Testing Our Critical Thinking

At least once a day, though we may not even realize it, our critical thinking is tested.  I received this in an email from a friend who participates in a weekly walking group at a local nature center.  It’s good exercise and a pleasant time, but one of the participants wanted to let us know about additional benefits.

The article attached to the email was about something called forest bathing, and it tells how walking in the woods can be healthy, in fact, healthier than walking down a city sidewalk.  The headline tells us:  “A Retreat To Nature Can Boost Immunity And Mood.”

But forest bathing is more than just walking in the woods and enjoying the natural surroundings.  The outing in the article was led by a Certified Forest Therapy Guide.  It is the guide’s job to encourage participants to “slow down and become immersed in the natural environment” and to help them “tune in to the smells, textures, tastes and sights of the forest.”  The guide leads them through exercises to help them isolate each of these senses to take in the unique sights, sounds and smells.

It’s clearly not like hiking, because the forest bathers have no particular destination.  It’s a slow, mindful walk, akin to walking meditation practiced at some yoga retreats.  The emphasis is on the present moment, rather than on plans or worries.

After describing the experience, they list the health benefits.  The practice began in Japan where one study showed that walking in a forest environment “led to more significant reductions in blood pressure and certain stress hormones” than walking the same distance in the city.  I followed the link and found that this study had only 16 participants – was that 8 in each group (a test group and a control group)?  If so, that is an extremely small sample size; if not, it's not really an experiment. (And always remember that linked does not mean causes.)

They cite other “preliminary” studies as well.  One referred to as a “small study” and another with no mention of sample size or the experimental design, but both touting benefits of being in close proximity to trees or enjoying certain scents of the forest.

Now comes the worrisome part.  Apparently we are not able to get these benefits on our own.  The Association of Nature & Forest Therapy is training and certifying Forest Therapy guides to help.  Using this rather sparse scientific justification and an unsupported assertion that “work-related stress accounts for up to $190 billion in health care costs each [year],” their representative makes a leap of faith that forest bathing should be part of every doctor’s toolkit and covered by health insurance – "It's my hope that the health care system will include [forest therapy] into the range of services they reimburse for.”

Now I don’t doubt that taking a nice quiet leisurely walk in the woods, being sensitive to and appreciating the natural surroundings is surely healthier and more relaxing than walking down a crowded city sidewalk.  That’s a no-brainer.  But do you need a coach to benefit from it, do you need to pay and should insurance be involved?

The whole thing begins to sound like the case of therapeutic touch, which has no scientific basis, but for which insurance companies reimburse hospitals.  It reminds me of the company that sells scooters to the elderly with the sales pitch, “if Medicare doesn’t pay for yours, it’s free.”  The forest bathing business (and it is a business) wants to slide into that category enjoyed by some other health-related businesses – “your insurance will cover most or all of the cost.”  We’ve heard the sales pitches over and over and should know deep down that when no one is paying, no one is caring how much it cost and no one is concerned about abuse or true quality.  Patients get placebo benefits and the therapists get insurance money.  Our health costs rise and everyone wonders why.

A Hospital Faces Reality

It’s nice to see hospitals beginning to make more responsible decisions about the difference between real medicine and folk remedies.  In this case the Children’s Hospital of Philadelphia (CHOP) has removed dietary supplements from their pharmacy shelves.  If, after receiving educational information on supplements, parents still want to provide them to their children, they “must sign a hospital waiver stating that they agree to be responsible for providing the product.”

“The hospital said the action was being taken because the Food and Drug Administration (FDA) does not routinely review the manufacturing of dietary supplements, and therefore cannot guarantee their safety and effectiveness.”  This is a fact that I have pointed out several times in the past (including June 22, 2012 and September 20, 2013).  CHOP goes on to explain:  “Because vitamins and dietary supplements are essentially unregulated, there is no sound information about adverse side effects, drug interactions, or even standard dosing for the vast majority of them.”

This lack of regulation must seem like a small problem to Americans who spend $20 billion every year on vitamins, minerals, herbs, botanicals, amino acids, enzymes and animal extracts including a long list of “natural” products.  The consistent advice from health experts has been that, except in unusual circumstances, it’s best to get the vitamins and minerals needed from a healthy diet rather than from multivitamins.  Otherwise most supplements lack evidence of effectiveness and must rely on endorsements from friends and celebrities with no guarantee of purity or safety.  (Ironically at a time citizens are urging the FDA to get involved with testing dog treats for safety, Congress still feels it proper to yield to pressure from the supplement manufacturers to leave them unregulated!)

Further illustrating the dangers are articles like this one from CNN about people dying or having to undergo liver transplants after taking a diet aid called OxyElite Pro.  They report further that the maker of this product once distributed OxyElite containing a substance called DMMA that the FDA determined to be a cause of “increased blood pressure, shortness of breath, chest tightening, cardiovascular problems and even heart attacks.”  Supplement companies, however, are not required to test for or warn of these side effects before selling their products.

Once again a little research and critical thinking tell us that supplements are at best a waste of money and at worst potentially fatal.  At a time when many hospitals offer and charge for the long-ago debunked practice of therapeutic touch, it’s refreshing to hear of at least one with the ethics to resist public pressure and do the right thing.

Psychic Healing

In February a Colorado woman was accused of stealing nearly $300,000 from clients and ordered to serve five years in prison and to pay restitution.  According to testimony, she told her clients that she needed their cash to draw out the bad energy and needed to check their credit cards to see how frequently the number 6 appeared.  She kept the cash and used the credit cards at local department stores.  She was found guilty on 14 counts of fraud and 2 of tax evasion. 

Imagine how desperate people must be to consult a psychic healer to help them solve their problems!  Despite articles like this one, and many others besides, that show psychic healing as well as other so-called psychic abilities are unsupported by scientific theory or actual results, Americans still pursue this as an avenue of relief.  In this case they were lucky and may get some of their money back.

Is it fair to paint all psychics with the same brush, labeling them all frauds?  Perhaps not, I’m sure some sincerely believe in the abilities they claim.  Still, James Randi, magician and debunker of things psychic, has for many years offered a $1 million prize to anyone who can demonstrate true psychic powers under controlled conditions.  He has gotten few takers and no winners.  Yet police sometimes call in psychics to help solve crimes.  If they don’t, they risk being accused by victims or their families of not doing “everything possible.”

Back in 1996 a nine-year-old girl for a science project devised a method of testing the validity of therapeutic touch, an “energy medicine” which claims to promote healing and reduce pain and anxiety when therapists move their hands over a patient to manipulate his or her “energy field.”  The girl contacted 21 experienced practitioners, sat them behind a screen and asked them which of their hands was experiencing the energy field from her hand.  Their success in detecting the energy field was no better than random guessing.  Results of this experiment were written up in the Journal of the American Medical Association.  Yet the State of California awards continuing education credits to nurses who learn this technique and “an American Hospital survey conducted in 2005 noted that about 30% of 1400 responding hospitals offered [and presumably charge for] therapeutic touch.”  

What we see here are further examples of uncritical acceptance of alternative practices based on anecdotal evidence rather than scientific testing.  This seems to be the trend.  We are encouraged to be open-minded, but there is a difference between being open-minded and foolish when it comes to our health and how we spend our money in general.