Recently a correspondent asked me for advice about his parents. He said they use things like homeopathy, acupuncture, and copper bracelets. They use conventional medicine too, but it seems to be a 50/50 approach that gives each an equal weighting. He has tried to talk to them about things like homeopathy and the placebo effect, but the shutters come down hard and fast. He tries to criticize the alternative treatment itself without offending or attacking the person, but his mother still sees it as a personal attack. He worries that as they get older and in need of more medical care, his parents may not make the best decisions. He asks about how to tactfully have these conversations and perhaps change their point of view.
That’s a very tough question that gets asked a lot, and I don’t have any good answers; but I do have some thoughts and untested ideas that could serve as the starting point for a discussion, and I hope readers will pipe up in the comments and tell us what has or hasn’t worked for them.
In the first place, you can’t change another person’s mind. They can only change it for themselves. If you can get them thinking to where they have an “Aha” moment and realize something for themselves, that’s far more effective than trying to tell them. I bet Socrates would have been good at that, but I’m certainly not. I did succeed once by accident. I had written an article about acupuncture in Skeptic magazine, and an acupuncturist wrote to me afterwards. He said:
Your article about acupuncture made me angry. I thought that you had to be wrong because (of course) I had heard about so much research about the evidence for acupuncture… got me to actually look at the literature instead of just ‘knowing’ that it exists. In trying to prove you wrong I proved myself wrong. One textbook made a claim that acupoint such and such is good for stimulating the pituitary to produce anti-diuretic hormone for patients with polyuria. I thought, “wow that’s really interesting I wonder where the reference is.” I looked for a reference and was struck by the fact there were no references at all anywhere in the book for any of the claims.
I have gradually let go of the belief that acupuncture has any basis for treating anything.
He decided to change his occupation to something based on reality. He was a rare person to be able to question the basis of his livelihood and change his mind in response to facts. All I did was create an opportunity (by making him angry) for him to think for himself.
You can’t change a person’s mind with science if their beliefs were not based on science in the first place. They may not understand or trust science. We are tempted to think that if someone only knew the facts as we know them, they would have to agree with us; but it doesn’t work that way. Instead of throwing science at them, you might try to understand their thinking. How did they come to form those beliefs? Can you trace the thought processes that led them to use CAM? Is CAM filling some emotional need for them? Does it give them hope? Do they feel frightened and helpless in the face of seemingly unpredictable disease? Do they “need” to believe that they can have some degree of control over their own health? That they can control their own fate rather than submitting to the whims of kismet? Did they have a bad experience with an MD? Are they rebelling against a medical system that betrayed them in some way? Are they frustrated because conventional medicine can’t offer a cure or complete relief of their symptoms? Did they have side effects from pharmaceuticals? Do they like to try new things and experiment? Do they hate to be told what to do? Do they have a knee-jerk rebellion to any source of authority? What have they been told about CAM? Were they influenced to try CAM by someone they trust implicitly? Do they have some basic misunderstandings of anatomy or physiology? Do they have any understanding of the many ways our minds tend to lead us to falsely conclude that a bogus treatment works? Unless you can get inside their head and understand how they think, what experiences they have had, what they don’t know, and what they know that isn’t so, it’s hard to communicate on a common level.
Do they have good critical thinking skills about other subjects? It might be useful to ask if there any kind of quackery they reject. If so, you could ask them to explain why they rejected that one but don’t reject others. Do they make fun of any of the late-night TV infomercial scams or laugh at advertisements for miracle products that make promises too good to believe? Do they distrust used car salesmen? Do they know anyone who has been victimized by a con artist? Are they skeptical about anything like Bigfoot, psychics, 9/11 conspiracy theories, AIDS denialism, anti-vaccine propaganda? Would they accept a subscription to either of the magazines Skepticor Skeptical Inquirer to read about the things they are skeptical or curious about? That might incidentally expose them to articles about things they are not currently skeptical about. Do they accept the advice of Consumer Reports for buying cars and appliances? Would they read Consumer Reports on Health?
I had an illuminating experience involving dowsing. I met a man who firmly believed in it, and I lent him the book Water Witching USA, by Evon Vogt and Ray Hyman, which explains all about the ideomotor effect, the forces acting on a forked stick, proof that the dowser is moving the stick without realizing it, the tests that have repeatedly and consistently shown that dowsing doesn’t work, the psychology of belief, etc. It’s a skeptical classic. I naively expected him to give up his belief when he read the same facts that had made me reject dowsing. We were scheduled to give a public presentation with him on the Pro side and me on the Con side. I was dumbfounded when I realized his presentation boiled down to only two arguments: he had seen it work, and lots of other people believed in it. I presented a summary of the information in the book, but no one was impressed. One woman commented afterwards, “I wanted to hear more about how it works and less about how it doesn’t work.”
I know better now. Facts and rational arguments have no effect on a true believer. People hear only what they want to hear. Most people refuse to listen to anything that contradicts their beliefs. Their confirmation bias accepts only confirming evidence to protect their ego from having to admit they were wrong. And there’s a real danger in arguing with them. They will come up with rationalizations that allow them to reject everything you say, and that only serves to reinforce their beliefs. They come out of an argument believing even more strongly than when they went in.
You could tell them that you are willing to change your mind, and explain what it would take to make you change your mind and accept that a CAM treatment was safe and effective (Essentially the standards for scientific proof: positive scientific studies that are well-designed and replicated, leading to a scientific consensus of experts based on a critical evaluation of all the published evidence; with more rigorous standards of proof for treatments that don’t have a plausible mechanism of action). Then you could ask them what it would take to make them give up their belief: what kind of evidence would convince them? What if several well-designed new studies found strong evidence that it didn’t work? I’ve had people say that couldn’t possibly happen, because it works. End of discussion.
If you read about someone who was harmed by X, it wouldn’t hurt to share the information as long as you preface it with something like “I read this and it made me worry about you. I’m not asking you to stop using X, but I know you care about me and how I feel, and I wanted you to understand why I feel this way and why I’m so concerned.”
Drops of water can eventually wear away stone, and they may also hear criticism of CAM from other sources and eventually begin to doubt some of their beliefs. You may be planting a seed that others will water and eventually a sprig of doubt may sprout.
There is hope. On both Quackwatch’s Healthfraud discussion list and in the SBM comments, quite a few people have said that a constant exposure to fact and logic on those websites had gradually had an impact over time. They said that they had learned how to think more critically about CAM and had given up prior beliefs.
Some people are true believers who will never change their minds. There’s really nothing we can do to alter their religious-like beliefs, just as you couldn’t expect to argue a Catholic or a Muslim out of their beliefs and into atheism. But lots of people are fence-sitters; they may not really have thought seriously about the subject before, or they may have heard arguments on both sides and still be undecided. If they haven’t irrevocably made up their minds, they may listen to what we have to say.
There’s a flip side to this question. If you have cancer, how do you answer well-meaning friends who want you to stop your chemotherapy and try their brand of snake oil instead? You can’t very well say you think their advice is stupid. How can you reject their advice without damaging the friendship? Is there some diplomatic sound-bite answer we could keep in mind for those occasions?
When talking with a loved one, it’s important to emphasize that you love the person and only hate what they are doing, and it’s important to help them understand why you are worried about them. Let them know that you will have to agree to disagree, but that you respect their right to make their own decisions, and that you will continue to love them and support them no matter what they decide or how unhappy it makes you.
As I said, I don’t have answers, just thoughts and suggestions. Maybe you can help. Let the discussion begin!
This article was originally published in the Science-Based Medicine blog