Rationally speaking, is a presentation of New York City skeptics dedicated to promoting critical thinking, skeptical inquiry and science education. For more information, please visit us at NYC Skeptic's Doug. Welcome to, rationally speaking, the podcast, where we explore the borderlands between reason and nonsense. I am your host marsupial YouTube. And with me, as always, is my co-host, Julia Gillard. Julia, what are we going to talk about today?

Well, Massimo, the topic of our podcast as a whole is about the borderlands between reason and nonsense. So in this episode, we're going to look at a few examples of practices that are sort of in the grey zone between meaningful and evidence based scientific practices and wew.

So we're we're going to we're not going to give a formal definition of.

Right. No, we'll you know. Exactly. Yeah. So and these various practices themselves occupy different locations in that gray zone, some of them darker, some of them lighter. But so the topic we're going to discuss are acupuncture and yoga and meditation and chiropractic, which to varying degrees have some positive effects, some documented positive effect, and also, to varying degrees, come bundled with a lot of mysticism and false claims.

So we're just going to try to disentangle some of the false from the true claims and talk about how much evidence there is for which claims as opposed to, say, a completely, you know, pseudo belief, such as, say, on the hoppity, where we both know that the theory doesn't hold up and the practice has been shown to not do anything beyond the placebo effect.

So that that of our great example, that's less interesting, really. OK, so shall we start with, say, you know, acupuncture, for instance? Sure.

Well, maybe before we get into any of the science, we should talk about our own personal experiences with, I mean, these things.

Do you have you tried any of these handful of practices?

I have tried only meditation and for a short period of time. But I did try it, you know, kind of semi seriously as precisely because I was curious as to what my friends were telling me that it was a good thing. And I wanted to see what what that would feel like and whether I actually would have any any effect on me. So I tried it for a number of weeks, probably a few months, actually. And yes, I definitely did feel relaxed.

OK, meditation.

Did you try a control control group of days where you just sat quietly and. Right, exactly. Well, that was the thing.

It wasn't doing anything dramatically different for me than just sitting on a chair and actually reading a book. In fact, I my problem was, and this may be my problem with my restless mind, I really got bored. And so if it was a matter of relaxing as in as in getting out of stressful, you know, reduce stress, then probably going out with friends and have a martini, what actually was actually both more pleasurable and more efficacious, although slightly more expensive and slightly more caloric, I suppose, and slightly more caloric.

That's correct. That's a good point. Hey, what are you saying here?

Just that, OK, just that.

And so, I mean, it did have effects. Of course, one can say, Melea. Well, you didn't try for long enough.

It was that which is certainly true.

And but I didn't. And I did see the point about cleaning your mind of some of the clutter. Um, it is an interesting experience that I certainly cannot claim to have reached any high levels in that in that practice. It is an interesting experience that it was worth trying. Unfortunately, I actually like the clarity of my mind. And to me, that is what I am. It's the clutter that goes on. It makes me think about things and different in different directions.

So to me, the whole as a as a scientist and rationalist, to me, the whole idea of emptying your mind means that you're empty yourself and there's nothing left there.

I suppose that's the point.

But it's not a it's not an experience that I actually enjoyed particularly. What about you? I also briefly tried meditation.

I don't think I stuck with it as long as you did. And I also got bored. And and I also I also had this problem that it was a very self limiting phenomenon for me. So I would try really hard to empty my mind. And then as soon as I managed to empty my mind, the pop into my mind, hey, I did my mind and my mind was no longer empty. It had a self-congratulatory thought in it. So that didn't work so well.

Oh, I also I tried a couple of my friends who practice meditation say that it helps them to take control of pain. So it helps them sort of separate out the experience of physical pain from the aversive ness, from the suffering so they can if they're in pain or if they're in, you know, some discomfort, like they're cold, they can recognise that. They're feeling that, but not actually suffer from it, which sounded like a really useful thing to be able to do.

So I sort of I've tried implementing that a couple of times. And more recently, I had. I had. This really bad cramp and I was trying to use this technique to reduce the pain because I was at work and I just I couldn't concentrate on my work because I was in a lot of pain. And so I tried really hard to, you know, put into practice all of the meditation techniques that my friends had told me about and concentrating really hard.

And gradually the pain started to lessen a little bit.

And I was so impressed at how well this technique was working. And then I remembered that I had actually taken four Advil about an hour ago.

And maybe that was why my mind if it was not a controlled experiment, you might have had something to do with it, that some research, some research that does show that meditation does, in fact, help with pain management.

And now but let's let's talk about this. Since we started with meditation, I guess. Let's continue with meditation. So, of course, one of the things that makes me skeptical initially, the first time that I encountered the concept of meditation is that it does come bundled with sort of a set of either religious or mystical, depending on how you want to look at them, beliefs and and language like that.

And that's actually, I think, an important distinction to make, because there are definitely a lot of unfounded and sort of spiritual or mystical beliefs. But there's also sort of fuzzy sounding language that may or may not be trying to pick out something real, because what I've often found is that it's difficult to describe some of the things that are happening in your brain during meditation or, you know, in your brain or body during yoga without using like we don't actually have really clear, precise language to talk about some of these things.

And so when language is fuzzy, either that can mean that there is nothing behind it or it can mean that there is something real behind it. And this is just sort of the best language we can come up with, sort of metaphorical talk about energy or about, gee, that's trying to pick out something real.

So that's a good point. And actually, that reminds me of the perennial problem in philosophy about phenomenology. That is first person experience that, you know, for one thing, by definition, it's inaccessible to others. I mean, you can you can try to do the same thing and perhaps or you will feel the same things or I have the same experiences, but there's no way for me to know whether you have the same experiences or not. Yeah.

So that's and that is related to the idea of it's difficult to to report especially unusual phenomenological experiences and that that that is a problem. Yeah. Yeah, that's true.

And I've wondered about that when. So I'm I'm sympathetic to the argument that I just made about using fuzzy sounding language because it's the best we can do to express the things that are going on inside of us. But but I'm not at all confident that when, say, your yoga teacher says, OK, move your energy upwards and students try to, quote, move their energy upwards and they feel different in some way, is what they're feeling the same as what the teacher is feeling that she expected them to feel?

I mean, you know what they mean by moving energy upwards.

Well, so, OK, let me at least make a reference to something, unfortunately, because I don't know, because I sort of copped out pretty early on the whole meditation investigation thing myself. I can only sort of allude to things other people have told me and what I've read. But a friend of mine who's very scientifically minded, very analytical, tried meditation for about a year, year and a half. Hmm. That's a respectable amount of time.

Yeah, I know it is. And he's reported some benefits, but maybe I'll get to talk about later.

But but he's he has found that he's able to create sensations of warmth or of tingling, for example, in various parts of his body just by focusing his attention on parts of his body.

And so and they're like clear sort of physiological sensations.

Right.

So so that that seems like a plausible thing that could be meant by move your energy. Like if you if you because that's what he's doing. His imagining the sort of vague, inchoate, intangible energy located at a certain point in his body. And he imagines that moving it around, like pushing it around with his mind. And that's what helped create these sensations. So something is happening.

Something is definitely happening. Now, there is actually evidence, of course, that something is happening. As you know, there has been, you know, brain scans of people meditating or on their deep prayer, which is actually a fairly similar condition. It's not identical, but but it's similar condition as far as the brain is concerned. Interesting. Yeah, it is interesting. But on the other hand, you know, I'm I'm always amused when people say, ha ha, they found an area of the brain or, you know, something special happened in the brain.

When you're having when you're doing X, where X could be meditating or.

Yeah. How the body experience or whatever.

Well, yeah. You know, my answer to that is, well, of course, they found something in the brain. I mean, you are having an experience where else right now in your stomach?

I mean, it's you know, we experience the world through the through the processing of information and sensations in our brain. So, yes, I am absolutely not surprised.

I mean, doing this to be a little more charitable to those people you're referring to, I guess their model of how things work is that the brain has sort of, you know, a natural baseline. It sort of hums along with little noise and then and and during its normal thinking faith, and then when you meditate it, the state are very different from how they would be when you're just thinking. Which is interesting. It is interesting.

Absolutely. Now, one of the ways in which they're different is, I think, particularly interesting research in neurobiology of meditation and the prayer show that one of the things that happens when people are in deep meditation is that they're proprioception shuts down. The perception is the ability of the brain to essentially tell where your body ends.

Right.

Which is very useful, because without that, they actually patients who have impaired perception and these people have a terrible time navigating the world, as you might imagine, because they literally can't tell where the body ends and where, say, a chair starts. So is a pathology is it's a terrible pathology, but it is a state that you can induce actually to different degrees during meditation.

What happens is that that those parts of the brain that are more involved with proprioception sort of basically shut down. And apparently the reason that happens is because there is not much central input coming into the brain. So this is something very similar to what people experience when they go into some sort of isolation tanks. So when you get immersed in a tank that is isolated from sound and light and you're immersed in water essentially, and it's a similar situation.

Now, what happens in that case is it's a couple of things. First of all, because your sense of perception is altered, you literally feel your body expanding, which, you know, is sort of becoming one with the universe. That doesn't mean you're actually becoming one the universe. It just means that you have shut down a normal functioning of the brain that tells you where your body ends. Now, that's something that sounds to me like an interesting experience, but it's certainly not a mystical experience.

It's nothing mystical about it. The other thing is one needs to be careful because although this doesn't seem to happen in the meditation, but in under some sort of deprivation, bizarre things happen because the brain at some point just makes up stuff. If if there is no central input to the brain, apparently really abhors a vacuum, a vacuum in that case, a mental vacuum.

And so there are reports of, for instance, people doing experiments with first and third operation. They start having a elucidations very vivid hallucinations. You know, like I said, remember this this report that I read some years ago, this guy that all of a sudden started seeing a Tyrannosaurus rex coming at him with really bad intentions and he got freaked out because he was so realistic. It was, you know, it came with sound and so on. And now he was in a sensory deprivation, sensory deprivation chamber.

Yes.

So, yeah, the brain can do very weird things.

And it was kind of like a screensaver.

Yes, that's right. Now, I also looked at where in India, the actual scientific research on meditation, which it's still in its infancy. There is not much out there, actually. But I found, for instance, that in 2007, the United States National Center for Complementary and Alternative Medicine, which is part of the NIH, published a report where they reviewed 13 different studies of different categories of meditation, practice, medication. And I'm going to read you sort of part of the conclusion of the report, which was this Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality and firm conclusions on the effects of meditation.

Practices in health care cannot be drawn based on the available evidence. Future research and meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results. In other words, there's anecdotal evidence. There's some suggestive evidence from a few studies, but not that much. Now, this was in 2007, so I actually went to Google Scholar and did a search of about all the papers that came out on researching my meditation from 2005 to 2010.

And I will not bore you with the individual reports, but they have titles like, for instance, Mindfulness Meditation for the treatment of chronic low back pain in older adults, a randomized controlled pilot study or mindfulness meditation training effects on CD4 plus T lymphocytes in HIV infected adults, a small, randomized controlled trial effectiveness, a transcendental meditation and functional capacity and quality of life of African Americans with congestive heart failure and so on and so forth. Now, if you go to these papers, the thing you will find over and over is that almost all of them are labeled, even sometimes in the title as preliminary or, you know, pilot and so on.

In other words, they're all based on very small sample sizes. So the situation hasn't changed much since the DNC and the matter. That's right. Some of the analysis. That doesn't mean that, of course, there's not suggestive evidence, but claims of very strong scientific evidence that there are positive effects of meditation and actually exaggerated.

As it turns out, there is some anecdotal evidence of some pilot studies, but not a lot out there.

So I think that the reasonable thing to do is to conclude that at the very least, it will relax you. At the very least, it's an interesting thing to try, since so many people have glowing reports about it. I would stay clear from the front, from the sort of religious or mystical part of it, because to me it makes no sense.

And then the jury still very much open about whether there are significant, serious long term health effects such that one could use it for the treating of even pain issues. Certainly, it doesn't doesn't do anything for more serious disease. Like, for instance, the study on HIV, it wasn't obviously to cure HIV with medication was just to manage the pain caused by the disease, which, of course, it's an important thing to do, but.

Right, right. Um, and I think even with the positive anecdotal evidence worth asking, what is the opportunity cost of the medication? Like, what could you be doing? Because I when I when I thought about continuing my meditation attempt, even the most positive things that people told me about with meditation had done for them, it had improved their focus or it had given them a little bit more ability to stay in the present moment and appreciate what was going on around them instead of their mind, instead of letting their mind jump around a bunch of other things that sounded like good skills to me.

But you have to meditate so much to get those benefits. So I was like, what else could I do if I devoted a half hour a day, you know, three or four days a week to it?

I could go.

I could accomplish a lot, but I value actually more than those. That is a very good point. That is, in fact, the thing that occurred to me when I was trying. And yeah, I imagine how many books I could be reading right now or, you know, blog entries to write that sort of stuff.

Okay, so we're not cut for that. Yeah. Just a brief tangent because this is a pet peeve of mine. I feel like there's this. This. Sort of unwarranted glorification of staying in the present moment. A lot of people have held up to be the sort of self-evident good thing to live in the present and not be jumping ahead to the future about the past or letting your mind wander and just appreciating what's going on around me. And I don't that does not make any inherent sense to me.

So my mental model of how you should be approaching the question of whether to live in the moment or let your mind drift is you have the sort of baseline of like this horizontal line of how much you enjoy daydreaming, whatever you like to dream or think about. And then what's around you sort of varies. It fluctuates. It goes up and down in terms of how interesting or enjoyable it would be if you paid attention to it. So you should just pay attention to what's around you when, you know, the fluctuating line is above the horizontal line and you should let your mind wander when the fluctuating line is below the horizontal line.

Very simple. It might take a good recipe to mean yes anyway. So now we can go back to acupuncture.

I think we were starting out with that. Now, the thing about acupuncture is, is interesting. So, again, the theory makes no sense. I mean, there is no thing no reason in modern scientific terms to think that there is such a thing as cheap energy going through meridians in the body or anything like that. Now, of course, the fact that there is not no evidence in in favor of a certain thing does not mean that we know for a fact that that that thing doesn't exist.

That doesn't work.

But, you know, we are looking from a skeptical or rational scientific perspective. Frankly, the burden of proof is on the person who makes the claim and not on us to say we've shown that it doesn't exist. I don't even know what cheap energy might possibly be or how you could possibly measure it and how does it work. So unless somebody comes up with a systematic idea about it, I think we can dismiss it as using that technical term that you introduce at the beginning of the podcast.

Who do you think that there's any different than that of evidentiary power between a theory that was just come up with by some like one single person without any good evidence or logic behind it, like put me up there versus a theory that doesn't actually have any scientific studies demonstrating it, but that's been practiced by people, you know, as sort of a folk medicine for a long time, that because at least in the latter case, it seems like you could think that, you know, there's more likely to be something to it just because it has stuck around for so long.

Again, not that there is something to it, but it's more likely than it would be if just one person came up with that. With that, I think you're right.

But I think that that applies to the practice and under the theory that is, for instance, want something that we're not actually going to talk about today, but herbal medicine, I mean, it's not surprising that some not all, but some herbal medicine works after a lot of our chemicals that we use in medicine do come out of, you know, biological. I have a biological origin, or at least originally where we're purified from biological sources and then eventually may become produced in an entirely different way.

Now, so does the practice of herbal medicine work? Well, yes, because people for thousands of years have tried you know, it's through a process of trying and after they figure out certain things, work for certain first, humans and other things might work for other means. But whenever they whenever people came up with theories such as, for instance, one of the most popular one is that there is a connection between, say, the shape of the plant and the kind of disease that it's good for because there's some kind of mystical connection between having between shakes.

Well, that makes no sense. That is simply a rationalization that people have come up with our posteriorly. It's not really it doesn't really even rise to the level of a theory, quote, unquote.

Oh, yeah, but but you can come up with theories like the theory of why acupuncture works involving genes that could just have been something people tried were using to try to explain the phenomenon they were observing. So that doesn't mean just because the theory doesn't make sense or isn't substantiated doesn't mean we should reject the practice itself.

That's right. It could be a real theory. That is correct. It could be a real theory that explains it.

Now, when I did some background reading about a couple of interesting things emerge. First of all, let's talk briefly about the history of the whole the whole idea. As it turns out, acupuncture and even so-called traditional Chinese medicine. As we understand it today, it's a fairly recent phenomenon. The term traditional Chinese medicine was invented in 1954 by the Chinese communist officials.

So so it's a very it was a very political thing. And it was, you know, a very recent thing. And now there are, of course, early manuscript Chinese manuscripts about medicine. I think the earliest one dates back to the second century BCE, according to a skeptic, the skeptic dictionary, for instance. But there's no mention of acupuncture. So it's not clear. And there are some of these I do some archaeological evidence of things that look like needles, but it's not clear what they were used for.

After all, people use needles, all sorts of things, just just to puncture each other. So it's not even clear exactly how traditional this was.

Now. In the in the West, the first use of acupuncture goes back to the 17th century and then more prominently much, much later on the 20th century with George Fallada Moran, who was the person that actually introduced it from from China. So it's actually a fairly recent, surprisingly, at least in the current form, surprisingly recent sort of practice.

Now, the thing that about the scientific evidence, it's interesting, there's a lot of studies about acupuncture and there are a lot of a lot of these studies do, in fact, show an effect on on certain kinds of things, particularly, again, pain management. Now, one thing before I go ahead with this, you will notice that a lot of these things that we're discussing about meditation, acupuncture, chiropractic and yoga, a lot of them seems to have effects.

The best evidence that they have, in fact, deals with pain management. That shouldn't be surprising because, first of all, pain is a it's a fairly vague concept. It's hard to measure. I mean, there are scales of pain that but they are obviously subjective because you can't measure pain. Intersubjectivity. It's not there is no pain meter, not that anybody has invented.

I think when doctors ask people to rate their pain and that usually sometimes they have the skill where they have their little smiley faces, ah, well, they start out smiling, but then they get progressively less smiling as you go down the scale until they look horrified.

Right. So there are these skills. But you know, it's not clear whether if I point that, you know, seven out of 10 on that scale really experiencing anything like what you would be experiencing. Right. We talk about that with happiness.

So it's very it's very subjective. It's very phenomenological. And of course, pain itself is managed by the body and by the endocrine system in in the nervous system in a variety of ways. You know, we produce chemicals naturally to dampen the pain, especially for these chronic pain, especially if it is long term pain. So it's very, very difficult to actually measure the pain. And it's also very difficult to say that a particular intervention has an effect on pain as opposed to the body recovering on its own, on its own, or taking other things, you know, changing your diet, changing your habits, et cetera, et cetera.

So I think it's interesting, however, that one of the things that these four things have in common is four parties have in common, is that by far the most obvious evidence, the most compelling evidence in their favor as a practice deals with things like pain management.

Right.

Or other even more subjective things like how stressed are you? Yes. Not a you know, a given moment sort of in general in your life has gone down on average. But it's incredibly subjective and and vulnerable to placebo effect or selective memory.

Right now, it's being a placebo effect. That's the thing with acupuncture. So acupuncture practitioners, acupuncture, you.

Yeah, you would you how would you want to call it?

Oh, no, I just thought that was clever. I didn't know if that was intentional or not. Let's go on the right hand.

Maybe this Freudian talk about another pseudoscience and we're not going to go, OK, so there's there's a lot of evidence that acupuncture does work, meaning that there are a lot of studies, published studies. But the problem, of course, as usual, is in the details. If you start looking at these studies, as it turns out, most of them are actually worthless or close to worthless for one of two reasons, typically, either because the sample size is very small and therefore whatever results may be the result of statistical fluctuations.

That's also related to the infamous file drawer effect. Right. So if you do 10 studies on acupuncture and then turns out in one case, you find a significant effect, that's the one that gets published because typically people don't publish studies where there are negative results. So it turns out you have a sort of a skewed accumulation of allegedly positive results, which in fact are not nothing other than statistical fluctuations. But these are much, much more fundamental problem.

Very few of the published studies include sham acupuncture as a controller because it's difficult to do.

Right.

How do you convince somebody that you put a needle in it without actually putting the needle? Right.

I've read about apparently you can do it. It's difficult. You actually have to be a trained acupuncturist. Do it. Well, you you you can simulate the feeling of putting the needle in and taking the needle out by stretching the skin to certain degree while you're putting them with, you know, the tip of the needle. Right.

Or you can put the needle, you know, you can put the needle inside a plastic tube and have the plastic to get in touch the skin. And the patient actually cannot tell whether the stuff is going right.

Exactly.

Well, there's also the sham aspect can come from the fact that the needles aren't being put in the locations. Exactly. Precisely where he says they should be placed.

There is there is the other thing. You can randomize the. The acupuncture points right now, so if we exclude all of those studies that do not have a sham control, which really are worthless because that they essentially don't have the proper control, that animal control for placebo. OK, it's just it's what it would be the same as doing a study on the efficacy of a drug, for instance, by injecting people with a particular substance or doing nothing serious.

Medical researchers should do that because, you know, that the patient could get could respond as a placebo effect. You should also inject a clean water solution as a further control. You need to control everything you do, these kinds of experiments, the control where you do, in fact, do nothing in the control, where you actually essentially try to to simulate the placebo effect now.

So if we exclude all of those studies on acupuncture where there is no sham control, we're down now to a very small number of studies.

And perhaps not surprisingly, if you do look at the ones with a sham control, there is essentially no effect.

Argument has no effect whatsoever on pretty much anything that the one that sham acupuncture was actually more effective.

Right. Of course, though, those are, of course, my favorite kind of results. Yes. They can also be a right, the result of statistical fluctuations, but. That's right.

So there are no differences with a sham and only that. But the other way of doing it, as you mentioned earlier, is by randomizing the acupuncture points. And again, it does it seems like there's pretty clear evidence that the points don't make any difference. Whatever you whatever you poke people, it's the same and you obtain the same results.

So I think actually after reading and preparation, particularly preparation for these areas that have been I mean, I've been reading about acupuncture here and there, but particularly just reviewing the literature more recently, I feel pretty comfortable, unlike the case of meditation, that we could actually push the acupuncture in the same category as normal. But that is not only the theory is flawed or untestable, the practice also doesn't seem to work beyond the placebo effect, which of course, doesn't work also for myopathy.

Right. And actually, I think it can be difficult just conceptually to figure out what is a placebo effect and what is actually an important result that we care about. So if the results were that stick in people's body with needles anywhere, no matter how deep you go or no matter where the needles are located, that helped manage their pain than that. I mean, it doesn't validate their theory as a whole, but it's still a sort of an interesting results.

And similarly, if if the results with meditation is that relaxing your mind, you know, for or just sitting quietly or praying can can reduce your stress overall.

And that's still kind of an interesting results or I don't know, with something like psychology, psychotherapy, if if the result is that talking to someone, no matter who that person is and what theory they're using, can actually improve your life. And that's then that's also interesting. So I guess I just want to separate out the testing, the theory associated with finding interesting results that we can use to improve our lives.

Now, let's go back to another practice and on the other hand, does seem to have significant, measurable, or at least potentially interesting, you know, positive effects. While the theory, again, seems pretty mystical to me and that that would be yoga.

So just to give our listeners an idea of how Mistick when in fact you can get I I found this these quotes from the Hindu scripture name the Yoga Sutra, which is apparently one of the foundational texts for more than yoga. And, you know, you hear you read things in there, like there's the emergence of the spiritual men from the veils and meshes of the psychic in nature. I have no idea what that means. I can't pass that on.

You know, the see, there's the final section of the book discusses the mechanism of salvation. And the idea is simple working of cosmic law, which brings the spiritual man to birth. All of that to me is just mumbo jumbo. It's just not it's I wouldn't even know where to begin in sort of analyzing that scientifically or philosophically.

So now that said, yes, go ahead.

I was just going to say that it just occurred to me that there are different kinds of mystic or fuzzy thinking about about yoga and other fields, too, like meditation, but especially yoga and the sort of modern, more cosmopolitan and I don't know, like Western urban version, flavor of fuzzy thinking about yoga.

Is this sort of new age?

Mm hmm. Not not necessarily mystical new age, but like psychological new age kind of talk that it centers you or somehow make. Are you a better or more complete person? I don't actually know all the jargon. I don't have a lot to me, but I've definitely heard this so many times. And they're vague words, but they're infused with this sort of value judgment about virtue or or purity, totally untestable, you know, but but still, like they're making claims about about what what yoga does for them.

And those are, in fact, completely untestable. Now, they they've been claims, however, about specific claims, about medical effects, you know, the health effects of yoga. And they are to come to a situation similar to the one we discussed.

If you look at the literature have with meditation, that is there is some evidence, but it's hardly conclusive and it's hardly compelling. For instance, uh. People have suggested that yoga has been used to treat, meditate, I'm sorry to treat depression that would be interested in yoga, meditation problem.

Have you tried yoga? That's right.

Now treating depression. Well, OK. But studies have you ever conclude that although there is there are results from criminal trials that are encouraging, they should be, in fact be seen as as preliminary because the trials suffer from substantial methodological limitations. So there is there's the usual problem of the small size, sample size or different, difficult to do control, different, difficult to actually do serious, serious studies about the effect of these things. Now, yoga is also being claimed again to, for instance, have effects on anxiety and depression.

A 2010 review, however, suggested that the evidence is not conclusive. There been suggestions about yoga's effect on hyperactivity disorders, but a 2010 review concluded that insufficient evidence to effect to assess the effectiveness there is. On the other hand, as I mentioned earlier, some evidence that yoga is effective for the management management of chronic, although not acute pain. So there is something there when it comes to more and more important diseases like cancer, for instance, the claim is not that yoga can cure cancer, but but again, that it can help the patient essentially deal with the situation again, deal with the pain and also affect the mood, therefore depression and so forth.

The evidence there, again, is mixed. There is insufficient evidence that yoga has any effect on dementia, which is another one of the claims that has been made in the literature. There's no evidence to support that yoga has any effect on epilepsy. There is yoga has not been shown to have any effect on menopause and so on. So there is a large number of these things where you do find effects.

As I said earlier, it was things like stress and pain, you know, and it presumably, since it is a form of physical exercise, of course, it also helps in general in terms of, you know, your ability to stretch and your ability, your physical ability to balance, not in the sense of being centered, but in the sense of physical violence, those kinds of things.

That's exactly that's another great example of this. What is our control group question that I was talking about earlier? You know, if you find benefits from yoga, well, if you're interested in the benefit of yoga as yoga, then you want to really know what the benefits are above and beyond the benefits you would get just from stretching or just from, you know, working. Your muscles are the sort of thing.

Now, interestingly, I found that, however, there is also a small but you know, what is in the literature about negative effects.

Oh, really? Yeah, exactly. I was surprised. Self-righteousness stuff, right? Yes.

Now, the literature is not about that, but I'm sure an interesting study that yes, there's anecdotal evidence of that.

But for instance, there is especially for because yoga can be practiced in a variety of a variety of levels, some of the practice is actually physically pretty demanding.

It's not it's not just, you know, minor little thing. So there's been reports, for instance, of tears in the carotid artery, which is something serious problems with bulging interview, intervertebral discs, injuries to the rotator cuff and so on and so forth, the compression of the spine, for instance. So there is there's things and even some stroke in young women practicing practicing yoga.

So there's one need to be careful.

It is a physical exercise and as such can be demanding and it needs to be done carefully. It's not the kind of thing where there's only advantages and disadvantages. As it turns out, the advantages are questionable. At least there is only very limited evidence of those advantages. And there is some evidence of of these advantages of one need to be careful since we're sort of running out of time.

Do you want to talk about chiropractic briefly before we wrap up? Yes. Very briefly, have you investigated the potential benefits and theoretical underpinnings of chiropractic?

So that one actually, it's it's interesting for a different reason. This is a very recent thing. There's not an ancient practice at all. And then, you know, the basic idea of chiropractic is that it cures or addresses problems that are caused by the misalignment of the spine.

OK, now we don't have problems with that. Well, because apparently, according to chiropractic theory, the misalign spine can cause malfunctioning of nerve signals to the rest of the body, into the brain, into the rest of the body, which apparently causes all sorts of ailments.

So the claims of chiropractic ranged from well, well, what we can do is really to to fix your. Back pain to really outrageous claims that they can cure pretty much everything. For instance, the practice actually was the idea of Didi Palmer, who came up with it in 1895, and this guy was a grocer and magnetic healer. So that was his background from Davenport, Iowa. And Palmer was influenced. He was an interesting character, apparently. I mean, he thought of himself as similar to Muhammad and Jesus.

So he had pretty good and, you know, self image, image. Thank you.

And he started making very interesting, very broad claims, like things like 95 percent of all diseases are caused by displays of depression, which is clearly false.

And he was probably very close to that calculation. Yes, it was very clearly false even at that point. So let alone now, the guy, however, was very successful and in promoting the practice and his son actually took over after his death. And the interesting thing is they bought a bunch of radio stations and they started publicizing the practice to do advertisement radio stations.

And they started sending these devices, devices that are supposed to be one of them was called the neuro km, which basically would measure the degree of misalignment of the spine. Now, needless to say, this thing doesn't measure anything. It costs a lot of money.

And it is the same kind of device, by the way, that the original chiropractor's study sending these the same kind of devices that you today see Scientologists using to measure stress is the same. And that's where they came from. And there is absolutely nothing to it.

Now, the thing is now does it work? So the theory is that work doesn't work.

Again, the strongest evidence there is for things that are most difficult to measure, such as back pain, are, you know, chronic pain things, the strongest evidence. That's that's where the strongest evidence is.

So first of all, it's very difficult to do a controlled experiment in this case.

You know, how would you do a controlled experiment? What you can do is to compare the efficacy of chiropractic to other things, to other kind of, you know, normal physiotherapy, for instance. And the studies that I look at don't seem to to really suggest that there is any particular effect, the positive effect of chiropractic for a lot of the things that are claimed chiropractic does, with the exception, as I said, of the same kinds of things you would get in a normal physiotherapy, which means it's not clear what it is, in fact, at all more efficient, efficacious than than the physical therapy.

Now, here's an interesting story about the American Medical Association, originally strongly fought, opposed chiropractic.

And in fact, the it was discredited, was criticized by the Committee on Quackery, a special name that is the official name of the medical association.

It is lovely, except that the chiropractic association fought back and filed the lawsuit.

And as you know, in this country, who filed the lawsuit then you can you can get quite a bit of mileage out of these kind of things. So this happened in 1976. The AMA was sued for restraining trade and the chiropractic association, one, which means that these days chiropractic and other complementary medicine approaches are actually not criticized by the AMA. The AMA doesn't endorse them, but they don't criticize them either. So the thing is, you know, it pays if you have lawyers and also if you can lobby Congress and state legislatures to do these kind of things, you will find a lot of more interesting references about chiropractic in the Skeptic Dictionary entry.

That's a very good jump. Jump in from that literature and then you can check from there. Um. So that seems to me the kind of things that it's somewhat similar to yoga, perhaps somewhere even somewhat even less effective, maybe the theory is coocoo, the practice is so and so. So let's see, what do we have at the end? We rank them. Yeah, let's see.

So we have meditation that probably has an effect on certain things. Certainly it comes down to in terms of stress, in terms of pain, perhaps. But then.

Well, I think there are other claims of meditation that haven't actually been studied in any scientific studies I've seen. But that there is anecdotal evidence for like how can you live in the present, you know, which might be time for study, but that's whatever that means.

Right. But other than that, there's not much evidence, in fact, that most of the studies are inconclusive. Yoga is in a similar situation. There is little evidence that it actually does a lot of what it's claimed.

But it does seem to have an effect on, you know, in terms of as a form of physical exercise, in terms, again, of pain management and so on and so forth. Chiropractic is even less than that there. There is even less convincing evidence that it's working. By the way, I should add that that just in as in the case of yoga, there is there are reports of serious injuries caused by chiropractic. So one needs to be careful, in fact, more serious than the one that one can encourage in yoga.

You can have serious and permanent damage to the spine if if the manipulation is not done properly. So you don't need to be really careful. The chiropractic can can be incredibly dangerous. And then I think I would put acupuncture way at the last at the bottom of the pile. And in fact, as I mentioned earlier, probably at this point out of the grey area and definitely into the I don't think so black.

So I don't know what direction probably goes black the in the. I don't think so area. Right, right.

So maybe we'll we will post this chart on our on our actually speaking podcast link. I think we are out of time for this section of the podcast. So let's move on to the rationally speaking PEX. Welcome back. Every episode, Julie and I pick a couple of our favorite books, movies, websites or whatever tickles our irrational fancy, let's start as usual with Julia Spik.

Thanks, Massimo. My pick is a book called Don't Shoot the Dog The New Art of Teaching and Training by Karen Pryor.

She is a former dolphin trainer, and the book is about how to train animals. But it's also about how to train people and how to train yourself. So it's really sort of a psychology book in disguise and it's a really fun read and really interesting. And so she'll do things like she'll take principles of training, like things that that people often get wrong when they're, say, trying to train a dog and she'll show you how they apply to people.

So, for example, one mistake that people often make when training their dogs is that they'll they'll they'll do something that will end up actually reinforcing the opposite of the behavior that they want to train their dog. So, for example. Yeah, so OK. So, for example, when their dog is running away and not listening to them and not coming when they call, they keep calling, they keep calling in front of the dog comes back and then they yell at the dog and they in their mind, they're yelling at the dog for having not listen to them.

But the dog experiences is OK. And then I got yelled at. So that's that's the opposite of what you want to be doing.

And dogs that reflect if it's right. Right.

They can't think back and, you know, you know, search their history for what could have caused it so. And so this is something that people do all the time. So let's say you you want your son to call you more.

And, you know, he doesn't call. He doesn't call and phone. He calls. And the first thing you say is, why don't you call me more?

Oh, yeah. My mother. Oh, yes. So right.

So I mean, this is just an example of the sorts of things we can learn from from training animals. And and there's other lessons for yourself in how to how to make yourself happier, too. So, for example, when you're training any animal, I think this definitely applies to dolphins. Intermittent rewards are actually more effective than constant rewards. So if you if you give the animal a treat, sometimes when it does the right behavior, but all the time, that's actually it takes the animal a little bit longer to figure out what the desired behavior is.

Well, once it figures it out, it'll do it much more consistently and it'll keep doing it much longer after you've stopped giving it treats than if you gave it a treat every time. So so you save on treats.

Do you save a treat to. Absolutely. And this is something that some people have theorized, explains our addiction to certain things like email. That email gives us intermittent rewards.

So when you check your email, usually there's nothing that exciting. But every now and then there's something really cool in there. And that just keeps us checking and checking and checking. So recognizing that pattern of behavior by seeing it in animals can help you reconsider how you're spending your time as a human. Sounds good.

Well, my pick is a book that came out a few years ago, actually. It's called Pleader, Not Prozac, Applying Eternal Wisdom to Everyday Problems. This is by a colleague of mine, actually. Limonov is a philosopher at the City University in New York City College. And I met Lou and we had discussions about this thing. It's a controversial idea. This is the idea of philosophical counseling. And the reason I'm bringing it up now, even though the book is a few years old, is because there was a very recent article in the press that I just wrote about, and I think it was in The Washington Post about philosophical counseling.

It's spreading. It's not a huge phenomenon still, but it is it is spreading. There's several hundred practitioners in the United States, mostly on the on the two coasts. But but they're all over the place. And there are there's an international organization that deals with philosophical counseling.

So the basic idea is, you know, the title of the book encapsulates quite a bit of it played on Prozac, although Lou is very careful in saying right at the beginning of the book that, look, if in fact you do have serious, you know, chemical imbalance in your brain, so much so that you can't think and you can't function in any way, the first thing you should do, in fact, is to get Prozac. Right.

Right. But the idea is that once you even after you take Prozac and you bring your brain down to a functional functional level, you still have questions that you want to ask yourself and answers that you want to find. So you have to use your brain in one way or another, in which case talk therapy might be a way to go. Now, there is an enormous variety of talk therapy, and the idea is that psychologically that I'm sorry for cancer is essentially a type of talk therapy and it deals with those situations where the questions and you might have the problem you might have are existential in nature.

And so you can draw instead of on, you know, psychoanalysis, you can draw on, say, on epicures ideas about friendship or love as opposed to, you know, Freud's ideas on the same topics. It's an intriguing idea. I have not tried. It is intriguing.

I've tried doing that to other people who have come to me with depression that they think is caused by, you know, not understanding what the meaning of life is. I mean, it could just be that I'm not good at it or maybe it's really hard to do. But but.

But I have not. I really found much success in making, like, clear philosophical arguments that actually change someone's emotional state, which makes me think that the existential attribution is not really the real cost.

This is probably a discussion. Yes. That maybe perhaps we should do a separate episode on this. Now, one of the commentators that that I follow after the article that came out in The Washington Post mentioned, however, that in fact, cognitive behavioral therapy, which is the only demonstrable, demonstrably functioning of psychotherapy that we have at this point, actually starts started out is based very much on.

Yeah, that's a great point. I should have mentioned that. But I, I think that's why I found it helpful that it really challenges your beliefs and ask you what evidence you have for those beliefs and so on and so forth.

So that's the idea. You know, it might be an interesting read and and something some food for thought, not Prozac. Very cool.

Thanks, Massimo. We are out of time. So this concludes another episode of rationally speaking. Join us next time for more explorations on the borderlands between reason and nonsense.

The rationally speaking podcast is presented by New York City skeptics for program notes, links, and to get involved in an online conversation about this and other episodes, please visit rationally speaking podcast Dog. This podcast is produced by Benny Pollack and recorded in the heart of Greenwich Village, New York. Our theme, Truth by Todd Rundgren, is used by permission. Thank you for listening.