by Paul Singh
As a strong believer in mind-body medicine, I started conducting weekly public seminars on mind-body medicine in Menlo Park and in Beekay Theatre in Tehachapi, California. These seminars were a series on mind-body medicine. I often emphasized the limitations of modern medicine in treating chronic conditions and provided an alternative to my patients—the “most powerful tool” we all possess, our mind. I even advertised on my websites at the time that “real medicine” was free and cost nothing because all one had to do was to employ the powers of one’s mind in just the right way. After ten years of motivational speaking and becoming a preacher of this gospel, I noted that my own patients were, in fact, not getting better and they were not changing bad habits. I tried to use my own conviction that the mind could heal the body in an attempt to help patients quit smoking, lose weight, overcome depression, cure hypertension, and so on. But I had only marginal success. I used the latest research in mind-body medicine to conduct my practice the best I knew how, but my success rate was extremely poor. Looking back on it now, I believe my success rate could not have been more than five percent at best. This was disheartening since I had been telling others that modern Western medicine was a failure. I emphasized the practice of self-control by using mindful meditation, and employed all my motivational skills to help my patients get better. I avoided prescribing medications whenever I could, substituting instead what I considered to be natural alternatives. I was convinced that I might have become one of the America’s best doctors, one who could spend an hour with a patient infusing spiritual strength, in the meanwhile losing a lot of money by not seeing more patients during the day like most doctors do.
My failure, however, bothered me because the mind-body medicine I strongly believed in was not working. By mind-body medicine I really mean meditation. The idea is that the mind can heal the body. The term “mind-body medicine” has been used and abused so much that it can refer to almost anything, just so long as it is not part of the Western scientific approach to medicine. Basically anything goes in mind-body medicine—not just meditation, but a host of other pseudoscientific practices: prayer, creative arts, yoga, Tai Chi Qigong, hypnosis, guided imagery, spirituality of all kinds, and innumerable healing practices such as acupuncture, ayurvedic medicine, breath work, and so on. Other terms have been invented and the lines between mind-body connection and holistic integrative medicine are blurred; they are frequently used interchangeably. It is unfortunate that the best medical schools in the United States have all adopted this model where anything goes and it is clear that science has lost to pseudoscience.
My experiments in mind-body medicine refer only to meditation, what I used to refer to as the mind-body connection. But my ego was hurt in not being able to achieve any success. I could not understand how something I espoused and firmly believed in simply did not work. I started living in denial, instead of doing something about it. I practiced everything based on the documented research on healing the body through meditation techniques. The fact that what I preached was not working was a secret that I harbored for a while, living my life in an internal cognitive conflict. I could not admit this failure to anyone. I was convinced that meditation worked even in the face of evidence to the contrary within my own practice. In retrospect, I know that I was experiencing what psychologists have termed denialism. Denialism has been found to be a real phenomenon by those who study it. Several studies in psychology also show that we are all victims of “investment bias” in that we do not back off from what we have already invested our resources in and therefore justify our behavior and rationalize what we might know deep in our heart of hearts makes no sense. This is something all educated people do. They do not necessarily learn to make better decisions with the increase in their knowledge. Instead, they learn how to rationalize what they want to believe in.
Not only could meditation not cure organic illness, it couldn’t even help people overcome old habits. I couldn’t understand why meditation was so ineffective. I was convinced that it must work, but it wasn’t working. After all, it was simply an issue of mind over matter, and everyone I had been taught by convinced me that our minds were more powerful than our bodies. But my patients were not responding to Eastern behavioral modification techniques such as meditation and mindfulness. Some patients sort of felt better, as they described it to me, but not quite. It bothered me that I could not explain any of this. I had spent decades studying Eastern and Western wisdom traditions and religions and I thought no one was better at it than I was. My own strong belief system did not and could not produce any change either in my own behavior or in the behavior of the patients that I cared for.
There were hundreds of research papers being published with findings that positive thinking, optimism, meditation and “relaxation response” (just another word for meditation invented by Western academics) lowered the risk of heart disease, ulcers, blood pressure, depression, anxiety, and headaches. There was some incredible research coming out that even prayer could cure diseases. Pop psychology was popping up everywhere in the 1990s making claims that one’s mind could cure one’s body. This included some New York Times best sellers that catapulted authors from rags to riches, such as Deepak Chopra’s book Ageless Body,Timeless Mind. It bothered me that my own patients were not getting better with the implementation of such ideas in my own medical practice. It disturbed me that the best mind-body medical doctor, whom I arrogantly regarded as myself, did not get the same results that the research journals in meditation were reporting. How could that be? Was something wrong with the way I practiced, I wondered. I compared my methods with others and they were no different. If anything, I had to be better at it, considering the amount of energy I put into motivating people. I had always been intimately conversant with Indian traditions, literature, and philosophy, having spent decades studying the Indian lore, much more so than any guru who came from India to acquire a following by selling his “Eastern wisdom” to Americans
My belief in the healing power of meditation started to peter out. Ten years was long enough to try, I said to myself. So I started looking carefully at the research literature that claimed that the mind could cure one’s body, could lower health risks, and improve outcomes. I must admit that I should have looked at this research more closely and much sooner. I noticed that the papers that I came across were published by people who had drawn their conclusions before they initiated their research, in that they were true believers in mind-body medicine before they did their research. So there was heavy-duty researcher’s bias. It seemed to me that they did not approach the subject matter of their research with hypotheses to be proven correct or refuted based on objective data alone. They set out to only prove it right. That is suicidal for any researcher in any branch of science. Most of these researchers had religious backgrounds or simply had a keen interest in the supernatural. Randomized double-blind studies were few and far between in the mind-body literature. Studies with negative outcomes were often disregarded by research journals that were managed and controlled by believers.
This was the highest publication bias that I had ever seen in the many years of my medical research in any branch of medicine. No other area of research in any branch of science had such a high degree of publication bias. Journals on mind-body medicine, I noticed, were not subject to external objective analysis, verification, duplication, or scrutiny. They were a cult of their own, and their research papers were published by believers, read by believers, and contributed to by committed believers. It is like a religion and its practitioners are simply preaching to the choir. If I were to submit a paper for publication to one of these “in-group” journals, a paper that showed that mind-body medicine didn’t work, it would be instantly rejected. They already know the truth so why be bothered with the facts?
I also learnt that there was a very wide spectrum that ranged from good science to pseudoscience and everything in-between. That is what made it difficult to prove these pseudo-scientists wrong. They use all the scientif
ic jargon and walk a thin line and blur true science with wishful thinking. Well-tested successful methodologies of science such as double-blind trials are also used to further blur the line between good and bad science. That makes it so much more difficult to distinguish genuine research from the false. This could be done only by shining the cold harsh light of scientific scrutiny on their research and passing their research data through the meat-grinder of scientific inquiry, which is an enormously time-consuming process and requires panels of experts to separate the wheat from the chaff, teased away with hair-splitting detail. With tens of thousands of research journals, including online journals, published around the world, the world of research is out of control and it has become so much easier to publish sub-standard papers or simply forge data without being accountable to anyone. This is bad enough in the mainstream science of medicine and health fields, but it is absolutely deadly in the home-made alternative medicine journals which are free to make any claim they wish and mislead people.
The mind as a separate entity from the physical brain has religious connotations, so it did not surprise me that such research had become so popular so quickly among physicians who often lacked proper scientific training. After all, the vast majority of the people in this world believe in a mind or a soul separate from the body. I also realized through this period of disillusionment in my life that I had suffered from a confirmation bias of my own without realizing it. It took me a long time to realize that research conducted by researchers in any area of science was not always conducted through strict scientific methodologies. This was particularly true of clinical research. Clinical research is prone to the vagaries of human bias due to the complexity of research topics and the varied and complex variables often not factored in and therefore very hard to control. That was another reason why we have to be extra cautious in interpreting medical research which is often questionable and misleading.
I also noticed that researchers in mind-body medicine often fell prey to what we call a sharp shooter fallacy. The fallacy stands for hitting a spot and then drawing a circle around the spot and claiming that it was the target. All negative outcomes are disregarded as though they were flawed research in the first place. The research with negative data is abandoned or discarded or repeated till the positive data that favor the researcher’s hypothesis start to surface by random chance. Most research projects conducted in mind-body medicine and related superstitious health care systems of healing arts are also rooted in such dubious science. Scientific methods are used but the science is ignored. How is that possible? It is possible when someone uses all the bells and whistles of scientific research but ignores the fact that the hypothesis fails based on basic laws of physics. Data is collected to show evidence and some mysterious basic science is presumed to exist behind such research supporting such research effort. If research-based evidence is in conflict with basic science principles, the evidence must be looked at with great skepticism. For example, from a scientific point of view the prior probability of homeopathy being true is nearly zero in that one drop of medicine diluted to the size of an ocean is scientifically not likely to have any medicinal effect. It is not only unscientific but also ignores basic laws of physics which makes such research a waste of time. So randomized trials on such homeopathic medications are not going to be science-based medicine but rather “evidence based,” which essentially means it will be unreliable no matter what the data shows. Many ideas in the health care system pass the test based on evidence but they fail the test on basic scientific principles. Good medicine must meet the criteria of both the evidence as well as be consistent with basic principles of science. For example, I read a research paper in homeopathy that claims that their herbs cure all levels of autism in children and the “p value” in their conclusion of the study is 0.00001. You don t even have to read the paper to see from the abstract that the entire study is a fraud and unscientific.
Science-based medicine is not the same as evidence-based medicine. Therefore it is not unusual to see researchers conducting research in so-called alternative medicine forging data to make it work, especially when their research conclusions do not make any sense. The “Toupee fallacy” also applies to this kind of research, where the person claims that he could always tell when someone is wearing a toupee but discounts the data when he fails to tell a toupee from one’s real hair. Such hit and miss research, even if it is labeled “double blind” and “randomized,” is a form of pseudoscience and deception.
I started attending annual conferences of the American Society of Integrative Medicine where about five hundred physicians showed up each year. These physicians were advocates of integrative medicine. Someone presented a paper in 2010 at a conference proving how intercessory prayer healed people. I asked the presenter, who was well known in this field, a sort of a Jewish kabala guru, if he would provide me with a copy of his research paper for me to scrutinize. He promised, but he has failed to provide me with his research to this day. Most of the physicians at the conference were apparently very impressed by his research paper, but they shouldn’t have been. Scientists shouldn’t be impressed with any research unless they are confident that the research has been thoroughly examined and criticized by other experts in the field. Most physicians, in general, swallow almost anything you feed them, as though it were a fact. This reflects their lack of training in methods and rules of peer-reviewed scientific research. Medical students are trained to memorize facts, not to think critically about the scientific methods that are employed to find out these facts. And when it comes to the so-called facts about mind-body medicine, I can assure you that there is little or no scientific basis for them at all. I looked very hard for the evidence for 10 years and never found any.
As I stated before, my own experiments with mind-body medicine had not resulted in any positive outcomes and was gradually turning me into a skeptic. I then decided to replicate such studies at my own office by performing double-blind experiments and randomizing them. For example, I conducted double-blind studies on the health benefits of meditation in mind-body medicine modalities such as meditation, acupuncture, and other forms of alternative treatments such as and homeopathic and ayurvedic medicine, and saw no benefit to patients from them at all. I will never know the harm I might have done to my patients in the process, which is an unknown risk that I took. Initially, when I started studying such methods in my office, my hope was that my own studies would confirm the conclusions of previous studies in mind-body medicine, conducted poorly elsewhere by others, so I could make my own claim that mind-body medicine worked. But it didn’t work. Mind-body medicine was my forte, or so I thought. But I was beginning to lose my faith in it.
I then made the bold decision to register for a Ph.D. program at a School of Natural Health where they taught all forms of alternative medicine and prescribed alternative medicine text books endorsed by self-proclaimed pop-culture Indian gurus like Deepak Chopra. Some of the claims in these text books defy common sense, let alone science. My intention was to have direct experience with these alternative practices to see for myself what kind of research is presented to students during their doctorate training. What I discovered was mind-boggling. This is not to say that everything they teach is false. But overall, it is bad news. Getting a degree as Doctor of Natural Medicine or a Ph.D. in natural medicine is like being a scholar in a seminary where you don’t question or ask for evidence. That is a sub-culture where asking such questions is looked upon as very strange. One is awarded a Ph.D. at the end of the day if one is devout enough; that is the main qualification of a good student.
I did obtain this Ph.D. after fulfilling all the school’s required courses and a dissertation towards the end. I have kept this certificate as evidence that I did actually attend such a school and am not making up these stories to promote my own viewpoint. The name of this school is not being divulged to avoid liability suits. No scientific evidence for alternative forms of therapies is provided for any claims made by the s
chool throughout the students’ training period. No student ever asks for evidence. If a student were to ask for evidence or proof, he or she would immediately be ostracized and considered arrogant, rude, or self-righteous.
It is a form of group-think governed by group dynamics. Such experiences made me a skeptic about many alternative forms of medicine practiced around the world. It restored my faith in science-based medicine despite its own limitations. I was trained as a scientist and I regret that I wandered off from my training in Western science for over a decade. Now I would rather live with the limitations of modern Western medicine than subscribe to quackademics. But my deviation from the mainstream was not a waste of time because it was a great learning experience. I would not have known what I know today, had I not got side-tracked for a while. My biggest objection to mind-body medicine or any other alternative practices has never been that they don’t necessarily work; that had never been the issue for me. My criticism of these alternative forms of medicine had been that the scientific evidence of their claims was missing and that the evidence provided is not consistent with fundamental scientific principles. I have kept my mind open, waiting for evidence to show up all these years. But so far none has.