Ever hear the phrase evidence based treatment?

If you haven't, you should get to know it. And know it well. Because every time you go for treatment, whether it's for a physical ailment or a mental one, the only treatment you should be ethically receiving is one that is evidence based to produce positive results. And in the worst case scenario, the evidence at least lets you know that even if there's no proof that it works on whatever it is you are suffering from; it does not harm either. (Although, here's the thing. If you are suffering and you get treatment that does not harm, what is harmful is that you are not getting the treatment that would alleviate the suffering. Something to think about, no?)

So question: What does it matter if something is evidence-based or not?

Darling, dearest Reader! Of course it matters. Because if there is no scientific evidence that a treatment works, then you are using a worthless treatment. At best, you lose money, time, effort, and sometimes your hope. At worst, you lose your life. Or quality of life.

Here. Let me tell you some interesting stuff. You remember George Washington? You know, the guy with the funny white wig and false wooden teeth? Yep. Our first president. Great guy, by the way. So on December 13, 1799, sixty-seven year old Washington woke up with a cold. A little sniffle. A little sore throat. Maybe a stuffed nose. Nothing to worry about. At least, not so Washington thought. He had survived, smallpox, tuberculosis, malaria, and a bunch of wars. Even when two of his horses were shot dead from underneath him, he survived. So he is definitely not worrying about a sore throat.

But his doctor didn't like this. And after applying a potion of dried beetles to his throat (Why bother with Tylenol? Dried beetles for a cold, anyone? ), he decided to do some bloodletting, using a lancet to make an incision in Washington's arm and drain his blood into a basin. If a person has about 5 liters of blood in his body, and half is drained of his body within a day, what do you think happens? Right. He dies. Which is what happened to poor ol' George. Because his doctor, who was considered a most esteemed physician of his time, utilized a treatment that was not evidence-based. But nobody considered him a killer (which he was, even if inadvertently), because everybody was into bloodletting in those days. Everyone swore by it. As a matter of fact, there were many people who went on to a full recovery after being drained of a significant amount of blood.

Right. And I am sure all my wonderful readers out there are running out this very minute to order a lancet from Amazon, anxious to save your favorite person from the common cold with the remarkable bloodletting treatment.

You are laughing, right? But you should not be. Because those people who survived bloodletting, survived despite that atrocious treatment, not because of it. The same way, so many of you are using alternative treatment, that is not evidence-based, because everyone swears by it, and my neighbor, aunt, sister's cousin's brother-in-law had a miraculous recovery after some treatment was applied that has absolutely no evidence that it works. So who is going to argue with your sister's cousin's brother-in-law?

Me. That's who.

The bottom line is that you need to ask any alternative healer who you are going for anxiety, depression, eczema, weight loss, back pain, headaches, infertility, insomnia, social awkwardness, Asperger's, bed-wetting, dyslexia, ADHD, trauma, or whatnot, if the treatment he or she is applying has any evidence that it works for specifically your ailment, and if yes, can s/he please direct you to any journal articles or research studies that prove that it is evidence-based. Because if your healer waves away your questions or cannot give you evidence-based, hard core answers, why would you waste your time with it? Of course some people have come away swearing by this alternative treatment. Research studies have conclusively found that placebos are extremely effective in a large number of people to alleviate symptoms. Research studies have also examined different ailments and shown the number of people who spontaneously become healed without any treatment at all, including cancer!

So how do you know if something is evidence-based? Who decides?

If something is evidence-based it means there was a rigorously controlled study that had a treatment group and a control group (a group that did not get the treatment) and under very specific conditions, the outcome is studied, observed, and documented. In addition, a study will only be published as accurate and evidence-based once it has been replicated over and over ; meaning, any authentic and accurate scientific study can be replicated by anybody in the world and the same results will occur. Meaning, the results are not skewed, are not a fluke, are not slanted to benefit the researchers. If another scientist will use the exact same methods of research, his research will yield the exact same results.

Now, here's the interesting thing. Although leeches, those nauseous worms used for bloodletting, killed people like the lancet killed George Washington; further research showed that leeches do have their place in modern medicine. For example, in 2007, a woman had leeches applied to her mouth four times daily following removal of a cancerous tumor and a tongue reconstruction to facilitate healing that was activated by hormones released by the application of these nauseous leeches.

Which means, that it may be true that some of the alternative healing you are obtaining may be beneficial to someone. But, you have no idea which, or when, for what, or even for whom (like, maybe not necessarily for you!) because your alternative healer has no idea either as it is not evidence-based; and you would be better off going for treatment that has a more accurate track record that is evidence-based. And more likely to be covered by your insurance. Your alternative healer is basing their judgment on anecdotal information, or extracting their information through teachings that are not either evidence-based, even though it may sound really good.

I will be honest with you.

I believe that there is knowledge in this world that we do not have evidence yet to substantiate their claims of healing, but the healing exists nevertheless. I believe there are healers that are born healers and that their knowledge of healing transcends our five senses. I do believe that. But I believe even more strongly that overall it is unwise to invest in treatment that is not evidence-based when there is so much healing that can be effected through evidence-based treatment in modern times. It is foolish to revert to medieval practice even if one day these practices may some day be proven to be helpful and even healing. Because although leeches today are scientifically proven to be healing, there are very specific conditions to its healing properties; yet, there are all those people who died of colds as a result of bloodletting. It is not a trade off that seems worth it.

There is a book called Trick or Treatment that identifies tens of alternative treatments and describes their effectiveness or lack thereof based on solid, scientific evidence. For example (and I know I am going to be blasted for this example), the research on chiropractic treatment shows that although neck and back pain can be alleviated to some degree, there is absolutely no evidence that supports that chiropractic treatment is effective in treating anything else unrelated to the back and spine; for example, headaches, infantile colic, asthma, or allergies (unless as a placebo).

Although I have plenty more to say on this topic, specifically as a social worker who treats clients (ONLY with evidence-based therapy!) who are also involved with alternative treatments, I (temporarily) rest my case.

Sure, you can refute everything I wrote here. But please, only with evidence-based rebuttals. Not anecdotal stuff from your Bubbah's Bubbah. I have heard enough of that already, thank you very much. Love ya, too!

Next week: reader's responses (angry ones!) and one more from me....

 NOTE: this was originally published in Binah Magazine


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