For the English-speaking Reader >
Know why we suffer, know why we get better
by Martin Winckler - translated in English par Christophe Thill
Article du 9 octobre 2005
This article is an answer to a message from a reader (see the message + answer in French), herself replying to an article about how homeopathy actually works through placebo effect, while its claimed principles are not valid. The reader tells how her homeopath physician always carefully listened to her, and how her two daughters were cured by homeopathic remedies. She opines that an 18-months old little girl couldn’t have been healed by the placebo effect or the intervention of the Holy Virgin.
I don’t know about the Holy Virgin’s intervention. But concerning the placebo effect, it’s definitely yes. Because the placebo effect is RE-LA-TIO-NAL and works with 18 months old children (or younger – you can believe my experience as a father of 6...), as it works with animals, as it worked with the young patient, severely brain-damaged, dumb and blind, who I followed when I was a country doctor, and who, though initially sick and agitated, calmed down whenever I talked to him, because he felt that his mother was comforted by my presence... And merely calming him lowered his temperature...
Where there’s medical care, there’s a placebo effect
And the placebo effect worked on me when, as a young adult, I was taking the pills that my father gave me : I was feeling better in 10 minutes, although the pills hadn’t yet dissolved in my stomach, which I knew.
And the placebo effect often works when I examine a child or an adult with a bellyache, and they get up and tell me that they already feel better, once I’ve explained where the pain comes from ; and they act very often so, without me having to prescribe anything.
The placebo effect is carried by the relationship – the voice, the words, the gestures, the attitude, the listening, the presence.
Thus, it definitely works on pre-verbal children and on animals. Just ask any vet. They see very well that, quite often, when the animal’s owner is comforted, the animal gets better. Even before taking any pill – homeopathic or not.
The placebo effect is the doctor effect, it is the purest, the softest kind of care. It is not even necessary to be a doctor to convey it. You just need to have a caring attitude, a desire to heal. It is an effect that depends upon the quality of exchanges, it is not verbal or intellectual, it is re-la-tio-nal... This is just what you [the reader] say when you describe this carer.
Indeed, many homeopaths possess this doctor effect, because they are often doctors whose desire is not to harm – this is why they chose homeopathy.
« First, do no harm » is the first condition of care. Many doctors unfortunately forget this.
The curious thing is that you confuse two things in my approach : reason and grudge. I don’t « have a grudge » against homeopaths (there’s nothing against THEM in my texts), no « grudge » against homeopathy, I just say that homeopathy has a placebo effect.
The placebo effect is powerful
The placebo effect is powerful, more powerful, when conveyed by a good homeopath, than an « efficient » painkiller wrongly prescribed by a bad doctor. (The nocebo effect does exist, too...)
But one thing that shouldn’t be done, regarding any form of treatment (be it homeopathy or allopathy) is replacing reason with faith.
Personnally, I don’t want healing to be linked with faith. With any kind of faith. With trust, sharing, sincerity, follow-up, quality of relationship, yes. But not faith. This is why I am a doctor and not a priest. This is why I never ask my patients to « believe me », but just to tell me if they agree with what I’m proposing.
And I never forget that they may disagree, that they have the right to do so, and that I can always propose something else : the patient’s refusal doesn’t disqualify me as a carer. This is another topic on which allopaths would have a lot to learn. Because the kind of relationship on which I do my work derives from mutual trust based on reason, not on blind faith.
Ideological vision and scientific reality
On the other hand, my scientific training (neither scientist nor dogmatic, as I think I have shown many times...) tells me that homeopathy has a placebo effect, and not a measurable, pharmacological effect – and I’d be dishonest if I said that it doesn’t matter to me. If I kept silent, if I just said : « After all, let them believe whatever they want, provided they believe it », that would be a lack of respect towards my readers.
In the same way, to take a different example, but not so different after all, I would never let anybody say that an IUD causes « mini-abortions » — this is an ideological vision, not a scientific reality.
But if a woman asks me : « Are you 100% sure that, with an IUD, I will never cause the death of a fertilized ovule ? », I answer : « No, I’m not 100% sure, nobody can be 100% sure ; I can just say that nothing that has been observed suggests it, whereas many other observations point to the contrary ».
If she refuses an IUD for that reason, I respect her decision : she has the right to choose according to what she feels, even if I think that what she feels is probably not the truth.
Yes, you may believe what you want, and you have the right to use homeopathy, but it is important that I have the possibility to tell you I think differently. Because the important thing is not what I believe, or what you believe, it’s what we agree upon in order to cure or to get cured.
When I say that homeopathy is efficient thanks to the placebo effect, I say something positive.
It is something, it is not insignificant ; I myself put permanently this effect to work, with other kinds of drugs, and sometimes with none at all, because I know that the « doctor effect » plays a great part in the way the patients see me.
To refuse to hear whatever positive I have to say is to oppose faith to scientific reasoning, and it will do no good, either to the homeopaths or to the patients they treat. It means putting an illusion between you and reality, whereas reality would cure you just as well.
I accept very well that people can get better with a homeopathic treatment. It’ not a problem to me, and I won’t make fun of it, and I’ll never speak badly of a user of homeopathy, because it’s a personal choice. But when I’m asked what I think of it, I just say it. And it doesn’t prevent my having a good relationship with the patients who use homeopathy. And the reason is that I have no « image » to protect ; this is why I’m not afraid to say publicly what I think about this, because in my opinion, it is important that there is a discussion.
The important thing is to know why we suffer, and why we get better
What I think is important is that people understand why they suffer and why they get better, and that they attribute this getting better to something that exists and is actually efficient (the placebo effect, the doctor effect, the body’s natural defences, stimulated by both) and not to something that is imaginary (the « power » of homeopathy).
Because imaginary things are the best weapons against us for those who want to sell us their snake oil. And, although I have met homeopaths who were great carers, I have also met many who were crooks, but who were never suspected... precisely because they were homeopaths.
If they hadn’t be able to abuse their patients’ gullibility, they wouldn’t have caused any damage...
Healing is often irrationnal, and based on feelings, but it’s not magic
You know, I love magicians. I’m captivated by their tricks, by their smiles. They make me happy. I never feel as good as when I’ve watched magicians perform their show. And even if I know that it’s just tricks, I feel good anyway. But I’ve never let my children believe that what they do is real magic. Do my children resent my telling the truth ? They don’t. They love magicians. And it makes them happy. Because they know that their show is not magic, but lots, lots of work, and much respect for their audience.
Healing is often irrationnal and based on feelings, and I say it, write it and defend it in my books quite often. But I also say that it has nothing to do with magic : it’s work and respect.
Respect is the essential thing. It has more value than any therapeutic method. For me, respect is neither faith, nor lies, nor make believe, nor illusions. It is each person’s truth. You say that homeopathy does you good. I don’t deny it. I only say : know the real nature of that which does you good. Don’t believe it is anything else than what it really is. It won’t prevent it from being efficient, but it will prevent people from abusing your trust.