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DR CHRISTIAN JESSEN AND "QUACKERY"

Comment by Deborah Marshall-Warren, 27th May 2009

Why do so many medical professionals feel it is necessary to knock complementaty therapy, and do so with maximum prejudice? I don't know the answer to that question, but I recently noticed another instance of it in the London Evening Standard, in a column authored by Dr Christian Jessen -- who, although he is medically trained, is described primarily as a "charismatic TV presenter" on his own web site (www.drchristianjessen.com). The article is entitled "Alternative therapy for back pain smacks of desperation" on the online edition of the Evening Standard, but more crudely "Let's See the back of Alternative Quackery" in the print edtion that was read across London on the evening of 27th May 2009. The message is the same: Dr Jessen wants nothing to do with any therapy outside the mainstream of established medicine. And if the NHS itself is recommending such therapies then heaven help us!

Dr Christian Jessen has damned all forms of alternative therapy, in this apoplectic protest against guidance issued by the NHS National Institute for Health and Clinical Excellence (NICE). The guidance in question consists of the modest proposal that acupuncture be used to alleviate back pain. Dr Jessen's grounds for wanting to sweep all alternative therapies off the face of the country is, apparently, just his ignorance of the evidence for how well they work. It's a form of argument much used by blinkered people: refuse to look up and read the evidence that supports the efficacy of the therapies, so you can claim it does not exist. Dr Jessen wrote, "There is no scientific evidence to support the efficacy of so-called 'complementary' treatment." Now, an honest sceptic might have said, "I disagree with how the scientific evidence was compiled", or "I don't think the scientific evidence is strong enough to warrant the NHS offering complementary therapies." But that is not what Dr Jessen says. He simply denies the existence of the evidence altogether! Since anyone with access to the internet can readily pull down numerous scientific studies of alternative medicine, Dr Jessen's claim immediately falls apart, along with his credibility. While the rest of the healing profession is moving toward 'evidence-based medicine' and even old-fashioned 'reality-based thinking', Dr Jessen is driven in the opposite direction purely by gut feeling. Speaking of which, he could begin his catching-up on the literature of alternative medicine with NICE's own recommendations on the use of hypnotherapy for irritable bowel syndrom (IBS). NICE tells us "Hypnotherapy has the highest probability of being the optimal strategy for cost per QALY thresholds under Ł20,000". Unlike Dr Jessen's ex cathedra damning of all complementary therapies, this is not based on gut feeling but on the hard work of scientists who have taken the trouble to test hypnotherapy and other therapies. The NICE guidance (which anyone can freely read on the internet) gives full references so that you can check the original peer-reviewed research papers (none of which exist according to Dr Jessen). As well as citing the scientific evidence for the efficacy of hypnotherapy, the NICE report gives a perfectly common-sensical rationale, namely "IBS is ideal for treatment with hypnosis, as there is no structural damage to the body". There's nothing magic about it. Hypnotherapy treats the mind, and the mind affects the state of the gut.

I have been practising interactive hypnotherapy for more than fifteen years and have seen at first hand, day after day, the efficacy of this particular complementary therapy -- for a wide range of challenges faced by clients. I am delighted to see more and more published clinical trials that confirm the efficacy of treatments that therapists have made available to their clients for many years. Mr Jessen's vitriol would be laughable were it not for the sad fact that many people who would benefit substantially from complementary medicine will be dissuaded from trying it, and doctors will be dissuaded from recommending it. All because Dr Jessen couldn't be bothered to do his homework.

Further reading:

If you have some time, take a look through the guidance for GPs’ patients, Primary Care Trusts, and Gastroenterologists on the subject of IBS (Irritable Bowel Syndrome), issued by NICE (National Institute for Clinical Effectiveness), a body operated by the NHS in the UK (www.nice.org.uk/nicemedia/pdf/IBSFullGuideline.pdf). Within that document, look up the following page references.

Page 31: the flowchart says for "[for IBS of] more than 12 months duration, consider psychological interventions: Hypnotherapy, Psychological therapy, CBT".
Page 40 says the same for patients for "Refractory IBS".
Page 374 poses the question "Does hypnotherapy have a role in managing IBS symptoms?" and answers it affirmatively for "gut-directed hypnotherapy". It also describes how "IBS is ideal for treatment with hypnosis, as there is no structural damage to the body".
Page 458 states "Although there is currently a lack of research in hypnotherapy, the GDG agreed there is potential for long-term benefits to the NHS from this behavioural therapy that need to be investigated further, including its use as a first line therapy. The GDG therefore decided to include hypnotherapy in one of its top five research recommendations, with the potential for this intervention to be considered as a first line therapy option."
Page 461 states "Hypnotherapy has the highest probability of being the optimal strategy for cost per QALY thresholds under £20,000" (this is in a comparison of the cost-effectiveness analysis of the three psychological interventions psychotherapy, CBT and hypnotherapy).
Page 464 mentions evidence in children with IBS, which showed that hypnotherapy is clinically effective as a first line therapy. The reference pages include all of the original papers that NICE used to reach its decisions about hypnotherapy. NICE has looked for the evidence for the value of hypnotherapy for IBS and found it in several peer-reviewed journals. That Dr Jessen cannot find any evidence for any complementary therapy for any presenting problem can mean only that he just did not look for it.

Whole-Being HypnotherapyNEWS & VIEWS

DR CHRISTIAN JESSEN AND "QUACKERY"

Comment by Deborah Marshall-Warren, 27th May 2009

Whole-Being Hypnotherapy
NEWS & VIEWS