Uncommon Descent Serving The Intelligent Design Community

Medical Practice, Biological Science, and the Power of a “Differential Diagnosis”

Share
Facebook
Twitter
LinkedIn
Flipboard
Print
Email

Because science is a search for causes, its practitioners are ethically bound to keep an open mind about the nature of those causes. The whole point of investigating any given phenomenon is to find a reasonable answer to the question, “why is this happening?” or “why did it happen?” In that spirit, the researcher develops a rigorous methodology that will address a narrowly-focused problem and facilitate the process of finding the most plausible solution, regardless of whose interests might be served. This is just as true for the practice of medicine as it is for the study of life’s origins.

If, for example, a physician is about to decide on the appropriate therapy for his patient, he will, if he is competent, perform what is known as a differential diagnosis. The strategy is to identify at least two possible causes of a given medical problem, weigh the evidence for each against the other, and choose the one which best explains the data. In other words, the diagnosis determines the therapeutic response. When this process is reversed, that is, when available therapies or technologies determine the diagnosis, personal agendas override the scientific method. If any form of institutional bias prompts the physician to ignore a potential cause, the practice of medicine has been fatally compromised.

Consider the fashionable problem of carpal tunnel syndrome. Medical professionals understand that this condition is the result of dysfunction in the median nerve at the wrist. The appropriate question from a diagnostic standpoint is, therefore, “what is troubling this nerve?” According to conventional wisdom, the nerve is compressed as it passes under a ligament at the wrist, which would indicate a physical or structural problem. Not so fast. Dr. John Sarno, professor of rehabilitative medicine, insists that CTS is a mind/body (psychosomatic) problem caused by stress. Negative emotions in the unconscious mind produce the symptoms to distract the sufferer from one or more intolerable psychological conflicts. If CTS was truly a structural problem, Sarno reasonably asks, “Why is it that millions of men and women who pounded typewriters since the beginning of the twentieth century never developed it?” Or again, if the body is producing the symptoms, why have countless sufferers been cured of the malady by recognizing the mind as its source and acting on that information through a step-by-step process of self-analysis?

Most physicians, by virtue of their training as “body mechanics,” are not professionally equipped to perform a differential diagnosis for this kind of condition. They either do not understand or refuse to accept the reality: The mind can be, and often is, the source of a physical symptom. To press the point even further, disharmonious domestic relationships or competitive professional environments are often responsible for a cluster of symptoms known as “fibromyalgia.” Sadly, mind/body disorders are seldom treated properly because the medical establishment no longer takes mind/body medicine seriously, assuming that all problems are structural problems. As a result, they don’t ask the critical question: Structural pain or psychosomatic pain? In many cases, patients are doing physical therapy for a perceived mechanical problem when the time would be more profitably spent dealing with their emotional conflicts.

Just as millions must endure unnecessary physical suffering because scientists do not always apply a differential diagnosis in the medical arena, millions more must endure mental suffering because Darwinist ideologues, and their Christian Darwinist lapdogs, refuse to conduct a differential diagnosis in the biological realm. The problem is how to best explain the origin and variety of life on our planet? The question for the differential diagnosis is clear: Undirected Natural Processes or Directed Intelligent Design? While ID scientists consider the strength for both arguments and draw an inference to design, anti-ID partisans resort to methodological naturalism, an arbitrary rule of science that bans design arguments from the arena of competitive ideas. It is very easy to win a contest when you are the only competitor. Similarly, it is very easy to diagnose a cause when only one cause is eligible for consideration.

But this reluctance to keep an open mind about alternative possibilities strikes at the very foundation of the scientific enterprise. To investigate nature rightly is to sit humbly at her feet so that she can reveal her secrets—recognizing that she is the teacher and we are the students–delegating to her the task of scrutinizing our intellectual convictions so that they may be tested, sifted, or fine-tuned—-asking about the truth rather than indulging in the illusion that we have already attained it.

“Go to the pine if you want to learn about the pine, or to the bamboo if you want to learn about the bamboo. And in doing so, you must leave your subjective preoccupation with yourself. Otherwise you impose yourself on the object and do not learn.— Matsuo Basho

ID scientists engage Darwinists and TEs with a similar challenge: Go to the DNA molecule if you want to learn about the DNA molecule. Observe its behavior and ask yourself, “Why is this happening?” Test your atheistic doubts or your religious presumptions against the facts in evidence. Study those facts, submit to the data, and conduct a differential diagnosis. Build your theories on the evidence. Don’t try to squeeze, pound, jam, or hammer out the evidence into your rigid theoretical mold and cry out in futility, “fit, damn you, fit.”

Clearly, institutional bias can cloud judgment in any area or specialty. Like the structuralist physicians who ignore scientific evidence that points to the mind as a cause for physical symptoms, materialist Darwinists (and Christian Darwinists) ignore scientific evidence that points to the mind as a cause for biological design. In both cases, the analyst subordinates truth to convention, which is the hallmark of anti-intellectual partisanship.

Still, there is a difference. To ignore evidence is irresponsible, but to forbid its expression is evil. In the latter case, anti-ID zealots have, by virtue of their exclusionary rule, decided that nature should not be allowed to reveal all her secrets. Methodological naturalism, the surrogate enforcer of intellectual tyranny, declares that nature’s testimony, because of its possible religious implications, is inadmissible and may not be heard. As Basho might put it, devotees of evolutionary biology are imposing themselves and their subjective preoccuptations on the object. Insofar as they arrogantly and presumptuously assume the role of teacher and reduce nature to the role of student, they render themselves and everyone under their influence, uneducable.

The problem of institutional bias is an old one, but it has become manifest once again. According to the National Academy of Science, the Kansas Board of Education, and a number of other institutions, the job of science “is to provide plausible natural explanations for natural phenomena.” Even a Pennsylvania judge weighed in on the matter, issuing the mindless verdict that non-natural explanations are impermissible for science. For the secular minded, there will be no differential diagnosis because the differential component has been taken off the table.

At this point, nature objects to this reversal of roles and reasserts her rightful place as a teacher. The “stones cry out” by asking a few questions: What are we to make of the fact that these same rule makers who limit science to the study of “natural causes” have no problem with Big bang cosmology, which also has religious implications and also hints at a non-natural cause? Why is the differential diagnosis acceptable in the cosmological sphere and unacceptable in the biological sphere? If cosmological fine-tuning is acceptable as a scientific concept, why is biological fine-tuning not acceptable as a scientific concept?

Indeed, if one is to rule out a differential diagnosis on the grounds that science is limited to “natural causes,” he should at least be able to explain this exclusion in a rational way. How do we define nature and what is a natural cause? Darwinists (and the TEs that follow them) say, apparently without embarrassment, that a natural cause is one that occurs or can be found “in nature.” In that case, how do we distinguish bombs from earthquakes—or burglars from tornados–or the humanly-produced artifacts found in ancient Pompei from the unhuman volcano that buried them? If all these causes are of the same kind, then there is no way to discern one from the other. On the other hand, if we finally confess the difference between the intelligent causes and natural causes indicated, how can we call then “natural” as if they were all of the same kind? The intellectual dictators who crafted this cuckoo formula have no answers. How can they presume to enforce a standard that they can’t even define?

It is an interesting social phenomenon that Darwinists and most TEs suffer from what C.S. Lewis once called “the horror and neglect of the obvious.” In fact, biological design really is obvious, which explains why evolutionary biologists feel the need to remind themselves to forget it. This is a violation of the scientific method and the legitimate exercise of reason. One cannot search for a cause and, at the same time, disdain the object of the search. To sincerely ask about the “why” from a scientific perspective is to honestly weigh the alternative explanations to find the most plausible solution, regardless of whose interests might be served.

Comments
CR:
It is logically possible that some highly advanced alien civilization billions of years older than our planet could have designed the biosphere. Yet, we’ve discarded this as well for the same reasons I’ve illustrated. It’s an explanation-less theory.
Your claim about what is logically possible has nothing at all to do with the fact that methodological naturalism rules out evidence for design even before the evidence has had a chance to speak..
Furthermore, a designer is not ruled out, but discarded along with an infinite number of other logically possible, but yet to be conceived explanations. Un-conceived theories are explanation-less because, well, un-conceived theories cannot have explanations
To say that something has not been ruled out but has merely been discarded is like saying that something has not been abolished but has merely been expunged. In any case, everyone knows what design means, especially the methodological naturalists who rule it out.
Good explanations include not only being predictive, testable, etc. They are also provide a long chain of independent, hard to details which are difficult to vary without effecting the entire theory.
I didn’t ask you to define a good explanation, which is obvious enough. I asked you to define a bad explanation since you said that a bad explanation could also be true.StephenB
September 25, 2012
September
09
Sep
25
25
2012
09:55 PM
9
09
55
PM
PDT
CR: First and most importantly, disagreement over the role evidence plays in the growth of knowledge does not constitute ignoring evidence. Surely, you can do better than this? SB: Methodological naturalism, as practiced by Darwinists, rules out all evidence for biological design in the name of science.
Again, surely you can do better than this? It is logically possible that some highly advanced alien civilization billions of years older than our planet could have designed the biosphere. Yet, we've discarded this as well for the same reasons I've illustrated. It's an explanation-less theory. Furthermore, a designer is not ruled out, but discarded along with an infinite number of other logically possible, but yet to be conceived explanations. Un-conceived theories are explanation-less because, well, un-conceived theories cannot have explanations. So, it's not evidence that is discarded, but bad or explanation-less theories for that evidence.
SB: Of course, just because something is a bad explanation doesn’t necessarily mean it might not be true. CR: What is your definition of a bad explanation?
Good explanations include not only being predictive, testable, etc. They are also provide a long chain of independent, hard to details which are difficult to vary without effecting the entire theory. From the Wikipedia entry on Explanatory Power
Physicist David Deutsch offers a criterion for a good explanation that he says may be just as important to scientific progress as learning to reject appeals to authority, and adopting formal empiricism and falsifiability. To Deutsch, these aspects of a good explanation, and more, are contained in any theory that is specific and "hard to vary". He believes that this criterion helps eliminate "bad explanations" which continuously add justifications, and can otherwise avoid ever being truly falsified. Deutsch takes examples from Greek mythology. He describes how very specific, and even somewhat falsifiable theories were provided to explain how the gods' sadness caused the seasons. Alternatively, Deutsch points out, one could have just as easily explained the seasons as resulting from the gods' happiness - making it a bad explanation, since it is so easy to arbitrarily change details.[1] Without Deutsch's criteria, the 'Greek gods explanation' could have just kept adding justifications. This same criterion, of being "hard to vary", may be what makes the modern explanation for the seasons a good one: none of the details - about the earth rotating around the sun at a certain angle in a certain orbit - can be easily modified without changing the theory's coherence.
An "abstract designer with no limitations" is easily varied because it retreats from any of the details that makes a designer a good explanation in the first place. It's only connected to design is the claim of being a designer, which a form of justificationism.
critical rationalist
September 25, 2012
September
09
Sep
25
25
2012
09:02 PM
9
09
02
PM
PDT
Jon, I understand that you are committed to a certain treatment model and I don't doubt that you have had some success with it. My guess is that you did a spectacular job with the information that was available to you. What we are discussing, though, is the approach that works best. The evidence--and there is plenty of it-- is on the side of Sarno's methods. I encourage you to follow up with the requisite reading. Responding to your objection, I don't think that adopting Sarno's approach would signal a return to Freudian psychoanalysis or atheistic paradigms. To recognize the existence and power of the unconscious mind is simply to face a incontestable fact. You seem to be arguing that we should forget about that fact simply because Freud's was an atheist and wrong about other things. In any case, Sarno draws on Charcot, Freud, Breuer, Adler, Alexander, Walters and others. Each was right about some things; each was wrong about many other things. More to the point, Sarno has achieved the breakthrough that no one else could achieve by studying the relevant literature, employing the empirical method, and, most of all, being a good detective. You speak of experience and I agree that it is important. We must all learn from our mistakes and make adjustments as we go. Institutional bias is a killer because it encourages misplaced loyalty and causes people to "double down" when they should be changing. In keeping with that point, I learn much more from those who have had forty years worth of experience than from those who have had one year's experience forty times.StephenB
September 25, 2012
September
09
Sep
25
25
2012
01:04 PM
1
01
04
PM
PDT
Stephen B
On the other hand, I am not aware of any long-term studies that would confirm the efficacy of Todd’s approach (or those of Patrick Wall/Ronald Melzack). I admire their independent thinking and their descriptions of phenomena, but I have no reason to believe that they can make people better.
That's fine, Stephen, I appreciate your position. I, on the other hand, do have reason to believe they can make people better, because I used them and they did. But you have no reason to believe me. After all my patients didn't post testimonials on the web, and I wasn't an accomplished self-publicist, being a mere state-funded practitioner rather than depending on fee-paying patients. Mind you, I've never heard of Todd before, who is just a random blogger representing an entire worldwide medical/physiological field of pain science. To assess that you'd need to start with some basic grounding in the anatomy and physiology, read the specialist literature and controlled studies, attend a few conferences, meet some pain consultants. I was particularly impressed by the research of one of the guys who taught me, on his spare-time work on people suffering traumatic amputations in the Sierra Leone civil war.
If Sarno’s diagnosis was incorrect, his therapy wouldn’t suffice.
You clearly haven't had much experience of the history and philosophy of medicine, then! If Sarno's diagnosis is right, it will mean we will have to rehabilitate Freudian Psychoanalysis, which was already well on the way to being debunked as myth when I studied social psychology in 1973, because that's his psychological model. Come back, Oedipus complex! All is forgiven!Jon Garvey
September 25, 2012
September
09
Sep
25
25
2012
01:31 AM
1
01
31
AM
PDT
critical rationalist:
First and most importantly, disagreement over the role evidence plays in the growth of knowledge does not constitute ignoring evidence. Surely, you can do better than this?
Methodological naturalism, as practiced by Darwinists, rules out all evidence for biological design in the name of science.
Of course, just because something is a bad explanation doesn’t necessarily mean it might not be true.
What is your definition of a bad explanation?StephenB
September 24, 2012
September
09
Sep
24
24
2012
06:22 PM
6
06
22
PM
PDT
Critical rationalist:
Now, if you’d like to move from the abstract to present some sort of explanation as to how the designer did it, the origin of the knowledge it used to do it, etc, *then* we would have something more than a mere possibility.
A scientific inference to design does not require a description of the designer’s mechanism. When, for example, the archeologist draws an inference about the design in an ancient hunter’s spear, ruling out natural causes such as wind, air, and erosion, he need not explain the process by which spear was designed. Those are the two logical choices: undirected naturalistic process vs. directed intelligent design.StephenB
September 24, 2012
September
09
Sep
24
24
2012
05:41 PM
5
05
41
PM
PDT
StephanB: Clearly, institutional bias can cloud judgment in any area or specialty. Like the structuralist physicians who ignore scientific evidence that points to the mind as a cause for physical symptoms, materialist Darwinists (and Christian Darwinists) ignore scientific evidence that points to the mind as a cause for biological design. In both cases, the analyst subordinates truth to convention, which is the hallmark of anti-intellectual partisanship.
First and most importantly, disagreement over the role evidence plays in the growth of knowledge does not constitute ignoring evidence. Surely, you can do better than this? Second, apparently I'm not a "material Darwinist" (whatever that means) as Darwinism falls under the same umbrella theory of knowledge that includes how knowledge is created in minds. No ignoring evidence here either. Third, asserting design or the appearance of it is some kind of immutable primitive that cannot be explained isn't anti-intellectual?
StephanB: Still, there is a difference. To ignore evidence is irresponsible, but to forbid its expression is evil. In the latter case, anti-ID zealots have, by virtue of their exclusionary rule, decided that nature should not be allowed to reveal all her secrets.
Again, see above. To forbid questions about the designer as taboo or claiming we cannot make progress in regards to details of the designer would not be evil? Furthermore, if you claim there are just some "secrets" about the designer that cannot be revealed, it's unclear how is this is any different from saying the designer is inexplicable, yet can effect us. I do not think proponents of such a view have though out the consequence of such a claim. From the same comment on the earlier thread.
If we really do reside in a finite bubble of explicably, which exists in an island in a sea of of inexplicability, the inside of this bubble cannot be explicable either. This is because the inside is supposedly dependent what occurs in this inexplicable realm. Any assumption that the world is inexplicable leads to bad explanations. That is, no theory about what exists beyond this bubble can be any better than “Zeus rules” there. And, given the dependency above (this realm supposedly effects us), this also means there can be no better expiation that “Zeus rules” inside this bubble as well. In other words, our everyday experience in this bubble would only appear explicable if we carefully refrain from asking specific questions.
Of course, just because something is a bad explanation this doesn’t necessarily mean it is might not be true. But, if we assume this is indeed true, for the sake of criticism, and that all observations should conform to it, this leads to the following question: “If bad explanations are indeed true, then how do you explain our ability to know anything?” However if, on the other hand, Cornelius means that Darwinism is nothing more than veering atoms, rather than a process that genuinely creates knowledge via emergence, then he’s attacking a strawman via an outdated definition of materialism.
critical rationalist
September 24, 2012
September
09
Sep
24
24
2012
01:15 PM
1
01
15
PM
PDT
Jon, I read as much as I could on Todd Hargrove, visiting two blogs where he comments. He agrees that Sarno’s methods work, but he doesn’t agree with Sarno’s explanation about why they work. That doesn't seem reasonable to me. If Sarno’s diagnosis was incorrect, his therapy wouldn’t suffice. That is why so many of Todd’s readers often interrupt his critique to praise Sarno and tell their stories of liberation. It also explains why so many studies confirm the efficacy of Sarno’s strategies. On the other hand, I am not aware of any long-term studies that would confirm the efficacy of Todd’s approach (or those of Patrick Wall/Ronald Melzack). I admire their independent thinking and their descriptions of phenomena, but I have no reason to believe that they can make people better.StephenB
September 24, 2012
September
09
Sep
24
24
2012
01:11 PM
1
01
11
PM
PDT
StephanB
The question for the differential diagnosis is clear: Undirected Natural Processes or Directed Intelligent Design? While ID scientists consider the strength for both arguments and draw an inference to design, anti-ID partisans resort to methodological naturalism, an arbitrary rule of science that bans design arguments from the arena of competitive ideas. It is very easy to win a contest when you are the only competitor. Similarly, it is very easy to diagnose a cause when only one cause is eligible for consideration.
Perhaps you missed my comment on this same issue from the anti-reality thread....
For example, it’s unlikely that anyone has performed research to determine if eating a square meter of grass each day for a week would cure the common cold. Why is this? Is it because it’s logically impossible? No. Is it because it’s unfalsifiable? No, this would be trivial to test. Is it because is “non-natural” or “non-material”? No. Why then is it unlikely to be the subject of research? Because we lack an explanation as to how and why eating a square meter of grass each day for a week would cure the common cold. As such, we discard it, a priori, before we even test it. [...] Without an explanation it’s a theory-less, mere logical possibility, which we cannot test for errors using observations. As such we discard it. And we do this for a near infinite number of mere possibilities every day across every field of science.
Now, if you'd like to move from the abstract to present some sort of explanation as to how the designer did it, the origin of the knowledge it used to do it, etc, *then* we would have something more than a mere possibility. But this will not occur for reasons that are obvious. So, if anyone is being reluctance here, it is ID proponents.critical rationalist
September 24, 2012
September
09
Sep
24
24
2012
12:23 PM
12
12
23
PM
PDT
Stephen Sure thing. But I trust you'll take the same advice yourself, eg here. Proverbs 18.17 relates!Jon Garvey
September 24, 2012
September
09
Sep
24
24
2012
12:08 AM
12
12
08
AM
PDT
Jon, if you get the chance, read "The Divided Mind," by John Sarno. In addition to his own exposition, several other physicians recount their experiences in the context of what they have learned after having been trained by him. In the meantime, check out the brief Wikipedia article. If you are open to the evidence, I think you will eventually be persuaded.StephenB
September 23, 2012
September
09
Sep
23
23
2012
01:52 PM
1
01
52
PM
PDT
StephenB I'm not passing judgement from this side of the Atlantic. I don't know enough to do so. But after a few decades in the profession, much of it dealing with patients with controversial conditions, who often had seen controversial practitoners, I've seen a lot, often gone against the mainstream and learned the place of healthy skepticism. Got some good results, too, though I says it myself as shouldn't. One rule of thumb I developed is that if the first dozen pages of Google hits for a "non-accepted" controversial therapy are full of advertisements and testimonials to it, it's not that "non-accepted" and I should look at the one gainsayer for information. Interestingly there's only one skeptic on the first Google page if I search "John Sarno", who has some quite interesting stuff on pain science... which still supports the point of your original post about blinkered establishments... only like all generalisations, they're generalisations.Jon Garvey
September 23, 2012
September
09
Sep
23
23
2012
10:12 AM
10
10
12
AM
PDT
Jon, I am very surprised at your reaction to the information presented here. If our roles had been reversed, I would have already asked you for more information and hurried to the library to read more comprehensibly on the subject. I would have wanted to learn about the multiple doctors from all over the U.S. who have interrupted their practice so they could fly to New York and study with John Sarno. I would have already devoured one of Sarno's books. At the very least, I would have Googled his name to get a brief description of his accomplishments. It would have only take five seconds to get to this paragraph: "Sarno's books describe two follow-up surveys of his TMS patients. The first in 1982 interviewed 177 patients selected randomly from those Sarno treated in the preceding three years. 76% stated that they were leading normal and effectively pain-free lives. A second follow-up study in 1987 restricted the population surveyed to those with herniated discs identified on CT-scans, and 88% of the 109 randomly selected patients stated that they were free of pain one to three years after TMS treatment. In 2007, David Schechter (a medical doctor and former student and research assistant of Sarno) published a peer-reviewed study of TMS treatment showing a 54% success rate for chronic back pain. The average pain duration for the study's patients was 9 years. In terms of statistical significance and success rate, the study outperformed similar studies of other psychological interventions for chronic back pain." Or this: "On February 14, 2012, John Sarno, MD appeared before the Senate Committee on Health, Education, and Pensions to address 'Pain in America: Exploring Challenges to Relief'. The committee was chaired by Senator Tom Harkin (D-Iowa) who was very supportive of the mind-body connection espoused by Dr. Sarno's treatment approach to pain. In fact Senator Harkin describes his own successful experience with pain relief from reading Dr. Sarno's books. Senator Harkin relates how his niece's chronic pain symptomatology from fibromyalgia resolved after reading Dr. Sarno's books as well."StephenB
September 23, 2012
September
09
Sep
23
23
2012
09:34 AM
9
09
34
AM
PDT
of semi-related interest:
The Population Control Holocaust - 2012 Excerpt:,,, the belief that the human race is a horde of vermin whose unconstrained aspirations and appetites endanger the natural order, and that tyrannical measures are necessary to constrain humanity. The founding prophet of modern antihumanism is Thomas Malthus (1766-1834), who offered a pseudoscientific basis for the idea that human reproduction always outruns available resources. Following this pessimistic and inaccurate assessment of the capacity of human ingenuity to develop new resources, Malthus advocated oppressive policies that led to the starvation of millions in India and Ireland. While Malthus’s argument that human population growth invariably leads to famine and poverty is plainly at odds with the historical evidence, which shows global living standards rising with population growth, it nonetheless persisted and even gained strength among intellectuals and political leaders in the twentieth and twenty-first centuries. Its most pernicious manifestation in recent decades has been the doctrine of population control, famously advocated by ecologist Paul Ehrlich, whose bestselling 1968 antihumanist tract The Population Bomb has served as the bible of neo-Malthusianism. In this book, Ehrlich warned of overpopulation and advocated that the American government adopt stringent population control measures, both domestically and for the Third World countries that received American foreign aid. (Ehrlich, it should be noted, is the mentor of and frequent collaborator with John Holdren, President Obama’s science advisor.),,, http://www.thenewatlantis.com/publications/the-population-control-holocaust
bornagain77
September 23, 2012
September
09
Sep
23
23
2012
07:13 AM
7
07
13
AM
PDT
StephenB Agree with paragraphs 2-4. My experience exactly - and therein lies the greatest parallel with Neo-Darwinism. "There must be a physical injury, because we only consider physical injuries". There is a long history of physicalism - but also a long history of mentalism, both with patchy records of success. The new (and to me exciting) kid on the block is neurophysiology, which can help integrate the undoubted physical elements ("your disc prolapsed") with key mental concepts ("the pain is real but not indicative of harm, fear is an important factor, your mental attitudes and physical approach will make a huge difference") with the hope of effective treatment too. That pain that has been allowed to become very chronic is a global ailment requiring psychological input I don't doubt. Para 1 - I'm not actually familiar with Sarno, but learned to be skeptical about individual units' claims of success rates years ago. Especially with a subjective symptom like pain. Charismatic practitioners have high success rates that never seem to transfer to others. Related to that is the interesting question of unintended consequences (ie the wrong theory working). In any case, 80% of the 10-15% who accept the diagnosis is around 10%, which isn't such a great success rate. In back pain I got used to dealing with people who'd been told all kinds of mutually incompatible nonsense by different types of people, but who'd had good results because, for example, the false explanation got them exercising normally instead of fearing their pain and deconditioning. So does the theory matter? Less than one would think, but my attitude is the closer one gets to how things are actually working, the less problems occur down the line. Telling someone they've got 6 discs "out" is fine until someone invents MRI and finds (a) it's not true or (b) that it's true but doesn't help the problem. So is the purely psychosomatic approach helpful because it's true, or because it leads to the right activity? Last para is possibly true, but by no means conclusive. The first rule in medicine is that things happen to individuals, not the whole species. For 25 years I handled annual flu outbreaks without being vaccinated, and only got ill once. There's some lesson to learn there, but it isn't that flu is imaginary. Similarly, some large percentage of people will never get Ca bronchus, or chronic lung disease, however much they smoke: but smoking still kills. So "Does RSI exist?" requires analysis of its first description to see if that was valid, analysis of current diagnosis to see if it's being misapplied, social analysis to see if it's become a fashionable thing to get, or even a standard excuse to get out of inhuman working conditions. So it exists - but what is it?Jon Garvey
September 23, 2012
September
09
Sep
23
23
2012
12:07 AM
12
12
07
AM
PDT
Jon, let's consider the evidence: Sarno's methods (and those who follow him) have generated cure rates at about 80% for those who accept the diagnosis, and it would likely be higher if everyone followed the recommended protocol. The solution works because the cause of the symptoms, the mind, has been identified. On the other hand, specialists from various branches of physical medicine have a dismal record in treating the problem of chronic pain because they continue to assume structural causes. The improvement rate for those who do not visit a back pain specialist is about the same as those who are treated. Interestingly, the x-ray and MRI often tell a story that doesn't necessarily reflect the dynamic in play. Those who register advanced degenerative changes often experience no pain whatsoever while those who register mild changes are often in agony. That should be instructive. Usually, the origin of the problem is not physical. Surgery does not help these difficulties in the long run and often makes things worse. Exercise, while valuable in other contexts, seldom has anything to do with the problem. The human body is not that delicate. Temporary improvements often occur because of the placebo effect and, later on, the problem comes back or else the brain places it in another part of the body in order to continue its strategy of distraction. Physical problems due to structural issues do not just jump around from one place to another. One hundred years ago, there was no such thing as a "repetitive strain" injury. Millions of people pounded on a heavy-handed Remington typewriter eight hours a day for thirty years and experienced no adverse effects. Now, we are being asked to believe that the a few hours of light tapping on a computer keyboard for a few months can create a burden too severe for the body to tolerate. Ridiculous!StephenB
September 22, 2012
September
09
Sep
22
22
2012
05:19 PM
5
05
19
PM
PDT
StephenB I could see myself coming to blows with Dr Sarno... but mainly because I now think the "psychosomatic" language is an oversimplification, since it implies that the mind is the source of the disease, or at least of the symptoms, which is another example of reductionism. I would rather say that the body and mind are closely connected - and the connections go via the spinal cord and then the brain, which is where pain actually happens. Chronic pain (ie neuropathic pain), in my view, is usually more to do with the spinal cord than the higher brain (though some people's brains seem to be in their spine somewhere!). Chronicity is affected by physical conditioning, and that is influenced by beliefs about the pain. But there's a genetic (or maybe epigenetic - that didn't exist when I was at work!) element too. So severe back pain is often caused by a genuine disc injury (in my case from lifting a bass amplifier in my ill-spent youth). Why do some become chronic? Not because the physical injury persists, but because a pain loop forms. Why is that? Sometimes because people tell them they'll never get better and will have to avoid exercise - but exercise is the best way of avoiding chronicity. But sometimes, as in my case, that pain loop gets reactivated from time to timeby purely physical mishap for a few weeks and it's easy to be fooled that there's a new physical injury. It's also true, as Sarno suggests, that you can become both a psychological and physical cripple if you treat yoursef, or are treated, wrong. Why am I telling you all this? Well, mainly because I don't get to talk about it much 4 years on from retirement, but also because it underlines the need for a genuinely holistic approach to medicine (as opposed to "New Age" type holism). And it shows, as C S Lewis said, that whatever scientific theory you work on, it's only a fragment of the truth that happens to fit your worldview. Sobering for scientists and especially doctors!Jon Garvey
September 22, 2012
September
09
Sep
22
22
2012
01:38 PM
1
01
38
PM
PDT
Mung @ 14, Perhaps I should have said that BA contributed to our understanding of another important dimension of the mind/body problem. To me, his ability to internalize the results of all that research constitutes a preternatural gift of some kind.StephenB
September 22, 2012
September
09
Sep
22
22
2012
11:36 AM
11
11
36
AM
PDT
You have contributed another important dimension to the mind/body problem.
How many dimensions were there before?Mung
September 22, 2012
September
09
Sep
22
22
2012
10:46 AM
10
10
46
AM
PDT
KF, you are right. Our civilization is playing with fire. We must return to a sane civil policy. Everything turns on recognizing the inherent dignity of the human person and (am I still allowed to say this?) the SOURCE of that dignity---God, the Creator.StephenB
September 22, 2012
September
09
Sep
22
22
2012
10:26 AM
10
10
26
AM
PDT
Jon, thank you for your comments. The breadth of your background is impressive. According to Dr. Sarno and several other experts in this field, several factors come into play: [a] Most chronic pain is psychosomatic. [b] Very few doctors are qualified to make the appropriate diagnosis. [c] If the mind is the source of the problem, and it usually is, the patient cannot get better if he doesn't accept that diagnosis and take the appropriate action (disciplined and systematic self-analysis). [d] Only 10-15% of patients can accept the diagnosis even if they are fortunate enough to find a doctor to provide it.StephenB
September 22, 2012
September
09
Sep
22
22
2012
09:59 AM
9
09
59
AM
PDT
BA77, thank you. I continue to be amazed at your ability to summon, apparently at will, so much relevant and illuminating scientific research. You have contributed another important dimension to the mind/body problem.StephenB
September 22, 2012
September
09
Sep
22
22
2012
09:43 AM
9
09
43
AM
PDT
UB @1, thanks for the kind words.StephenB
September 22, 2012
September
09
Sep
22
22
2012
09:30 AM
9
09
30
AM
PDT
Supplemental notes:
Materialism of the Gaps - Michael Egnor (Neurosurgeon) - January 29, 2009 Excerpt: The evidence that some aspects of the mind are immaterial is overwhelming. It's notable that many of the leading neuroscientists -- Sherrington, Penfield, Eccles, Libet -- were dualists. Dualism of some sort is the most reasonable scientific framework to apply to the mind-brain problem, because, unlike dogmatic materialism, it just follows the evidence. http://www.evolutionnews.org/2009/01/materialism_of_the_gaps015901.html “As I remarked earlier, this may present an “insuperable” difficulty for some scientists of materialists bent, but the fact remains, and is demonstrated by research, that non-material mind acts on material brain.” Sir John Eccles - Nobel Prize in Physiology or Medicine 1963 Do Conscious Thoughts Cause Behavior? -Roy F. Baumeister, E. J. Masicampo, and Kathleen D. Vohs - 2010 Excerpt: The evidence for conscious causation of behavior is profound, extensive, adaptive, multifaceted, and empirically strong. http://carlsonschool.umn.edu/assets/165663.pdf
bornagain77
September 22, 2012
September
09
Sep
22
22
2012
05:14 AM
5
05
14
AM
PDT
Of related interest to the mind body question, and its relation to medical diagnostics, is the burgeoning field of epigenetics:
The Mysterious Epigenome. What lies beyond DNA - video http://www.youtube.com/watch?v=RpXs8uShFMo
A little known fact, a fact that is very antagonistic to the genetic reductionism model of neo-Darwinism, is that, besides environmental factors, even our thoughts and feelings can 'epigenetically' control the gene expression of our bodies:
Anxiety May Shorten Your Cell Life - July 12, 2012 Excerpt: These studies had the advantage of large data sets involving thousands of participants. If the correlations remain robust in similar studies, it would indicate that mental states and lifestyle choices can produce epigenetic effects on our genes. http://crev.info/2012/07/anxiety-may-shorten-your-cell-life/
The following studies are more bold in claiming mental states and lifestyle choices influence the genome:
Genie In Your Genes - video http://www.genieinyourgenes.com/ggtrailer.html Upgrade Your Brain Excerpt: The Research; In his book The Genie in Your Genes (Elite Books, 2009), researcher Dawson Church, PhD, explains the relationship between thought and belief patterns and the expression of healing- or disease-related genes. “Your body reads your mind,” Church says. “Science is discovering that while we may have a fixed set of genes in our chromosomes, which of those genes is active has a great deal to do with our subjective experiences, and how we process them.” One recent study conducted at Ohio University demonstrates vividly the effect of mental stress on healing. Researchers gave married couples small suction blisters on their skin, after which they were instructed to discuss either a neutral topic or a topic of dispute for half an hour. Researchers then monitored the production of three wound-repair proteins in the subjects’ bodies for the next several weeks, and found that the blisters healed 40 percent slower in those who’d had especially sarcastic, argumentative conversations than those who’d had neutral ones. http://experiencelife.com/article/upgrade-your-brain/ Genie In Your Genes - Book Book review: First of all, if you are a newcomer to Dawson Church's writing, you need to know that his facts are unimpeachable - they were stringently peer-reviewed before publication. What is more, when Church makes categorical statements, he provides research to corroborate them. http://www.amazon.com/gp/product/1604150114?ie=UTF8&tag=eliboo-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1600700225
And though, as Darwinists would hold, many epigenetic (histone) markers on the genome, which were gathered through the life cycle of a organism, are generally 'wiped clean' during reproduction, some epigenetic effects are, in fact, found to carry forward transgenerationally:
Epigenetics: Feast, Famine, and Fatness - 2009 Excerpt: In the last five to ten years, there has been more and more evidence showing there is a non-genetic part that can be passed down to children and even grandchildren. As of this summer there are over 100 scientific articles documenting non-DNA inheritance, also called transgenerational epigenetics (1) http://www.precisionnutrition.com/epigenetics-feast-famine-and-fatness Histone-modifying proteins, not histones, remain associated with DNA through replication - August 23, 2012 Excerpt: A study of Drosophila embryos,, found that parental methylated histones are not transferred to daughter DNA. Rather, after DNA replication, new nucleosomes are assembled from newly synthesized unmodified histones. "Essentially, all histones are going away during DNA replication and new histones, which are not modified, are coming in,",, "What this paper tells us," he continues, "is that these histone modifying proteins somehow are able to withstand the passage of the DNA replication machinery. They remained seated on their responsive binding sites, and in all likelihood they will re-establish histone modification and finalize the chromatin structure that allows either activation or repression of the target gene." http://phys.org/news/2012-08-histone-modifying-proteins-histones-dna-replication.html
Moreover, some epigenetic effects, completely contrary to what the Central Dogma of neo-Darwinism would hold, are found to makes changes all the way down to the genome itself:
Does the central dogma still stand? – Koonin EV. – 23 August 2012 Excerpt: Thus, there is non-negligible flow of information from proteins to the genome in modern cells, in a direct violation of the Central Dogma of molecular biology. The prion-mediated heredity that violates the Central Dogma appears to be a specific, most radical manifestation of the widespread assimilation of protein (epigenetic) variation into genetic variation. The epigenetic variation precedes and facilitates genetic adaptation through a general ‘look-ahead effect’ of phenotypic mutations.,,, http://www.ncbi.nlm.nih.gov/pubmed/22913395
Materialists are infamous for holding that we are merely 'victims of our genes' and that we really have no control of what we do in life (genetic determinism). This following video humorously reveals the bankruptcy that atheists have in trying to ground beliefs within such a materialistic, 'genetic determinism', worldview;
John Cleese – The Scientists – humorous video http://www.youtube.com/watch?v=-M-vnmejwXo
bornagain77
September 22, 2012
September
09
Sep
22
22
2012
05:13 AM
5
05
13
AM
PDT
JC: In a fundamentally amoral context driven by evolutionary materialist nihilism and its fellow travellers, "quality of life" is subject to the usual might and manipulation make 'right' tactics that are ever so familiar from so many things happening in the name of reform and progress. (Note where that "progress is going, here.) Coming out the back-end of that is the notorious concept, life unworthy of life. Let's put it in the original German: "Lebensunwertes Leben." I hope that makes the point. This is the concept that then grounds the Schaeffer-Koop cascade: abortion, infanticide, so-called voluntary euthanasia, patently involuntary euthanasia, genocide of targetted groups. The USA is at the so-called voluntary euthanasia threshold now. Resemblance to Rom 1:18 - 32 is NOT coincidental. Medical care needs to be rationed, as do all finite resources in a world of scarcity. A much wiser approach is one that is economic through some sort of insurance market, modified by a Pareto extension based on a common fund used to relieve the needs of the destitute or the ones caught up in catastrophic costs. But, rationing based on faceless bureaucrats unaccountable to the public, and "overseen" by habitually deceitful pols and media corrupted by an amoral agenda, is a recipe for disaster. Singer is a warning-sign on where that is headed. And, I find that a pivotal issue is that we have increasingly become unable to reason morally on sound first principles. The recent UD debate over whether people could accept that torturing innocent babies for fun is self-evidently evil, speaks volumes on the sort of moral numbness and willful blindness that now affects especially the USA. The same destructive and suicidal trend is fast spreading across our whole civilisation. Even here, just this week I sat in as a stakeholder on a culture policy. In the theme group looking at self worth etc, it was being resisted that the issue is pivotal that by virtue of our nature endowed by our Creator, we have moral worth, and that this worth must be reciprocally recognised. (This is the only sound basis for moral reasoning; if you doubt me, try to build another, that is what is at stake in these debates over origins science etc.) Then, when I pointed out that as a matter of historical fact, in the pivotal passage in Locke's second treatise on civil gov't where he grounds what would become modern democracy, he cited Canon Richard Hooker on how the golden rule arises from that reciprocal duty, that too was resisted. One key point we all must face is that evolutionary materialist atheism undermines morality through its inherent, inescapable amorality. This opens the door to nihilist ruthless factions who equate morality with power games and seek to gain power to do as they will. Liberty -- per "my right to swing my arm ends where your nose begins" -- is not freedom to do as one pleases; that is license leading to that anarchy that calls forth despotism in the name of restoring order. Our civilisation is playing with serious fire. KF PS: Here is that cite, with a bit of introduction and some continuation in Hooker:
objective morality is grounded in the roots of our nature and in the moral Creator behind those roots. Richard Hooker, in his Ecclesiastical Polity sums this view up in a key passage cited by Locke in his Second Treatise on Civil Government, Ch 2 Sect. 5, to justify liberty and justice in government:
. . . if I cannot but wish to receive good, even as much at every man's hands, as any man can wish unto his own soul, how should I look to have any part of my desire herein satisfied, unless myself be careful to satisfy the like desire which is undoubtedly in other men . . . my desire, therefore, to be loved of my equals in Nature, as much as possible may be, imposeth upon me a natural duty of bearing to themward fully the like affection. From which relation of equality between ourselves and them that are as ourselves, what several rules and canons natural reason hath drawn for direction of life no man is ignorant . . . [[Hooker then continues, citing Aristotle in The Nicomachean Ethics, Bk 8:] as namely, That because we would take no harm, we must therefore do none; That since we would not be in any thing extremely dealt with, we must ourselves avoid all extremity in our dealings; That from all violence and wrong we are utterly to abstain, with such-like . . . ] [[Eccl. Polity,preface, Bk I, "ch." 8, p.80, cf. here.
We cannot say we have not been warned on the fire we are playing with.kairosfocus
September 22, 2012
September
09
Sep
22
22
2012
04:03 AM
4
04
03
AM
PDT
Steve: Thought-provoking, as usual. KFkairosfocus
September 22, 2012
September
09
Sep
22
22
2012
03:32 AM
3
03
32
AM
PDT
As someone who once treated carpal tunnel syndrome regularly I might quibble on some details above, but the general point is well made. My (hopefully helpful) quibbles would be firstly that insisting a condition is either physical or psychological is an example of the kind of compartmentalisation of knowledge you're making. The real question is "What is the interaction between mind, body and anything else involved that explains this problem best?" That means refusing to allow the physically-minded to treat the mind as an off-limits black-box, but equally refusing to let the psychologically-inclined to treat the body as a black box. Fybromyalgia is an interesting case in point. I don't think I ever met a sufferer who wasn't functioning abnormally in the psychological sense. But in doing some studies with cutting-edge pain physiologists, I discovered that the neurological response to pain in fybromyalgia sufferers is very different to that in normal subjects. In other words, the pain is a neurophysical abnormality. Physicians tended to say the patients were nuts (mind is a black box, and we don't do minds); psychiatrists tended to say the pain was a purely psychological manifestation (body is a black box - we don't do bodies). As a result, the condition is poorly understood by anybody. My specialist field was chronic back pain, where the demarcation problem was severe - the traditional view of orthopods, rheumatologists, physiotherapists, chiropractors etc was biomechanical: something's broken, so let's operate, manipulate or use anti-inflammatories. The emerging truth was that the issue is primarily neurophysiological, but that's a completely different paradigm with different management and, most importantly, a different mental model. In fact, back pain mainly becomes a psychological problem because of erroneous, or conflicting, mental models of what's going on. You'd think that everyone would be pleased to learn from other approaches. But in human activity, defending turf is usually more important.Jon Garvey
September 22, 2012
September
09
Sep
22
22
2012
01:07 AM
1
01
07
AM
PDT
@ba
Singer supports health-care rationing based on “quality of life.”
This one sticks out from everything else in the list. Is there a better criteria than this to use for rationing healthcare?JoeCoder
September 21, 2012
September
09
Sep
21
21
2012
09:12 PM
9
09
12
PM
PDT
Despite the seeming full time job Darwinists have in labeling everything they don't understand in the human body as vestigial or junk the plain fact is that The Human Body is simply amazing:
The Human Body - You Are Amazing - video http://www.metacafe.com/watch/5246456 Human Anatomy - Impressive Transparent Visualization - Fearfully and Wonderfully Made - video http://vimeo.com/26011909 One Body - (Harvard) animation - video http://www.youtube.com/watch?v=pDMLq6eqEM4 Fearfully and Wonderfully Made - Glimpses At Human Development In The Womb - video http://www.metacafe.com/watch/4249713 The Baby In The Womb (for full video, please follow link in description) http://www.youtube.com/watch?v=CPPkXe8KUg0 Alexander Tsiaras: Conception to birth — visualized – video http://www.youtube.com/watch?v=fKyljukBE70 Mathematician Alexander Tsiaras on Human Development: "It's a Mystery, It's Magic, It's Divinity" - March 2012 Excerpt: 'The magic of the mechanisms inside each genetic structure saying exactly where that nerve cell should go, the complexity of these, the mathematical models on how these things are indeed done, are beyond human comprehension. Even though I am a mathematician, I look at this with the marvel of how do these instruction sets not make these mistakes as they build what is us. It's a mystery, it's magic, it's divinity.' http://www.evolutionnews.org/2012/03/mathematician_a057741.html (Psalms 139:14) I praise you because I am fearfully and wonderfully made. Fearfully and Wonderfully Made - video http://www.metacafe.com/watch/5289335/ Fearfully and Wonderfully Made - Dr. David Menton - video http://www.youtube.com/watch?v=_Kt3Kk8mtlo
bornagain77
September 21, 2012
September
09
Sep
21
21
2012
07:15 PM
7
07
15
PM
PDT
1 2 3 4 5

Leave a Reply