Medical Study On Shamanic Healing

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    Sep 19, 2011 5:31 AM GMT
    Apparently, in specific cases, like those unresponsive to normal medicine, shamanic healing does work...

    http://www.ncbi.nlm.nih.gov/pubmed/17985808

    Temporomandibular joint disorders (TMDs) are chronic, recurrent, non-progressive pain conditions affecting the jaw and face. Patients least likely to respond to allopathic treatment are those with the most marked biological responsiveness to external stressors and concomitant emotional and psychosocial difficulties. These characteristics describe individuals who are "dispirited" and may benefit from shamanic healing, an ancient form of spiritual healing

    This study demonstrated the feasibility and acceptability of clinical trials of shamanic healing. The mean of usual pain went from 4.96 to 2.70, P<.0001; worst pain from 7.48 to 3.60, P<.0001, and functional impact of TMDs from 3.74 to 1.15, P<.0052. Only 4 women were clinically diagnosed with TMDs at the end of treatment.


    Thats four out of 23 initial patients.. meaning that 19 had sufficient reduction of pain to be no longer considered ill... far beyond placebo if anything..

    Could have been purely a lucky shot, but still, its interesting
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    Sep 19, 2011 11:07 AM GMT
    Sigh, here we go again. I'm not trying to be negative here, but standard medical literature critical reading applies to all studies. (And I haven't had my cup of tea yet so here goes...)

    (BTW, all kinds of stuff gets on pubmed, and I wouldn't appeal to that authority. It's just a repository for abstracts of medical journals of varying quality.)

    Positives:
    --it's safe (that's why they call it a phase 1 study, although how you would "dose" shamanistic medicine is questionable)
    --markedly positive result

    Negatives:
    --markedly positive result (i.e. needs replicated. Often the most positive results are the ones that are impossible to replicate)
    --small trial (low statistical power)
    --no placebo control (how do you know that a "fake" shaman won't have the same effect? or that literally a sugar pill labelled as "shamanistic healing" won't do the same thing?) The natural history of their TMJ could very well be the same with or without the intervention.
    --problem of patient selection (what does "dispirited" mean? self-selected? previous treatments?)
    --publication bias (usually positive trials are published)
    --confounders (did they mention concurrent treatments? nontreatment related changes in emotional and psychosocial status?)
    --threat to "external validity":
    http://en.wikipedia.org/wiki/External_validityThe most common loss of external validity comes from the fact that experiments using human participants often employ small samples obtained from a single geographic location or with idiosyncratic features (e.g. volunteers). Because of this, one cannot be sure that the conclusions drawn about cause-effect-relationships do actually apply to people in other geographic locations or without these features.


    Future research directions:
    --much larger number of patients in different centers
    --standardized patient and placebo selection
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    Sep 20, 2011 9:55 PM GMT
    We also need scientific trials on love.

    And whether Bach is moving.

    Kthnxbai
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    Sep 20, 2011 10:55 PM GMT
    Shamanic healing?

    Oh dear! Shamanic is another word for Witchcraft. It is another form of the occult.

    Mary Baker-Eddy had a healing experience on one occasion, a basis on which she wrote her volume Science and Health with Key to the Scriptures which became the holy book for Christian Science.

    Not long after this, a fellow named Daniel Palmer had extraordinary revelations from "other-worldly masters" (occult) on the issue that a vertebrate slightly misaligned was the cause of all ailments, and manipulating the affected site by means of massaging would be the cure all of all illnesses. Not wanting to clash with Baker-Eddy, who believed that meditation was the cure for all ailments, Palmer founded his own massaging school and called it Chiropractics.

    Oh well, I suppose it's time for me to lobby at the British Medical Association for all hospitals and Doctor's surgeries to close down. After all, the NHS is a heavy burden on the British taxpayer.

    Christian Science and Chiropractics should be the norm for all treatments. After all there are two. If one does not work, there is always the other!
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    Sep 20, 2011 11:00 PM GMT
    NotThatOld saidShamanic healing?

    Oh dear! Shamanic is another word for Witchcraft. It is another form of the occult.


    ??? in what universe is shamanic occult? There is nothing occult about it.... Its a traditional form of spiritual healing... who called it occult.. the Christian churches? As if they know what they are talking about icon_lol.gif
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    Sep 20, 2011 11:01 PM GMT
    q1w2e3 saidSigh, here we go again. I'm not trying to be negative here, but standard medical literature critical reading applies to all studies. (And I haven't had my cup of tea yet so here goes...)

    (BTW, all kinds of stuff gets on pubmed, and I wouldn't appeal to that authority. It's just a repository for abstracts of medical journals of varying quality.)



    Actually, for your doing, I find you surprisingly non-biased up here lol
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    Sep 20, 2011 11:06 PM GMT
    q1w2e3 said
    --no placebo control


    Hmmm, doesnt placebo have the same statistical results no matter what? So that using placebo would be rather superfluous, as you would expect a moderate increase in any placebo case? Like sugar pills? Isnt the whole point of the statistical analysis to show that the increase is more marked than placebo?

    Cause if not.. and if placebo is different in every case, and needs to be retested with every treatment.... what on earth is the value of the placebo? If its not predictable in its outcome, it cannot be considered useful for study purposes

    Just my critique
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    Sep 20, 2011 11:14 PM GMT
    GreenHopper,

    You said it yourself,
    A traditional form of spiritual healing...

    Say no more.
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    Sep 20, 2011 11:21 PM GMT
    Duh! I remember the AMA publishing a study that showed there was no effective way to lower blood pressure other than drugs. That's when I realized that superstition is historically the creation of myths to control your fellow man. Scientific superstition is the latest form of that kind of mind control.
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    Sep 20, 2011 11:23 PM GMT
    It doesn't matter how you define placebo here--it is just missing. Without a placebo, you don't have a control, so how do you know that ToT (tincture of time) wouldn't have worked?

    It matters because you want to tease out what it is about shamanistic healing that is effective, and from there, explore mechanisms that might explain why it's effective, with the hope of making it MORE effective. (Imagine people still taking foxglove rather than digoxin).

    If the results are no different with a placebo, you might as well use a placebo rather than a "real" shaman. (e.g. fake acupuncture vs. "real" acupuncture had similar effects) Cheaper that way.

    Here are some possible placebos they could have included:
    --just observe similar patients without any intervention
    --a shaman who did not intend to heal but goes through the same motions as the shamans who did
    --a "fake" shaman

    And the patients should not have known who was real and who wasn't (blinding).
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    Sep 20, 2011 11:24 PM GMT
    Alpha13 saidDuh! I remember the AMA publishing a study that showed there was no effective way to lower blood pressure other than drugs. That's when I realized that superstition is historically the creation of myths to control your fellow man. Scientific superstition is the latest form of that kind of mind control.


    Quote me that study please. I personally know of several ways of lowering blood pressure without pills, e.g. treating sleep apnea, relaxation techniques, DASH diet, etc.
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    Sep 23, 2011 11:02 AM GMT
    Thanks q1w2e3 you saved me the felt need to debunk some of the design errors in this study. TMD is actually in my field of expertise as is critical analysis of scientific research.
    Whilst this article is interesting, I cannot give it any more importance or authority than pure entertainment.
    to mention just a few things:
    - 23 participants is too few
    - a placebo is essential
    - so is blinding (double blinding is not possible in the case as the practitioner but be aware of the intervention given. The patient should, however, not be aware of the intervention given.... hence the need for a placebo)
    I am assuming that the patients not only knew what the intervention was but also what the desired outcome was.
    -I also assume there is a population bias here as all patients agreed to Shamanic healing, not exactly conventional treatment. I also assume that these patients didn't come from a wide referral base either meaning there is possibly selection bias also, these were not randomly selected patients. The only thing random was the assignment of patient to practitioner.
    -TMD is often (not always) a subjective disorder. The perception of pain is also a subjective process. So studying these 2 factors with a patient most likely aware of the study outcome (how could they not be aware, they have pain and want it gone) and the participant also in control of the degree of success or failure of the study and willing to accept non conventional treatment leaves the door wide open for a very biased result.
    (please note I did not say false result except that the result is biased).
    As a surgeon it is my job to be up to date with the research in this area. It is also my job to assess the validity of such trials and the efficacy of the outcomes. Unfortunately I could not send someone for this treatment with any confidence in the absent of further more rigorous studies.
    Now that is my professional opinion.
    Thanks for the interesting read GreenHopper icon_smile.gif
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    Sep 23, 2011 11:03 AM GMT
    MMTM, why do you have to be so ad hominem? I'm only 3 years younger than you. icon_biggrin.gif

    When I said:

    "(BTW, all kinds of stuff gets on pubmed, and I wouldn't appeal to that authority. It's just a repository for abstracts of medical journals of varying quality.)"

    I was responding to your statement

    "Glad this was published on pubmed.gov as this site is credible."

    Your argument seems to be that since this abstract was published on the credible pubmed.gov, its conclusion is true.

    Pubmed is credible in that it's an accurate repository of abstracts (and occasionally free articles) of all kinds of journals. Some are well respected and peer-reviewed, some are not. You still have to read the articles/abstracts you find there with a critical eye. And yes, I usually use Pubmed as a starting point, not the end point.

    Ask any doctor about what I wrote above (including the criticism of the study).

    I really wish I could email you a copy of this:
    http://www.amazon.com/Studying-Study-Testing-Test-Literature/dp/0316745219/ref=pd_cp_b_1
    I had the 1st edition back in 1995.

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    Sep 23, 2011 9:02 PM GMT
    Maybe the ones who are resistant to medical treatments are resistant to it because they think medicine is a bunch of hooey, and put their faith in shamans.

    It's not really a good test group. Why wouldn't they study a regular group? Might it not be as effective if they try it on everyone? Maybe they did, and the results weren't as favourable so they didn't publish that.

    Studies don't prove shit.
  • nanidesukedo

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    Sep 23, 2011 9:10 PM GMT
    MuchMoreThanMuscle saidMy argument is only that since it was published through pubmed and was conducted through a well known institution (that has been around for nearly seventy years) that there is a possibility that there is some validity to this study. I'm simply not willing to dismiss it.

    And while I do agree that placebo trials have some value and can validate approaches to improving a person's health we must also consider that there really isn't enough available to help those who suffer from a myriad of health problems and pain. The medical community has not successfully provided the general public with an efficient solution for chronic and recurrent pain sufferers regarding TMD. If they did, people would not be exploring alternative options.

    People are not as stupid and ungrounded as you'd like to presume them to be. People explore alternative options because the medical community either provides long term "crutches" to sustain their medical condition (to barely acceptable levels) or the accepted westernized approaches did not provide any benefit to begin with. If an alternative treatment provides relief for people experiencing chronic suffering then it should be utilized. What is the other option? Pain medications/narcotics that constipate people and create various other health imbalances that then require other medications like stool softeners, etc. such as:

    Constipation
    Respiratory depression (slowed rate of breathing, one of the more serious concerns)
    Nausea
    Vomiting
    Drowsiness
    Dizziness
    Weakness
    Dry mouth
    Confusion
    Difficulty urinating
    Itching., not to mention possible drug addiction/illicit activity with prescription drugs that become underground, and so on?

    Above copied from health.com.

    With all the side effects above, I'd be willing to try a treatment that does not induce a litany of possible annoyances that require more drugs to counter. And all they do is mask the pain, they're not treating the root of the problem. Hence, they only provide crutches. And all this chemical crap winds up in our Eco-system once expelled from humans which is also not healthy for our environment.

    The medical community demands that alternative care stand up to rigorous testing standards in order to be acceptable. But more often than not, when it comes to improving chronic conditions they do not offer much other than harsh drugs to mask the problem and not address the root of it.



    I see where you are coming from...and I was actually trained to support alternative forms of therapy and medication...However, I think that they should be used in conjunction with gold standard treatment - I would never support the use of alternative medicine in place of the gold standard of care. Also, many of the supplements and drugs have quite the nasty array of side-effects themselves and can be rather dangerous, especially as they can interact with prescription and OTC medicines.

    Most people are embarrassed to discuss it, but, if alternative medicine is a route that one would like to take, you should always discuss it with your doctor and form a plan in conjunction with them. I've seen a few incidences where the patient didn't tell the doctor what alternative supplements they were taking and it interacted rather negatively with the blood thinner, warfarin.
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    Sep 23, 2011 9:42 PM GMT
    MuchMoreThanMuscle saidI go with what works. And I'll also try to explore the route that is the least expensive, and creates the least side effects/impact on me and my environment.

    I don't feel good when I take drugs that basically shut down my intestines from working.


    Sounds sound to me. I wouldn't take anything that made my intestines shut down either.

    I don't assume drugs will do any good for me either and wait to see what the effects are.

    nanidesukedointeracted rather negatively with the blood thinner, warfarin.


    and rat-killer! icon_twisted.gif
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    Sep 23, 2011 11:31 PM GMT
    I'm the last person to take a drug if I don't have to. But I know when I need to take a drug. And that's coming from a doctor.

    But to get back to my original point, this is a poorly conducted study because of the flaws I pointed out. I'm not impugning the honesty of the patients, the institution and investigators--I don't have enough information to say otherwise. At the same time, one cannot appeal to authority when reading the literature critically. (Recent scandals in the medical world include the VIGOR trial that was published in the New England Journal of Medicine, and this was done by well respected investigators.)

    The results don't "prove" anything except that in this very (self-)selected set of patients, it seems to decrease pain. (and that's without a placebo, i.e. we don't know whether a placebo would have done as well or better than shamanic healing). And it needs replication, as with all positive results.
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    Sep 23, 2011 11:40 PM GMT
    It's a matter of definition about treating the "true" cause of any disease.

    In most cases, it's balancing the risks and benefits of treatment. You're trading a set of problems for another set of problems in the majority of the time.

    E.g. By replacing a heart valve with a mechanical valve, you need anticoagulation. Pig valves don't need anticoagulation, but last less longer, so you're risking the need for surgery later on.

    With almost all transplants, at least right now the need for lifelong immunosuppression is universal (except in very rare cases such as twins and in certain patients that have immune tolerance to the graft), which comes with its own set of serious problems.

    And antibiotics have their own side effects, as you well know.

    Does shamanic healing treat the "true" cause of TMD? Doubtful. 4 out of 23 were still diagnosed with it because they still fit the criteria of TMD. The others probably still have pain but don't have it enough to be diagnosed with TMD.
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    Sep 24, 2011 12:59 AM GMT
    But again, it is a very self-selected set of patients. I'm glad it (somewhat) worked for them (we'll never know since there was no placebo or tincture of time for comparison), but nobody can say it works for any patient with TMD.

    The "if" in your statement:
    "if a healing provides similar, equal or better pain management then I would support this approach. "

    has not been shown by this study.
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    Sep 24, 2011 1:03 AM GMT
    If "shamanic healing' works, so does praying away the gay.

    Please make sure Ladybird Bachmann is made aware of this.

    KTHXBAI
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    Sep 24, 2011 1:58 AM GMT
    OK, so I thought this thread would be a healthy, informed discussion about alternative medicines and "western" (biomedical model) medicine relating to TMD, chronic pain and therapy. However, this is not a forum of ppl wishing to discuss a topic, rather, certain ppl wishing to push their point of view without wishing to have it tested and examined.
    Enjoy your argument (because it's not a discussion or debate).