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The cure for pseudoscience: alternative medicine

Posted 16 August 2016 by Matt Young

I just saw my colleague Paul Strode, with whom I wrote a book a few years ago. Knowing my interest in pseudoscience, Mr. Dr. Science Teacher (the name of his blog) directed me to his article Acupuncture Study as a Cure for Pseudoscientific Thinking. The article is, I think, really two articles. The first describes an experiment that his students perform, but he sets it up so that they generally overlook one important variable. The outcome of the experiment is therefore not necessarily useful. The second article, which relies to some extent on the first, is largely about acupuncture, and that seems to me to be where he gets down to brass tacks. I will only summarize here. Mr. Dr. Strode concludes that acupuncture is better than no treatment but that it is not better than a placebo. He cites a number of studies showing that sham acupuncture, including poking with a toothpick, works as well as "real" acupuncture. He observes that acupuncture can sometimes have deleterious side effects (nocebo effect) and cites a reference to the effect that there have been five confirmed cases of death resulting from acupuncture treatment. Finally, and perhaps this is really a third article, Dr. Strode describes perusing the website of the National Center for Complementary and Integrative Health; he is impressed primarily by "how tentative each headline is." Then he singles out one article, not about acupuncture but rather about how "Meditation or Exercise May Help Acute Respiratory Infections, Study Finds." May help. May help. I did not read the original article, but Dr. Strode helpfully provides a P-value of 0.054, and an effect size of 0.043. The P-value means that there is only about a 1 in 20 chance that the claimed effect is real the result (or a more extreme result) could have happened by chance. Statisticians often define a study to be statistically significant when the P-value is less than 0.05, so this study is marginal at best. Effect size is, in the simplest case, the ratio of the difference between the two means and the sample standard deviation. For example, if the mean of the test group and the mean of the control group differ by one standard deviation, then the effect size equals 1. The means in this study differ by 0.043 standard deviation; in other words the two means are virtually the same. The headline says that meditation or exercise may help acute respiratory infections. Indeed they may. This study has not ruled out the proposition, but to my mind neither has it provided one whit of evidence in its favor. Dr. Strode claims that meditation is useful anyway, and it differs from acupuncture by being free. He concludes,

In summary, we may be able to cure our students (our future voters) of pseudoscience and pseudoscientific thinking by exposing them to the claims of practices like acupuncture that masquerade as medical science and by helping them identify and unpack the pseudoscientific assertions of these practices and understand why the claims are indeed pseudoscientific.

To which I have nothing more to add.

24 Comments

Henry J · 16 August 2016

So, it may be better for one to think than to pay somebody to needle them?

John Harshman · 16 August 2016

The P-value means that there is only about a 1 in 20 chance that the claimed effect is real.
Presumably you mean a 1 in 20 chance that the claimed effect is not real. More properly, it's the probability that a result as extreme or more extreme would happen by chance, i.e. if the null hypothesis of no effect were true.

Matt Young · 16 August 2016

Presumably you mean a 1 in 20 chance that the claimed effect is not real. More properly, it’s the probability that a result as extreme or more extreme would happen by chance, i.e. if the null hypothesis of no effect were true.

I sure do! A 1 in 20 chance that the result could have happened by chance (or, as you say, that result or a more extreme result). I will fix that sentence forthwith.

AdelyneMld · 16 August 2016

That still isn't a proper formulation. The p-values measures the probability to get a result as extreme or more extreme assuming a specified hypothesis is correct, which is most of the time the null hypothesis. This is a conditional probability. The American Statistical Association explains it better than I do: https://www.amstat.org/newsroom/pressreleases/P-ValueStatement.pdf

Jonboy · 17 August 2016

This reminds me of all that stupid "cupping" we saw on some famous Olympic performers over the last few days. Not a good example of modern athletic medicine to present to the world.

Roger Lambert · 17 August 2016

Dr Strode makes the statement:

"The placebo effect is a real, measurable biological phenomenon ..."

which I think is fairly misleading and ripe for misinterpretation. It implies that a treatment - for example, acupuncture as a substitute for chemical anesthesia, has some biological effect as an anesthetic. But this is NOT true. The placebo effect is not a targeted biological effect, but merely a psychosomatic effect as a confounder in a clinical study. Any beneficial effect reported by patients in such a study are outcome effects. And these effects are due to the psychological benefits of expectation fulfilment and attention, ie, being chosen to participate, getting attention, breaking a normal routine, being physically touched, an expectation that a studied treatment is bound to be effective, etc.

The placebo effect is (mis)interpreted by millions as a beneficial biological targeted effect that you can get essentially without the cost, side effects,and hassle of real medicine. This misinterpretation leads millions to a very badly contrived conclusion - that the placebo effect can be harnessed, that it "can't hurt to use such sham medicines, or to use "harmless" quackery. The placebo effect is not biological, it is psychological and its only effect is to confound clinical conclusions.

eric · 17 August 2016

Roger Lambert said: Dr Strode makes the statement: "The placebo effect is a real, measurable biological phenomenon ..." which I think is fairly misleading and ripe for misinterpretation. It implies that a treatment - for example, acupuncture as a substitute for chemical anesthesia, has some biological effect as an anesthetic. But this is NOT true.
The way I interpreted the statement is that the subject of a placebo treatment often shows a measurable biological effect not seen in 'no treatment' individuals. I didn't take it as implying that the placebo 'thing' (treatment, pill, etc.) caused some biological effect. Everyone knows what is meant by a 'placebo' - that's part of the reason alternative therapy promoters get so upset about their therapies being called that, because they know everyone knows what it means and it will be bad publicity for them. :) So I don't think we need to worry unduly about semantics, because in this case, I think most people will get the gist. As an aside, I wouldn't be too surprised if some of these treatments did have a measurable effect. IMO many of them are just a crappy and unnecessarily complicated form of muscle massage. The cupping used by the Olympic swimmers is a good example: it pulls on your skin hard enough to break capillaries. Well, if I pinched and pulled your tired and stressed muscles with my fingers instead, that would probably have an effect on them. So why be surprised or skeptical if pinching it with negative air pressure has an effect? Thought about this way, cupping is just a crappier and more dangerous (and, to stab at the heart of the industry, more profitable) flavor of pinching with fingers, so why not anticipate it might have a similar effect? The same thing is true with chiropractic treatments and probably a few other things too. If you're using some "mystical" technique to push and pull on someone's musculature, it should still have the effect that pushing and pulling on their musculature with perfectly mundane (and cheaper) hands would give you. Where the pseudoscience and con-artistry comes in, is in claiming some mystical additional effect, or added efficacy not supported by evidence. And, of course, in being able to pump up the applier's cache, so that the victim-patient doesn't feel robbed for paying $500/hr for what amounts to a crappy massage given by a poorly trained and misinformed non-professional.
The placebo effect is (mis)interpreted by millions as a beneficial biological targeted effect that you can get essentially without the cost, side effects,and hassle of real medicine. This misinterpretation leads millions to a very badly contrived conclusion - that the placebo effect can be harnessed, that it "can't hurt to use such sham medicines, or to use "harmless" quackery. The placebo effect is not biological, it is psychological and its only effect is to confound clinical conclusions.
Well, its hardly ever given for free. That's where the graft and corruption come into play. And as you allude to, substituting a placebo for a real and available cure for a serious medical condition is a horrible outcome that we need to educate people to avoid. But I wouldn't bash psychological problems or effects so much. Humans get them. Not just crazy people, normal people do too. The medical community has to deal with them, too, not just broken bones and such. And the public is pretty darn resistant to education as the long term cure; nobody wants to be told (and most refuse to accept) that some problem they have is psychological. So short-term symptomatic treatment has a place. Is lying okay? Seems like something we should really avoid, it just continues the problem. But OTOH doctors have been dealing with hypochondria for decades if not centuries. If that community has concluded, after experience dealing with us normal imperfect patients, that the sugar pill is occasionally warranted, I'm not going to second-guess that decision.

Matt Young · 17 August 2016

Roger Lambert said: Dr Strode makes the statement: "The placebo effect is a real, measurable biological phenomenon ..." which I think is fairly misleading and ripe for misinterpretation. It implies that a treatment - for example, acupuncture as a substitute for chemical anesthesia, has some biological effect as an anesthetic. But this is NOT true. The placebo effect is not a targeted biological effect, but merely a psychosomatic effect as a confounder in a clinical study. Any beneficial effect reported by patients in such a study are outcome effects. And these effects are due to the psychological benefits of expectation fulfilment and attention, ie, being chosen to participate, getting attention, breaking a normal routine, being physically touched, an expectation that a studied treatment is bound to be effective, etc. The placebo effect is (mis)interpreted by millions as a beneficial biological targeted effect that you can get essentially without the cost, side effects,and hassle of real medicine. This misinterpretation leads millions to a very badly contrived conclusion - that the placebo effect can be harnessed, that it "can't hurt to use such sham medicines, or to use "harmless" quackery. The placebo effect is not biological, it is psychological and its only effect is to confound clinical conclusions.
I want to make sure I understand you. Are you saying that, if I could put a physical pain detector inside someone's head, then that detector's reading would be unchanged in response to a placebo, even if the person testified that the pain was less? That seems to me to be a plausible interpretation of the placebo effect, but is it true? What if a person took a placebo for insomnia and demonstrably slept sooner or longer? Would that not be a physical result of taking a placebo? After all, there has to be a reason that the placebo effect confounds clinical studies, and it is hard to imagine that it is purely the result of something like confirmation bias. It seems as though you are saying that the brain cannot cause physiological effects in the rest of the body. I do not think that is so. For example, my wife can raise the temperature of a thermistor placed on her finger at will. Please explain if I am misunderstanding your comment.

Bobsie · 18 August 2016

This reminds me of the classic management engineering study of the 1920s where researchers focused on improving worker productivity.

At first they increased lighting by increments, each time followed by an increase in productivity. Then they decreased lighting in increments and also found productivity increases each time. Just being the object of study was the common factor for productivity increase.

It became known in management engineering circles as the "Hawthorne effect" named after the Hawthorne Works in Cicero Il where the study was conducted.

harold · 18 August 2016

Matt Young said:
Roger Lambert said: Dr Strode makes the statement: "The placebo effect is a real, measurable biological phenomenon ..." which I think is fairly misleading and ripe for misinterpretation. It implies that a treatment - for example, acupuncture as a substitute for chemical anesthesia, has some biological effect as an anesthetic. But this is NOT true. The placebo effect is not a targeted biological effect, but merely a psychosomatic effect as a confounder in a clinical study. Any beneficial effect reported by patients in such a study are outcome effects. And these effects are due to the psychological benefits of expectation fulfilment and attention, ie, being chosen to participate, getting attention, breaking a normal routine, being physically touched, an expectation that a studied treatment is bound to be effective, etc. The placebo effect is (mis)interpreted by millions as a beneficial biological targeted effect that you can get essentially without the cost, side effects,and hassle of real medicine. This misinterpretation leads millions to a very badly contrived conclusion - that the placebo effect can be harnessed, that it "can't hurt to use such sham medicines, or to use "harmless" quackery. The placebo effect is not biological, it is psychological and its only effect is to confound clinical conclusions.
I want to make sure I understand you. Are you saying that, if I could put a physical pain detector inside someone's head, then that detector's reading would be unchanged in response to a placebo, even if the person testified that the pain was less? That seems to me to be a plausible interpretation of the placebo effect, but is it true? What if a person took a placebo for insomnia and demonstrably slept sooner or longer? Would that not be a physical result of taking a placebo? After all, there has to be a reason that the placebo effect confounds clinical studies, and it is hard to imagine that it is purely the result of something like confirmation bias. It seems as though you are saying that the brain cannot cause physiological effects in the rest of the body. I do not think that is so. For example, my wife can raise the temperature of a thermistor placed on her finger at will. Please explain if I am misunderstanding your comment.
I will give you my answer because I think this is a fascinating question. I agreed with the comment you actually replied to here, but will let the original author elaborate, but your question is very interesting. I think it would depend where in the nervous system you put that pain detector. Let's pretend it's an incredibly useful one that can measure activity changes almost anywhere in the nervous system. I want to emphasize in advance that I am NOT justifying unethical use of placebo. A placebo is by definition an ineffective intervention, offered deceptively. Its effects are by definition fairly superficial. It is by definition something that does not work as well as the worst possible effective intervention. Deliberate placebos are used, in fact, to prevent us from accidentally mistaking others placebos for real treatments. Even if patients are experiencing hypochondriasis due to anxiety, they should be offered specific therapy for that condition, not deceived with a placebo. In almost all other cases using a placebo deliberately would be even less ethical than in that case. Let's design a mildly inhumane experiment - I do a safe but painful subcutaneous histamine injection into three experimental groups. One is then given a fast acting oral analgesic, one is given a placebo, and one is given nothing. Suppose the placebo group reports less overall pain than the "no intervention" group, but much more than the real analgesic group, as we would typically expect. Did the placebo act physically in some way? Of course it did, in the broad sense. It absolutely depends on what you measure. The real analgesic might work (not necessarily exclusively) at any number of levels; at the level of peripheral histamine receptors, or at the highest level of integration of sensory data in some brain area, or anywhere in between. The placebo pretty much has to be working on the brain. Even if placebo effect is caused by some people lying when given a placebo (there is no evidence for this, I'm just using an extreme example of a very non-physical effect), it has to do something. The neuronal firing patterns for saying "I rate my pain as 6" are different than for saying "I rate my pain as 9", no matter how or why you say one or the other. It's more likely not deliberate lying, but some kind of interaction between anticipation, bias, and the actual input from the pain receptors. It does do something - just not something that justifies the use of deliberate placebo as treatment. What if I had used a "more physical example" like placebo seeming to cause a mild reduction in fever? The same principle would hold true. The effect has to be from the brain. There are claims that dogs and cats can experience placebo effect as well. That actually makes some sense.

eric · 18 August 2016

harold said: The real analgesic might work (not necessarily exclusively) at any number of levels; at the level of peripheral histamine receptors, or at the highest level of integration of sensory data in some brain area, or anywhere in between. The placebo pretty much has to be working on the brain.
I mostly agree with you, but 'the brain' can lead to a cascade of other effects. An obvious example would be if the placebo relieves your stress. Stress causes changes in how well your digestion works. In your sex drive. In heart rate, breathing rate, and liver function (it releases more glucose under stress). Stress also activates the pituitary gland and hypothalamus, to release adrenaline. When you have to run from a tiger, these are all good things. But they don't do squat for social stress, and constant triggering of the stress response can harm your health and actually reduce your lifespan. So, the placebo works on the brain. But the brain works on the rest of the body. And if you've got a patient who is stressed out but doesn't need to run from a tiger or fight in a cage match, getting that stress down or giving them an easy way to self-manage it (whether a mantra, meditation, petting a cat, whatever), can be a very, very good outcome.

harold · 19 August 2016

eric said:
harold said: The real analgesic might work (not necessarily exclusively) at any number of levels; at the level of peripheral histamine receptors, or at the highest level of integration of sensory data in some brain area, or anywhere in between. The placebo pretty much has to be working on the brain.
I mostly agree with you, but 'the brain' can lead to a cascade of other effects. An obvious example would be if the placebo relieves your stress. Stress causes changes in how well your digestion works. In your sex drive. In heart rate, breathing rate, and liver function (it releases more glucose under stress). Stress also activates the pituitary gland and hypothalamus, to release adrenaline. When you have to run from a tiger, these are all good things. But they don't do squat for social stress, and constant triggering of the stress response can harm your health and actually reduce your lifespan. So, the placebo works on the brain. But the brain works on the rest of the body. And if you've got a patient who is stressed out but doesn't need to run from a tiger or fight in a cage match, getting that stress down or giving them an easy way to self-manage it (whether a mantra, meditation, petting a cat, whatever), can be a very, very good outcome.
There is nothing in my comment that is intended to disagree with this.
But the brain works on the rest of the body.
That is essentially what I am saying.
And if you’ve got a patient who is stressed out but doesn’t need to run from a tiger or fight in a cage match, getting that stress down or giving them an easy way to self-manage it (whether a mantra, meditation, petting a cat, whatever), can be a very, very good outcome.
I should note that good anti-stress techniques are not placebos. It is, of course, difficult to measure things like meditating or interacting with therapy animals directly against placebos. However, we can measure them against anxiolytic drugs which have been measured against placebos. There is very decent evidence for beneficial effects of things like this, and they should not be considered placebos (except if used in a context that makes no sense; e.g. a relaxation meditation technique might be effective as part of a program for mild hypertension, but would presumably be a worthless placebo relative to antibiotics in bacterial infections). If stress is ever discounted in medicine, that's only because it can be difficult to quantify and difficult to control. It would be the height of foolishness to deny the potential health effects of acute or chronic stress when we not only, just for a single obvious example, not know the powerful effects of adrenal hormones, but frequently use them as medicines for those powerful effects. A placebo is an easy concept to understand but a somewhat hard concept to define perfectly. A placebo is something which shows the minimum and least useful effect on the brain. We use them in studies to make sure we don't mistake that effect as a beneficial effect of what we are actually studying. It is plausible that transient stress reduction may be part of the placebo effect, but standard "sugar pill" placebos aren't even effective stress reducers. I made this point above and want to make it again. The "most therapeutic" thing you can say about placebo arms is that "maybe they reduce anxiety" or some such thing. However, they don't even do that as well as actual techniques and drugs that do work specifically for anxiety. It's important to make this point because there has been a "Sure I sell placebo but so what, placebo effect is beneficial" rationale offered by quacks. In this link it's offered, ironically, for chanting yoga mantras - something that is likely to have a real, not placebo, effect, on mood and anxiety and can be defended better than this - but this is a quick example of someone doing what I'm talking about https://books.google.com/books?id=7-kDAAAAMBAJ&pg=PA159&lpg=PA159&dq=so+what+if+it%27s+just+placebo&source=bl&ots=wz4jiBV36w&sig=e9OEbxHu2RPV_2hG1Wz8AuKY770&hl=en&sa=X&ved=0ahUKEwj46MeLr83OAhXBLyYKHZUNCjwQ6AEITjAH#v=onepage&q=so%20what%20if%20it's%20just%20placebo&f=false

Robert Byers · 20 August 2016

I recently saw on a youtube show about unexplained biology phenomena how much the placebo effect was real.
As a Christian/creationist we are taught in the bible that laughter is like a good medicine. So the "mind' must have a affect on the biology.
Howevrr I speculate its the power of memory. Not our free will but our memory has alrady its channels for reacting to some true medicine and so the fake one can trigger these channels also. A person with a phobia about heights, upon suddenly at some height, sweats, heart races, confusion, etc etc just because of the memory noticing the height.
For sure the body is triggered by thoughts. Everyone knows this.
i always like the placebo effect because it confirms to me the power of the memory, on its own and not our controlling it, to affect our bodies. Very profoundly beyond was is recognized in science.
So not a mysterious spooky healing thing by a fake thing.

DS · 20 August 2016

i speculate that speculation is worthless

Rolf · 20 August 2016

DS said: i speculate that speculation is worthless
You are doing it wrong. Try Youtube before speculating and see if you don't get the same answers as Robert.

Frank J · 21 August 2016

This is only anecdotal, but I can vouch that meditation cures a lot of ills. For example, I know that evolution (the fact and the theory) is true. But it's not fun, being related to last night's dinner and all. So sometimes I try to convince myself that creationism is true instead. At first it's a wonderful "serenity now!" thing - a nice picture of "kinds" popping up on dry land "a long time ago," then marching two by two onto an ark... But invariably I start thinking "when was 'a long tome ago'? billions of years ago, only thousands? something else?" And "does the earth go around the sun or the other way around." "Can YEC and OEC both be true at the same time?" "Is Behe right that I'm still related to last night's dinner, but that 'RM + NS' alone could not drive the speciation?" Soon I'm back to the same old same old. But it was fun while it lasted.

harold · 21 August 2016

Robert Byers said -
I recently saw on a youtube show about unexplained biology phenomena how much the placebo effect was real.
It's important to understand, though, that the placebo effect is by definition the minimal beneficial effect that can be accomplished with any nonspecific psychological technique. Anyone can always apply placebo effect to any problem anyone else happens to have. (This is what the word "placebo" means and we need a word that has this meaning.)
As a Christian/creationist we are taught in the bible that laughter is like a good medicine.
Just because placebo effect is essentially psychological does not mean that all psychological interventions are mere placebo. If fact humor leads to improved mood and is beneficial in many circumstances. There is also a decent amount of evidence that laughter itself has beneficial effects https://en.wikipedia.org/wiki/Laughter#Health A confounding variable is that healthier people are more likely to laugh, but the overall evidence does suggest that inducing sincere laughter can be beneficial for certain things. It isn't always the "best medicine"; for bacterial meningitis, intravenous antibiotics will work a lot better and so on. Frank J said -
This is only anecdotal, but I can vouch that meditation cures a lot of ills.
In fact there is good evidence that meditation has plenty of benefits, as well. It's critically important to note the difference. There is abundant evidence that meditation, humor, and laughter have stronger than placebo beneficial effects in many circumstances. So do various forms of talk therapy, interacting with friendly animals, and so on. In other words, some pure placebo offered by some fraud or crackpot, or scientist to a placebo arm of a study, is not necessarily as good as laughter or meditation (if studying anything where those can have benefit).

harold · 21 August 2016

Another way of looking at placebo is that it is "that class of 'treatment' which can be replaced by virtually anything else to achieve the same effect".

E.g. if I have a bunch of patients with mild tension headache and no contraindication against aspirin. I give some of them a reasonable dose of aspirin, I tell some of them to "tough it out", and I give the rest a whole range of things from "psychic healing intervention", "magic beans", inactive material described as "Indonesian herbal remedy", "Perkins' tractors" https://en.wikipedia.org/wiki/Elisha_Perkins, etc.

Even though tension headache has a psychological component, it's almost certain that the aspirin will work best, because it has a well known strong effect in this type of headache.

The placebos will probably all "work better than nothing", but they'll all be worse than the aspirin and all be about as good as each other.

It follows logically that you'd have to be silly to pay a lot of money for Perkins tractor therapy, because you could just get a "magic" pinto bean somewhere worth a fraction of a cent, swallow it, and get an equally good "effect".

Rolf · 21 August 2016

Robert, I hope you will see the wisdom of learning to know the enemy you are at war with. Below is the place to begin:

I tried to take the course some years ago, but to my dismay I found that I was too late. Age had got the better of me. It just took too much mental effort to digest the stuff and work out the right answers. (I am 86 now.)
Here is my advice to you, take this free course:

https://www.coursera.org/learn/genetics-evolution

Buyuk Aslan · 21 August 2016

First, I still see people separating phenomena into the distinct categories of "psychological" and "biological". They are the same. What is referred to as psychological is just the net output of all the biological processes. All of our thoughts/emotions/feelings result from the balance of neurotransmitters and neuronal output in our brains. Before anyone states that someone could then use this to excuse any behavior ("My brain's neuronal activity made me do it.") it is a two-way street. While our brain chemistry can alter behavior our behavior can also alter our brain chemistry. It is why cognitive behavioral therapy has some efficacy.

The Placebo Effect often crops up in treatment studies, especially in the area of drug addiction. As has been already pointed out, many times a patient will appear to do better because someone is simply paying attention to them. When I was in research, the clinical researchers would state that a pharmacological treatment for drug addiction would often show much better efficacy in an in-patient unit than for walk-in patients. The reason is that the in-patient subjects had people caring for them, showing interest in them, etc.. Of course, anyone with a drug addiction would feel better with that treatment alone.

With the improvement in imaging techniques we are increasing our understanding of brain function and the Placebo Effect. Studies imaging the brains of people suffering from depression revealed that people in which a placebo had efficacy showed increased activity in the pre-frontal cortex while in those patients in which drug treatment showed efficacy had decreased activity in the pre-frontal cortex. This shows that there are multiple brain pathways that can lead to the same output.

The question is why do some people show efficacy with placebos? What is it about their brain chemistry that results in a placebo showing efficacy?

I am abhorred by people passing off the Placebo Effect as some amazing therapy that the "evil" medical/pharmaceutical industry is suppressing. I also do not like it when people use mystical explanations to explain biological phenomena. There are studies in which the brains of monks in deep meditation are revealing really cool information on brain function. I am truly excited what future imaging studies will reveal about brain function. I expect many "mystical" phenomena to eventually be explained by sound scientific inquiry (bye bye crystals, pyramid sitting, etc.). Similar to how some religious beliefs have been explained away by science.

Bobsie · 21 August 2016

Frank J said:... it's not fun, being related to last night's dinner and all.
I'm sure you known that includes plants as well as animals. And ultimately includes gasses and rocks if you go all the way back to the BB via super novae. Just sayin'.

harold · 21 August 2016

First, I still see people separating phenomena into the distinct categories of “psychological” and “biological”.
That's an extremely good point but I hope no-one is actually making the mistake you imply, in this thread. Of course, these terms are of some use. For example, it's not uncommon to successfully treat bacterial infections with antibiotics, in patients who are unconscious. There is no need for them to be consciously aware of the antibiotics at all for the effect. This is also true of many drugs that have impact only on human cells, such as cardiac medications. On the other hand, if a group of people with depression undergo rationally planned cognitive behavior therapy and it works better than placebo control, we would pretty much give nearly all the credit to processes that came from their sensory perceptions and the way they interpreted and responded to them. Of course in both cases the effects are ultimately biological, but only the second can reasonably also be described as "psychological". However, we can use terms like "cognitive", "emotional", and so on. These terms can never be defined so precisely that they completely exclude one another. There is usually some overlap. Yet they can be useful if defined correctly.

Frank J · 21 August 2016

Bobsie said:
Frank J said:... it's not fun, being related to last night's dinner and all.
I'm sure you known that includes plants as well as animals. And ultimately includes gasses and rocks if you go all the way back to the BB via super novae. Just sayin'.
Plants, other eukaryotes and prokaryotes, probably even viruses. But those, like us animals, are systems, while glasses, rocks, etc., are just matter. So we're "related" in a sense only that their atoms were, at some point, part of our system (body) and/or that of distant relatives. But a system (the matter and the reactions) is something special, more than just the sum of its parts. That's not to defend the ID scam by any means, and in fact needs to be part of a thorough refutation. If one lets peddlers of ID/creationism get away with their usual nonsense that "'Darwinists' think that we're just matter," one gives them a big advantage with most audiences.

harold · 21 August 2016

“‘Darwinists’ think that we’re just matter,”
I once took a perfectly okay freshman elective philosophy course, and Thomas Hobbes took quite a beating https://en.wikipedia.org/wiki/Thomas_Hobbes He generally seems to serve the same purpose in introductory philosophy courses that "Lamarck" serves in intro evolutionary biology, and like Lamarck his views are somewhat misrepresented, although I think less unfairly so. Hobbes did, of course, suffer from the same thing that Ussher suffered from - lack of psychic ability to perceive future developments. So it's a bit anachronistic to judge him by modern standards, but people do seem to have been doing so for a good three hundred years. In addition to being a grouch who advocated authoritarianism, he was also a decent mathematician but became known for some big errors and his stubbornness about them. A lot of the "materialism" and "matter" strawman crap that creationists love to falsely ascribe to "evolutionists" seems to be a distorted version of Hobbes. It's likely that he's taught as an easy target in religious schools everywhere. Hobbes actually denied being an atheist, although almost anyone would have in 1650, out of self-preservation.