maps and manual techniques for releasing trigger points were adopted by physical therapists over the following decades. (For what it’s worth, body workers have probably been doing ischemic compression for ages, without calling it ischemic compression.)
Travell also found that she was able to release trigger points by injecting them with numbing agents or saline. However, it emerged that the most effective aspect of this practice wasn’t the injection of fluid, but the mechanical act of probing at the trigger point with a needle. That is, a release could be accomplished even with a “dry” needle, without injecting anything.
Based on this new expression, one could say that all acupuncture is “dry needling.” This is precisely what acupuncturists have always done, although the insertion of needles into these local epicenters of pain is generally just one aspect of an effective acupuncture treatment. What makes an acupuncture treatment holistic (i.e., addressing the whole person) is that the treatment also addresses the underlying mechanisms that led to the surface issue (e.g., stress, diet, digestive problems, more global structural or energetic imbalances, etc.).
In the 1980s, an osteopath and acupuncturist named Mark Seem, founder of Tri-State Acupuncture College in New York City, began integrating Travell’s trigger point maps into traditional acupuncture. He met with Travell and demonstrated his approach. Travell immediately recognized the value of using a much thinner, solid, and springy acupuncture needle (which has a cone-shaped tip), as compared to the hypodermic needles she had been using (which have a scalpel-like hollow beveled tip).
Over the following decades, physical therapists gradually discovered that “dry needling” with acupuncture needles is often a faster and more effective trigger point release method as compared to the various forms of pressure, friction, stretching, exercise, and structural education that have been part of the physical therapists’ palette for their hundred-ish year history. In court cases between acupuncturists and physical therapists, PTs often argue that the insertion of needles into trigger points is a simply an extension of these “manual therapies” described in their scope of practice, and the decision comes down to whether or not the judge agrees.
The other common argument by PTs is that there are many differences between dry needling and acupuncture. In my opinion, having observed PTs doing dry needling and having studied many styles of acupuncture, there’s clear evidence that acupuncturists have been doing everything encompassed in dry needling for a very long time. PTs have insisted that because they know nothing of the acupuncture meridians (energy circuits along which acupuncture points are located), dry needling therefore isn’t acupuncture. But this is like saying that because you haven’t studied anatomy, when you cut into someone with a scalpel you’re not actually doing surgery. Further, there are many systems of acupuncture, several of which don’t utilize meridians.
Enough about the arguments. My purpose isn’t to determine whether or not it’s right for physical therapists to do dry needling, but to clarify the differences in the consumer’s experience.
While acupuncture is great for pain, not all acupuncturists are pain specialists, and most acupuncturists don’t specifically target the trigger points mapped by Travell. If that’s what you’re looking for, it may be worth seeking out an acupuncturist who specializes in pain. Or you might be happy with a skilled physical therapist who does dry needling.
Both acupuncturists and physical therapists run the spectrum from mediocre to brilliantly talented. I have no doubt that there are some masterful PTs out there who get great results doing acupuncture (dry needling) – perhaps better for structural issues than an average-level acupuncturist. I have had patients ask me to “fix” them after a painful dry needling session from a PT that worsened their condition, and I’ve had other patients report good results from dry needling.
If you are skittish about needles, you may not enjoy dry needling from a physical therapist, since it tends to be more intense than the average acupuncture treatment. That said, any form of acupuncture that specifically focuses on releasing trigger points is unlikely to be painless. Regardless of the style of acupuncture I’m performing, I always tell my patients I’m not the person to see if they don’t want to feel anything; I believe a certain degree of sensation is productive.
If you’re someone who cares about how much training your practitioner has received, perhaps it’s meaningful to you that an acupuncturist typically spends ten times as many hours learning their craft than a physical therapist spends learning dry needling. (And virtually all of the acupuncturist’s continuing education will be in acupuncture as well.)
If your primary concern is having your treatments covered by insurance, you’re more likely to get this from a physical therapist. There are some acupuncturists who bill insurance, but more often it will be up to you to submit your receipts and hope for reimbursement.
If it’s important to you that your treatment gets to the root and addresses the whole you, including non-structural issues, you’ll probably be more satisfied with treatment from an acupuncturist. The common experience of “going to acu-land” as some of my patients call it – i.e., becoming deeply relaxed or even having a transcendent experience – isn’t part of the dry needling session. Some would consider the peaceful effect of acupuncture merely a pleasant bonus, but I believe it’s often much more instrumental in the overall outcome than people realize. How often do we stop, rest, and drop all of our concerns? It can be akin to the benefit of a session of deep meditation. The alleviation of stress and a nervous system “reset” is no small thing, especially when stress is the root cause of so much pain.
That said, I find that many patients honestly aren’t concerned with a holistic treatment, and that’s fine. They want a practitioner who will get right into the painful area and work the hell out of it. It might be intense and they might feel beat up afterwards, but there’s a time and place for this kind of work if it’s effective. Personally, I don’t mind receiving aggressive treatments. Occasionally they’ve been miraculous (other times they’ve left me temporarily crippled with no relief). And of course, if the pain itself is one’s primary stressor, one could argue that getting rid of the pain should be a higher priority than alleviating stress (though we don’t have to choose one or the other). In my experience it’s a slight minority of acupuncturists who work this way, while it’s quite common for a physical therapist.
Whew! That was a long-winded exploration of this topic. I thought about removing parts of this article to shorten it, but having had this conversation so many times, I’ve found that many people are curious about all the facets of this subject. I hope I offered some clarity.
Be well,
Dr. Peter Borten
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Last week I wrote about the theory of homeopathy. Homeopathy is the practice of prescribing specially prepared homeopathic remedies made from extremely dilute natural substances. In many cases, a remedy is used to treat the symptoms that a larger dose of the same substance would cause. For instance, chopping onions may cause redness, burning and tearing of the eyes, and a runny nose. A homeopathic preparation of onion (Allium cepa) is used to treat these conditions, such as when they occur due to a cold or allergies.
Today I want to clarify some points and explore homeopathy’s conundrum. First, since people sometimes confuse the terms, homeopathic is different than holistic, which refers to any treatment that aims to consider and support the whole individual. Acupuncture and naturopathic medicine are examples of holistic systems, though most acupuncturists don’t practice homeopathy, and homeopathy is usually a relatively small fraction of what most naturopathic physicians do.
Second, most of the scientific community believes homeopathy is pseudoscience and no more effective than a placebo. Indeed, there are numerous studies that invalidate homeopathy. Advocates of homeopathy point out that the unfavorable studies involve giving subjects a homeopathic remedy matched to a particular symptom or medical condition without utilizing the specificity that’s essential in effective homeopathic diagnosis. Homeopaths contend that when a remedy is matched not only to the dominant symptoms, but the whole picture of the individual, the rate of success is much higher.
As I said in the last article, I’ve witnessed many cases in which homeopathy did nothing useful – though at least it was entirely harmless and without side effects – and I have also witnessed cases in which it was remarkably effective. Could it have been a placebo effect? Sure. But if it was “merely” a placebo effect, it was a profound placebo effect: a perfect medicine that was entirely beneficial, painless to administer, palatable, with zero downside. One should be asking, “How can we reproduce this?”
Homeopathy is vastly popular around the world. Its use is especially prevalent in France, Italy, India, Switzerland, Mexico, Germany, England, and the U.S. 29% of the EU population uses homeopathy on a daily basis. About half of Germans have used homeopathic medicines and about 70% say they are satisfied with its effects.1 History shows us that sheer number of adherents doesn’t make something correct or morally right, but we’re smarter than ever and have more options.
So, what’s going on here? Why do so many people use it if it’s a sham? Well, there are two possibilities. 1) The thousands of practitioners and roughly 200 million people who use homeopathy on a regular basis are fooling themselves. They think homeopathy is useful but it’s just a placebo and/or wishful thinking. Or 2) There is actual benefit to homeopathy which can’t be substantiated by current science and is not accurately reflected by the research.
Trust me, as a scientist, it’s hard to understand its validity, but I also know what I’ve seen. Are there other systems of medicine with higher rates of success? Probably. To be frank, it is not my go-to modality except for a small number of conditions for which I consistently get good results with homeopathic remedies. However, I’m a mediocre homeopath and I have more training and skill in other forms of medicine.
But when it works, it works. And I have seen cases where several medicines were tried but only the homeopathic one succeeded, including numerous instances in which the patient was highly skeptical of homeopathy. If it were a placebo effect, why would the other medicines not have produced a benefit equal to that of homeopathy? Why would a skeptical patient have a placebo effect when the basis for a placebo response is an expectation of benefit? Should science have the ability to invalidate someone’s subjective experience of benefit?
I don’t have the answers to these questions. I know some incredibly intelligent doctors who practice homeopathy, and I have seen it and them derided by the medical mainstream. Skeptics’ concern, they say, is that people might not get effective medical help because they’re using homeopathics instead. I agree that if someone isn’t getting a benefit from a chosen medical modality, it might be useful to consider other options. I also believe it’s everyone’s right to manage their health in whatever way they wish – even if it hastens their demise. For perspective, it’s important to note that, according to a recent Johns Hopkins study, 250,000 Americans die each year due to medical errors, making mainstream medicine the third leading cause of death after heart disease and cancer. I have seen people killed by mainstream medical treatments. A modality’s safety is no small thing.
While there are plenty of people who are averse to biomedicine, we tend to treat the mainstream with a greater degree of respect than is extended to alternative fields. For instance, when we hear that a particular drug or procedure doesn’t work, most people conclude that this particular intervention wasn’t effective. We don’t say, “Well, biomedicine doesn’t work.” In contrast, when an alternative medicine fails to benefit a certain condition, a common conclusion is that the entire modality is worthless. I can’t tell you how many times I’ve seen an author cite a single failed acupuncture study as proof that acupuncture is bunk. It’s an unfortunate reflection of the tendency for the mainstream to squash its rivals, even when they don’t truly threaten it.
It's important, therefore, that we all keep our eyes wide open and practice critical thinking (and not just when it comes to medicine). Be your own advocate, trust your intuition, listen to your body, and don’t assume that just because someone has a degree they know what’s right for you.
Be well,
Dr. Peter Borten
- https://www.hri-research.org/resources/essentialevidence/use-of-homeopathy-across-the-world/ ; https://en.wikipedia.org/wiki/Regulation_and_prevalence_of_homeopathy ; https://homeopathyeurope.org/
[post_title] => Are We Fooling Ourselves When We Believe in Alternative Medicine?
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