Quack Word #37: ‘Holistic’

As you know, the quackometer works by counting words, or combinations of words, that strongly suggest the web site is full of quackery. I thought I would write about a few of those words and why they are dead give-aways.

So, ‘Holistic’ – not in itself necessarily anything to do with medicine, but this word is often used with medicine when quackery is at work. Why is this and what do quacks mean by it? Why is almost exclusively used by quacks? Spot this word and you spot a quack.

The word was coined by Jan Smuts, the South African statesman, in a work entitled “Holism and Evolution” and defined it as “the tendency in nature to form wholes that are greater than the sum of the parts”. Holistic thinking involves an approach to systems where analysis of individual parts of a system may not adequately describe the behaviour of the whole. As such, it is a thoroughly respectable scientific concept that has recently seen popularity through the emergence of chaos theories. However, the word often appears to set itself up against science by appearing to be the opposite of ‘reductionist’ – the claim that science always tries to break phenomena down into component parts and so ignores the ‘whole’. Whilst reductionist approaches have proven to be enormously successful in science, it would be not true that science is only concerned with dissection and dismantling. More of this later.

Alternative medicine advocates rarely describe what they mean by holistic is such terms though. Googling “define: holistic” throw up lots of alternative medicine definitions along the lines that holistic means to ‘ treat the whole person and not just the symptoms’. What this really means is not clear to me. Press a quack and they slip and slide (as always). However, what I guess is going on is that by using the word ‘holistic’ the quack is setting up a straw man argument about ‘conventional’ medicine and then knocking it down.

The Straw Man goes something like this:
– ‘conventional’ medicine is only concerned about treating symptoms
– it fails to seek ‘underlying reasons’ for illness
– it fails to look at the ‘whole person’, spiritual and physical.
– your medical practitioner never has time for these other aspects
My quack therapy, on the other hand, does treat the ‘whole person’. Therefore, you should spend your money on me.

These are, of course, all canards. Since when is medicine concerned with only treating symptoms? Do antibiotics cover up the nasty effects of infections? Does chemotherapy just sweep under the carpet the misdoings of that cancerous growth? Do heart patients take aspirin to gently mask their next infarction?

Well, the quack argues, why did you get ill in the first place? Your ‘energy levels’, ‘immune system’, ‘spiritual balance’ is not right – or some further set of canards – I can set this right. Before you know it, you might be onto a never ending set of ‘deeper causes’. The quack will intervene when the chain of causality intersects with their personal quack philosophy, whether that be meridians, Qi, auras, chakras or whatever.

Perhaps the only truths encountered in this chain of reasoning are to do with the impersonal nature of much modern medicine. The busy GP, the arrogant consultant and so on. The word ‘holistic’ is used as an advertising brand word as a shortcut to say that “We are none of these thing. You can count on us to give you time and some TLC.”

The huge irony is of course that alternative medicine is as narrowly focused and reductionist in its outlook as its supposed enemies. Each type of alternative medicine has its own pseudoscience associated with it, its own explanations of illness and approach to cures. The more science-like it sounds, the more credence we are supposed to give it.

I would also argue that alternative medicine can be far less holistic than real medicine. For a start, you will never find an alternative medicine advocate who looks at all the evidence to support their claims. They will only look at the evidence that suits. Usually poorly executed, small studies that found a small effect. Big, comprehensive trials are ignored because they do no support their claims. Hardly holistic.

What is more, the lack of holism in alternative medicine can be positively dangerous and sometimes fatal. The recent example of the BBC Newsnight investigation into homeopathy practitioners’ advice for malaria prevention showed how narrow and blinkered their approach was. All ten homeopathists, in the investigation, suggested using their little sugar pills for malaria prevention with no discussion of the need for proven prophylactics and no discussion of bite prevention measures (nets, sprays, clothing). Utterly unholistic, as Simon Singh pointed out to the spokesperson for the Homeopathic Society on the programme.

So, finding the holistic on a web page is surely worth awarding a ‘Canard’. Meaningless rot.