Pseudoscience is the term given for any belief or practice that is mistakenly based on the scientific method. The scientific method is an iterative process that includes systematic observations, measurements and experiments to test an idea / hypothesis for its accuracy. When an idea is considered accurate enough, it is considered to be scientific. People who attempt to pass ideas and practices as scientific which have yet to show rigorous evidence of accuracy via the scientific method are pushing pseudoscience. These people may be naïve, true believers or charlatans. Pseudoscience is harmful as at the least it parts people from their money, and at worst can lead to people’s untimely death. Unfortunately, in the health industry, people are often looking for simple solutions to complex problems and so are prone to falling for pseudoscience. This can be both the person seeking to resolve their own health issue, or practitioners offering solutions.

Scientific Method Versus Pseudoscience Claims

Science is not an ideology, religion or set of facts. Science is a process for trying to determine a more accurate Truth of what is Real. I have capitalised the T in Truth as a reference to an ideal philosophical objective Reality Truth, which relies on their being a consistent set of fundamental rules to the entire universe for all time. When I use a small t truth, then I am referring to an approximation of that fundamental Truth, that is more accurate than the previous idea. The capitalisation of Real is similar, referring to that ideal philosophical objective Reality Truth.

Even though science is a good process, it is a process that is done by people, so we do have to contend with the flawed human factor. While there are problems with how we implement the scientific process, it is still the best method we humans have developed for understanding the difference between an idea that is false and an idea that is accurate.

As part of the scientific method, we construct a model for how we think something in the real world works. This will by necessity be a simplification of how it truly works, as we are trying to construct a rule that explains a range of similar phenomena in such a way as to predict what is going to happen next. In science, we are looking for the most accurate model that is the most useful.

“Essentially, all models are wrong, but some are useful”, George E.P. Box, Empirical Model-Building and Response Surfaces

George Box, a British statistician, working on quality control, time-series analysis, design of experiments, and Bayesian inference. Box’s helpfully points out that what we want is a useful model, even though we know it isn’t 100% correct.

Don’t settle for models that are useless, and don’t be fooled by models that have yet to be fairly tested.

Good science involves formulating a hypothesis to explain the phenomena. A good hypothesis will try to explain a mechanism for what is happening such that you can make predictions for what should happen next, and what would happen if you changed a certain something in that process. This leads to testable predictions. The scientist (person who tests these ideas using the scientific method) will then perform experiments to test the predictions, ideally for both “is it true” and “is it false”. If the hypothesis is not accurate enough, modifications will be made to try to improve the accuracy of the hypothesis. If the hypothesis is inaccurate enough, then it will be discarded and replaced by a new hypothesis. Often there are several models that are being pitted against each other, and the scientific method is attempting to reveal which of the models are more accurate and more useful.

However, just because an experiment shows that Model A is more accurate than Model B does not mean that Model A wins. That is merely 1 data point. Good science relies on replication, ideally by someone else, somewhere else, using a similar method to test the same experiment. If their experiment also concludes that Model A is more accurate, we now have some level of credence that Model A is more accurate, and that the experimental result was not a fluke.

Various experts will also look at the methods that were used to test the models to determine if these were fair tests, a plausible model, and that the results are not flawed. The results could be flawed if the method measures the wrong thing. For example, if the idea being tested is that people wearing red shirts will run faster, and a running race is held with various runners wearing various coloured shirts, the winner wearing a red shirt may prove the idea correct, or it may be just coincidence. Was there only one runner in the race? How many of the runners were wearing a red shirt? Is there any mechanism proposed for why a red shirt would change the speed of the runner? Is the expected fastest runner always assigned a red shirt prior to the race? These are all ways that this idea and test may be flawed.

A model may be shown to be a better predictor, with a reasonable proposed mechanism and it may be replicated, but there is room for even better science. When different fields of science come to a similar conclusion, then we have a convergence of hypothesis pointing to a more fundamental layer of Truth. For example, Einstein’s General Theory of Relativity has been verified from many different lines of enquiry, showing that it is not just a good model for certain predictions, but that it is an excellent model for how the universe seems to work. Even so, we know that it is not complete as it does not describe quantum events. Even though we know it is incomplete, we don’t know what needs to change to make it even better.

A model may be flawed or even wrong, yet it may point to another model that is useful.

For example, blood tests from people diagnosed with Depression found a consistently low presence of Vitamin D. A hypothesis was formed that low Vitamin D causes Depression. Two predictions can be formed from this model. One is that raising the level of Vitamin D will decrease measured Depression, the other is that all people with similarly low levels of Vitamin D will be noticeably Depressed. Experiments showed that supplementing Vitamin D such that the test subjects tested “normal” levels of Vitamin D in their blood did not improve their depression and not all people with low Vitamin D were noticeably Depressed. This effectively destroyed the hypothesis that low Vitamin D causes Depression.

These experiments were replicated (repeated) by various peoples, and the logic of the outcome is sound. Low Vitamin D is a marker for possible depression and their may be a connection that is not direct like the hypothesis first predicted.

A hypothesis that I propose is that since Vitamin D is made out of LDL cholesterol, and LDL cholesterol is also used to regulate the production of Dopaminergic Neurotransmitters (Dopamine, Noradrenaline and Adrenaline) via the hormone Oestradiol (Oestradiol is an end product of LDL cholesterol), then problems in the processing of LDL cholesterol can lead to both low Vitamin D and problem’s in synthesising sufficient Dopaminergic Neurotransmitters, which is a leading contender for Depression. At this point, this is just a hypothesis since to the best of my knowledge, there is no study to investigate this.

If I were to use this untested theory as a statement of scientific truth, promoting a medical treatment for Depression, then I would be engaging in Pseudoscience. Just because it makes medical sense does not mean it is correct, nor does it mean it is wrong. I just means it isn’t scientifically tested, and any claim to say “this is how it works” misses the fact of no evidence yet shows it to be so. A more accurate statement is “this is how it may work”.

For a belief or practice to be considered Pseudoscience, it is either shown to not be accurate by the scientific method, or it has yet to be tested by the scientific method. Ideas that have withstood the scientific method are considered to be in the large space of provisionally passed ideas called science, while those that have no reliable evidence showing that they are correct, or have been discredited, yet are still being promoted as scientific are called Pseudoscience.

For a more comprehensive breakdown on good science and its limits, check out Understanding Science.

The Obfuscation of Evidence Based Therapies

We just talked about how good science has good experiments to test a reasonable mechanism led hypothesis / model, and that we don’t consider it evidence without replication. We also noted that scientists are human, and sometimes humans make mistakes – sometimes genuine, sometimes self serving.

Many proposed treatments are thought up to resolve various health problems. To try to distinguish between misleading claims of efficacy and scientific claims of efficacy, the statement of “Evidence Based” is often used in connection with “Therapy” to show that there is evidence behind the claim that this treatment should be expected to work. Not all research is created equal, and too many charlatans have created false or flawed studies to fabricate “evidence” that their therapy works. It often isn’t reasonable for people looking for health therapies to be able to do the research themselves and figure out if a particular therapy is legitimate or pseudoscience.

The best lies have a kernel of truth wrapped in a smothering of lies.

Many studies are flawed in common ways.

• All the positive studies are done by those who promote the therapy (self interest biases the results)
• Only a few studies show that it may work (lack of replication)
• The study design is flawed (no via mechanism for the claim, testing the wrong thing, biased set up, inadequate number of participants or too many participants without reasonable constraints)
• Unstated premise (where the study assumes that the treatment works, or some key element of the treatment is presumed to be true)

To save you some time, I have compiled a list of common therapies that are pseudoscience, and why they are regarded as such.

Quick Red Flag Tests for Pseudoscience Treatment

Ancient / Traditional Treatment

If the words Ancient or Traditional are used to describe the treatment, it is probably pseudoscience.

Medical treatments are updated all of the time as newer and better ways to provide the therapy are discovered. The fact that this treatment is ancient and unchanging is a big red flag. Good scientific medicine progresses and evolves.

Anecdotes and Testimonials

The claims of efficacy rely mostly on anecdotes and testimonials that this treatment really works, rather than testimonials at the professionalism of the therapist.

The plural of anecdote is not data. It can be a beginning point for why a research study should be done for that claim, but it is not evidence that the claim is real without the research to back it up.

Burden of Proof is Misplaced

If I make a truth claim, it is my burden of proof to show that it is true or acknowledge that I cannot. Pseudoscience will often shift the burden of proof to show that their claims don’t work, rather than showing that their claims are correct.

Cures or Treats Everything

No single treatment treats everything. If it did, it would be a part of everyone’s required daily existence actions – like breathing both in and out.

When a treatment is claimed to treat many different unconnected or poorly connected conditions, it is time to get suspicious. A good test question is “does this treatment also treat …” and list something not connected to any of the conditions listed on the promotional material. If there answer is a quick “yes”, then get very, very suspicious. Better answers are “no”, or “I don’t know, let me go and check”.

Magic Energy: ki / spirit / chi / qi / life energy

No scientific investigation has found this energy.

Scientific tools can measure the ripple of gravitational waves that chance space time as little as 1/10,000 of the width of a proton, can measure the movement of water inside of a body, can look at bones without surgery and so on, but can’t seem to find the spirit energy that many pseudoscience treatments claim to treat with magnets, bone manipulation and needle points.

Hospitals Don’t Use it

Western Hospitals provide the best recommended treatments for health conditions. While a new therapy may not be available yet in a specific hospital, that same treatment is not likely to be available in a small private hospital either.

• If a health expert is claiming that their new treatment works but hospitals aren’t providing it, be careful and check for further signs of pseudoscience.
• If a health expert is claiming that this ancient or old treatment works, but hospitals aren’t providing it, it’s a scam.

There are treatments that exist that are not suitable for hospitals for certain conditions. When this is the case, these treatments provided in clinics are considered to be The Standard of Care for that condition, or is listed as a common treatment for that condition. Unfortunately, many pseudoscience treatments have manage to weasel their way on to “standards of care”. Check our list below to see if the treatment or practitioner is listed in our Pseudoscience Therapies section.

Quantum Explanation

Somewhere in the description for the lay person (pamphlet / flyer / packaging) the word “quantum”, “entanglement”, “superposition” or some other quantum physics term is used to describe why this treatment works is a huge red flag.

Technically, everything is quantum, and when you want to get really low down in the details of how something does what it does, eventually you’ll hit the quantum level. For most people, that just isn’t necessary. It is a red flag for general level information to start talking about quantum effects, while it is fine for this discussion to happen in expert papers.

Pseudoscience Therapies

Pseudoscience therapies may be

• Untested therapies
  • Without the transparency of it being untested (as discussed above)
• Purple Hat Therapy
  • Where real treatments are snuck in, but you are paying a fortune for the purple hat
• Complete nonsense
  • Literally not sensible, without a real mechanism for why it would work and certainly no good evidence that it does
• Disproven therapies
  • Where it has been well established that this treatment does not meet the claims and therefore is not a viable treatment
• Combinations of the above

Pseudoscience is almost always harmful, from wasting your money and time, complicating the condition with other problems or delayed treatment, or even directly harmful and even deadly.

Acupuncture

Red Flags: Spirit Energy, Ancient, Alternative Medicine, Nonsense Explanation, Quality Research shows “doesn’t work”

Acupuncture is said to be an ancient Chinese medicine, dating back thousands of years, where piercing the skin in key locations will change the flow of ki energy in humans, which can either harm or heal a person. We have never found evidence that this ki / spirit / chi / qi energy is real.

What we recognise to be acupuncture now is fairly new, as the technology to make thin needles is only a few hundred years old, so what we recognise to be acupuncture logically cannot be thousands of years old.

To determine if a model works, you need to test it. Many scientific examinations of this have been performed. A few of these tests have shown that acupuncture works better than chance and better than the placebo effect. Acupuncturists state, therefore, that acupuncture is Evidence Based Medicine.

The problem with this claim of Evidence Based, is that most of the evidence says it doesn’t work.

Acupuncturists refuted scientific assessments of acupuncture by asserting that the unbiased scientist didn’t compare sham acupuncture (random placement of the needles) with real acupuncture points. In an American study, recognised acupuncture specialists were brought in to instruct the testers on where the real acupuncture points were. These leading practitioners disagree with each other about where these acupuncture points are, yet state that there version consistently works and is the only model that is true.

If where you insert the needle doesn’t matter, then it isn’t acupuncture, it is just stabbing you. If it does matter, then how can there be many systems of “real” with the statement that the other expert’s location is a sham? When setting up a trial for acupuncture, trying to compare “real” versus “sham” puncturing is impossible when there is no agreed upon definition for “real”.

Even so, scientists have tested most of the leading versions of “real” and found that they consistently give the same result as the sham, which is often no greater than the placebo effect (where you think you are better because you got treated, regardless of whether the treatment was real or not).

Conclusion:

• Acupuncture relies on unblocking spirit energy that is supposed to flow through your body. No scientific study has ever found this spirit energy.
• Acupuncture and its relatives (acupressure, acupoints etc) has been thoroughly studied. The studies have gone out of their way to factor in the criticisms from acupuncturists. They found no consistent positive effect.
• Acupuncturist leaders disagree with each other about where the acupoints are, while at the same time stating that their system is the only system that actually works.

Read more: 

• Acupuncture is Theatrical Placebo
• Acupuncture on Science Based Medicine
• Acupuncture: A History

Chiropractic

Red Flags: Purple Hat Therapy, Spirit Energy [Innate Force], Nonsense Explanation, Alternative Medicine, Quality Research shows “core Chiropractic doesn’t work”

Chiropractic is faith healing through bone manipulation, invented by D. D. Palmer, Sep 18, 1895. He claims that he adjusted the spine of a deaf man and allegedly restored his hearing. From what we know of from modern medicine, this is a very implausible claim.

Chiropractic (that is the right grammar) relies on the 33 Principles of Chiropractic. These are non sensical statements that approximately equate to faith healing, attempting to reverse the interreference of life forces by adjusting dislocated bones along the spine.

TLDR:

• These are the 33 Principles of Chiropractic.
• They are all about defining the world in a very weird way, often contradicting itself.
• The only part about “healing” is clauses 28, 29, 30 and 31, which effectively say that “disease is caused by an interference in the transmission of innate force [chi type energy] from subluxation [dislocation] of the spinal column”.
• There is zero evidence that there is such an energy / force in humans, and zero evidence of dislocated bones along the spinal column for the vast majority of people who receive a spinal adjustment from a chiropractor.

Science Based Medicine reports that there is no credible evidence to support the claims of the above principles for their practice, and no evidence that adjusting the bones of the spine, or anywhere else, give any reliable medical therapeutic treatment to the vast majority of the diseases that Chiropractors claim to treat.

We can divide Chiropractic practitioners into 3 categories:

1. Straight practitioners, who only adjust the spine
2. Mixed alternative medicine practitioners, who include other pseudoscience treatments like acupuncture, kinesiology etc
3. Mixed with physiotherapy (and probably the pseudoscience treatments)

When studying the efficacy of chiropractic, the chiropractors that show consistent positive results are in the third category, those who mix in physiotherapy treatments. However, chiropractors rarely have a degree in physiotherapy and so are not technically qualified to do physiotherapy treatments. When studying the efficacy of the pure chiropractic interventions, no reliable positive results occur, indicating that it is an ineffective treatment. The risk, though, is high. There is a slight chance that with a spinal adjustment you can be paralysed or have a stroke. Many people have had strokes after a spinal adjustment.

Conclusion:

• This risk analysis effectively says “pay money for a treatment that can kill you with zero reliable evidence that this treatment will help you”.
  • Purely chiropractic treatment is faith healing with zero evidence that it works.
  • The only reliable treatment that Chiropractors give is physiotherapy, which most are not qualified to give. If you want physiotherapy, go and see a physiotherapist.
  • There is a risk of paralysis or stroke, which is a serious consequence, without any evidence of reliable positive results.

Eye Movement Desensitisation Realisation (EMDR)

Red Flags: Purple Hat Therapy, Quality Research shows “core EMDR doesn’t work”

TLDR: EMDR, started as pure pseudoscience and has now become an expensive Purple Hat Therapy. The unique thing about EMDR from TF CBT is the eye movement while talking about trauma, and this has failed to show any improvements alone on the gold standard treatment, TF CBT (for Trauma).

EMDR is supposedly a method of managing traumatic or disturbing thoughts via saccadic eye movement. An alternative to saccadic eye movement is tapping your hand (aka Emotional Freedom Technique, another pseudoscience). Proponents cite that a benefit of EMDR is that you don’t have to discuss or disclose your traumatic memories and experiences, while the Australian Guidelines for PTSD state that now that modern EMDR incorporates CBT elements in its therapy, it has now got about as good as TF CBT, and is effectively no different to Trauma Focused Cognitive Behaviour Therapy (TF CBT) where you do actually explore memories, while wiggling your eyes, however the Eye Movement component has zero evidence of effectiveness.

EMDR: the questionable origin story

The usual origin story is that EMDR was invented by Francine Shapiro in 1987 while she was taking a walk in a park [Revisiting the Origins of EMDR, 2023]. Shapiro states that she realised that she was able to cope better with disturbing thoughts when she used saccadic eye movement. Saccadic means to rapidly move your eye to different points. Shapiro noted that she was looking at the trees on either side of the path, disturbing thoughts rose and disappeared without intentional effort. Shapiro states that when she specifically considered those thoughts, they seemed to be no longer upsetting.

However:

In 1985 during Shapiro’s fourth year of studying Psychology, two years prior to her stated origin story, Shapiro published a paper in Holistic Life Magazine discussing theories on various topics about NLP (Neuro-Linguistic Programming – another pseudoscience), and the importance of eye movement patterns. In this, Shapiro makes it clear that despite her fourth year studying of psychology, she does not understand the concepts of “scientific” and reliable. She states “In other words, Neuro-Linguistic Programming is scientifically rather than merely theoretically based.” Publications at the time showed the NLP was not consistently replicable – a cornerstone of “scientific”. Additionally, the claims made by NLP practitioners is wild, clear signs of pseudoscience.

It was revealed in 2014 by B. Grimley in his article Origins of EMDR- a question of integrity? that while she worked for Grinder in administration, John Grinder had asked Shapiro to use an NLP technique to assist a friend who had been sexually assaulted, to put them into a “resourceful state” via asking her to “systematically move her eyes through the various accessing positions typical of the major representational systems”. “You may imagine my surprise when I later learned that she had apparently turned these suggestions into a pattern presented in an extended training, with no reference to source, with a copyright and a rather rigorous set of documents essentially restricting anyone trained in this from offering it to the rest of the world” stated Grinder.

But does it work? (no)

Shapiro’s explanation for why EMDR works is filled with neurology babble, words that sound like science, but don’t mean anything or make any actual neurological sense. Often a red flag for pseudoscience.

Many of the research papers for EMDR should not have passed peer review. For example, many of them have no control group (like this one), is unblinded (therapy versus medication) or is compared to no treatment (like this relaxation or therapy one). Modern EMDR research is confounded due to the recent inclusion of CBT style practices in the EMDR training, effectively comparing EMDR+CBT with CBT, and finding them about the same level of effectiveness. That is the very definition of a Purple Hat Therapy.

In my opinion the these two particular paragraphs from the Australian Guidelines for the Treatment of Acute Stress Disorder & Posttraumatic Stress Disorder, 2013 are very pertinent.

Summary

TF CBT + medication is the most reliable therapeutic model for trauma therapy. If you want to get the best of EMDR or TF CBT, then just spend your money on a talented CBT therapist and don’t waste your money on a fancy Purple Hat that doesn’t help you.