Bad Science (2 page)

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Authors: Ben Goldacre

Tags: #General, #Life Sciences, #Health & Fitness, #Errors, #Health Care Issues, #Essays, #Scientific, #Science

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Is there anything more to these patches than that? Yes. There is a new device, which we should call the hassle barrier, another recurring theme in the more advanced forms of foolishness that we shall be reviewing later. There are huge numbers of different brands, and many of them offer excellent and lengthy documents full of science to prove that they work: they have diagrams and graphs and the appearance of scienciness, but the key elements are missing. There are experiments, they say, which prove that detox patches do something…but they don’t tell you what these experiments consisted of, or what their “methods” were; they offer only decorous graphs of “results.”

To focus on the methods is to miss the point of these apparent “experiments”: they aren’t about the methods; they’re about the positive result, the graph, and the appearance of science. These are superficially plausible totems to frighten off a questioning journalist, a
hassle barrier
, and this is another recurring theme, which we will see—in more complex forms—around many of the more advanced areas of bad science. You will come to love the details.

If It’s not Science, What is it?

 

But there is something important happening here, with detox, and I don’t think it’s enough just to say, “All this is nonsense.” The detox phenomenon is interesting because it represents one of the most grandiose innovations of marketers, lifestyle gurus, and alternative therapists: the invention of a whole new physiological process. In terms of basic human biochemistry, detox is a meaningless concept. It doesn’t cleave nature at the joints. There is nothing on the “detox system” in a medical textbook. That burgers and beer can have negative effects on your body is certainly true, for a number of reasons; but the notion that they leave a specific residue, which can be extruded by a specific process, a physiological system called detox, is a marketing invention.

If you look at a metabolic flowchart, the gigantic wall-size maps of all the molecules in your body, detailing the way that food is broken down into its constituent parts, and then those components are converted between each other, and then those new building blocks are assembled into muscle, and bone, and tongue, and bile, and sweat, and booger, and hair, and skin, and sperm, and brain, and everything that makes you you, it’s hard to pick out one thing that is the “detox system.”

Because it has no scientific meaning, detox is much better understood as a cultural product. Like the best pseudoscientific inventions, it deliberately blends useful common sense with outlandish, medicalized fantasy. In some respects, how much you buy into this reflects how self-dramatizing you want to be or, in less damning terms, how much you enjoy ritual in your daily life. When I go through busy periods of partying, drinking, sleep deprivation, and convenience eating, I usually decide—eventually—that I need a bit of a rest. So I have a few nights in, reading at home, and eating more salad than usual. Models and celebrities, meanwhile, “detox” with Master Cleanse and the Fruit Flush Diet.

On one thing we must be absolutely clear, because this is a recurring theme throughout the world of bad science: there is nothing wrong with the notion of eating healthily and abstaining from various risk factors for ill health like excessive alcohol use. But that is not what detox is about; these are quick-fix health drives, constructed from the outset as short term, while lifestyle risk factors for ill health have their impact over a lifetime. But I am even willing to agree that some people might try a five-day detox and remember (or even learn) what it’s like to eat vegetables, and that gets no criticism from me.

What’s wrong is to pretend that these rituals are based in science or even that they are new. Almost every religion and culture have some form of purification or abstinence ritual, with fasting, a change in diet, bathing, or any number of other interventions, most of which are dressed up in mumbo jumbo. They’re not presented as science, because they come from an era before scientific terms entered the lexicon, but still: Yom Kippur in Judaism, Ramadan in Islam, and all manner of other similar rituals in Christianity, Hinduism, the Baha’i faith, Buddhism, and Jainism are each about abstinence and purification (among other things). Such rituals, like detox regimes, are conspicuously and—to some believers too, I’m sure—spuriously precise. Hindu fasts, for example, if strictly observed, run from the previous day’s sunset until
forty-eight minutes
after the next day’s sunrise.

Purification and redemption are such recurrent themes in ritual because there is a clear and ubiquitous need for them; we all do regrettable things as a result of our own circumstances, and new rituals are frequently invented in response to new circumstances. In Angola and Mozambique, purification and cleansing rituals have arisen for children affected by war, particularly former child soldiers. These are healing rituals, in which the child is purged and purified of sin and guilt, of the “contamination” of war and death (contamination is a recurring metaphor in all cultures, for obvious reasons); the child is also protected from the consequences of his previous actions, which is to say, he is protected from retaliation by the avenging spirits of those he has killed. As a World Bank report put it in 1999:

These cleansing and purification rituals for child soldiers have the appearance of what anthropologists call rites of transition. That is, the child undergoes a symbolic change of status from someone who has existed in a realm of sanctioned norm-violation or norm-suspension (i.e. killing, war) to someone who must now live in a realm of peaceful behavioral and social norms, and conform to these.

 

I don’t think I’m stretching this too far. In what we call the developed Western world, we seek redemption and purification from the more extreme forms of our material indulgence: we fill our faces with drugs, drink, bad food, and other indulgences, we know it’s wrong, and we crave ritualistic protection from the consequences, a public “transitional ritual” commemorating our return to healthier behavioral norms.

The presentation of these purification diets and rituals has always been a product of their time and place, and now that science is our dominant explanatory framework for the natural and moral world, for right or wrong, it’s natural that we should bolt a bastardized pseudoscientific justification onto our redemption. Like so much of the nonsense in bad science, “detox” pseudoscience isn’t something done
to
us, by venal and exploitative outsiders; it is a cultural product, a recurring theme, and we do it to ourselves.

Brain Gym
 

Under normal circumstances this should be the part of the book where I fall into a rage over creationism, to gales of left-wing applause. But if you want an example that’s less covered in the media, there is a vast empire of pseudoscience being peddled, for hard cash, in such liberal enclaves in the United States as Boulder, Colorado, and Portland, Oregon. It’s even more successful abroad, where it has been taught in more than eighty countries and made it into public schools up and down the United Kingdom.
3
It’s called Brain Gym, it’s an export from the United States (thanks), it’s swallowed whole by teachers, it’s presented directly to the children they teach, and it’s riddled with transparent, shameful, and embarrassing nonsense.

At the heart of Brain Gym is a string of complicated and proprietary exercises for kids that “enhance the experience of whole brain learning.” They’re very keen on water, for example. “Drink a glass of water before Brain Gym activities,” they say. “As it is a major component of blood, water is vital for transporting oxygen to the brain.” Heaven forbid that your blood should dry out. This water should be held in your mouth, they say, because then it can be absorbed
directly
from there into your brain.

Is there anything else you can do to get blood and oxygen to your brain more efficiently? Yes, an exercise called “Brain Buttons”: “Make a ‘C’ shape with your thumb and forefinger and place on either side of the breastbone just below the collarbone. Gently rub for twenty or thirty seconds whilst placing your other hand over your navel. Change hands and repeat. This exercise stimulates the flow of oxygen carrying blood through the carotid arteries to the brain to awaken it and increase concentration and relaxation.” Why? “Brain buttons lie directly over and stimulate the carotid arteries.”

Children can be disgusting, and often they can develop extraordinary talents, but I’ve yet to meet any child who can stimulate his carotid arteries inside his rib cage. That’s probably going to need the sharp scissors that only Mommy can use.

You might imagine that this nonsense is a marginal, peripheral trend that I have contrived to find in a small number of isolated, misguided schools. But no. Brain Gym is practiced in hundreds, if not thousands, of mainstream state schools throughout the U.K. As of today I have a list of over four hundred schools that mention it specifically by name on their websites, and many, many others will also be using it. Ask if they do it at your school. I’d be genuinely interested to know their reaction.

Perhaps if they could just do the “hook-up” exercises on page 31 of the
Brain Gym Teacher’s Manual
(where you press your fingers against each other in odd contorted patterns), this would “connect the electrical circuits in the body, containing and thus focusing both attention and disorganized energy,” and they would finally see sense. Perhaps if they wiggled their ears with their fingers as per the Brain Gym textbook, it would “stimulate the reticular formation of the brain to tune out distracting, irrelevant sounds and tune into language.”

The same teacher who explains to children how blood is pumped around the lungs and then the body by the heart is also telling them that when they do the “Energizer” exercise (which is far too complicated to describe), “this back and forward movement of the head increases the circulation to the frontal lobe for greater comprehension and rational thinking.” Most frighteningly, this teacher sat through a class being taught this nonsense by a Brain Gym instructor, without challenging or questioning it.

In some respects the issues here are similar to those in the chapter on detox: if you just want to do a breathing exercise, then that’s great. But the creators of Brain Gym go much further. Their special, proprietary, theatrical yawn will lead to “increased oxidation for efficient relaxed functioning.” Oxidation is what causes rusting. It is not the same as oxygenation, which I suppose is what they mean. (And even if they are talking about oxygenation, you don’t need to do a funny yawn to get oxygen into your blood: like most other wild animals, children have a perfectly adequate and fascinating physiological system in place to regulate their blood oxygen and carbon dioxide levels, and I’m sure many of them would rather be taught about that, and indeed about the role of electricity in the body, or any of the other things Brain Gym confusedly jumbles up, than this transparent pseudoscientific nonsense.)

How can this nonsense be taught in schools? One obvious explanation is that the teachers have been blinded by all these clever long phrases like “reticular formation” and “increased oxidation.” As it happens, this very phenomenon has been studied in a fascinating set of experiments from the March 2008 edition of the
Journal of Cognitive Neuroscience
, which elegantly demonstrated that people will buy into bogus explanations much more readily when they are dressed up with a few technical words from the world of neuroscience.

Subjects were given descriptions of various phenomena from the world of psychology and then randomly offered one of four explanations for them. The explanations either contained neuroscience or didn’t, and were either “good” explanations or “bad” ones (bad ones being, for example, simply circular restatements of the phenomenon itself or empty words).

Here is one of the scenarios. Experiments have shown that people are quite bad at estimating the knowledge of others; if
we
know the answer to a question about a piece of trivia, we overestimate the extent to which other people will know that answer too. In the experiment a “without neuroscience” explanation for this phenomenon was: “The researchers claim that this [overestimation] happens because subjects have trouble switching their point of view to consider what someone else might know, mistakenly projecting their own knowledge onto others.” (This was a “good” explanation.)

A “with neuroscience” explanation—and a cruddy one too—was this: “Brain scans indicate that this [overestimation] happens because of the frontal lobe brain circuitry known to be involved in self-knowledge. Subjects make more mistakes when they have to judge the knowledge of others. People are much better at judging what they themselves know.” Very little is added by this explanation, as you can see. Furthermore, the neuroscience information is merely decorative and irrelevant to the explanation’s logic.

The subjects in the experiment were from three groups—everyday people, neuroscience students, and neuroscience academics—and they performed very differently. All three groups judged good explanations as more satisfying than bad ones, but the subjects in the two nonexpert groups judged that the explanations
with
the logically irrelevant neurosciencey information were more satisfying than the explanations
without
the spurious neuroscience. What’s more, the spurious neuroscience had a particularly strong effect on people’s judgments of “bad” explanations. Quacks, of course, are well aware of this and have been adding sciencey-sounding explanations to their products for as long as quackery has existed, as a means to bolster their authority over the patient (in an era, interestingly, when doctors have struggled to inform patients more and to engage them in decisions about their own treatment).

It’s interesting to think about why this kind of decoration is so seductive, and to people who should know better. First, the very presence of neuroscience information might be seen as a surrogate marker of a “good” explanation, regardless of what is actually said. As the researchers say, “Something about seeing neuroscience information may encourage people to believe they have received a scientific explanation when they have not.”

But more clues can be found in the extensive literature on irrationality. People tend, for example, to rate longer explanations as being more similar to “experts’ explanations.” There is also the “seductive details” effect: if you present related (but logically irrelevant) details to people as part of an argument, this seems to make it more difficult for them to encode, and later recall, the main argument of a text, because their attention is diverted.

More than this, perhaps we all fall for reductionist explanations about the world. They just feel neat somehow. When we read the neurosciencey language in the “bogus neuroscience explanations” experiment—and in the Brain Gym literature—we feel as if we have been given a physical explanation for a behavioral phenomenon (“an exercise break in class is refreshing”). We have somehow made behavioral phenomena feel connected to a larger explanatory system, the physical sciences, a world of certainty, graphs, and unambiguous data. It feels like progress. In fact, as is often the case with spurious certainty, it’s the very opposite.

Again, we should focus for a moment on what is good about Brain Gym, because when you strip away the nonsense, it advocates regular breaks, intermittent light exercise, and drinking plenty of water. This is all entirely sensible.

But Brain Gym perfectly illustrates two more recurring themes from the industry of pseudoscience. The first is this: you can use hocus pocus—or what Plato euphemistically called a noble myth—to make people do something fairly sensible like drink some water and have an exercise break. You will have your own view on when this is justified and proportionate (perhaps factoring in issues like whether it’s necessary and the side effects of pandering to nonsense), but it strikes me that in the case of Brain Gym, this is not a close call: children are predisposed to learn about the world from adults, and specifically from teachers; they are sponges for information, for ways of seeing, and authority figures who fill their heads with nonsense are sowing the ground, I would say, for a lifetime of exploitation.

The second theme is perhaps more interesting: the proprietorialization of common sense. You can take a perfectly sensible intervention, like a glass of water and an exercise break, but add nonsense, make it sound more technical, and make yourself sound clever. This will enhance the placebo effect, but you might also wonder whether the primary goal is something much more cynical and lucrative: to make common sense copyrightable, unique, patented, and
owned
.

We will see this time and again, on a grander scale, in the work of dubious health care practitioners and specifically in the field of “nutritionism,” because scientific knowledge—and sensible dietary advice—are free and in the public domain. Anyone can use it, understand it, sell it, or simply give it away. Most people know what constitutes a healthy diet already. If you want to make money out of it, you have to make a space for yourself in the market, and to do this, you must overcomplicate it, attach your own dubious stamp.

Is there any harm in this process? Well, it’s certainly wasteful, and it does seem peculiar to give money away for basic diet advice or exercise breaks at school. But there are other hidden dangers, which are far more corrosive. This process of professionalizing the obvious fosters a sense of mystery around science and health advice that is unnecessary and destructive. More than anything, more than the unnecessary ownership of the obvious, it is disempowering. All too often this spurious privatization of common sense is happening in areas where we could be taking control, doing it ourselves, feeling our own potency and our ability to make sensible decisions; instead we are fostering our dependence on expensive outside systems and people.

But what’s most frightening is the way that pseudoscience makes your head go soggy. Debunking Brain Gym, let me remind you, does not require high-end, specialist knowledge. We are talking about a program that claims that “processed foods do not contain water,” possibly the single most rapidly falsifiable statement I’ve seen all week. What about soup? “All other liquids are processed in the body as food, and do not serve the body’s water needs.”

This is an organization at the edges of reason, but it is operating in countless schools. When I wrote about Brain Gym in my U.K. newspaper column in 2005, saying that “exercise breaks good, pseudoscientific nonsense laughable,” while many teachers erupted with delight, many were outraged and “disgusted” by what they decided was an attack on exercises that they experienced as helpful. One—an assistant head teacher no less—demanded: “From what I can gather you have visited no classrooms, interviewed no teachers nor questioned any children, let alone had a conversation with any of a number of specialists in this field?” Do I need to visit a classroom to find out if there is water in processed food? No. If I meet a “specialist” who tells me that a child can massage both carotid arteries through the rib cage (without scissors), what will I say to him? If I meet a teacher who thinks that touching your fingers together will connect the electrical circuit of the body, where do we go from there?

I’d like to imagine that teachers might have the common sense to spot this nonsense and stop it in its tracks. Just one thing gives me hope, and that is the steady trickle of e-mails I receive on the subject from children, ecstatic with delight at the stupidity of their teachers:

I’d like to submit to Bad Science my teacher who gave us a handout which says that “Water is best absorbed by the body when provided in frequent small amounts.” What I want to know is this. If I drink too much in one go, will it leak out of my arsehole instead?

“Anton,” 2006

 

Thank you, Anton.

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