I know you're out there. I can hear you reloading.
—Billy Crystal's character, insult-comic Buddy Young Jr., in the mah-velous (and often overlooked) 1992 comedy-with-a-point, Mr. Saturday Night.
I figured the above epigram was appropriate given the tenor of some of the recent comments on SHAMblog as well as the feedback to my pieces on alternative medicine and positive thinking. In fact, today, I present for your reading pleasure salient portions of a critique of the latter piece received by Skeptic, followed by the full text of my response to same. See what you make of it all.
The critique in question was lengthy, and arrived in fully annotated, academic-journal form from Andrew Newberg, MD, and Mark Waldman, co-authors of several books including How God Changes Your Brain*. Waldman and Newberg tell us that their "research has been published in dozens of peer-reviewed journals and academic texts."
Bracketing themselves as "skeptical researchers with a penchant for thorough and accurate assessments of the strengths and weaknesses of positive thinking and optimism," they argue as follows:
"...We are dismayed by Salerno's apparent lack of comprehension (and exclusion of references to back up his claims) when it comes to the hundreds of studies relating to this important psychological and neurological topic." After accusing me of "not [doing my] homework," they assert that "hope, optimism, and the belief in a positive future (i.e., faith) is essential for human psychological and neurological functioning." They invoke psychiatrist and Nazi death-camp survivor Viktor Frankl, who, in his book, Man's Search for Meaning, said (they're paraphrasing) "the single most important thing that kept a survivor alive was faith. If a prisoner lost faith in the future, he was doomed, because the will to live seldom returned." They then quote Frankl directly a time or two.**And herewith, my response, written at the invitation of Skeptic editor Michael Shermer:
Authors Waldman and Newberg note that optimism is central to the placebo effect, and state that "placebos can cure, on the average, 30% of the majority of physical and emotional diseases." They tell us that a team of National Institutes of Health researchers concluded that optimism also appears to play a "crucial role in controlling anxiety, depression, and rage," and that "even the medical researchers at the Mayo Clinic stress the importance of optimistic thinking for maintaining optimal health. They found that positive thinking decreases stress, helps you resist catching the common cold, reduces your risk of coronary artery disease, eases breathing if you have certain respiratory diseases, and improves your coping skills during hardships."
Waldman and Newberg then provide a laundry list of minor studies suggesting that this or that disease is responsive to positive thinking, adding that even "an unrealistically optimistic belief about the future appears to be health protective, even when dealing with a disease as serious as AIDS." Finally, they contend that pessimists don't live as long as optimists.
Sometimes when I receive criticism I'm left wondering: Did they actually read the piece? This is such a case.* and that has to get consideration as one of the more unintentionally comical titles of recent vintage. Maybe it's just me, but it "reads funny."
For the record, I have never argued that optimism has no legitimate role in life. I argue that the frenzied overselling of optimism as a blanket prescription for all that ails us is one of the more subtly destructive forces in American culture. Just as scholastic self-esteem gurus were dead-wrong when they led us to believe that so-called “bolt-on” self-esteem automatically yields academic excellence, there's no question that today's gurus of optimism have led the nation down the primrose path in declaring that an upbeat attitude is its own foolproof reward. My real quibble, then, is with undue optimism about optimism—“the notion that the riddle of success is more easily solved by attitude than aptitude,” as I wrote near the top of the story. I was primarily indicting the commodification of optimism, and I stand by that assessment. (The gurus are right about one thing, however. Optimism does produce a great deal of wealth: their own.)
Authors Waldman and Newberg, meanwhile, offer us an object lesson in how a few scraps of “emerging science,” as it's called in those smarmy TV ads for dubious new health-care products, become conventional wisdom. They write, for example, that “medical researchers at the Mayo Clinic stress the importance of optimistic thinking for maintaining optimal health. They found that positive thinking decreases stress, helps you resist catching the common cold, reduces your risk of coronary artery disease, eases breathing if you have certain respiratory diseases, and improves your coping skills during hardships.” That's one seriously overstated mouthful, because the Mayo researchers “found” no such thing; if you go to the Mayo site,*** you'll see that they speculate that positive thinking may pay these dividends...and even those tentative declarations are made based on some (cherry-picked?) studies. Not coincidentally, this is the same strategy elevated to an art form by the National Center for Complementary and Alternative Medicine in touting its pet nostrums.
The authors also rely on the common ploy of argument-by-poetry, framing philosophy as truth. This is most clear in the several quotes from Frankl. Much like the transcendent line, “All men are created equal,” the Frankl quotes sound terrific but enjoy no scientific standing. As for the charge that I haven't done my homework: Although my piece may not be annotated in strict academic style, I wonder how the authors overlooked the references to the work of Roy Baumeister, Charles Elliott, Charles Sykes, etc.—people who clearly have done their homework. But that's not even the main point. Cleverly, the authors have embraced another staple New Age tactic by inverting the scientific method: telling me it's my job to prove that optimism is ineffective, when in fact it's their job, as members of the movement making all these claims, to conclusively demonstrate the efficacy of optimism, hope, PMA, etc.
We still have no way of knowing whether optimistic people actually do better at life or whether they just feel better about the same old crappy life (and therefore are less motivated to change anything). Do they end up like those American students, steeped in self-esteem, who got the worst grades in international testing but had the highest subjective self-assessments?
To paraphrase the famous line from the movie, “Show us the money.”
Overall, the authors represent a blended (and, as I see it, disingenuous) “compromise” between science and spirituality that, on closer inspection, necessarily calls for throwing science out the window. Waldman and Newberg are authors of a new book, How God Changes Your Brain, whose very premise and central concept—God—cannot, by their own admission, be proved. In their book, Waldman and Newberg write, “Having an accurate perception of reality is not one of the brain's strong points.” And: “The human brain seems to have difficulty separating fantasies from facts.” Fair enough...but is that where a true scientist should leave things? Do we then embrace the fantasies? Isn't it the scientist's job to weed out the real from the unreal; to wean people off the unreal; and to encourage people to work within the realm of the real, even if reality is less comfortable than fantasy? Otherwise what is the purpose of skepticism to begin with?
One final point. What I find amusing about the so-called “studies” of the role of mental outlook in health care is this: If a positive attitude is so decisive in health-care outcomes, then why not do a real controlled study wherein the control group tries to heal itself through PMA alone? Say, let's have two groups of grievously ill heart patients, both with 95 percent blockage of the coronary arteries. Group 1 undergoes heart bypass plus blood thinners, etc. Group 2 forgoes all medical intervention and tries to get better just by visualizing the unclogging of their arteries. (If you like, we can even compose Group 1 from a bunch of pessimistic curmudgeons.)
Report back and tell me how it goes.
** The reason I'm not reproducing their remarks in full is twofold. One, their commentary is very long and massively footnoted (the footnotes themselves go on for several pages). But more importantly, they wrote not to me but to Shermer, who has said he intends to publish it, and therefore deserves the courtesy of owning "first rights" to the material. I think this summary falls under applicable provisions of the "fair comment" rule.
*** This is the actual site that the authors reference in making their case.