Alternative Therapies BBC2 Monday 24/3/2008
In an appallingly crafted hour of 'investigation' into whether reflexology works Professor Kathy Sykes interviews various reflexologists, their patients and eminent scientists. This was very bad TV because you could see the bias from the beginning and the conclusion is telescoped well in advance.
Of course an anatomist was wheeled out to show everyone what they already knew: there is no anatomical connection between the soles of the feet and specific areas parts of those soles are connected to according to reflexology. No mention was made of parallels with acupuncture and it's subtle meridians - not fully accepted by medical science but used by the Chinese for a mere 5000 years or so. These meridians are the most plausible explanation for the reflexology effect.
Trials showing that reflexology did indeed make patients feel better but no more so than head massage were described to show that it basically is all in the patients' minds. It's okay for others to feel better by being duped but this is not for people like Prof Sykes who think their highly personal mechanistic and deterministic view of the universe is common sense and people who disagree are deluding themselves.
I'm used to this low brow fare from the BBC these days - so why am I discussing this?
Because this programme by implication expressed a very damaging view of what has been called the 'placebo effect' And as in previous blogs - I have said that it is terribly poorly understood. And so it proved to be last night by the prof.
Kathy Sykes came to the conclusion (which we saw coming all through the programme) that it was the ambience, the kindness and most of all the touch that did the healing - not the reflexology. Something was said about touch alleviating the 'emotional burden' of the illness and about GP's not having enough time to do this.
Not enough time? She might have added not enough inclination and not enough training but more important than this is a simple point: These holistic/alternative approaches do not work if the practitioner does not believe in what s/he is doing. A GP who touches his patient on the shoulder reassuringly will get better results than one who doesn't but he won't get better results from this than a reflexologist who sincerely believes that what he is doing works beyond the healing effect of touch.
Personally I believe there is more to reflexology than just touch. I believe it works in its own right but also because of the whole healing set up - which would not be there if the reflexologist did not believe in the healing effect of the work. There are other systems of medicine where one part of the body has a map on it that represents other parts. These include auricular acupuncture and iridology both of whom have many adherents including medical doctors. Almost every cell in the body has the DNA to clone the whole body again. Thus it's not surprising to me that one part of the body could have some subtle knowledge about another part. No mention of this of course.
The only part of the programme of value was watching Prof Sykes admitting that going to a 'cuddle club' in LA really moved her and made her feel better. Interestingly as she said this, she was unable to look at the camera. Heaven help her if the viewer saw tears in the scientist's eyes as she felt better for reasons her central nervous system could not fathom.
This was a programme that probably hurt some people who have benefited from reflexology whatever its operating mechanism. It certainly wasn't good for reflexologists who in my opinion do a lot of good and many of my patients have reported very good results from going to see them. And there is the rub. If patients feel that reflexology does them good then so be it. Let them see reflexologists. But no - in an age of ugly scientism we have people like Prof Sykes on TV there to rid us all of our 'illusions'. No surprise to see 'quackbuster' Raymond Tallis on the programme but no doctor who advocates an holistic approach in medicine. Boy do I love paying the license fee!
Science Rules okay? No it's not okay. Medicine is an art as well as a science as every doctor knows. And reflexologists practise the true art of healing a lot better than most doctors, not that I'd go to one if I had appendicitis of course. We doctors can learn from this and what we should learn is something about the art of medicine - not condescendingly diminish people who are genuinely helping others, say it's all in the mind and oh what a pity that NHS GPs don't have the time to get people better using touch, care and love.