by Ben Goldacre
But what if the wax and toxins are being drawn into the candle by some other, more esoteric route, as is often claimed?
For this you will need 10 do something called a controlled experiment, comparing the results of two different situations, where one is the experimental condition, the other is the ‘control’ condition, and the only difference is the thing you’re interested in testing. This is why you have two candles.
Put one ear candle in someone’s ear, as per the manufacturer’s instructions, and leave it there until it burns down.*
≡ Be careful. One paper surveyed 122 ENT doctors, and collected twenty-one cases of serious injury from burning wax falling onto the eardrum during ear-candle treatment.
Put the other candle in the clothes peg, and stand it upright using the Blu Tack: this is the ‘control arm’ in your experiment. The point of a control is simple: we need to minimise the differences between the two setups, so that the only real difference between them is the single factor you’re studying, which in this case must be: ‘Is it my ear that produces the orange goo?’
Take your two candles back inside and cut them open. In the ‘ear’ candle, you will find a waxy orange substance. In the ‘picnic table control’, you will find a waxy orange substance. There is only one internationally recognised method for identifying something as earwax: pick some up on the end of your finger, and touch it with your tongue. If your experiment had the same results as mine, both of them taste a lot like candle wax.
Does the ear candle remove earwax from your ears? You can’t tell, but a published study followed patients during a full programme of ear candling, and found no reduction. For all that you might have learnt something useful here about the experimental method, there is something more significant you should have picked up: it is expensive, tedious and time-consuming to test every whim concocted out of thin air by therapists selling unlikely miracle cures. But it can be done, and it is done.
Detox patches and the ‘hassle barrier’
Last in our brown-sludge detox triptych comes the detox foot patch. These are available in most high-street health-food stores, or from your local Avon lady (this is true). They look like teabags, with a foil backing which you stick onto your foot using an adhesive edging before you get into bed. When you wake up the next morning there is a strange-smelling, sticky brown sludge attached to the bottom of your foot, and inside the teabag. This sludge—you may spot a pattern here—is said to be ‘toxins’. Except it’s not. By now you can probably come up with a quick experiment to show that. I’ll give you one option in a footnote.*
≡ If you take one of these bags and squirt some water onto it, then pop a nice hot cup of tea on top of it and wait for ten minutes, you’ll see brown sludge forming. There are no toxins in porcelain.
An experiment is one way of determining whether an observable effect—sludge—is related to a given process. But you can also pull things apart on a more theoretical level. If you examine the list of ingredients in these patches, you will see that they have been very carefully designed.
The first thing on the list is ‘pyroligneous acid’, or wood vinegar. This is a brown powder which is highly ‘hygroscopic’, a word which simply means that it attracts and absorbs water, like those little silica bags that come in electronic equipment packaging. If there is any moisture around, wood vinegar will absorb it, and make a brown mush which feels warm against your skin.
What is the other major ingredient, impressively listed as ‘hydrolysed carbohydrate’? A carbohydrate is a long string of sugar molecules all stuck together. Starch is a carbohydrate, for example, and in your body this is broken down gradually into the individual sugar molecules by your digestive enzymes, so that you can absorb it. The process of breaking down a carbo-hydrate molecule into its individual sugars is called ‘hydrolysis’. So ‘hydrolysed carbohydrate’, as you might have worked out by now, for all that it sounds sciencey, basically means ‘sugar’. Obviously sugar goes sticky in sweat.
Is there anything more to these patches than that? Yes. There is a new device which we should call ‘the hassle barrier’, another recurring theme in the more advanced forms of foolishness which we shall be reviewing later. There are huge numbers of different brands, and many of them offer excellent and lengthy documents full of science to prove that they work: they have diagrams and graphs, and the appearance of scienciness; but the key elements are missing. There are experiments, they say, which prove that detox patches do something…but they don’t tell you what these experiments consisted of, or what their ‘methods’ were, they only offer decorous graphs of ‘results’.
To focus on the methods is to miss the point of these apparent ‘experiments’: they aren’t about the methods, they’re about the positive result, the graph, and the appearance of science. These are superficially plausible totems to frighten off a questioning journalist, a hassle barrier, and this is another recurring theme which we will see—in more complex forms—around many of the more advanced areas of bad science. You will come to love the details.
If it’s not science, what is it?
Find out if drinking urine, balancing on mountain ledges and genital weightlifting really did change their lives forever.
—Channel 4’s Extreme Celebrity Detox
These are the absurd extremes of detox, but they speak of the larger market, the antioxidant pills, the potions, the books, the juices, the five-day ‘programmes’, the pipes up the bum and the dreary TV shows, all of which we will torpedo, mostly in a later chapter on nutritionism. But there is something important happening here, with detox, and I don’t think it’s enough just to say, ‘All this is nonsense.’
The detox phenomenon is interesting because it represents one of the most grandiose innovations of marketers, lifestyle gurus, and alternative therapists: the invention of a whole new physiological process. In terms of basic human biochemistry, detox is a meaningless concept. It doesn’t cleave nature at the joints. There is nothing on the ‘detox system’ in a medical textbook. That burgers and beer can have negative effects on your body is certainly true, for a number of reasons; but the notion that they leave a specific residue, which can be extruded by a specific process, a physiological system called detox, is a marketing invention.
If you look at a metabolic flow chart, the gigantic wall-sized maps of all the molecules in your body, detailing the way that food is broken down into its constituent parts, and then those components are converted between each other, and then those new building blocks are assembled into muscle, and bone, and tongue, and bile, and sweat, and bogey, and hair, and skin, and sperm, and brain, and everything that makes you you, it’s hard to pick out one thing that is the ‘detox system’.
Because it has no scientific meaning, detox is much better understood as a cultural product. Like the best pseudoscientific inventions, it deliberately blends useful common sense with outlandish, medicalised fantasy. In some respects, how much you buy into this reflects how self-dramatising you want to be; or in less damning terms, how much you enjoy ritual in your daily life. When I go through busy periods of partying, drinking, sleep deprivation and convenience eating, I usually decide—eventually—that I need a bit of a rest. So I have a few nights in, reading at home, and eating more salad than usual. Models and celebrities, meanwhile, ‘detox’.
On one thing we must be absolutely clear, because this is a recurring theme throughout the world of bad science. There is nothing wrong with the notion of eating healthily and abstaining from various risk factors for ill health like excessive alcohol use. But that is not what detox is about: these are quick-fix health drives, constructed from the outset as short-term, while lifestyle risk factors for ill health have their impact over a lifetime. But I am even willing to agree that some people might try a five-day detox and remember (or even learn) what it’s like to eat vegetables, and that gets no criticism from me.
What’s wrong is to pretend that these rituals are based in science, or even that they are new. Alm
ost every religion and culture has some form of purification or abstinence ritual, with fasting, a change in diet, bathing, or any number of other interventions, most of which are dressed up in mumbo jumbo. They’re not presented as science, because they come from an era before scientific terms entered the lexicon: but still, Yom Kippur in Judaism, Ramadan in Islam, and all manner of other similar rituals in Christianity, Hinduism, the Baha’i faith, Buddhism, Jainism, are each about abstinence and purification (among other things). Such rituals, like detox regimes, are conspicuously and—to some believers too, I’m sure—spuriously precise. Hindu fasts, for example, if strictly observed, run from the previous day’s sunset until forty-eight minutes after the next day’s sunrise.
Purification and redemption are such recurrent themes in ritual because there is a clear and ubiquitous need for them: we all do regrettable things as a result of our own circumstances, and new rituals are frequently invented in response to new circumstances. In Angola and Mozambique, purification and cleansing rituals have arisen for children affected by war, particularly former child soldiers. These are healing rituals, where the child is purged and purified of sin and guilt, of the ‘contamination’ of war and death (contamination is a recurring metaphor in all cultures, for obvious reasons); the child is also protected from the consequences of his previous actions, which is to say, he is protected from retaliation by the avenging spirits of those he has killed. As a World Bank report put it in 1999:
These cleansing and purification rituals for child soldiers have the appearance of what anthropologists call rites of transition. That is, the child undergoes a symbolic change of status from someone who has existed in a realm of sanctioned norm-violation or norm-suspension (i.e. killing, war) to someone who must now live in a realm of peaceful behavioural and social norms, and conform to these.
I don’t think I’m stretching this too far. In what we call the developed Western world, we seek redemption and purification from the more extreme forms of our material indulgence: we fill our faces with drugs, drink, bad food and other indulgences, we know it’s wrong, and we crave ritualistic protection from the consequences, a public ‘transitional ritual’ commemorating our return to healthier behavioural norms.
The presentation of these purification diets and rituals has always been a product of their time and place, and now that science is our dominant explanatory framework for the natural and moral world, for right or wrong, it’s natural that we should bolt a bastardised pseudoscientific justification onto our redemption. Like so much of the nonsense in bad science, ‘detox’ pseudoscience isn’t something done to us, by venal and exploitative outsiders: it is a cultural product, a recurring theme, and we do it to ourselves.
2 Brain Gym
Under normal circumstances this should be the part of the book where I fall into a rage over creationism, to gales of applause, even though it’s a marginal issue in British schools. But if you want an example from closer to home, there is a vast empire of pseudoscience being peddled, for hard cash, in state schools up and down the country. It’s called Brain Gym, it is pervasive throughout the state education system, it’s swallowed whole by teachers, it’s presented directly to the children they teach, and it’s riddled with transparent, shameful and embarrassing nonsense.
At the heart of Brain Gym is a string of complicated and proprietary exercises for kids which ‘enhance the experience of whole brain learning’. They’re very keen on water, for example. ‘Drink a glass of water before Brain Gym activities’, they say. ‘As it is a major component of blood, water is vital for transporting oxygen to the brain.’ Heaven forbid that your blood should dry out. This water should be held in your mouth, they say, because then it can be absorbed directly from there into your brain.
Is there anything else you can do to get blood and oxygen to your brain more efficiently? Yes, an exercise called ‘Brain Buttons’: ‘Make a ‘C’ shape with your thumb and forefinger and place on either side of the breastbone just below the collarbone.
Gently rub for twenty or thirty seconds whilst placing your other hand over your navel. Change hands and repeat. This exercise stimulates the flow of oxygen carrying blood through the carotid arteries to the brain to awaken it and increase concentration and relaxation.’ Why? ‘Brain buttons lie directly over and stimulate the carotid arteries.’
Children can be disgusting, and often they can develop extraordinary talents, but I’m yet to meet any child who can stimulate his carotid arteries inside his ribcage. That’s probably going to need the sharp scissors that only mummy can use.
You might imagine that this nonsense is a marginal, peripheral trend which I have contrived to find in a small number of isolated,-misguided schools. But no. Brain Gym is practised in hundreds if not thousands of mainstream state schools throughout the country. As of today I have a list of over four hundred schools which mention it specifically by name on their websites, and many, many others will also be using it. Ask if they do it at your school. I’d be genuinely interested to know their reaction.
Brain Gym is promoted by local education authorities, funded by the government, and the training counts as continuing professional development for teachers. But it doesn’t end locally. You will find Brain Gym being promoted on the Department for Education and Skills website, in all kinds of different places, and it pops up repeatedly as a tool for promoting ‘inclusivity’, as if pushing pseudoscience at children is somehow going to ameliorate social inequality, rather than worsen it. This is a vast empire of nonsense infecting the entirety of the British education system, from the smallest primary school to central government, and nobody seems to notice or care.
Perhaps if they could just do the ‘hook-up’ exercises on page 31 of the Brain Gym Teacher’s Manual (where you press your fingers against each other in odd contorted patterns) this would ‘connect the electrical circuits in the body, containing and thus focusing both attention and disorganised energy’, and they would finally see sense. Perhaps if they wiggled their ears with their fingers as per the Brain Gym textbook it would ‘stimulate the reticular formation of the brain to tune out distracting, irrelevant sounds and tune into language’.
The same teacher who explains to your children how blood is pumped around the lungs and then the body by the heart is also telling them that when they do the ‘Energizer’ exercise (which is far too complicated to describe), ‘this back and forward movement of the head increases the circulation to the frontal lobe for greater comprehension and rational thinking’. Most frighteningly, this teacher sat through a class, being taught this nonsense by a Brain Gym instructor, without challenging or questioning it.
In some respects the issues here are similar to those in the chapter on detox: if you just want to do a breathing exercise, then that’s great. But the creators of Brain Gym go much further. Their special, proprietary, theatrical yawn will lead to ‘increased oxidation for efficient relaxed functioning’. Oxidation is what causes rusting. It is not the same as oxygenation, which I suppose is what they mean. (And even if they are talking about oxygenation, you don’t need to do a funny yawn to get oxygen into your blood: like most other wild animals, children have a perfectly adequate and fascinating physiological system in place to regulate their blood oxygen and carbon dioxide levels, and I’m sure many of them would rather be taught about that, and indeed about the role of electricity in the body, or any of the other things Brain Gym confusedly jumbles up, than this transparent pseudoscientific nonsense.)
How can this nonsense be so widespread in schools? One obvious explanation is that the teachers have been blinded by all these clever long phrases like ‘reticular formation’ and ‘increased oxidation’. As it happens, this very phenomenon has been studied in a fascinating set of experiments from the March 2008 edition of the Journal of Cognitive Neuroscience, which elegantly demonstrated that people will buy into bogus explanations much more readily when they are dressed up with a few technical words from the world of neuroscience.
Subjects were given descriptions of various phenomena from the world of psychology, and then raiadomly offered one of four explanations for them. The explanations either contained neuroscience or didn’t, and were either ‘good’ explanations or ‘bad’ ones (bad ones being, for example, simply circular restatements of the phenomenon itself, or empty words).
Here is one of the scenarios. Experiments have shown that people are quite bad at estimating the knowledge of others: if we know the answer to a question about a piece of trivia, we overestimate the extent to which other people will know that answer too. In the experiment a ‘without neuroscience’ explanation for this phenomenon was: ‘The researchers claim that this [overestimation] happens because subjects have trouble switching their point of view to consider what someone else might know, mistakenly projecting their own knowledge onto others.’ (This was a ‘good’ explanation.)
A ‘with neuroscience’ explanation—and a cruddy one too—was this: ‘Brain scans indicate that this [overestimation] happens because of the frontal lobe brain circuitry known to be involved in self-knowledge. Subjects make more mistakes when they have to judge the knowledge of others. People are much better at judging what they themselves know.’ Very little is added by this explanation, as you can see. Furthermore, the neuroscience information is merely decorative, and irrelevant to the explanation’s logic.
The subjects in the experiment were from three groups: everyday people, neuroscience students, and neuroscience academics, and they performed very differently. All three groups judged good explanations as more satisfying than bad ones, but the subjects in the two non-expert groups judged that the explanations with the logically irrelevant neurosciencey information were more satisfying than the explanations without the spurious neuroscience. What’s more, the spurious neuroscience had a particularly strong effect on people’s judgements of ‘bad’ explanations. Quacks, of course, are well aware of this, and have been adding sciencey-sounding explanations to their products for as long as quackery has existed, as a means to bolster their authority over the patient (in an era, interestingly, when doctors have struggled to inform patients more, and to engage them in decisions about their own treatment).