Ear Acupuncture to Support Mental Health

Jonathan Keyes
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928

In the last 30 years, acupuncture and Chinese medicine have become increasingly popular as a modality for helping people not only with health concerns but also with emotional distress and addictions issues.  Acupuncture has been especially helpful for people who are detoxing from drugs and alcohol as well as those who have experienced a high degree of trauma, such as returning military veterans.  One of the most innovative and wide spread ways of helping this population is through something known as the five needle protocol, or the NADA protocol.

Five needle protocol involves placing acupuncture needles in five points inside both ears.  Often people are treated in groups and sit comfortably in chairs and allow the needles to rest for 30-45 minutes.  For many people the effect of incredible calm and relaxation is immediate.  People suffering from symptoms of anxiety, restlessness and psychomotor agitation often feel a release and relief from the intensity of their symptoms.

Because of this powerful effect, 5NP has been adopted as an integrative treatment tool in many locations throughout the country including detox and outpatient mental health centers, hospitals and prisons.  The National Acupuncture Detoxification Association is the prime group that promotes this protocol throughout the country.  Though trained acupuncturists often provide this service, NADA promotes non-acupuncturists to become Acu-Detox Specialists to help support people in their community.

Here in Portland, Oregon, one of the main places to go for mental health and detoxification services if you are poor or uninsured is Central City Concern.  This incredible clinic not only offers counseling, but 5 needle protocol as well as Qi Gong classes.  When I last visited I was amazed to see a well lit room filled with plants staffed by people offering ear acupuncture to a group of homeless people dealing with addiction issues.  In the corner a young woman was playing a harp to add to the soothing atmosphere.

The innovation and adoption of 5NP as a treatment strategy for those detoxing and in emotional distress came out of the work of a man named Dr. Michael Smith.  After developing this treatment tool in the 70s, he went on to help start NADA in 1985 and it continues to grow and this treatment model has been adopted by many states throughout the country.

The five points in the ear refer to specific acupuncture points that have different effects.  These include the “kidney point”, which helps to reduce fear, the liver point, to help with intense anger as well as for detoxification, the lung point, which helps allow deeper breathing and to release grief, the Shen Men, or “Spirit Gate” and the autonomic point, which helps being calm and relaxation.

Traditional Chinese Medicine views each person as unique and requiring holistic care for both the mind and body.  Practitioners often prescribe diet and lifestyle changes, encourage sacred movement such as qi gong, and offer massage and acupuncture, including the 5NP.

There has been quite a bit of research that validates the efficacy of the 5NP treatment approach.   Much of the research has shown tremendous results in a wide variety of settings.  This protocol is being implemented in over 130 prisons in Europe.  It has been implemented in Indian reservations, a number of psychiatric hospitals and the Yale medical school has established a NADA training program for residents.  The VA supports the use of 5NP for people diagnosed with the label PTSD.  To view more about this research, please look here.

On a personal note as someone married to an acupuncturist, I have had the chance to get “the ear treatment” when I have felt anxious, unsettled and emotionally intense.  In every treatment I had the sensation of feeling profoundly more relaxed and calm, like a weight had been lifted from me.  It is one of the first line tools I use to help myself when I am feeling overwhelmed.

I believe this protocol can be very helpful for people who are in the process of tapering off of psychiatric drugs.  Many of the symptoms of tapering include profound anxiety, waves of depression, anger, agitation as well as insomnia.  It can also be very helpful to anyone prone to big mood swings and emotional distress.  One of the strong benefits of this protocol is that it is done in groups and therefore can be much cheaper to access than a regular one on one treatment.   Group acupuncture can also be helpful for creating a strong bond between people without the pressure of asking them to explore deep and sometimes uncomfortable emotions.

As a therapist who promotes mindfulness, it can be challenging to encourage people to start a regular practice of meditation.  One of the best ways to help them get started is to introduce them to acupuncture. Instead of the pressure to include meditative practice into a busy lifestyle, acupuncture helps people to gain the benefit of deeper relaxation and increased somatic awareness that often happens while meditating.   Though the NADA protocol should not be seen as a panacea, it has become an increasingly important adjunct tool to help improve emotional health and well being.

 

 

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

110 COMMENTS

  1. Jonathan,

    I’ve been carefully reading your comments since you introduced yourself to us with your first blog post.

    As you know, I came on strong at first, but have come to see a person who certainly does seem to care a great deal. And I’ve become grateful that you’re part of the dialogue here on MIA for that reason.

    And now you show an understanding in acupuncture… IMO, you’re okay, Jonathan. You seem to me to be a good person.

    Thank you,

    Duane

    • Only in your opinion. You can’t speak for so many others who find these kinds of alternative treatments to be helpfu;. Acupuncture treatment goes back thousands of years and is seen to be more reliable for many people than the usual toxic drug treatments which are the only thing the mental illness system offers to people at this point. We already know the effects of these drugs. So, if other people besides you find acupuncture to be helpful in dealing with daily life, so be it. You can’t go around speaking for all the rest of us here on this site.

  2. “Much of the research has shown tremendous results in a wide variety of settings.”

    Really?

    http://www.bmj.com/content/338/bmj.a3115
    Authors: Matias Vested Madsen, physician, Peter C Gøtzsche, director, Asbjørn Hróbjartsson, senior researcher

    “Conclusions: A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.”

  3. Jonathan,

    You’re in Portland?!! Me, too! We should get together some time and chat – I sense we’d have a lot to talk about.

    As to this skepticism about acupuncture – in Asia, they have done operations using acupuncture as a pain relieving treatment for centuries. I think we’d know from the patient pretty quick if the pain relief was imaginary! Aside from which, even if it’s “only placebo,” apparently, that’s true for the SSRI antidepressants, too, and people sell them for billions of dollars. The placebo effect is important and not to be disregarded as “not real.” If we can get the same effect with a few needles, a lot less money, and almost zero side effects, why wouldn’t we do it?

    — Steve

    PS My wife is a doula and has seen acupuncture be used on more than one occasion to induce labor. Can’t tell me it has no effect!

  4. Who needs 5,000 year-old “new age” acupuncture?

    We have our tried and true half-century old drug treatments for everything condition under the sun.

    Who cares if our drugs cost 100,000 lives every year (under-reported by FDA’s own admission), for prescription drugs *taken as directed*.

    The main thing is to stay away from all that “unproven” alternative medicine… Yeah, that stuff is “dangerous.”

    Give me a break!

    http://discoverandrecover.wordpress.com/a-z-health-conditions/

    Duane

  5. I’m open to the possibility that sticking thin needles in the skin (ear) to induce little pain can reduce pain. I just have not found any scientific evidence for the concept of the ear’s liver and kidney points and have no reason to believe that sticking needles at these specific points somehow supports detox.

    Just because it’s mostly harmless, doesn’t mean it is a good treatment. Just because people are claiming it’s working, doesn’t mean that it is. May I remind you of all the clinical trials sponsored by the pharma industry that have positive outcomes? How many people report that drug X have saved their life? Still, if we look at the meta-analysis of these trials, we see that e.g. antidepressants are only slightly better than placebo (in the short term).

    I don’t see any reason to be less critical, when the acupuncture lobby designing their own (probably biased) studies to proof that acupuncture works (better than placebo). Especially as we quote the studies of the Cochrane Collaboration (Peter Gøtzsche) when it’s about psychiatric drugs, but ignore their research when we discuss alternative treatments.

    I think this is harmful for the reputation of MiA in the long-term.

  6. My friend Ed Duff talks about how the NADA people came to Joplin after their nasty tornado when thousands were wandering around traumatized. http://wellnesswordworks.com/trauma-after-natural-disasters/

    I myself also used it once when I was at a “peer” conference that the state took over and kicked me off stage as I was just processing grief that had been delayed by psych meds. I was in this mess of emotional turmoil and Ed needled me and totally settled me down.

    My only question is, “Why only use 5 points when the whole body is full of points?” I’ve been using acupuncture for my brain injury. My very first visit I had just been yelled at for two hours by the ER for demanding a scan for a potential brain bleed. The ER thought my injury wasn’t severe enough but two ER doc friends had told me to get checked out. I walked out of the ER and into the acupuncture clinic, in so much pain and trauma and turmoil that I could barely talk. It was hugely settling and relieving. Great stuff. Good data on it, too, that NADA has.

  7. Acupuncture is very popular and is used by millions of people. One might describe it as having “empirical validation” in the sense that many people find it useful (as noted by Jonathan, “the proof is in the pudding”). Acupuncture providers believe that their clinical experience supports its effectiveness. Scientific research may not show it to work better than placebo, or to be based on a plausible scientific theory, but there’s no denying the fact that it is greatly valued by many who enjoy its benefits.

    This *exact* argument is often offered in support of psychiatric medications, with antidepressants being the paradigmatic example. Most of the above points were made by the president of the European Psychiatric Association when I debated him on the efficacy of antidepressants. I was unimpressed with this argument because in my opinion, a treatment based on a pseudoscientific theory that does not work better than placebo is not a good treatment, regardless of how well-liked and popular it is.

    Acupuncture has the advantage of being free from the adverse effects and baggage of biomedical psychiatric treatments, and based on that alone I understand its appeal. However, from my perspective as a proponent of therapies that are scientifically credible and effective, it is a bit disconcerting when I see folks at MIA heartily endorse pseudoscientific non-psychiatric treatments at the same time as they vigorously criticize psychiatric treatments because they are pseudoscientific. I’ve too often seen the opportunity costs my clients suffer when they invest their time, money, effort, and hope in pseudoscientific approaches instead of well-established approaches that would have likely proved more helpful.

    Best,

    Brett

    • Don’t tell me Brett, let me guess…
      Talk therapy?

      Is that the “well establish” approach you speak of?

      All I can say is that many folks have underlying physical conditions that need to be addressed. Others find ways to fully recover that don’t involve meeting weekly with a psychotherapist. In fact, some people have been deeply harmed by talk therapists… and are exhausted by talking…. talking is not always the answer!

      And frankly, it matters not that you have a doctorate and disagree. Because it’s not about you and what you think may/may not be in the best interest of others.

      Each person has a right to choose options they think are in their best interest – without the approval of a doctor, therapist, or anybody else.

      I would simply encourage more people to do so, and to ignore naysayers who tend to know very little or nothing about the integrative medicine they dismiss!

      Duane

  8. Hi Jonathan and Duane. It’s a pleasure to correspond with you.

    I said: “Scientific research may not show [acupuncture] to work better than placebo, or to be based on a plausible scientific theory, but there’s no denying the fact that it is greatly valued by many who enjoy its benefits.”

    Jonathan said: “Interesting you say this- but really its not true,” and quoted the 1997 NIH statement.

    With all due respect Jonathan, yes, it is true.

    Did you actually read the NIH statement? I did, and I see nothing to contradict my assertions that (a) acupuncture is based on a pseudoscientific theory, and (b) does not consistently perform placebo in controlled studies. While we’re citing experts, have you read the Cochrane Reviews on acupuncture (http://www.thecochranelibrary.com/details/collection/691705/Acupuncture-ancient-tradition-meets-modern-science.html), which are considered the “gold standard” in rigorous reviews of treatment studies? Do so and you will find conclusions like:

    “We found insufficient evidence to recommend the use of acupuncture for people with schizophrenia.”
    “We found insufficient evidence to recommend the use of acupuncture for people with depression.”

    Duane noted “470 research articles on acupuncture.” There are 744 research articles on “lobotomy” (http://www.ncbi.nlm.nih.gov/pubmed/?term=%22lobotomy%22). So what?

    To reiterate, I take no issue with the claim that acupuncture is highly regarded and perceived as helpful for many people. Exactly the same can be said for antidepressants. Both treatments are based on a pseudoscientific theory and both offer no discernible benefit over placebo in scientific studies. So, to clarify, are you content to promote one of these pseudoscientific treatments, and discourage the other? If so, on what basis? I’m just hoping to get some clarity on your answer on this question so I understand where you’re coming from.

    Best,

    Brett

        • I would never discourage someone from seeking a counselor or therapist.

          But it would be *impossible* to argue that doing so is risky. There is a lot of sexual assault in the fields. There are those who practice therapy who enjoy being in a position of power… lots of reasons to be careful. If you dare:

          http://www.amazon.com/Against-Therapy-Jeffrey-Moussaieff-Masson/dp/1567510221

          Also, there is some good evidence to suggest a high level of *pseudoscience* in the talk therapies. And if you’ve not come across articles on such pseudoscience, it may be that you’re in a bit of denial regarding just how “evidence based” psychotherapy is (actually *isn’t*).

          Again, I’m not trying to persuade people not to seek a good counselor or therapist, because there are some very good, loving, caring souls out there. But the art of listening and the success of counseling and therapy is the story of our own humanity and the healing that takes place with good relationships. This may work, and at times, work well. But it is not the stuff of *science.”

          There is much more science; much more evidence in areas such as nutrition and acupuncture. The mental health field simply refuses to let go of a monopoly – both in psychiatry and psychology and related fields (social work, counseling, etc).

          Duane

          • Jonathan and Duane, this will be my last post on this thread because I am done being insulted. I assume at this point that neither of you will actually respond to the points I made, but I will be pleasantly surprised to find myself mistaken.

            I noted that acupuncture, despite being helpful to many, is pseudoscientific and has not been shown to be anything other than a placebo treatment. This is acknowledged even in the credible literature reviews you highlight. In response, you criticized me for advocating “talk therapy” (which I never mentioned), and “pretending to be an expert in an area I know nothing about (Duane, how in the hell do you know that I know nothing about acupuncture, especially given the fact that I sent you links to rigorous scientific reviews that you felt free to ignore? Surely I could bash you with this same argument for the talk therapies I advocate that you feel free to denigrate?).

            Duane, you said: “I would walk out of a talk therapy session with you so fast it would make your head spin!

            You come across as arrogant.”

            Duane, without commenting on the irony of your statement, I am exercising every last ounce of my restraint in limiting my response to this: I do not appreciate being insulted by you, and I advise you to review the posts in this thread and consider whether or not your vitriol is warranted.

            If you insist we discuss a subject I never mentioned –talk therapy- than you might be glad to know that vigorous criticism of pseudoscientific psychotherapies is a major theme of my teaching and research. I am an outspoken critic of pseudoscientific treatments – whether they be bogus psychotherapies, bogus medications, or bogus alternative treatments. We apparently differ on this last point.

          • Brett,

            This is my last comment on this post.

            Interesting that you found me to be the one who “ignored” what it was you had to say.

            I felt the same way… ignored, dismissed, and ridiculed.

            I reported several of my own comments, in hopes that they will be erased.

            To you, and fellow readers – I apologize for going over the line and for being so personal.

            Duane

  9. Hi Jonathan. I read the report in its entirety, and I thank you for sending it to me as I was glad to do so. I re-read that conclusion you quoted, and it seems (my interpretation) to show that people benefit from acupuncture, but not show that (a) it is based on a scientific theory, or (b) it is reliably better than placebo. Which was my point. Did you read the Cochrane reviews I provided? We may be crossing streams here by invoking two different types of evidence. Research clearly shows that some people benefit from acupuncture – I acknowledged this in my first post – but research also shows that acupuncture is not based on a scientific theory and is not superior to placebo treatment. Maybe we’re both right? If so, perhaps the question is how to think about a pseudoscientific, helpful placebo treatment? This is the question I posed initially, because how we answer this question has profound implications for many mental health treatments.

    Best,

    Brett

    • Brett, thanks for comments that are pushing the discussion forward.

      “Maybe we’re both right? If so, perhaps the question is how to think about a pseudoscientific, helpful placebo treatment? This is the question I posed initially, because how we answer this question has profound implications for many mental health treatments.”

      Is it better to get a harmless instead of a harmful placebo treatment? Maybe. But I have concerns when people are encouraged to make treatment decisions based on false or incomplete information.

      I have no problem with acupuncture as a ritual that is helpful for some people. My assumption is that the positive effects have to do with the relationship between acupuncturist and the client, relaxing setting, being heard, hopefulness, maybe some form of mindfulness, etc.

      Convincing people with unscientific claims to get an acupuncture treatment is unethical (in my opinion).

  10. You know what? My attitude is that if it helps some people to achieve a better level of health and well being than the damned toxic drugs then more power to them if they want to use acupuncture. Who gives a fat damn. I don’t give a damn whether it’s scientific or not scientific; if it helps people and they want to use it then by golly hot damn, let them use it. I don’t feel the need to go around and tell them that they’re doing something that’s not scientific.

    As a First Nations person (what white people call Native Americans; many of us don’t call ourselves that)I knoiw that many of the spiritual and healing things that my people did and use and still use today are not one damned bit “scientific” but they work for us and I don’t have to know how they work to use them to achieve better health for myself! Science is not the end all and be all of everything!

  11. Just because something hasn’t been understood by science at this point doesn’t mean it’s not real…any honest scientist understands this…there is much in the natural world we simply do not yet know how to measure…

    many of us who’ve learned to care for ourselves are very much scientific in learning to apply that which works for us…unfortunately we do not have the funds of pharma to see if it’s repeatable for others…and frankly it doesn’t always matter…we’re individual enough that finding what works for us through experimentation and the scientific method is just fine by me.

    • Duane, My understanding of the goal and jist of Brett’s posts and blog and as a “debunker” is that placebo is everywhere pervasive in all healing systems therefore lets leave biological psychiatry in place with coming “improvements” as there are already so many millions receiving and believing in its “benefits” even if they are also placebo never mind their suffering and living 25 years less ,let’s not upset the juggernaut, its the best overall solution.

      For many of us including myself the best solution starts with your post of the “Chief” video. And onwards to the conclusions and recommendations of psychiatric survivors to dismantle this Spanish Inquisition clone of a system ,and birth, recover,discover, .get funded and spread ” First Do No Harm” non coercive replacement peer strategies and other alternative natural modalities that work and cause no harm.

      As far as I’m concerned no apology necessary .Duane we need you to keep on posting ,and I appreciate your concise style that is dead on and makes us smile at how well the truth has been conveyed.
      Sincerely, Fred

        • Brett, I can’t honestly say ,”I’m sorry I ruffled your feathers”. I can honestly say, I wish you and others employed in psychiatry would dedicate yourselves, risk more, and throw psychiatry overboard , (like dismantle it) instead of trying to reform it. I don’t really think anyone can understand how unbearable it is to be at the point of the spear of its forced “treatments” and the ramifications unless they’ve been there.
          Do you realize even you one day will have psychotropics forced on you if you end up in a nursing home? Be smart enough to ask psychiatric survivors what works and wise enough to heed our recommendations.
          That is what’s real.
          Science Oh Science ! WHAT CRIMES ARE COMMiTTED IN THY NAME !

          • “Science Oh Science ! WHAT CRIMES ARE COMMiTTED IN THY NAME !”

            True! Let’s be clear. I’m critical of acupuncture, but when it comes to psychiatry I’m more than critical. It is organized crime, science gone wrong and delusional thinking.

            I don’t think the idea of reforming psychiatry makes any sense. It’s like reforming fascism.

          • This thread has been the most bizarre discussion I’ve been involved in on this site. Fred, 5 minutes of research should reveal to you that (a) I am not employed in psychiatry, (b) I am not in favor of “reforming” the biomedical paradigm, and (c) I am dedicated and taking risks in support of what I believe. If you’re going to unapologetically “ruffle my feathers,” which is fine, at least doing it without blatantly mischaracterizing who I am and what I stand for. There is not enough space here, and I lack the time at the moment, to enter into a debate about the merits of science vs. subjective impression in identifying helpful treatments. As a scientist and practitioner, I try to adhere to the doctrine of open-minded skepticism: be open minded, but not so open-minded your brains fall out.

  12. After 38 years of study,research,discovery, and some work on others besides myself with various other than “modern medical modalities” such as Traditional Naturopathy , Homeopathy , Yuen Method (an advanced energy healing system) and others: I have realized that 100 or more different people for example all complaining about about a pain in the same place could each require a unique approach to solve their problem.Also that each solution would still be only one approach among others that could have solved their problem.That is not saying all approaches would resolve it at the same speed. Also that their issues are solved in relation to what they believe at a subconscious level and that even their subconscious belief on a certain issue can be changed with their permission for their benefit with Yuen Method.That is not saying there are not other ways to do this. In Yuen Method it is understood that a person’s subconscious knows everything about them on 6 different levels: spiritual,mental,psychic,emotional,psychological,and physical and that each level can affect any number of the others in regard to a specific issue an individual might have .It is understood that in effect that with a clients permission, concerning an issue of their concern on any level,their subconscious can be accessed as though it were a bio computer to find any causes of their problem and that any points on the quantum field that pertain can be strengthened or weakened to the clients benefit . For example a high level of depression could be made less intense or completely relieved.The client is protected in that if a practitioner had any negative intention it would affect the practitioner as well as any corrections if needed by the practitioner as well would be experienced by them. This is all done very rapidly ,silently ,except for explanations and feedback, without any physical contact. It is a very advanced “First Do No Harm System.” Included in it is a way to do acupuncture without needles and Homeopathy without physical remedies.In Maimonides “oath for physicians” he states that “for the knowledge of healing is boundless”. This system could also pinpoint for a specific client the best modality to try for a given issue from wherever it comes from saving them time, resources, and energy.

  13. Thanks for your article. At one point, you mention that TCM views every patient as unique, with specific treatment needs for body and mind. But then you proceed to describe what is basically a one size fits all treatment!

    To the skeptics above, they should know that TCM aims to minimize harmful side-effects for the patient. So you are free to confront your own biases, and trial TCM treatment to see if it works for you. And then simply choose to stop if not satisfied. So what do you have to lose? Whereas psychiatric treatment practically enslaves the patient and shortens their lifespan…

    Lastly, I don’t think the medical journals are in a position to pass judgement on TCM proper. Funding for researching TCM is sparse – no billion dollar profits to be made there. But even within TCM, acupunctures limitations are well known. More chronic illnesses are always treated with more herbs and less acupuncture. Where a TCM doctor constantly tweaks the treatment as their patient’s condition changes.

    But to my mind, the real gift of TCM is its medical theory and system of diagnosis. It allows us to understand conditions where conventional medicine has failed us badly. But within psychiatry, uninformed skepticism as regards TCM is rife. That being the main reason why I left the mental health system, and never returned.

    Uninformed skepticism hurts patients.

    • “Uninformed skepticism hurts patients.”

      Please enlighten me. I’m still waiting for a comment that explains how acupuncture works (besides the effects of placebo and ritual).

      “A well trained TCM doctor should be able guess your list of symptoms without you telling them first.”

      Next topic: cold reading

      • >> “A well trained TCM doctor should be able guess your
        >> list of symptoms without you telling them first.”
        >Next topic: cold reading

        In my case, my TCM doctor had recently arrived from China with only sparse English. So long explanations were impossible. The 1st appt. included an objective assessment of my physical symptoms, from which she then inferred an accurate diagnosis. Not a cold reading.

        > Please enlighten me. I’m still waiting for
        > a comment that explains how acupuncture works.

        TCM is not fully explained by Science. And as a patient, I do not require it to be. Do you think I should wait another 100 years for Science to catch up, before I benefit from this treatment?

        Although TCM is not Science, it does provide explanations, albeit from a different tradition. Is it your belief that Systems of Knowledge other than Science are completely without value?

        Most patients who visit a TCM clinic have already tried conventional medicine, albeit without success. Medical Science has already failed them, and has become irrelevant. So their thought process is more pragmatic, to go with whichever doctor can best provide an explanation that describes all their symptoms, and a treatment that works best for the patient.

        > (besides the effects of placebo and ritual).

        Please don’t knock placebos; they are widely used in conventional medical too. My TCM doctor has kept me out of hospital and tranq. free for the last 13 years. So TCM has worked for me.

        If conventional medicine works for you, then stick with it. Treatment with TCM will almost always cost more. If you’re biased against TCM, then don’t use it either. And if you discourage enough patients from trying TCM, then you will drive the price of my treatment down. So thanks for that 🙂

      • Why do you need to always know how something works? There are some things in this world that we will never understand but that’s not going to keep me from making use of them if they truly make my life better. I don’t have the overpowering need to understand how everything works to be able to use things. It’s enough for me to know that it works for me. It may not work for you but if it works for me then fine, I’m going to make use of it even though I can’t diagram, define, and disect it to the nth degree.

  14. Hi Stephen. How would you respond to someone who advocated this position with respect to psychotropic drugs? Would you be sympathetic to the argument that, for example, it is not important to know how “antipsychotic” medications work because it’s enough to simply know that some people find them helpful? If we accept this argument, would we be in a position to benefit from what Robert Whitaker and Joanna Moncrieff (among others) have learned about the mechanism and effects of antipsychotic medications?

    • What I know is this. The so-called “antipsychotic” drugs, and I call them drugs because they are not really medications, have terrible effects and they don’t cure anything and they don’t correct any chemical imbalance. This I know. We also know how they “work.” At best they are useful only in small doses and at the very beginning of problems. They did not in any way, shape or form make my life better. In fact, they nearly destroyed me.

      What I also know is that acupuncture works for me without any terrible effects. I don’t know how it works. Being a First Nations person I know that sweat lodges work for me. I don’t know how or why this works but it does for me. It has no terrible effects to deal with. I know that meditation works and that living in the Present Moment works. These two things I do know something about but I don’t understand them completely. But they work for me. For me it’s a matter of what really works and what kinds of effects they have that people must deal with after making use of them.

      Call me simplistic but it feels to me like some people deny any and every thing that doesn’t have some kind of “scientific explanation.” I think that this limits the use of some very useful things. Just because a philosophy or a process doesn’t fit into the Western scientific model or explanation is no reason to discount it.

      I feel that Westerners like to set their own explanation for things as superior to any and all other ways of seeing and explaining things, they enjoy being King on the Hill. Many Westerners look down their noses on anything Eastern and consider them of little or no value. They have very little or no understanding of what Eastern philosophies teach but that doesn’t matter; they know that their way is superior, no matter what. The feeling that I get when I read some of the respnses here is that the automatic response from some is to deny and discount acupuncture because it does come from an Eastern philosophy. At the hospital where I was trained I witnessed a Tibetan Buddhist monk make a diagnosis simply by looking at and sniffing the urine of the person who was experiencing the difficulty. The Western doctors were amazed that he was absolutely correct. But then they balked because his recommendation for treatment was not their Western way of doing things. I was trained in a university hospital were interesting things were done.

  15. It seems to me that a major theme on MIA is criticism of biomedical psychiatric treatments because of false advertising with regard to how they work. For example, we now know that antidepressants and antipsychotics do not work by correcting a chemical imbalance in the brain. We know this because of the work of scientists who believe it matters to know how treatments work. Research on this topic has revealed important insights, like the observation that these drugs produce brain changes that actually make some people worse in the long-term.

    Unless I’m mistaken, many people at MIA appear to care how psychiatric treatments work. And they are critical of the validity of psychiatric treatments because of what we have learned about how they work. Jonathan Leo and Jeffrey Lacasse often wrote eloquently on this theme.

    You asked, “are you saying that it does indeed matter how a treatment works for it to have validity, or worth?” In the world of science, it is accepted that the validity of a treatment does depend, in part, on how it works. For example, medications that work entirely because of the placebo effect are not considered valid. A drug that is supposed to work via its effect on neurotransmitter systems, but turns out to work due to the placebo effect instead, is not a valid treatment. It may be *useful* for some people, but usefulness is a different issue from validity and that is not an issue I am addressing here.

    Jonathan, would you be upset if you paid thousands of dollars for a blood pressure medication that was advertised as directly working on the biological causes of hypertension, only to find out later that the drug worked no better than a sugar pill? If you answer yes to this question, than it would seem that you believe, at least in some cases, that how a treatment works is relevant to determining its validity.

    Are you comfortable saying that how a treatment works is important in assessing the validity of psychiatric treatments, but irrelevant in assessing the validity of alternative treatments? I’m not, because this seems like a double standard.

    I’d be happy to hear your thoughts.

  16. Hi Jonathan. Thanks for engaging in this dialogue with me. I think we are in broad agreement about a number of issues. For example, there is a lot of monkey business in science, and what is touted as scientific is sometimes revealed to be anything but. To my mind, the solution is to do better science, but I understand (and share) skepticism about how this approach is sometimes applied. I also don’t believe we need double-blind studies to prove that slippers keep the feet warm, or that sunlight makes us feel happy. Like you, I think scientific validity is important when the stakes are high. Like when an intervention is touted as providing a specific healing effect for a significant problem. Like when considering acupuncture as a treatment for PTSD, for example (you described it as effective for “those who have experienced a high degree of trauma, such as returning military veterans”).

    Holistic treatments are not directly harmful in the way, say, “antipsychotic” medications can be. Although this might be grounds for some scientific leniency, I am not inclined to give them a free pass because they may be indirectly harmful in other ways. You said, “using acupuncture as one modality to help with emotional distress rates very very low on the potential harm-o-meter.” What if a veteran returning from Afghanistan seeking treatment for PTSD is informed that acupuncture is the treatment of choice for this problem? Other, well-established treatments exist for PTSD, and participating in acupuncture might cause opportunity cost, in which the veteran would be invest time, money, and effort in the wrong treatment. Opportunity cost is harmful. I see it, extensively, in most anxious clients I work with in practice. They have often invested a great deal of money, faith, and effort in unsubstantiated treatments. Often, none of their practitioners even informed them about the existence of highly effective, evidence-based treatments like exposure therapy. The quality of life costs can be extraordinary.

    I have no problem with people pursuing whatever treatments they like to feel better, pursue meaning, etc. Like you, my critical thinking meter gets activated when strong claims made for a treatment’s benefits, which have the potential to affect people’s lives in significant ways. We may differ on this, but to me strong claims include not just efficacy in reducing problems (e.g., acupuncture helps with trauma in veterans) but also claims about how treatment work (like your claim that the ear includes a “kidney point” that helps to reduce fear). I think we may have a fundamental difference in our willingness to selectively “suspend our intellect,” so to speak, when considering alternative treatments.

  17. Brett,

    In the VA page you recommended…

    Not only is acupuncture recommded as a ‘somatic’ treatment for PTSD, so is ECT – for severe, chronic, “medication” and psychotherapy resistant vets.

    See page 49:

    http://www.healthquality.va.gov/ptsd/CPGSummaryFINALMgmtofPTSDfinal021413.pdf

    Not sure what to say, Brett… other than from what I read the VA report was the same old boring stuff… CBT and psychotherapy, and not a lot else…. No mention of hyperbaric oxygen therapy, for instance.

    I suppose you made my point, better than I could have.

    Be well,

    Duane

    • Duane, the bottom line is that you and I have opposing values. I value science and reason, and want approaches to be credible based on scientific knowledge and demonstrably safe and effective. When such approaches are available, I think they should be recommended over approaches based on unsubstantiated theories with little or no scientific evidence of effectiveness. Your values are the opposite of my own, which is fine, but this means we can’t have a reasonable dialogue about issues like the topic of this thread.

      Brett

      • Brett,

        I’m not sure you’re fully aware of how you come across sometimes, Brett. How can you assume that I do not value science? I spend almost as much time keeping up with developments on the NASA site as MIA!

        How can you say that EMDR is not as substantiated as other therapies? I know several practitioners who use this method for PTSD. Are you saying that neurofeedback is “unsubstantiated?”

        The grad school I attended was one of the first in the country to incorporate a neurofeedback lab. A doctorate in our program spent several decades doing research in this area. No scientific evidence or effectiveness?

        Oh, and I suppose the methods recommended by the VA (the link you provided) are the “evidenced-based” treatments that we all need to respect? Really, Brett Did you read the paper? With its references to ECT, psychiatric drugs, etc.

        I lost it earlier in this thread. And I felt horrible about doing so. I appreciate your accepting my apology.

        I must say that I’m beginning to feel the same level of frustration again. I will simply say that you do not know me well enough to *assume* that I do not value science or reason. And, IMO, you do not seem to have enough knowledge of some of the approaches you quickly dismiss.

        Maybe we can at least agree that the VA should not get the last word? I hope so. There have more service members who’ve taken their own lives than who’ve been killed in war theater during these two campaigns (Afghanistan and Iraq). In the meantime, the VA has done little to help, including taking a strong stand against psychiatric drugs for PTSD.

        No appreciation of science?
        I’ve been in love with NASA since I was just a kid:

        http://www.nasa.gov/

        Duane

  18. Duane, your comments on this thread give me the strong impression that you do not value science as a criterion against which to judge the credibility and effectiveness of mental health treatments. Either that, or what you consider “scientific” reflects an idiosyncratic definition not shared by the broader scientific community. I say this because you consistently push treatments that are not considered credible in the scientific community, and you are quick to dismiss and disparage highly science-based psychotherapies. When I point this out, you accuse me of saying things I didn’t say, engage in ad hominem attacks, mischaracterize the facts (read the VA report again and you will see acupuncture is not recommended as a first-line treatment, which is a critical distinction you ignored), and make off-topic and hostile comments like “I suppose landing a rover on Mars is not *real* science.”My final word is this: “I’m not sure you’re fully aware of how you come across sometimes.” And with that, I am done.

    • Brett,

      I wanted to give you the last word, but your comment about acupuncture is not accurate.

      From the link *you* posted.
      The VA rates acupuncture for PTSD:

      E-2 Acupuncture:

      1. Acupuncture may be considered as treatment for patients with PTSD. [B]

      [B] A recommendation that clinicians provide (the service) to eligible patients. At least fair evidence was found that the intervention improves health outcomes and concludes that benefits outweigh harm.

      I’ve had enough, Brett.

      Duane

    • I don’t care if what works for me is “scientific” or not. If it works I’m going to use it. Psychiatry claims all kinds of “scientific” things about its wonderful treatment of the toxic drugs and unfortunately Americans believe all of the lies. I sometimes feel that science is put on too high of a pedestal these days, to the detriment of other things that work for people.

  19. Duane, I too have had enough. I hoped to be done with this threat until I saw your last post. I am exasperated at this point with your mischaracterizations of my words, and wish to follow up on your most recent one simply because I think the issue you mischaracterized is important.

    In my last point I said: “read the VA report again and you will see acupuncture is not recommended as a first-line treatment, which is a critical distinction you ignored.”

    You followed up with “your comment about acupuncture is not accurate.” You then quoted text from the VA report showing that acupuncture is recommended, albeit at level B.

    I never said anything about whether or not the report recommends acupuncture.

    Strongly recommended treatments are at level A. These are known as first-line treatments. What the VA considers first-line treatments are described in “Sidebar 4: First-Line treatment.” This sidebar says: “Initiate psychotherapeutic intervention using effective modalities of trauma-focused therapy, or stress management, and/or initiate pharmacotherapy (monotherapy using SSRI or SNRI).”

    Acupuncture is not a first-line treatment in the VA report. My comment noting this fact is verifiably accurate.

    • Brett,

      I *never* claimed the paper said it received a “first-line” recommendation.

      I said this:

      Not only is acupuncture recommded as a ‘somatic’ treatment for PTSD, so is ECT – for severe, chronic, “medication” and psychotherapy resistant vets.

      *You* misrepresented what I said… and you *ignored* (a term you love to use, by the way) the VA’s recommendation of ECT.

      You continue to say that the treatments I mention lack science. If you read the link on EMDR, then you ignored this:

      EMDR:

      World Health Organization (2013). Guidelines for the Management of Conditions That are Specifically Related to Stress. Geneva, WHO.
      * Trauma-focused CBT and EMDR are the only psychotherapies recommended for children, adolescents and adults with PTSD.

      American Psychiatric Association (2004). Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Post-traumatic Stress Disorder. Arlington, VA: American Psychiatric Association Practice Guidelines.
      * EMDR therapy was determined to be an effective treatment of trauma.

      Department of Veterans Affairs and Department of Defense (2004, 2010). VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress. Washington, DC.
      * EMDR therapy was placed in the “A” category as “strongly recommended” for the treatment of trauma.

      24 randomized controlled (and 12 nonrandomized) studies have been conducted on EMDR in the treatment of trauma.

      Enough, Brett.

      Duane

  20. Duane, can you please, for the love of God, tell me in simple and plain terms what you meant by this: “your comment about acupuncture is not accurate.”

    We were talking about acupuncture’s status in the VA report. I only said one thing about this: “read the VA report again and you will see acupuncture is not recommended as a first-line treatment, which is a critical distinction you ignored.”

    I made only this one comment. It is verifiably accurate. Do you dispute this?

    One last observation: I never claimed you said acupuncture was a first-line treatment. Therefore, I did not misrepresent what you said in this regard. Did I? If so, please tell me specifically how I misrepresented what you said about acupuncture being a first-line treatment.

  21. When you said:

    “… (read the VA report again and you will see acupuncture is not recommended as a first-line treatment, which is a critical distinction you ignored).”

    I felt like you were indicating that I intentionally “ignored” that it was not a first-line treatment; more importantly, that I attempted to present it as a first-line treatment. I did neither. I stated it was “recommended” – It is!

    That’s how the word “ignored” comes across. It’s a strong word, Brett.

    I’m tired.

    Duane

  22. Hi all, See the article” When Science Goes Astray” in the archives here at MIA Nov. 9, 2013 . its on page 4, if you choose to read the article , after, you may want to read the comments.There are only 3. Mine is the 2nd one and everything there is most appropriate for this thread.
    Them that haven’t tried it and need it should try the 5 needle ear stick (thanks Jonathan). I know I would and cranial osteopathy too(thanks Duane) and TCM and the countless great therapies from the various cultures of the world tried and true.It is safe to experiment with first do no harm therapies. Always investigate if the AMA has subverted therapy’s that compete with them.They’ve been known to have bought by stealth a Naturopathic college in Oregon , and subvert the original tried and true teachings by embedding some of their own useless and dangerous money makers like radiation and chemo-therapy within them to fool the public. Certainly they will buy and subvert or marginalize competing therapies and healing systems if they can and do what it takes to push for denial of insurance coverage for traditional competing healing systems .The AMA guild likes to have first and foremost a monopoly.The APA and ADA too.They work hard and spend much money to hide the fact that they are terribly ineffective less then 35% as a group and most all the usefulness is in physical trauma with countless millions with shortened life,extra suffering, and premature death in their wake. Besides all labeling and hiding what they don’t know behind terminologies. Psychiatry is by itself a chemical electric murder incorporated as if a meteor struck the earth. How are we to stop this raging fungus ? Read Edwin Blacks book “War Against The Weak” and everything will be illuminated. A real find is someone who has gone through what you have and come out of it vibrantly healthy and full of life and has at least 5 years experience in healing others.” If there is any life left nature will always cure it.”” Elimination and Purification ” Joseph Liss ND

    “Words are like the leaves on the trees they shade the fruit. But what is the fruit of the sensibility” ? Alexander Pope
    All the Best,
    Fred

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