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Alternative Medicine 
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Post Alternative Medicine
I saw geo's post on the "Faith and Confidence" thread, in which he cited the biological facts behind the effectiveness of the polio vaccine as an example of objective knowledge upon which we can rely. Shortly after, I read an article in last month's Atlantic titled "The Triumph of New Age Medicine," by David H. Freedman. I also recall that geo a while back pointed out that acupuncture has never been show to work in randomized trials. The article is somewhat mistitled (a habit of the Atlantic's, lately), in that the author doesn't extol new age medicine. The triumph he speaks of is the inclusion of alternative practices in the curricula of the best medical schools and at the Mayo Clinic. He does bring up the strong evidence that all alternative medicine works, if it does work, only by the placebo effect.

But, that's the catch. The placebo effect isn't confined by any means to new agey medicine, but occurs frequently in Western, drug-and-surgery centered medicine as well. It might be said that a primary goal of all medicine should be to increase the placebo effect, which is only harnessing the mind's power to affect physical systems. New Age medicine tends to correlate with practitioners establishing better relationships with patients. They look at lifestyle factors and spend more time listening to patients. In contrast, it seems broadly true that conventional medicine dispenses cures without as much regard to how the patient feels, thinks, and lives. And the results of that medicine are being called into question even by those who take a strictly scientific view. Simply put, many surgeries and drugs just don't measure up to claims, or they have side-effects that can be worse than the ailments they supposedly cure. Western medicine was hugely successful in wiping out most infectious diseases, but against diseases that tend to be chronic and without point causes, not so much. Thus we're seeing the walls of resistance to all sorts of formerly strange practices, coming down in the medical establishment. Why not give them a try?, seems to be the feeling.

Is there something of value in "faith-healing"?

http://www.theatlantic.com/magazine/arc ... cine/8554/


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Post Re: Alternative Medicine
My problem with “alternative” medicine, beside the fact that it often preys on the ignorance and financial gullibility of the public, is that the industry has been infiltrated by many charlatans hyping unregulated vitamin and dietary “supplements” primarily to make a buck. In the early days of what was known as “holistic” medicine, many of its practitioners were honest believers in blending the physical, psychological and spiritual aspects of good health, sometimes employing ancient herbal treatments and other methods, like acupuncture, acupressure, yoga, shakra adjustments and the like. Though I am not much of a believer in the medical efficacy of such treatments, I do recognize the enormous role the placebo effect plays in medical treatment, and that it probably accounts (at least in part) for 30% to 40% of all “cures,” from those attributed to certain modern drugs, to the practices of ancient shamans, to the “spontaneous” remissions attributed to prayer and other spiritual influences.

My father was a general practitioner in St. Petersburg, Florida for many years back in the ‘40s, and ‘50s, at a time when medical and psychological specialists were limited in number and fields of practice. Consequently, he tended to serve in the same capacity as the early holistic practitioners, acting as a personal and family advisor, psychologist, and even spiritual consultant (he was an ordained minister before he became a medical doctor). Because of this intimate knowledge of his patients, he knew just about everything there was to know about them, and he treated them, not only according to their complaints and actual medical needs, but also taking into consideration their mental, spiritual and emotional state and how that might influence their health. I mention this to point out that he was also quite aware of the placebo effect, and that one of his oft-used treatments was the prescribing of what he called “sugar pills.”

Today, however, the exploitation of the placebo effect has gone way beyond anything actually intended to effectively treat illness. One need only watch a bit of television, listen to the radio, or read a few newspapers and magazines to become aware of the incredible claims made for various supplements and unregulated chemical compounds—claims that, when these products are put to the test in legitimate, peer-reviewed, double-blind studies, are almost always found to be false. And these studies are controlled to account for the placebo effect. This now-huge industry is little different than that of the early traveling patent medicine salesmen, who used hype and salesmanship to sell bottles of pure crap to unsuspecting dupes. Nor is it much different than the charlatan “preachers,” whose charm, acting ability and gift of gab relieves thousands of susceptible people of millions of dollars every year.

This is not to say that there aren’t a few sincere, dedicated and sensible practitioners of alternative medicine, but for the most part, these are also medical doctors, who have the expertise to recognize when a placebo may be of benefit, or who rely on legitimate medical evidence of a therapy, drug or supplement’s value.

Say what you will about the ineffectiveness of today’s drugs and medical treatments, however, you might also take a look at the tremendous increase in life expectancy as medical science has matured over the past couple of centuries. Of course, a lot of this has to do with improved hygiene and living conditions, however, it was the medical researchers and scientists who pioneered the move to better hygiene, waste treatment, the use of antiseptics and many other beneficial changes in environmental and lifestyle practices. Along with these improvements, however, we have also done a great deal to pollute our environment and create food and other products that lead to all manner of chronic health problems that medical researchers and practitioners must cope with.

Unfortunately, with drug and medical device manufacturers now funding much of the medical research at universities and private labs, and hospital and insurance industry lobbies influencing medical care in all its manifestations, the emphasis has turned from caring for the patient to caring about the bottom line. It’s a sad thing to face, but the fact is that in today’s super-profit-oriented atmosphere, dealing with health issues, whether through alternative or traditional medicine, has become all about the money.


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Post Re: Alternative Medicine
If alternative medicine actually worked it would be called . . . get ready for it . . . conventional medicine.

But here's the rub. Quite a number of studies have been done on acupuncture which show time and again that it doesn't work, at least no better than the placebo effect. (Actually it shows slight effectiveness in one area that I can't remember). And, yet, acupuncture is in fairly wide practice because people seek it out. The question becomes why do people seek out alternative medicine in the first place. Part of the reason is, as DWill says, traditional medicine is frequently cumbersome to navigate and also dehumanizing.

I don't know if this is true or not, but I would suspect that acupuncture is in a better position to promote the placebo effect better than traditional medicine precisely because of the woo factor. There's a ceremonial aspect to it, probably some music and talk of energy channels and the promise that it is derived from ancient medicine practiced for thousands of years (appeal to antiquity). Likewise, most chiropractics talk about energy channels and other kinds of bogus nonsense. It turns out that some of what chiropractics do actually works for entirely legitimate therapeutic reasons. But again, your typical patient doesn't want to know about all that legitimate stuff. They want the woo.

I think of some alternative medicine as perfectly fine for that reason. It's giving the customers what they want. I was in the local Convenient Care recently and I was surprised to see a poster on the wall advertising a local acupuncture service. I don't know what the arrangement they had with Convenient Care, but they were very careful to describe it as supplemental to traditional health care. So here's a way to get legitimate medicine and a little woo on the wide.

I think the danger in offering alternative medicine at the Mayo Clinic and such is that is that it legitimizes alternative medicine and opens up the doors for all kinds of charlatanry. This is basically a cutthroat industry that will prey on people's ignorance. Traditional medicine needs to uphold its standards of double blind trials and empirical evidence. The alternative health industry would love to blur those lines. When health insurance starts paying for alternative health cures which I think is already happening to some degree, we can be pretty sure that medicine is becoming corporatized and that patient care is the last thing that anyone cares about.


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Last edited by geo on Thu Sep 22, 2011 10:17 pm, edited 1 time in total.



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Post Re: Alternative Medicine
geo wrote:
Likewise, most chiropractics talk about energy channels and other kinds of bogus nonsense. It turns out that some of what chiropractics do actually works for entirely legitimate therapeutic reasons.


My dad considered chiropractors and osteopaths to be "quacks," since, at that time (the '40s and '50s) they could get their degrees and certification via mail order, and their theories that all illness emanated from the spinal column didn't make sense. I'm not sure what the requirements are today, but there are some chiropractors who are also MDs, and I have known a couple of people who benefited from chiropractic treatment after traditional therapies failed (both had serious back problems). Whether or not this was the "woo" factor at work, I couldn't say with any assurance, but if were a betting man, I would throw down a grand or two on the square that said it was.


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Post Re: Alternative Medicine
You two did a great job of carrying that ball--thanks. I have a friend who has been into homeopathy, reflexology, and acupuncture as well as a few others. It's almost a touchy subject between us. I do believe that a lot of what he likes about the alternative practitioners has to do with attention. It's perhaps harder to find a regular doc who shows genuine concern and is a sort of cheerleader or coach. But it's hard to generalize. The best statement I ever heard about health was told to me by a doctor (psychiatrist, actually), who said that there should be a sign in every doctor's office reading, "75% of you will get better anyway." And I've found that often to be true about bodily ailments such as tendonitis. I leave it alone and it improves or goes away. If I were to treat it with anything, either conventional drugs or homeopathy, I'd then attribute the improvement that comes around naturally as due to the substance.

Leaving aside the whole alt. medicine industry, it's apparent that we're doing something wrong in the U.S. with our standard care: the most expensive healthcare in the world yet 37th in effectiveness among industrialized countries. It could be that the new agers are exploiting deficiencies in the way we do things.


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Post Re: Alternative Medicine
DWill wrote:
. . . Leaving aside the whole alt. medicine industry, it's apparent that we're doing something wrong in the U.S. with our standard care: the most expensive healthcare in the world yet 37th in effectiveness among industrialized countries. It could be that the new agers are exploiting deficiencies in the way we do things.


When I was living in Florida, my doctor was a "boutique" doctor, meaning that he didn't accept or have anything to do with insurance. I paid him per visit, including the annual physical which was required for me to be his patient. Consequently, our relationship was truly doctor to patient. I went to see my doctor once or twice a year and I knew if I had any problems, he was my doctor and he would be there for me. He knew who I was, knew all about my history of stomach issues which was great because that's what his specialty was. This doctor will even make house calls if the situation warrants it.

Here in North Carolina, I became established with a local physicians' group, but the couple of times I've gone in, the physician's assistant who I'm assigned to doesn't know who I am from any of his other million patients. Take a number. Recently I threw my back out and I tried to make an appointment, but the physicians' group couldn't get me in right away so I went to Convenient Care instead and they fixed me right up.

Most medical issues will go away on their own without any medical intervention at all. So probably most people who go to an acupuncturist are just getting some attention and reassurance which, as DWill says, is all they really want anyway. And when the problem goes away, they believe it was the acupuncture that cured them.

It's that little bit of attention that our standard health care system doesn't provide. They've turned it into an assembly line, run you through a battery of tests where you have to deal with nurses and physicians's assistants who are overworked and underpaid. The physicians' group doesn't require an annual physical and so you would only ever go to to them if you're pretty damned desperate and chances are they won't be able to help you anyway.


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Post Re: Alternative Medicine
DWill wrote:
It's almost a touchy subject between us.


I know what you mean. Having been a science and medical writer for most of my career, I am often asked for medical advice from friends (which I refuse to give beyond directing them to some websites I trust, like those of the NIH and Mayo Clinic). If they ask my opinion on alternative medicine, I give it; if they don’t, I don’t offer because it inevitably leads to a debate, with them quoting anecdotal studies funded by those with a financial interest in the therapies they believe in. Plus, if whatever they are doing works for them, I don’t want to mess with that. Even if I believe the positive results are due to the placebo effect, I see no reason to attempt to burst their bubble.

DWill wrote:
I do believe that a lot of what he likes about the alternative practitioners has to do with attention. It's perhaps harder to find a regular doc who shows genuine concern and is a sort of cheerleader or coach.


This touches on a major problem with physicians who practice “traditional” medicine. For centuries, doctors were trained to be “clinical” in their diagnoses of illness and in their interactions with patients. This “distance” was thought to be best for a variety of reasons now being proven wrong, just as the early practice of lying to patients about the seriousness of their conditions has been.

Some 20 years ago, I attended a seminar for general practitioners, aimed at urging physicians to improve their “bedside manner” and treat patients like human beings, rather than conglomerates of living matter that needed only to be treated as one would a sick or injured tree. I wrote a piece for MD Magazine on the seminar, and was hopeful that some of what the physicians took home with them from the lectures would lead to a new attitude. Unfortunately, at least in my personal experience, this has not been the case. Though there are a few (such as the one geo refers to) primary care physicians who now take time to discuss and consider the emotional and mental health of patients, the assembly line treatment scenario many have employed in order to maximize profits leaves little time for interaction on a personal level (how personal can you get in five minutes?).

DWill wrote:
"75% of you will get better anyway."


I love this; and it’s true!

DWill wrote:
It could be that the new agers are exploiting deficiencies in the way we do things.


Yes, though in some cases I do believe there is a certain level of sincerity involved in what they are doing. When someone actually cares about you (or at least, pretends to do so convincingly), there can be a positive emotional response and, as medical researchers now know, such a response can trigger positive physical reactions in brain chemistry, which in turn can lead to enhanced immune-system activity. And more and more, researchers are turning to the incredible power of the human immune system as the primary avenue through which to create therapies to fight both mild and devastating diseases.

Unfortunately, the profit motive seems to be stronger (for both traditional and alternative practitioners) than the sincere desire to consider the best therapies to offer patients. Couple that with the fear of malpractice suits (resulting in exorbitant insurance costs), the corporate takeover of US healthcare and its incredible lobbying power, and you have the scenario we face today: too many unnecessary tests; over prescribing of often-ineffective drugs; unnecessary surgeries; billions being spent on R&D to produce drugs that are only slightly different from their predecessors (because patents have run out and they must go to war against newly introduced generics); research funded by corporations with financial interests in the outcomes; private hospitals being built on every corner to suckle at the huge financial teat of Medicare and Medicaid; and a health care system with no real interest in improving the health of the general public.

All of this leads to an exponential increase in health-care costs and a decrease in the efficiency of the system that is supposed to protect and preserve the health and wellbeing of the populace.

In view of these failings, I might suggest that all physicians hark back to the oath to which they have sworn to adhere, which says nothing of profit, social station, a five handicap in golf, or driving a BMW. Instead, it says, in part:

I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.


Image

Nuff said!


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Post Re: Alternative Medicine
This is some of the most intelligent and comprehensive stuff I've ever seen on this website. I have nothing to add, because I'm not nearly as knowledgeable as you guys, but I just wanted to say that you have certainly got me thinking about a subject I had never given much thought to before. Thanks, all of you!


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Post Re: Alternative Medicine
DWill started this thread as a spinoff from ideas discussed in the thread on Confidence Vs. Faith, which Johnson had spun off from the thread The Insult of Disbelief, which in turn came from Johnson's amazement at the confidence of our young friend's opinions regarding her question Am I an Athiest?, a thread that is still going strong at eleven pages.

The crisis in medicine is a perfect illustration of the problem in finding the balance between confidence and faith. Science tells us to rely on confidence in evidence alone, so suggests, in the practice of scientific medicine, that making people well is a matter of applying evidence. And yet, as Le Beaux has aptly shown, psychology is central to health, and faith is central to psychology, as shown in the utility of 'sugar pills' as a placebo. People trust their doctor, and this can be more important than the chemical processes of drugs.

Jesus said if you have faith you can move mountains. Paul said salvation is by grace through faith. What these strange ideas really mean is that the right psychological attitude and narrative framework are central to any achievement. Pretending that we can reduce health to a mechanistic science, ignoring the pastoral role of relationships and care, is entirely futile. As Mick Jagger put it nearly half a century ago, she goes running to the shelter of her Mother's Little Helper.

There is a brilliant set of articles in the New York Review of Books this year about the illusions of psychiatry and the epidemic of mental illness. The key point is that drugs have replaced understanding as a key to mental health, because of the corruption of the system by money. The problem with understanding is that it is nested within metaphysical therapeutic concepts such as faith and love, which have become suspect because of the prevalence of scientific focus on confidence in evidence. So mechanistic science has abetted the crisis of faith in the health system.


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Post Re: Alternative Medicine
R. LeBeaux wrote:
I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

Where did you find this updated Hippocratic Oath? If it's your work, you should submit it somewhere else as well.


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Post Re: Alternative Medicine
DWill wrote:
R. LeBeaux wrote:
I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

Where did you find this updated Hippocratic Oath? If it's your work, you should submit it somewhere else as well.


In a brief pbs.org NOVA article on the evolution of the oath, which includes both the classic and modern versions. I said "in part" because I selected only the parts I thought relevant to the discussion. The article is at:

pbs.org/wgbh/nova/body/hippocratic-oath ... today.html


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Post Re: Alternative Medicine
Quote:
Jesus said if you have faith you can move mountains. Paul said salvation is by grace through faith. What these strange ideas really mean is that the right psychological attitude and narrative framework are central to any achievement.


I think the character Jesus was actually talking about moving mountains. Equating that with the placebo effect is clutching at straws Robert. Believing a sugar pill will cure your depression is one thing. Magically moving a mountain is another. Also, the correct psychological attitude may be a necessary component to achievement, but a narrative framework wouldn't be necessary. I can see achievements happening without.

You write hybrid sentences with half good philosophy, half bunk, in your attempts to reconcile science and theology. I guess that's expected as part of religion is the cryptic wording, and any part of the text can be interpreted to apply to your personal opinion of what things 'mean'. If you believe Jesus was speaking of the placebo effect(indirectly even) when talking about moving mountains, I can't say that you're wrong. I would say that I don't share your interpretation.


I do like thinking of the placebo effect as a sort of artifact of faith, however.

LeBeaux wrote:
Even if I believe the positive results are due to the placebo effect, I see no reason to attempt to burst their bubble.


If you did burst their bubble, you'd render their medicine impotent in one blow. I respect the placebo effect, as much as I respect the effectiveness of some chemical compounds. In conversations with people who swear by alternative medicine, I engage with them but offer no debate. I even encourage their choice, but in the back of my mind I'm cheering for the placebo effect.


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Post Re: Alternative Medicine
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In conversations with people who swear by alternative medicine, I engage with them but offer no debate. I even encourage their choice, but in the back of my mind I'm cheering for the placebo effect.


I agree with this and this is my intention, but I find it sometimes hard not to end up in debate when the alternative medicine is being pushed on me and I am not interested in trying it. Not so much that I am against the idea of an alternative, but I am a minimalist when it comes to any kind of treatment and mostly I believe time will take care of it (75% anyway) along with heathly living.

Quote:
When someone actually cares about you (or at least, pretends to do so convincingly), there can be a positive emotional response and, as medical researchers now know, such a response can trigger positive physical reactions in brain chemistry, which in turn can lead to enhanced immune-system activity.


I think this works for self-care as well and people who are sold on herbal remedies for every ailment get a good feeling from applying them regardless of any other benefit. I stick with raw veggies as the are considerably cheaper and probably have a greater benefit to my health. I am sure that broccoli can cure just about 75% of whatever ails me, along with a good run down the road.



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Post Re: Alternative Medicine
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I agree with this and this is my intention, but I find it sometimes hard not to end up in debate when the alternative medicine is being pushed on me and I am not interested in trying it. Not so much that I am against the idea of an alternative, but I am a minimalist when it comes to any kind of treatment and mostly I believe time will take care of it (75% anyway) along with heathly living.


It's hard in some situations. An acquaintance telling you that you should use some alternative therapy because it's been working great for them, for example. There aren't really any good thought-terminating cliche's that would work well.

My pest control guy was pushing acupuncture on me. I really didn't know enough about it and didn't want to agree or disagree with him due to the agnosis. I told him I'm immune to the placebo effect, and he didn't really know how to respond. Then the conversation moved on to why spiders can get past the bug "barrier" chemicals(they don't groom). It was fluid and thankfully free of any awkward moment. For me at least. I think he's still confused.


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Mon Sep 26, 2011 1:24 pm
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Post Re: Alternative Medicine
Interbane wrote:
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Jesus said if you have faith you can move mountains. Paul said salvation is by grace through faith. What these strange ideas really mean is that the right psychological attitude and narrative framework are central to any achievement.


I think the character Jesus was actually talking about moving mountains. Equating that with the placebo effect is clutching at straws Robert. Believing a sugar pill will cure your depression is one thing. Magically moving a mountain is another.
Interbane, this is a classic example of the tendency to argue that Christians believe something absurd, and therefore are stupid. That argument is true regarding some other beliefs, but not this one. The idea of moving mountains is an allegory, an image that stands for something else. No one has ever moved a mountain by faith. What the text really means is that belief is powerful, that people can achieve things through belief that otherwise they cannot, and that without faith people will be stuck in a paralysis of inaction and isolation.
Quote:
Also, the correct psychological attitude may be a necessary component to achievement, but a narrative framework wouldn't be necessary. I can see achievements happening without.
Your statement here again reflects a weak understanding of the nature of faith. Faith actually is a narrative framework, as the articulation of a mindset or paradigm that explains the nature of reality. A narrative framework embeds a strategic vision of what is good and what is evil, how people should live, and what is true and false. It provides a popular story that gives a prism to explain everything. So, when Paul says we are saved by faith and not by works, he means that our actions have to be motivated by ideas, and that even good actions that are motivated by false ideas 'avail nothing'. It is the ideas (faith) that provide the strategic direction, bringing disparate actions together to support a common goal. I find this a very profound insight, and one that readily lends itself to the rebasing of Christian faith on a scientific framework. Can you nominate any great achievements that have occurred which were not inspired by some one who had complete faith in their own vision?
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You write hybrid sentences with half good philosophy, half bunk, in your attempts to reconcile science and theology. I guess that's expected as part of religion is the cryptic wording, and any part of the text can be interpreted to apply to your personal opinion of what things 'mean'. If you believe Jesus was speaking of the placebo effect(indirectly even) when talking about moving mountains, I can't say that you're wrong. I would say that I don't share your interpretation.
My interpretation here is the reasonable one, and your claim that Jesus was literally talking about mountains is silly. No mountains have ever been levitated "hence to yonder place" as the King James Version puts it at Matthew 17. This idea is a parable for the power of faith. There is nothing cryptic about that, except to someone who holds an irrational aversion to faith on principle.

The placebo effect is one instance of the broader phenomenon of faith healing. This magical tradition was central to shamanic practice, as the only recourse in the absence of scientific medicine. The problem now is that the great success of drug treatments has become a new faith, the idea that pills are the key to health. As so often happens, we have moved from one extreme, magic, to the other extreme, science, and find it difficult to see that reason requires a middle path that integrates the best of both.

The purely scientific attitude to medicine undermines the reality that health requires a number of factors where faith is important, especially the strength of social links, which are generally strengthened by shared belief. This is why prayer has such an enduring attraction and power as a way of articulating community views and bringing people together. Even false belief can be adaptive in this context, as a basis for social loyalty and belonging, although false belief inevitably creates undesirable side effects. True belief can be even more powerful, when it recognizes the psychological role that faith plays as a form of social glue and statement of purpose and direction .


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