How to deal with the "But it works" retort

[ObscureReferenceMan]

I just recently spoke with a co-worker, and the topic of accupuncture came up. I gave my 2¢ about it, letting her know that there was no scientific basis for its efficacy (i.e. works no better than placebo). Her response was, "But it works for me!" I had no comeback for this.

Other than something sarcastic/facetious like "Well, then you might as well rub a lucky rabbit's foot", I don't know how else to respond. But I do want something. Any ideas?

[Moochie]

That "it works for" her is not really disputable -- there is an effect, which you can test for yourself, if you have some spare pins lying around.

The woo resides in all the "chakra" and "meridians" nonsense. We've learned that needles stuck anywhere in the skin can have an "effect."

Hitting oneself repeatedly on the head with a hammer has a reproducible effect, too.

M.

[Luke T.]

I see some good scam potential behind this.

*Quack waves hands over Client*

Quack: You have an imbalance in your liver.

Client: Oh my God! What do I do?

Quack: Let me stick these needles in you.

Client: Here's two thousand dollars. Save me!

(Eight session later)

Quack: You are healed!

Client: Oh, thank you, thank you, thank you!

(Later, at work)

Skeptic: Acupuncture doesn't work.

Client: It works for me!

[Luke T.]

I think the approach to take "but it works for me" is to ask who diagnosed them, and who treated them. Also ask if they were receiving any traditional (i.e. real) medical treatment at the same time.

[ObscureReferenceMan]

I think a big part of the problem is most people are unaware of the lack of scientific basis for "fringe" treatments, and just assume accupuncture, homeopathy, chiropractic ("subluxations"), et al are the same as traditional treatments. Only "we just don't know how they work". So, if accupuncture "works" and physical therapy (as in the case of my co-worker) doesn't, well, you can't argue with success! (Also, the arguement that many diseases/conditions - ESPECIALLY back problems - are cyclic will be lost as well.)

[ChristineR]

Acupuncture does appear to do some positive things, although there are better ways to get the effects. The part about "unblocking chi" and such is all nonsense. In this case I personally would rather have the scientific version--safer, more effective, but apparently some people like to pretend their chi is blocked.

[desertyeti]

My chi was blocked once, but strong coffee and a bowl of Raisin Bran flushed it right out.

[Diogenes]

My chi was blocked once, but strong coffee and a bowl of Raisin Bran flushed it right out.

Ingested orally .. Right ? :blush:

[lenny]

...letting her know that there was no scientific basis for its efficacy (i.e. works no better than placebo). Her response was, "But it works for me!" I had no comeback for this.

so, in short, JREF has nothing on offer ObscureReferenceMan here?

other than waiting until it "stops" working for her? (if indeed it does stop working).

[Lord Muck oGentry]

The question I'd be asking is not how she knows it works better than a placebo, but how she knows it works better than doing nothing at all.

[Cuddles]

That "it works for" her is not really disputable -- there is an effect, which you can test for yourself, if you have some spare pins lying around.

The woo resides in all the "chakra" and "meridians" nonsense. We've learned that needles stuck anywhere in the skin can have an "effect."

This isn't entirely true. I did some research for a thread a while ago and found studies that showed the fake needles used as a placebo in acupuncture treatment are noticeably different from real needles, even to people who have never had acupuncture before. This means that there has never been a placebo controlled trial of acupuncture and we can't actually say that there is an effect above placebo, although we do know that it doesn't make any difference where you stick the needles.

Edit : Not the one I found before (http://eprints.soton.ac.uk/24554/), but same conclusion, and this was for a new needle, designed specifically to feel the same.

[El Greco]

There are some people with whom you can discuss nothing, period. A few hours ago I had a discussion with someone who had bought an "homeopathic ointment for pain relief". This was how it was advertised. Without even going into why homeopathy doesn't work, I tried to explain to him that the product he had bought was not homeopathic. It was herbal but not homeopathic since it had red pepper in non-homeopathic concentrations and also a distinct smell of eucalyptus and mint. I explained to him that such herbal ointments are a dime a dozen. I tried to explain the difference between "homeopathic" and "herbal". It was like trying to explain rocket science to a preschooler. That man not only had a strong belief in homeopathic products, but was also convinced that a product promoted as homeopathic could be nothing else but homeopathic. When I understood that he was looking at me as if I was trying to trick him, I gave up. I'd rather argue one thousand times with a homeopath about "water memory", at least in that case there would be something to discuss. Some people are hopeless and there are no arguments that can sway them. It's that simple.

[Geckko]

Start a dialogue with them.

Open with: "how do you know it work(s/ed) for you?

possible response: "because I felt better/because my XX healed"

You respond with more questions: "how did you know that the [insert woo here] caused you to heal/feel better."

possible response: "because I felt better/healed after the treatment"

just keep quizzing them: "Have you ever suffered from a complaint that seemed to clear up of its own accord?" or "have you ever had a complaint that tends to come and go over time, or from which you suffer from, from time to time (like a cold?)"

Just keep doing that until they can make the logical connection for themselves. It won't necessarily work, but then some people genuinely believe they have been abducted by aliens.

[Big Les]

so, in short, JREF has nothing on offer ObscureReferenceMan here?

other than waiting until it "stops" working for her? (if indeed it does stop working).

Not true. He can explain why it "works for her" i.e. placebo, and risk undermining her perceived improvement, if indeed it's in effect. He can suggest medically effective treatments, and/or explain the concept of self-limiting medical conditions.

If she comes to understand these concepts, and that acupuncture is not the same thing as a medical treatment, and yet still have the placebo effect work to her advantage*, then everybody's happy. Especially the acupuncturists.

The final step here at "winning her over" would be that she understand she is basically paying for nothing. People are making money from a quirk of her psychology, not for actually providing goods or services. If like many of us here, she sees that as ethically wrong, she may choose to cease "treatment".

I don't see that as us having "nothing to offer". At the risk of undermining any credibility I may have by paraphrasing "the Matrix"**, ObscureReferenceMan can only show her the door. She has to choose to step through it.

*For example, I know OD'ing on VitC does nothing to help a perceived onset of a cold, yet still do it, to apparently some (placebo) effect.
** With apologies to the guys on the CT forum!

[Moochie]

This isn't entirely true. I did some research for a thread a while ago and found studies that showed the fake needles used as a placebo in acupuncture treatment are noticeably different from real needles, even to people who have never had acupuncture before. This means that there has never been a placebo controlled trial of acupuncture and we can't actually say that there is an effect above placebo, although we do know that it doesn't make any difference where you stick the needles.

Edit : Not the one I found before (http://eprints.soton.ac.uk/24554/), but same conclusion, and this was for a new needle, designed specifically to feel the same.


Here we go:

http://www.youtube.com/watch?v=Iz4Y9jDv4Z8

Indisputable proof!

M.

[Dr Adequate]

Well, every time I get ill, I lie in bed smoking cigarettes. This is evidently a cure for all diseases, since I invariably get better.

It works for me!

And yet so-called "scientists" will tell you that smoking is bad for you.

[Moochie]

Came across this while researching:

Some of you will be very skeptical about what you will read in this collection of articles on Qigong (pronounced chee gung). I believe a bit of skepticism is always healthy. In fact, I often visit some of the web sites of various societies of skeptics and have run across an few papers on acupuncture and Chinese medicine. Now being skeptical is quite different from being a confirmed, certified Skeptic. Skeptics set out to debunk anything in which they do not believe. They claim that Science is their one and only God. However, this form of skepticism has very little to do with science; it is a belief system, a religion. It is as much biased and prejudiced as any superstition, because when faced with contradictory science, the Skeptic will set out to debunk that too.

http://www.mnwelldir.org/docs/qigong/index.htm

"A bit of skepticism is always healthy?" I suppose a whole lot of skepticism can be downright dangerous...

M.

[Luke T.]

so, in short, JREF has nothing on offer ObscureReferenceMan here?

other than waiting until it "stops" working for her? (if indeed it does stop working).

Did you not see posts 3 and 4?

[ponderingturtle]

Ingested orally .. Right ? :blush:

Probably not the coffee, but I have never heard of Raisin Bran Enema's endorsed by anyone, not even John Harvey Kellogg

[JohnboyMN]

Today's 'Peanuts' comic is appropriate!
(http://www.unitedmedia.com/comics/peanuts/archive/images/peanuts20071832610104.gif)

[ObscureReferenceMan]

There are some people with whom you can discuss nothing, period.

Very true. But some time, you don't know that until after the fact.

There have been some good suggestions here, but the bottom line is, I think, no matter how I respond, I will come off as condescending, pedantic, etc. This person believes "there's something to it" - which is a difficult thing for me to change/argue/discuss. But is also aware of the placebo effect. Odd combination. I think there's just a huge lack of critical thinking going on, that nothing short of a major perspective shift will cure.

[lenny]

The question I'd be asking is not how she knows it works better than a placebo, but how she knows it works better than doing nothing at all.

could you give me an experimental design to test that question...?

uniqueness of place is difficult, of not impossible, to control for in such cases; she'd have a point...

[lenny]

Did you not see posts 3 and 4?

i saw them, but do not think them likely to help; that said i like 4 better than 3 (and in fact 14 better than 4).

but i expect we all buy into general theories that, on the whole, serve us well. "she" may not. and she is interested in a particualr case.

if clear, relevant evidence against her ideas is not too hand, then we are just selling our priors. (no doubt we'll be right often, but why should she care about that?)

[Blue Mountain]

I just recently spoke with a co-worker, and the topic of accupuncture came up. I gave my 2¢ about it, letting her know that there was no scientific basis for its efficacy (i.e. works no better than placebo). Her response was, "But it works for me!" I had no comeback for this.
Other than something sarcastic/facetious like "Well, then you might as well rub a lucky rabbit's foot", I don't know how else to respond. But I do want something. Any ideas?[/SIZE][/FONT]

You could try a reductio ad absurdum approach. I have a plushie of the Linux mascot "Tux" (http://shop.cheapbytes.com/cgi-bin/cart/1000010003.html), and whenever someone suggests some woo treatment for something, I tell them I get really good relief by tying it my head for a few hours a day while I'm at home, and ask them why they think it works.

[Lord Muck oGentry]

could you give me an experimental design to test that question...?

uniqueness of place is difficult, of not impossible, to control for in such cases; she'd have a point...

Good heavens, no! I leave experimental design to the experts. What I'd be looking for from her is a sentence that goes something like ' Now that you ask, I've found that a quiet lie-down/ potter about/ game of patience seems to work just as well...'

[Dr Adequate]

You could try a reductio ad absurdum approach. I have a plushie of the Linux mascot "Tux" (http://shop.cheapbytes.com/cgi-bin/cart/1000010003.html), and whenever someone suggests some woo treatment for something, I tell them I get really good relief by tying it my head for a few hours a day while I'm at home, and ask them why they think it works. Artificial penguins contain chemicals.

You should use a natural organic penguin.

[Mojo]

Mmmm, organic pengins! [/homer simpson]

[Luke T.]

i saw them, but do not think them likely to help; that said i like 4 better than 3 (and in fact 14 better than 4).

but i expect we all buy into general theories that, on the whole, serve us well. "she" may not. and she is interested in a particualr case.

if clear, relevant evidence against her ideas is not too hand, then we are just selling our priors. (no doubt we'll be right often, but why should she care about that?)

She should care because she may have an actual illness and have been fooled by a quack into thinking the illness is cured and seek no further treatment.

So I guess an additional retort would be, "Have you followed up with a traditional doctor to verify your condition is healed/improved?"

[Blue Mountain]

Artificial penguins contain chemicals.

You should use a natural organic penguin.
Oh no! All those awful chemicals getting into my skull through my hair follicles and--gasp--into my brain! Someone point me to a good detox diet!

[Luke T.]

You could try a reductio ad absurdum approach. I have a plushie of the Linux mascot "Tux" (http://shop.cheapbytes.com/cgi-bin/cart/1000010003.html), and whenever someone suggests some woo treatment for something, I tell them I get really good relief by tying it my head for a few hours a day while I'm at home, and ask them why they think it works.

I don't know how to tell you this, but plush toys really do help people, particulary children, feel better.

:)

Come to think of it, this is an excellent example one could use to explain the placebo effect. Almost everyone has experienced or seen the healing properties of a plush toy in action. :)

[ChristineR]

I don't know how to tell you this, but plush toys really do help people, particulary children, feel better.

:)

Come to think of it, this is an excellent example one could use to explain the placebo effect. Almost everyone has experienced or seen the healing properties of a plush toy in action. :)

Hmm, I wonder if it's more than that. A plush toy provides physical comfort, exercise, a degree of warmth and shelter. Has anyone looked into the possibility that doing things that are associated with health-promoting activity are themselves health-promoting? For example, giving the baby the sensations associated with breast feeding (cuddling) without actually breastfeeding it.

[Beleth]

The question I'd be asking is not how she knows it works better than a placebo, but how she knows it works better than doing nothing at all.
How can anyone ever know that?

[lenny]

Good heavens, no! I leave experimental design to the experts. What I'd be looking for from her is a sentence that goes something like ' Now that you ask, I've found that a quiet lie-down/ potter about/ game of patience seems to work just as well...'

Understood. Self-discovery would make us feel better. But she (nor we) would really know which of the four "really" "worked". no?

[lenny]

She should care because she may have an actual illness and have been fooled by a quack into thinking the illness is cured and seek no further treatment.
"Should" is one of those hard-for-us-to-justify (in her head) words...

let's not should on her.

So I guess an additional retort would be, "Have you followed up with a traditional doctor to verify your condition is healed/improved?"
she'd likely smile, knowing that you really cared, but at the moment she knows she has improved...

[lenny]

could you give me an experimental design to test that question...?Good heavens, no! I leave experimental design to the experts.

just to be clear: i'd argue that there is no experimental design which tests that quesiton!

[Yawn]

One of the problems with the 'But it works!' retort is you've really got to
pin down what the 'works' refers to. Take this:-


-----------------------------------------------------------------------
Man goes to homeopathic (erm....) practioner with flu symptoms
Homeo takes 20mins to ask about general lifestyle then prescribes 'EyeofNewt 30CH'
Man goes home feeling like it's going to cure him
3 Days to a week later , He feels better.

Now I ask him 'Did it work?' and he says 'Yes'
------------------------------------------------------------------------


Now OK, knowing more about the non-physics of homeopathy
than he does I think 'Uh huh, natural progression of the illness', placebo effect etc.'
but there's a more of a problem here, let's run this again:-


------------------------------------------------------------------
Man goes to a Medical Doctor with flu symptoms

Doctor takes 5mins to ask about lots of physical stuff about snot levels, bowel movements, lupus? and then

thinks to himself 'Can't fix this with anything, I'll try giving him a placebo!' (nb: Assume the doctor has

no suitable drug to give at the time)

The MD gives him sugar pills labelled 'ThisulfixUupinNotimeium'

Man goes home feeling ok, but he doesn't have a clue what 'ThisulfixUupinNotimeium' is and isn't all that

sure about it, it's a long name and he doesn't have the time, money, braincells, to get on the net and check

it out)
3 Days to a week later , He feels better.

Now I ask him 'Did it work?' and he says 'Well, Maybe'
-------------------------------------------------------------------


Now of course if it was me I'd be grilling the Doc about what the dope was
and then I'd be straight back home on the net looking it up for more information. But woo's
don't tend to do this sort of thing in any systematic way.

In the first example the patient got 20 minutes of their ego being preened
by someone really grooving on their case and general well-being.

In the second example the patient got a straight up placebo pill.


When debating with homeopaths it can be a real problem that the experiences
of the man in each case would have been very different in terms of how 'Good'
he felt about the treatment he was receiving. Pseudoscientific explanations
HAVE to be built up around placebo pills (or homeopathic remedies) in order for the
patient to believe that the medicine is doing them any good.

Now in the case of the MD they are bound by time constraints, medical ethics and an inbuilt
aversion to 'woo wooing' their clients, hence their attempts at placebo are likely to be
'thin' compared to the 20 minutes of nonsensical drivel and emotional appeals like 'natural',
'holistic' from the homeopath. And let's face it, the science of pharmaceuticals is
way more difficult than the pseudoscience of 'homeopathy/crystal healing/chakras etc.'


So in the sense of 'works' can there can be a difference of 'levels' of placebo effect?

I'm not too keen on the 'woo' label in a lot of cases, it's a bit derogatory and
they're usually nice creative and artistic people to be around, just misinformed.

However the term is great for some of the nutty ideas on this forum!

[TjW]

Came across this while researching:



http://www.mnwelldir.org/docs/qigong/index.htm

"A bit of skepticism is always healthy?" I suppose a whole lot of skepticism can be downright dangerous...

M.

Presumably it's healthy only in homeopathic doses.

[JoeTheJuggler]

And doing this [waves arms about in a silly manner] will ward off tigers. The fact that there are no tigers anywhere around here shows that "it works".

[Lord Muck oGentry]

How can anyone ever know that?

Well, we might try:

1. snake oil,

2. fake oil (placebo), and

3. no oil

on her condition.

If she reports the results of 1, 2 and 3 as identical, then there isn't even a placebo effect. It doesn't even work for her. Save for post hoc, propter hoc and a blind faith in snake oil.

I assume that what I wrote earlier was not very clear. If so, apologies.

[firecoins]

I have has acupuncture done for psoraisis. The psorasis got lighter. I than tried it with a placebo. THe placebo did just as good.

[Lord Muck oGentry]

Understood. Self-discovery would make us feel better. But she (nor we) would really know which of the four "really" "worked". no?

I'm sure you're right about self-discovery. Capital stuff.

But your no? is elegantly to the point. No indeed: neither she nor we could know without testing.

[Yawn]

I had a cold once, took a week to recover with orthodox medicine
but homeopathic stuff cured me in seven days!!!!

[SezMe]

I have has acupuncture done for psoraisis. The psorasis got lighter. I than tried it with a placebo. THe placebo did just as good.
What motivated you to try acupuncture for this condition?

[Beleth]

Well, we might try:

1. snake oil,

2. fake oil (placebo), and

3. no oil

on her condition.

If she reports the results of 1, 2 and 3 as identical, then there isn't even a placebo effect. It doesn't even work for her. Save for post hoc, propter hoc and a blind faith in snake oil.
But a lot of conditions just need time for the body to repair itself. We can try all of those things in series but we can't try them in parallel on the same person, and if we can't do that, then we can't really know whether doing something is better than doing nothing (i.e. just waiting for the body to repair itself).

Note that I'm just talking about things where the body is capable of repairing itself, like backaches or the flu or somesuch, and not things known to be terminal without treatment such as cancer.

[Yawn]

Perhaps she is basing her conclusions on a different definition of 'better' (ie: not actually getting better but feeling better about the situation)

Homeopaths extend this to the 'homeopathy works on animals/babies' idea where the owner/parent feels better about the TREATMENT and projects
this into seeing the patient is 'better' for having the medicine (water)

Its very difficult to sway believers from these convictions, 'common sense' for such people can be swayed more easily by anecdotal evidence than (to them) the boring yaddah yaddah of proper scientific evidence and statistics.

[chocolatepossum]

Ask your friend to define what they mean by "works". Personally, if I say a medical treatment works, I mean that it does what it claims to do. Whether or not a medicine which is purported to relieve physical symptoms "works" is not a matter for subjective interpretation. Of course, if the treatment is merely claiming pain relief then things get a bit more tricky.

[Geckko]

Came across this while researching:



http://www.mnwelldir.org/docs/qigong/index.htm

"A bit of skepticism is always healthy?" I suppose a whole lot of skepticism can be downright dangerous...

M.


At the risk of being pithy:

Captain: "Abandon ship!!!!"

Skeptic: "Why?"

Captain: "The ship is sinking!!!"

Skeptic: "Prove it"

:)

Partly jest, but I assume (!!) you get my point.

[Lord Muck oGentry]

1.But

2. a lot of conditions just need time for the body to repair itself.

3.We can try all of those things in series but we can't try them in parallel on the same person,

4.and if we can't do that, then we can't really know whether doing something is better than doing nothing (i.e. just waiting for the body to repair itself).

5.Note that I'm just talking about things where the body is capable of repairing itself, like backaches or the flu or somesuch, and not things known to be terminal without treatment such as cancer.


1. And, surely, rather than But?

2. Quite.

3. Cutting the grounds for the lady's belief from under her feet.

4. Quite.

5. Of course.


Let me add a general comment. I'm pretty sure that we are not disagreeing about the distinction between sensible and silly beliefs here, but there may have been some misunderstanding. My first point is that there are cases where an effect is reported but does not exist ( see Yawn's joke upthread about the cold that would last for seven days but for the homoeopathic treatment that sees it off in a week). The second is that assertions such as It works for me ( but needn't work for anyone else) or ( worse still) It worked for me in one set of circumstances ( but needn't work again, even in similar circumstances) are hopelessly untestable.

[ponderingturtle]

At the risk of being pithy:

Captain: "Abandon ship!!!!"

Skeptic: "Why?"

Captain: "The ship is sinking!!!"

Skeptic: "Prove it"

:)

Partly jest, but I assume (!!) you get my point.

And do to a crowded theater and shout "Fire" and see what a lack of skepticism will do for you then.

Of course you just jumped off of a perfectly good ship because someone in a funny hat is playing a joke on you, so either way it proves the point.

[firecoins]

What motivated you to try acupuncture for this condition?
It was all over my body and the standard medical treatment that was scientifically proven to work did not work. I found acupucture helped a little bit. But than a doctor tried a different medical treatment that worked much, much better. Most dermatologists are not fans of the new medical treatment so I have to go to this 1 dermatologist at NYU.

[ponderingturtle]

How do people feel about useing Trepanation as an example of "But it works"

People who have had the procedure clearly are in favor of it afterwards, but why aren't the people who say "it works for me" lining up to get a hole drilled in their head?

[Beleth]

1. And, surely, rather than But?

2. Quite.

3. Cutting the grounds for the lady's belief from under her feet.
No, I meant But, because it cuts the grounds from under our feet as well.

If someone has a condition where it's possible but not certain that the body will heal itself, then it is impossible to tell whether a course of treatment does any better than doing nothing, since we can't do both at the same time and compare the results. This includes traditional medicine courses of treatment also.

Compare the textbook post hoc ergo prompter hoc "I went to an acupuncturist and my headache went away afterwards, therefore the acupuncture cured my headache" to the perfectly-reasonable-sounding "I took aspirin and my headache went away, therefore taking aspirin cured my headache".... Headaches can go away by themselves, so how can you tell whether any course of treatment actually did anything?

[lenny]

But your no? is elegantly to the point. No indeed: neither she nor we could know without testing.and if the boundary conditions are such that no (relevant to her) test is available (or perhaps none exists), then we are reduced to remaining uncertain. but at least as skeptics we can admit this. yes?

[lenny]

We can try all of those things in series but we can't try them in parallel on the same person, and if we can't do that, then we can't really know whether doing something is better than doing nothing.
yep. one of the reasons physicists like to play with electrons which are all identical, at least in theory...
Note that I'm just talking about things where the body is capable of repairing itself, like backaches or the flu or somesuch, and not things known to be terminal without treatment such as cancer.

i do not think you can even have that. there is no "the body". you cannot "know something to be terminal" except in particular cases, and then only after the fact. you can redefine "cancer" after the fact (as in "most have been a mis-diagnosis") but that does not seem very helpful...

[lenny]

No, I meant But, because it cuts the grounds from under our feet as well.
not if there was any ground there to begin with: all it does is limit what we can say, and vastly reduce what we can be "sure" of. well, it allows us to see what we might better remain uncertain of.

All theorems are true. All models are wrong. All data are inaccurate. What are we to do?

the next line in this text is, roughly, "We must remain uncertain."

could have been "we must remain skeptical". that even sounds like a good thing, no?

Headaches can go away by themselves, so how can you tell whether any course of treatment actually did anything?

we cannot "know" for an individual. of course we can take statistics from a population and see if we see anything that looks systematic. this might help us treat an army of people with headaches. still hard to say much about a collective of one.

von mises wrote some nicely/clearly on this 80-ish years ago; but googling "von mises collective" didn't hit it.

[Moochie]

At the risk of being pithy:

Captain: "Abandon ship!!!!"

Skeptic: "Why?"

Captain: "The ship is sinking!!!"

Skeptic: "Prove it"

:)

Partly jest, but I assume (!!) you get my point.

Actually, I don't "get your point."

Please elaborate.

M.

[Moochie]

It seems there is a large contingent of people who believe in all manner of fairy tales, and who seem averse to altering their belief to match the facts, no matter what.

Are they all idiots, or just those with a vested interest in keeping a sizable proportion of the population in the dark for their own fiscal advantage?

M.