55-3 How do alternative therapies fare under scientific scrutiny?

The tendency of many abnormal states of mind to return to normal, combined with the placebo effect (the healing power of mere belief in a treatment), creates fertile soil for pseudotherapies. Bolstered by anecdotes, heralded by the media, and broadcast on the Internet, alternative therapies can spread like wildfire. In one national survey, 57 percent of those with a history of anxiety attacks and 54 percent of those with a history of depression had used alternative treatments, such as herbal medicine, massage, and spiritual healing (Kessler et al., 2001).

Testimonials aside, what does the evidence say? This is a tough question, because there is no evidence for or against most of them, though their proponents often feel personal experience is evidence enough. Some, however, have been the subject of controlled research. Let’s consider two of these. As we do, remember that sifting sense from nonsense requires the scientific attitude: being skeptical but not cynical, open to surprises but not gullible.

EMDR (eye movement desensitization and reprocessing) is a therapy adored by thousands and dismissed by thousands more as a sham—“an excellent vehicle for illustrating the differences between scientific and pseudoscientific therapy techniques,” suggested James Herbert and seven others (2000). Francine Shapiro (1989, 2007, 2012) developed EMDR while walking in a park and observing that anxious thoughts vanished as her eyes spontaneously darted about. Back in the clinic, she had people imagine traumatic scenes while she triggered eye movements by waving her finger in front of their eyes, supposedly enabling them to unlock and reprocess previously frozen memories. Tens of thousands of mental health professionals from more than 75 countries have since undergone training (EMDR, 2011). Not since the similarly charismatic Franz Anton Mesmer introduced animal magnetism (hypnosis) more than two centuries ago (also after feeling inspired by an outdoor experience) has a new therapy attracted so many devotees so quickly.

Does it work? For 84 to 100 percent of single-trauma victims participating in four studies, the answer is Yes, reports Shapiro (1999, 2002). Moreover, the treatment need take no more than three 90-minute sessions. The Society of Clinical Psychology task force on empirically validated treatments acknowledges that EMDR is “probably efficacious” for the treatment of nonmilitary posttraumatic stress disorder (Chambless et al., 1997; see also Bisson & Andrew, 2007; Rodenburg et al., 2009; Seidler & Wagner, 2006).

Why, wonder the skeptics, would rapidly moving one’s eyes while recalling traumas be therapeutic? Some argue that eye movements serve to relax or distract patients, thus allowing the memory-associated emotions to extinguish (Gunter & Bodner, 2008). Others believe that eye movements in themselves are not the therapeutic ingredient (nor is watching high-speed Ping-Pong therapeutic). Trials in which people imagined traumatic scenes and tapped a finger, or just stared straight ahead while the therapist’s finger wagged, have also produced therapeutic results (Devilly, 2003). EMDR does work better than doing nothing, acknowledge the skeptics (Lilienfeld & Arkowitz, 2007). But skeptics suspect that what is therapeutic is the combination of exposure therapy—repeatedly calling up traumatic memories and reconsolidating them in a safe and reassuring context—and perhaps some placebo effect. Had Mesmer’s pseudo-therapy been compared with no treatment at all, it, too (thanks to the healing power of positive belief), might have been found “probably efficacious,” observed Richard McNally (1999).

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Have you ever found yourself oversleeping, gaining weight, and feeling lethargic during the dark mornings and overcast days of winter? There likely was a survival advantage to your distant ancestors’ slowing down and conserving energy during the dark days of winter. For some people, however, especially women and those living far from the equator, the wintertime blahs constitute a seasonal pattern for major depressive disorder. To counteract these dark spirits, National Institute of Mental Health researchers in the early 1980s had an idea: Give people a timed daily dose of intense light. Sure enough, people reported they felt better.

Was light exposure a bright idea, or another dim-witted example of the placebo effect? Research sheds some light. One study exposed some people with a seasonal pattern in their depression symptoms to 90 minutes of bright light and others to a sham placebo treatment—a hissing “negative ion generator” about which the staff expressed similar enthusiasm (but which was not even turned on). After four weeks, 61 percent of those exposed to morning light had greatly improved, as had 50 percent of those exposed to evening light and 32 percent of those exposed to the placebo (Eastman et al., 1998). Other studies have found that 30 minutes of exposure to 10,000-lux white fluorescent light produced relief for more than half the people receiving morning light therapy (Flory et al., 2010; Terman et al., 1998, 2001). From 20 carefully controlled trials we have a verdict (Golden et al., 2005; Wirz-Justice, 2009): Morning bright light does indeed dim depression symptoms for many of those suffering in a seasonal pattern. Moreover, it does so as effectively as taking antidepressant drugs or undergoing cognitive-behavioral therapy (Lam et al., 2006; Rohan et al., 2007). The effects are clear in brain scans; light therapy sparks activity in a brain region that influences the body’s arousal and hormones (Ishida et al., 2005).