Jo Marchant is the author of Cure: A Journey into the Science of Mind Over Body.From her Q & A with Caroline Leavitt:
Why haven’t more doctors embraced the neuroscience of mind-body therapies? Is it a fear that people will fall prey to charlatans and not get the medical care that they need? Or is the simply the way alternative healers present their cures?--Marshal Zeringue
I think there are several intertwined reasons for this. Much of the skepticism does seem to come from a fear that if we acknowledge a role for the mind in health, this will encourage people to believe in the vastly overblown claims of some alternative therapists. The mind cannot shrink a tumor, banish a life-threatening infection, or mend a broken spine. To pretend otherwise raises false hope and put patients at risk if they don’t get the conventional treatment they need. (I agree that we need to be clear about the limitations of the mind in health, but underestimating it is dangerous too. When scientists and doctors ignore or deny evidence that alternative therapies do help some people, this damages trust in science among the millions of people who feel they benefit from these therapies, and pushes them towards pseudoscientific explanations.)
Another reason for the reluctance to accept research in this field is that science in general is based on a reductionist, materialist worldview that goes all the way back to Descartes, in which subjective elements – thoughts, feelings, experiences etc – as seen as less “real”, and less worthy of scientific exploration, than measurable physical matter. For many fields of research this is a useful distinction, it helps us to get rid of observer bias in experiments, for example. But in medicine the way we feel is of crucial importance, and I think we have to find a way to take this more seriously.
Then there’s the fact that our medical system is based on evidence from clinical trials. We compare treatments against placebos (fake medicines) to make sure they work. That’s important, and works well for physical interventions such as drugs. But it means we underestimate the value of other components of care. This is partly because most trials are funded by drug companies. A more fundamental problem is that placebo-controlled studies are specifically designed to discount any effect of the mind – pathways such as expectation, stress reduction and social support – because these elements are all present in the placebo group too. Any approach that harnesses these mechanisms will automatically fail the trial, no matter how much it benefits patients.
We’re left with medical systems that ...[read on]