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Does experience of the ‘occult’ predict use of complementary medicine? Experience of, and beliefs about, both complementary medicine and ways of telling the future
e ‘occult’ predict use of complementary medicine?
Does experience of the ‘occult’ predict use of complementary medicine? Experience of, and beliefs about, both complementary medicine and ways of telling the future A. Furnham Department of Psychology, University College, London, UK
SUMMARY This study looked at the relationship between ratings of the perceived effectiveness of 24 methods for telling the future, 39 complementary therapies (CM) and 12 specific attitude statements about science and medicine.A total of 159 participants took part.The results showed that the participants were deeply sceptical of the effectiveness of the methods for telling the future which factored into meaningful and interpretable factors. Participants were much more positive about particular, but not all, specialties of complementary medicine (CM).These also factored into a meaningful factor structure. Finally, the 12 attitude to science/medicine statements revealed four factors: scepticism of medicine; the importance of psychological factors; patient protection; and the importance of scientific evaluation. Regressional analysis showed that belief in the total effectiveness of different ways of predicting the future was best predicted by beliefs in the effectiveness of the CM therapies.Although interest in the occult was associated with interest in CM, participants were able to distinguish between the two, and displayed scepticism about the effectiveness of methods of predicting the future and some CM therapies. © 2000 Harcourt Publishers Ltd
INTRODUCTION
Professor Adrian Furnham Department of Psychology, University College London, 26 Bedford Way, London WCI, UK. E-mail: [email protected]
There seems little doubt that there is a considerable rise in public and research interest in complementary medicine (CM).1,2 One index of this is the theme issue of the Journal of the American Medical Association (JAMA)3 which included results of a follow-up study looking at trends in America. Extrapolating to the population as a whole, they found a 47.3% increase in total visits to CM practitioners from 427 million in 1990 to 629 million in 1997 exceeding visits to primary care physicians. A number of studies have focused on doctors’ (general practitioners and specialists) perceptions
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© 2000 Harcourt Publishers Ltd
of CM,4–7 as well as the beliefs of medical students8–10 and CM practitioners themselves.11 These studies did not compare the results from the different groups and were nearly all descriptive but they did show that both orthodox medical students and trained practitioners were positive and openminded about CM. Naturally, CM practitioners held positive attitudes about their own and other CM specialties. Ernst, Resch and White12 reviewed 12 other surveys done in six different countries and report remarkable similarity between them. However, they did not find a trend to suggest that complementary medicine is increasingly perceived as useful or effective. 266
Does experience of the ‘occult’ predict use of complementary medicine?
Furnham and Vincent13 have argued that there are two fundamental research questions with regard to CM: does it work? Why do people choose it? The first requires careful, expensive, double-blind, placebo-controlled, randomized studies to demonstrate efficacy. In some cases this has been achieved. The latter, in a sense, requires little investigation if the answer to the former, is unequivocably positive but this is clearly not the case. Hence the second revolves around why patients pay for, and apparently enjoy and benefit from those treatments whose effectiveness is not proven or indeed proven to be ineffective save for possible placebo effects. It is possible that attitudes to science are part predictors of why people deliberately choose or avoid CM. This study goes some way to exploring this issue. Attacks on CM come from many quarters. Skrabenek14 claimed that it is often difficult to evaluate any complementary practitioner’s health claims because they lack a clear diagnosis. He attacked homoeopathy for treating not the disease but the problem; his complaint against osteopathy was poor reliability and diagnosis; while his attack on acupuncturists was based on the idea that its success is due entirely to the placebo effect. Stalker and Glymore15 were particularly critical of the ‘holistic’ theories which they claim contain a ‘reactionary impetus to turn the practice of medicine to the practice of magic and to replace logic and method with occultism and obfuscation’ (p.23). They do view the implicit belief that all states of health are psychosomatic as simply wrong, but even if it were so, it would simply call for the scientific method to investigate the claim. One theme of those that attack from the biomedical perspective is that a belief in CM is a flight from, or rejection of, science16. However, the notion that belief in CM represents a rejection of science was not supported by a study by Astin.17 At the academic level this is usually at the heart of a debate between empiricists and realists or between those who support a biomedical versus post-modern perspective. Gray18 has, in fact, pin-pointed four quite different approaches to CM two of which are the biomedical approach which is deeply critical of CM and postmodernists who tacitly support it. The Biomedicine Perspective is concerned with the curing of disease and control of symptoms where the physician–scientist is a technician applying high level skills to physiological problems. This approach is antagonistic toward and sceptical of CM, believing many claims to be fraudulent and many practitioners unscrupulous. Physicians and medical scientists within this camp often believe CM patients are often naïve, anxious and neurotic. However, the competitive health care market place has seen a shift even in the attitudes of ‘hardliners’ to be more interested in, and sympathetic to unconventional therapies. The Postmodern Perspective approach enjoys challenging those with absolute faith in science, reason
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and technology and deconstructing traditional ideas of progress. Followers are distrustful of, and cynical toward science, medicine, the legal system, and institutionalized religion and even democracy. Many believe orthodox practitioners to be totalitarian persecutors of unconventional medicine. However, because many CM practitioners can be theoretically convinced of their position and uncompromising, they can also be subject to postmodern scepticism. The assumption underlying these debates is that a rejection of, empiricism – positivism affects all aspects of one’s perception of the world. This idea, fits in with the scathing criticism of some from the biomedical perspective who see people who advocate, believe in, or use (non-proven) CM therapies as rejecting science and no doubt believers in other equally bogus and non proven ‘belief systems’ like astrology etc. Indeed this study sets out to test the assumption that the rejection of science relates to interest in CM and other non-proven belief systems. Furnham19 investigated part of this claim by looking at people’s perception of various future-ologies concerned with either personality assessment and/or predicting the future and various CM therapies. He found participants were able to clearly differentiate between the two and that whereas the CM therapies (particularly osteopathy) were rated as moderately effective in doing what they claimed to do, most future-ologies (particularly tasseography) were rated as ineffective. He also found belief in the efficacy of CM was best predicted by gender (female), increased familiarity with a range of CM therapies and less familiarity with future-ology practices. This study replicates the above study by looking at the association of beliefs in very different non-medical and CM systems. It extends the previous study by increasing the number of both types of systems examined with 24 ‘predictive systems’ (astrology, tarot cards) looking at both the less and more well known. It also increases the number of CM therapies considered to a fairly comprehensive list of 39 in total from the very familiar to the less familiar. One aim of the study was to investigate the perceived underlying structure of both lists of systems. Second, it also examines attitudes to (modern) medicine using the questionnaire developed by Vincent and Furnham2 which showed logical relationships between attitudes to modern medicine and the perceived efficacy of CM therapies. Third, it looks at the best predictors of belief in the two types of system. It was predicted that interest and belief in the efficacy of various CM therapies would be systematically related to beliefs about science, attitudes to ways of predicting the future and to demographic differences. Specifically that the more participants had heard of, and believed in future-ologies, the more sceptical they were about medical science and the less well educated they were, the more they would be interested in, and believe in the efficacy of CM.
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METHOD
RESULTS
Participants
There was a 98% response rate with nearly all questionnaires correctly completed.
There were 69 males and 90 females: 35.1% were students; 34.2% in professional jobs and 30% in skilled employment. Their income ranged from under £10 000 to over £65 000 p.a. Their mean age was 26.25 years (SD = 9.04 years) with ages ranging from 17 to 81 years. In all, 27% were single while the remainder were married or divorced. Asked about mothers’ occupation 23% put housewives, while 71.2% had working mothers. In all, 86% of the respondents had working fathers nearly all in middle class professions. In total, 51% reported themselves in excellent health while 47.7% said they were in good health. Most 91.9%, had English as a first language. Half of the group (80) were recruited by a market research agency while half were found among a university department subject panel. The former were contacted from an extensive mailing list, the latter by advertisements and personal contacts. Overall, there was a 98% response rate. Participants were debriefed where possible.
Questionnaire This was divided into three parts: 1. Ways of predicting the future. This questionnaire described 24 different methods to predict the future (Table 1). Each had a short, one-sentence description. They were taken from various books on the topic.21 Participants made four ratings on each: had they heard of it (yes/no) (overall alpha 0.88); do they think they know how it works (yes/no) (overall alpha .90); have they tried this particular technique (yes/no) (overall alpha 0.91) and do they believe it is effective at curing and alleviating symptoms (doing what it says it does) (1–10) (overall alpha 0.95). 2. Complementary medicine. The Research Council for Complementary Medicine (RCCM) in London provided a list, in alphabetical order, of therapies relatively widely known and practiced in the UK (Table 2). The list is fairly comprehensive though a case could be made for the inclusion of various other therapies. Each therapy was listed alphabetically and required the same four ratings as above. Again alphas were all above 0.85. 3. Attitudes to medicine. This was a 12-item questionnaire2 that required responses on a 7point agree-disagree scale (Table 2). Of the 12 items, four expressed a positive attitude to ‘scientific medicine’; four the importance of psychological factors in medicine; and four expressed opinions around the possible harmful effects of modern medicine.
Beliefs about predicting the future Table 1 shows the mean results for the ratings of the 24 personality assessment methods. Most of the participants had heard about astrology (96%), palmistry (93%), tarot (93%), clairvoyance (90%), graphology (88%), oriental astrology (85%), dowsing (78%) and necromancy (78%). On the other hand, very few had heard of aeromancy (4%), geomancy (11%), hydromancy (11%) and molescopy (13%). With regard to the numbers of participants who thought they knew how the techniques worked, the highest figures were for astrology (42%), dowsing (46%), graphology (54%) and palmistry (39%). Large numbers had no idea how the technique supposedly worked: scrying (70%), pyromancy (68%), augury (67%), cartomancy (65%), molescopy (65%), metoposcopy (65%) and numerology (65%). Also, participants had tried very few of these: astrology (62%), palmistry (49%) and Tarot (41%). Less than 10% had tried aeromancy, augury, geomancy, hydromancy, molescopy, metoposcopy, phrenology, physiognomy, pyromancy and scrying. Those techniques rated as most effective were graphology (4.40) and dowsing (4.01) while those rated least effective were augury (1.53), aeromancy (1.56) and hydromancy (1.61). Not one of the techniques got a score of even 5.00 on the 10-point scale indicating that the participants seemed extremely sceptical about all of them. The next task was to attempt to determine how these 24 techniques ‘clustered’ based on the responses of the participants. To explore this question two factor analyses were done, first on the ‘heard of it’ ratings (yes/no) and then on ratings of the perceived efficacy of the technique (1–10). Five factors emerged which, in total, accounted for nearly half the variance. In the first factor analysis the first factor contained four systems which where each quite well known and well documented with a long history (tarot, clairvoyance, palmistry, astrology). The second factor contained six methods which use analysis of dreams, crystal balls, casting lots, playing cards, fire and handwriting to tell the future. The third factor contained six lesser-known methods of predicting the future based on an analysis of such things as water, wind, sand as well as moles on the body, lines in the forehead and facial features. The penultimate factor contained two oriental systems (I Ching and oriental astrology) and the final factor a mix of well known (dowsing) and unknown (augury) methods. The meaningfulness of the second, fourth and fifth factors is far from clear.
Does experience of the ‘occult’ predict use of complementary medicine? Table 1
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Simple results for the first part of the questionnaire on future
Technique 1. Aeromancy: the prediction of the future by the study of wind conditions 2. Astrology: explores the effects of the sun, moon and eight of the planets upon the future and individual personality 3. Oriental Astrology: the belief that we obtain various animal characteristics according to the year in which we were born 4. Augury: divination by Roman Augurs who consulted omens to ascertain the wishes of the Gods on proposed plans of action 5. Biorhythms: belief that we can plot the rise and fall of three inter-related cycles—physical, emotional and intellectual to predict peak days and critical days 6. Cartomancy: prediction of the future using modern playing cards 7. Clairvoyance: ‘means clear seeing’. Divination by seeing the future ahead of time 8. Dowsing: a technique used for finding water in arid areas. Also used to locate mineral deposits and even dead bodies 9. Graphology: used to make an assessment of personality from individuals handwriting 10. Geomancy: prediction of the future by interpretation of patterns in sand or soil 11. Hydromancy: the prediction of the future by the study of water 12. I Ching: series of Chinese symbols used as a means of prediction as well as offering wisdom on how to cope with your future 13. Moleoscopy: prediction of future and assessment of personality from moles on the body 14. Metoposcopy: the assessment of individual’s character by the reading of lines on the forehead 15. Necromancy: the questioning of the dead about events in the future. Commonly achieved by using a Ouija board 16. Numerology: interpretation of numbers to obtain an individual character analysis and potential in the future 17. Oneiromancy: the prediction of future events by analysis of dreams 18. Palmistry: personality assessment and prediction of the future by the reading of lines on the hand 19. Phrenology: the evaluation of an individual’s character by examination of the shape of the skull 20. Physiognomy: character analysis from the physical appearance of facial features 21. Pyromancy: the foretelling of the future by reading images in fire 22. Scrying: predicting future events by gazing into a reflecting surface or through the use of crystal balls 23. Sortilege: prediction of the future by casting or drawing of lots i.e. tossing a coin to make a decision of drawing straws to select a person 24. Tarot: the reading of cards bearing occult symbols to predict events in the future
Heard of ** Yes No
Works Yes No
Tried Yes No
Effective X SD
R*
7
150
8
97
2
110
1.56
(1.10)
97
155
2
68
82
100
53
3.38
(2.42)
144
136
23
38
100
59
84
2.64
(2.00)
132
46
111
10
108
4
121
1.53
(1.12)
105
102
56
49
83
23
119
3.45
(2.34)
119
84
73
24
105
21
115
1.96
(1.94)
117
145
14
55
87
28
122
3.16
(2.55)
122
125
33
75
70
24
123
4.01
(2.75)
123
142
17
87
58
50
102
4.40
(2.39)
135
25
133
10
102
4
112
1.90
(1.56)
100
19
137
8
102
2
116
1.61
(1.25)
100
68
90
32
94
18
122
2.62
(2.32)
110
22
136
8
105
7
118
1.71
(1.52)
103
132
25
9
105
5
121
2.00
(1.61)
104
125
32
50
85
40
102
2.91
(2.44)
118
83
74
23
105
27
107
2.20
(1.95)
115
117
40
55
76
48
91
2.50
(2.43)
121
150
7
63
85
79
75
3.05
(2.49)
136
101
54
29
100
8
131
2.17
(1.83)
109
61
92
28
94
11
122
2.37
(2.08)
111
49
105
12
109
4
127
1.50
(1.20)
108
110
43
20
112
6
133
1.60
(1.30)
108
85
68
43
83
48
86
2.51
(2.45)
115
149
7
59
90
66
88
2.99
(2.47)
129
*Response rate to this question: people never completed the row if they did not answer yes to the first question. **Frequently the total does not add up to 159 because of missing data.
Because the above factor analysis was based on a two point (yes/no) rating scale it was thought to be sensible to redo the factor analysis on the 10 point efficacy rating which should yield a more robust factor structure. The results of this analysis indicate one very large factor that accounted for nearly half of the variance. Eight methods loaded on it as varied as biorhythms and tarot. Compared with most of other methods these seemed fairly well known and among the most effective. It should be borne in mind that still the overall mean was less than 3.00 on a 10 scale (where 10 is very effective). Three other factors emerged. The second factor also contained a number of relatively well known methods like clairvoyance, palmistry and numerology. The third factor had six methods loading on it which were all rated as essentially ineffective. The same
was true of the fourth factor which accounted for just over 5% of the variance (details of both factor analyses available from the author).
Beliefs about CM Table 3 shows the raw data of the ratings of the 39 CM therapies. The most well known therapies were acupuncture, hypnosis, herbal medicine, homoeopathy and traditional Chinese medicine, where around 90% or more of the sample had heard of them. The five least well known were autogenic training, biochemical tissue salts, chelation and cell therapy, ozone therapy and ayurveda. When asked if they thought they knew how the therapy works over 100 of the sample (nearly 75%) said they thought they knew how magnetic therapy,
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Table 2 Therapy
Results from the four ratings of the 39 therapies Heard of Yes/No
1. Acupuncture 155/3 2. Acupressure 112/45 3. Alexander technique 90/86 4. Aromatherapy 153/4 5. Art therapy 94/64 6. Autogenic Training 12/144 7. Ayurveda 40/117 8. Bach flower remedies 73/83 9. Biochemic tissue salts 19/138 10. Biorhythms 97/60 11. Chiropractic 137/19 12. Chelation and cell therapy 23/132 13. Colonic irrigation 128/29 14. Colour therapy 82/73 15. Crystal and gem therapy 82/74 16. Dance movement therapy 90/68 17. Healing 130/24 18. Herbal medicine 151/6 19. Homeopathy 144/13 20. Hypnosis 152/13 21. Magnetic therapy 64/93 22. Massage 149/9 23. Meditation 154/4 24. Music therapy 118/39 25. Naturopathy 53/105 26. Nutritional therapy 97/60 27. Osteopathy 128/28 28. Ozone therapy 23/133 29. Reiki 45/113 30. Reflexology 141/17 31. Relaxation 146/11 32. Shiatsu 106/51 33. Spiritual healing 133/23 34. Talk therapies and counselling 142/15 35. Traditional Chinese medicine 144/13 36. Therapeutic touch 72/84 37. Visualization 68/89 38. Voice and sound therapy 57/100 39. Yoga 151/7
Works Yes/No
130/19 87/46 61/66 116/33 64/65 10/95 27/82 48/74 12/90 44/81 91/48 14/93 81/53 46/72 62/61 58/76 114/36 105/45 99/48 28/94 136/14 136/14 127/22 83/49 28/91 75/52 83/52 13/92 21/86 85/55 125/20 61/59 57/75 116/29 75/64 27/86 41/72 23/88 116/32
massage, acupuncture, relaxation, aromatherapy, talk therapies (counselling) yoga, healing and herbal medicine worked. Less than 20 participants said they knew how autogenic training, biochemical tissue salts, chelation cell therapy and ozone therapy worked. The figures for the column concerning whether participants had actually tried any of the therapies showed a dramatic difference from previous columns. Forty per cent or more of the participants had tried aromatherapy, massage and relaxation and less than 20% had tried 26 of the 39 different therapies. However, probably the most interesting column were ratings of efficacy. Six treatments got ratings of > 6.00 on a 10 point scale. They were in descending order: massage, talk therapies, relaxation, music therapy, acupuncture and yoga. On the other hand seven therapies received ratings of < 3.00 indicating participants thought they were particularly ineffective. These were autogenic training, ozone therapy, crystal and gem therapy, cell therapy, colour therapy, biochemical tissue salts, and reiki.
Tried Yes/No
23/132 22/117 17/121 76/76 19/115 3/115 12/107 35/96 6/110 14/121 34/115 1/119 8/134 18/110 12/119 19/115 25/118 64/89 61/92 27/125 7/126 105/47 70/83 33/110 9/117 29/104 33/105 3/114 9/112 35/111 91/54 24/106 16/125 69/81 29/121 7/116 22/103 9/115 63/91
Effective (1 = not effective, 10 = very effective) Mean SD 6.11 4.96 4.93 5.08 4.55 2.14 3.13 3.81 2.56 3.10 5.26 2.45 3.86 2.53 2.44 4.20 4.15 5.52 5.02 5.21 3.37 6.79 6.18 5.38 3.27 5.31 5.48 2.37 2.74 4.63 6.20 4.87 3.89 6.22 5.07 3.49 3.76 3.33 6.08
(2.28) (2.57) (3.04) (2.73) (2.62) (1.99) (2.57) (2.86) (2.25) (2.32) (2.60) (2.05) (2.55) (2.53) (2.09) (2.65) (2.85) (2.56) (2.68) (2.46) (2.76) (2.34) (2.45) (2.57) (2.62) (2.88) (2.79) (2.36) (2.34) (2.80) (2.81) (2.99) (2.90) (2.62) (2.61) (2.71) (2.84) (2.56) (2.43)
No. of responses 132 110 94 132 99 63 70 94 64 99 118 64 111 89 81 92 104 132 129 121 78 137 136 107 75 99 113 63 72 116 132 91 105 133 118 83 80 69 133
As before, a factor analysis was done on the effectiveness ratings, which revealed four factors which in total accounted for nearly 60% of the variance. The first main factor clustered together 17 different therapies and what they had in common was that all were rated as fairly ineffective by the participants. The second factor had eight treatments loading on it relating to art, dance, music, talk therapies and relaxation. These may involve a creative element and allow the expression of emotional issues. The third factor had seven of the most familiar and established CM therapies loading on it. The final factor contained six therapies half of which were in some sense herbal/chemical and others about healing but no obvious interpretation of why these therapies loaded on the same factor. This analysis showed that it was the therapies loading on the second and third factor that were rated as modestly effective while those (nearly half) loading on the first factor were rated as generally ineffective.
Does experience of the ‘occult’ predict use of complementary medicine? Table 3
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Factor analysis (VARIMAX rotated) of efficacy (1 = not effective, 10 = very effective)
6 Autogenic training 7 Ayurveda 25 Naturopathy 28 Ozone therapy 9 Biochemical tissue salts 12 Chelation and cell therapy 29 Reiki 10 Biorhythms 36 Therapeutic touch 21 Magnetic therapy 37 Visualization 38 Voice and sound therapy 8 Bach flower remedies 3 Alexander technique 14 Colour therapy 13 Colonic irrigation 26 Nutritional therapy 34 Talk therapies (counselling) 24 Music therapy 16 Dance therapy 23 Meditation 31 Relaxation 32 Shiatsu 22 Massage 5 Art therapy 11 Chiropractic 27 Osteopath 1 Acupuncture 4 Aromatherapy 30 Reflexology 39 Yoga 2 Acupressure 17 Healing 18 Herbal medicine 33 Spiritual healing 19 Homoeopathic 35 Traditional Chinese medicine 20 Hypnosis
0.81 0.80 0.76 0.75 0.75 0.74 0.72 0.69 0.66 0.64 0.64 0.60 0.60 0.58 0.55 0.51 0.40
α .89 Eigenvalue 16.36 Variance 42.0% Mean 3.44
α .81 Eigenvalue 3.06 Variance 7.9% Mean 5.54
0.73 0.65 0.63 0.61 0.61 0.58 0.57 0.51
Attitudes to medicine In the third part of the questionnaire participants were required to rate 12 attitude statements about medicine. Results are shown in Table 4. Of the 12 statements participants seem to agree fairly strongly with three (> 5.50 on a 7.00 scale). All in fact loaded on the second factor and indicated the importance of psychological factors (state-ofmind) in health. Participants strongly disagreed with one statement (4) which loaded with one other statement (12) on the final factor, which questioned the exclusive value of ‘scientific medicine’. Participants tended to show slight agreement with four statements that loaded on the first factor. They were all concerned with the potentially negative side-effects of orthodox medicine. Participants also slightly agreed with the two items that loaded on the third factor both of which concerned the scientific evaluation of treatments. The alpha coefficients indicate clearly the coherence of these four factors which were all interpretable and similar to the factor analysis of Vincent and Furnham20.
Predictors of attitudes A central concern in the study was the relationship between attitudes to, and experience of, both
0.78 0.66 0.64 0.55 0.55 0.53 0.52
α .80 Eigenvalue 1.76 Variance 4.5% Mean 5.37 0.77 0.69 0.61 0.54 0.39 0.36
α .70 Eigenvalue 1.69 Variance 4.3% Mean 4.81
predicting the future and CM. Despite the interpretability of the factor analyses for reasons of parsimony it was decided to examine the internal coherence (alpha) of the four ratings (heard of it; know how it works; tried it; perceived efficacy). The measures are internally coherent with the lowest alpha being 0.79 and the highest 0.96. This suggests that when looking at for instance CM therapies, people tend either to know about, to try and to rate efficacious many or a few rather than be particularly differentiating. Given the size of these alpha coefficients it seems quite reasonable to combine each into a single score. Following this, a series of regressions were computed. They addressed the central question of what were the best predictors of attitudes to, and beliefs about, future-ologies and CM. In each of the regressional analyses it was decided to investigate which of a set of factors best predicted the four outcome measures. First five demographic factors were examined which had previously been shown to be related to experience of CM. Then the four clear attitudes to medical science factors were considered as predictor variables. Thirdly the four ‘ways of predicting the future’ variables were regressed on to each of the four CM variables and vice versa. Table 5 shows the results of the four regressions onto the four scores derived from the ‘ways of
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Table 4 Means, standard deviations and factor analytic results for the 12 attitudes to medicine statements Statements
Mean
SD
Loading
1. Patients are sometimes operated on when they do not need it 2. Psychological treatment (e.g. relaxation, counselling) should not be used more widely 3. The side-effects of modern drugs are often severe and sometimes dangerous. 4. Treatments which are not based on modern scientific discoveries are worthless 5. Being fit and well depends as much on your state of mind as on the functioning of your body 6. People sometimes feel worse rather than better after orthodox medical treatments 7. Every treatment should be thoroughly tested by doctors and scientists before people are allowed to try it 8. Many forms of medical treatment do more harm than good 9. Complementary (alternative) therapies should be scientifically evaluated 10. The ‘will to live’ can be a significant factor in whether people recover from a serious illness or injury 11. State of mind is a crucial part of achieving better health; positive thinking can enhance physical health 12. Medicine is a science and should be based on rigorous scientific principles
5.31 5.59
(1.80) (1.40)
0.70
5.65
(1.36)
0.71
2.28
(1.46)
5.92
(1.27)
5.36
(1.45)
5.09
(1.68)
4.15 5.04
(1.75) (1.57)
6.21
(0.99)
0.76
6.24
(0.98)
0.87
4.52
(1.68)
Eigenvalue Variance α
0.56
0.82 0.70 0.78 0.85 0.78 0.78
0.65 2.87 1.82 1.64 23.9% 15.2% 13.7% 0.72 0.72 0.63
1.12 9.4% 0.91
7 = strongly agree; 1 = strongly disagree.
predicting the future’. The pattern is very clear. Whilst each regression was significant and could account for between 16 and 35% of the variance it was only the four CM factors that were significant predictors. Thus, the more that people claimed to have heard of each of the future-ology methods, the more they had heard of CM therapies. Claimed knowledge of how future-ology methods worked was best predicted by whether the participant had tried CM therapy and their ratings of their efficacy. The best predictor of whether participants had tried any future-ology methods was both the extent to which they had heard of, and believed they knew how CM therapies worked. Finally, the simple and most powerful predictor in the efficacy of the combined future-ologies was the extent to which participants rated the combined efficacy of the CM therapy. The final analyses looked at the four CM factors and identical regressional analyses were run but with the four future-ology factors as independent variables. There were two significant predictors of the extent to which participants had heard of complementary therapies—they were the extent to which they had heard of the various futurologies specified and believed they knew how they worked. The only predictor of the extent to which participants claimed they knew how the many different CM therapies worked was whether they had ever tried using the futurologies. There were two predictors of the variable which looked at how many of the CM therapies people had tried—it was the extent to which they believed psychological factors influenced health and the number of futurologies they tried. Finally, the only variable, accounting for
nearly a third of the variance, that predicted participants ratings of the overall efficacy of the various methods of CM was the efficacy of methods aimed at predicting the future.
DISCUSSION With few exceptions (astrology, palmistry, clairvoyance, graphology), the participants were relatively ignorant of most methods of predicting the future listed in this study. They also claimed by-and-large not to know how they worked, had never tried them nor indeed thought them effective. Clearly these four issues are related: if one believes a treatment or method of prognostication is successful one is tempted to try it, read up about it and try to understand how it works. The precise causal pathway is not clear however. Certainly in all instances more people had heard about than tried, any of these methods of telling the future. The most frequently tried (astrology and palmistry) could be done by many methods (reading newspapers, popular books) without consulting practitioners or taking the process very seriously. The pattern was very different for the CM therapies. Many more were heard of than in the case of the future-ologies although often very small numbers claimed they had tried the various technique. Ratings of efficacy of the 39 CM therapies were from ineffective to comparatively effective with 6 (15%) getting a score of > 6.00 on a 10 point scale. Clearly the participants were more aware of, and sympathetic to, CM therapies than ways of telling
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Table 5 Regressional Analysis examining the best predictors of experience of, and attitude to, ways of predicting the future
Independent variable Sex Smoker Religious Vegetarianism Health Scepticism Psychology Protection Research HCM WCM TCM ECM
Heard of β –09 –00 00 00 08 11 –01 –03 –05 0.47 00 00 07
F(13,145) R square
Tried β
t –1.21 –0.11 0.00 0.08 1.08 1.49 –0.22 –0.46 –0.68 5.56*** –0.08 0.05 0.95
02 08 –02 02 08 06 01 –04 –08 08 13 25 19
Works how β t
t 0.31 1.07 –0.25 0.26 1.11 0.80 0.15 –0.55 –1.19 1.00 1.43 2.95** 2.51**
=4.52*** 25
–00 12 –04 –04 –03 –07 04 –09 –01 0.32 0.20 –05 07
–0.09 1.52 –0.53 –0.62 –0.44 –0.87 0.43 –1.11 –0.13 3.61*** 2.09* –0.61 0.84
5.45*** 0.27
Efficacy β –10 –02 00 10 03 02 07 –12 –05 12 10 00 50
t –1.58 –0.39 0.00 1.47 0.49 0.30 1.07 –1.79 0.78 1.59 1.31 –0.09 6.70***
3.32*** 0.16
5.45*** 0.27
**P<0.01. ***P<0.001.
Table 6
Regressional analyses examining the best predictors of experiences of, and attitudes to CM
Independent variable
Heard of β
Sex Smoker Religious Vegetarianism Health Scepticism Psychology Protection Research HPF WPF TPF EPF
–09 –00 10 05 02 11 06 –05 –02 38 24 04 –04
F(13 145) R square
0.30
t 1.37 0.00 1.40 0.77 0.28 1.51 0.77 –0.72 –0.23 5.13*** 3.02** 0.48 –0.46
Tried β 10 –04 09 –04 00 00 0.15 –08 –07 05 15 19 12
=6.35***
t 0.21 –0.80 –0.02 0.44 –0.54 0.00 1.78 –1.04 0.07 1.10 –0.05 4.02*** –0.09 =4.28** 0.21
Works how β t 02 –06 00 03 –04 00 14 –08 00 09 00 40 –00
0.21 –0.80 –0.02 0.44 –0.54 0.0 1.78 –1.04 –0.07 1.10 –0.05 4.02*** –0.09 =3.50*** 0.17
Efficacy β t 09 11 06 –13 03 00 08 07 –05 –02 –11 05 56
1.34 1.59 0.97 1.47 0.50 0.01 1.22 0.93 –0.65 –0.35 –1.49 0.57 6.40*** =7.35*** 0.34
**P < 0.01. ***P < 0.001.
the future. Results from studies using the same questionnaire but with a larger sample tell essentially the same story.20 In this study those therapies that participants said they thought they ‘know how it worked’ included acupuncture (83.7%) aromatherapy (75.2%), herbal medicine (74.3%), homoeopathy (85.9%), hypnosis (70.9%), massage (84%), meditation (72.8%), relaxation (78.0%), counselling (70.6%) and yoga (73%). This is not surprising given the number of books and popular media reports on them. A number of therapies were little understood – the following are percentages of people who believed ‘they worked’: autogenic training (3.9%), ayurveda (7.6%), biochemic tissue salts (8.9%), chelation (6.9%), magnetic therapy
(15.1%), naturopathy (10.3%), ozone therapy (4.0%), reiki (10.1%) and voice/sound therapy (13.9%). Again this is reflected in the number of books and articles on these particular therapies. However, these results differ from country to country where various therapies have been widely known and well practiced. Furnham20 found the percentage of people who had tried the various therapies was much lower Nearly 50% had tried aromatherapy, 36% herbal medicine, 61% massage and 50% relaxation. Less than 10% had ever tried: acupuncture, acupressure, the Alexander technique, art therapy, autogenic training, ayurveda, biochemic tissue salts, biorythms, chelation, colonic irrigation, colour therapy, cystal/’gem therapy’, dance/movement therapy,
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magnetic therapy, naturopathy, nutritional therapy, ozone therapy, reiki, shiatsu, therapeutic touch and visualization. Again the results from Furnham20 with a population nearly four times the size of this study yielded similar results to those of this study. Rated on the 10 point efficacy scale the top five were massage (7.04), relaxation (6.42), counselling (6.31), acupuncture (6.30) and yoga (6.17). Those rated as least effective were autogenic training (2.87), ozone therapy (2.82), chelation (3.18), ayurveda (3.20) and reiki (3.26). Clearly there is a close relationship between knowledge of a technique and belief in its efficacy. Although factor analysis of various ratings produced interpretable structures it was found that when the internal reliabilities were calculated they tended to be high. What this indicated was that participants tended not to differentiate closely between different methods. Participants tended to give similar ratings to all therapies, that is, the they tended either to be believers or non-believers, sceptics or enthusiasts. However, the factor analysis of the 12 attitudes to medicine revealed four clear independent factors. it showed the participants were wary of orthodox medicine and concerned by its potential sideeffects. It also showed that they believed psychological factors to be very important in determining scientific evaluation of practice or what one may call evidence-based medicine. Perhaps the most interesting and important part of the analysis was the regressional analysis shown in Tables 5 and 6 which tested the central hypotheses in this study. They showed that interest in both future-ologies and CM therapies was best predicted from each other. There were no significant demographic predictors. That is, despite the observation that women are more interested in, and more likely to be users of CM than men, none of the variables examined was significant in the eight regressions performed. Nor were four beliefs about medicine significant predictors with one exception. This maybe due to the size and representativeness of the sample in this study or may simply indicate that there are few demographic correlates of these ratings. It is however surprising that attitudes to science and orthodox medicine had no statistical impact. In the earlier study of this topic Furnham19 found that attitudes to science and medical treatment were powerful statistical predictors of the perceived efficacy of future-ologies. The results from the regressions did, however, indicate that the best predictors of attitudes to and knowledge of, ways of predicting the future were attitudes to, and knowledge of, CM and vice versa. Even more specifically the best predictor of the extent to which participants had ‘heard of’ the 24 ways of predicting the future was the extent to which they had ‘heard of’ the 39 CM therapies. The same was true for ratings of efficacy which accounted for most of the variance. This indicated
quite clearly that the higher one rated the efficacy of the futurologies, the higher one rated the efficacy of CM. These results may be interpreted as confirming beliefs that interest in the occult is related to interest in CM therapies. These results do indicate that taking an active interest in, and trying, scientifically dubious ways of telling the future is indeed related to taking an active interest in and trying CM. But it would be incorrect to suggest that the results indicate that participants were unable to distinguish between the two. It was obvious from an analysis of the sample means as well as the factor analytic results that participants made clear and logical distinctions both within and between ways of predicting the future and the CM therapies. It was clear that participants were deeply sceptical about the efficacy of the ways of predicting the future and furthermore equally sceptical about many of the CM therapies. Nevertheless, it was the case that the one score did predict the other. This suggests that sympathy for, and scepticism of, non-scientifically orthodox procedures may co-occur. One implication is that expressed interest in any set of alternative and complementary treatment is fairly predictive of interest in others. What these results seem to suggest is that Gray’s four academic philosophical perspectives on CM may apply equally to lay people.18 That is, those who support the biomedical perspective, would be strongly against both unproven and often bogus ways of telling the future and CM. Equally it may well be that those who are sympathetic to CM maybe more willing to explore some of the older, better known, ways of predicting the future. Reliance on the clinical experience of practitioners rather than scientific data is indeed the evidence of efficacy claimed by both some CM and futureology practitioners. However the pathways by which people come to CM therapies may be the best predictors of their world view.2 Some are attracted by the theory and philosophy of different therapies and may get involved and interested out of sheer curiosity. Hence they read widely and may even try treatments out of little more than curiosity. On the other hand there are those who come out of desperation having been disappointed by orthodox medicine. Those who ‘lose their faith’ in orthodox medicine and are suffering from a chronic illness may embrace alternative therapies and world views quite differently than those who are simply ‘shopping for health’ or are interested in life-style issues. Future research would benefit from longitudinal research on a representative sample whose medical history was known. This would overcome the limitations of this research and help understand causality in the development of beliefs about CM and related issues. Thus it could be that a chronic illness which seems unresponsive to orthodox medicines leads a desperate patient to seek out a CM treatment
Does experience of the ‘occult’ predict use of complementary medicine?
and in doing so his/her attitudes and beliefs become changed about health. It may for instance make them less cynical even sceptical about CM and thus open to more interest of and experience with other forms of CM and about science in general. ACKNOWLEDGEMENT This research was supported by a grant from the Homoeopathic Trust, based in London.
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Abbot N, White A, Ernst E. Complementary Medicine. Nature 1996; 381: 361. Vincent C, Furnham A. Complementary medicine: state of the evidence. Jr Soc Med 1999; 92: 170–177. Eisenberg D, Davies R, Ettner S, Appel S, Wilkey S, Van Rompay M, Kessler R. Trends in alternative medicine use in the United States, 1990–1997. Results of a followup national survey. JAMA 1998; 280: 1569–1595. Gray R, Fitch M, Greenberg M, et al. Physician perspectives on unconventional cancer therapies. J Pallia Care 1997; 13: 14–26. Knipschild P, Kleijnen J, T Riet G. Belief in the efficacy of alternative medicine among general practitioners in the Netherlands. Soc Sci Med 1990; 31: 625–626. Reilly D. Young doctors’ views on alternative medicine. British Medical Journal 1983; 287: 337–339. Sikand A, Laken M. Pediatricians’ experience with and attitudes toward complementary/alternative medicine. Arch Pediatr Adolesc Med 1998; 152: 1059–1064. Furnham A, Hanna D, Vincent C. Medical students’ attitudes to complementary medical therapies. Complementary Therapies in Medicine 1995; 3: 212–219.
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9. Furnham A, Yardley L, Fahmy S, Jamie A. Health beliefs and preferences for medical treatment: a comparison between medical student and social science students. Complementary Therapies in Medicine 1999; 7: 101–109. 10. Halliday J, Taylor M, Jenkins A, Reilly D. Medical students and complementary medicine. Complementary Therapies in Medicine 1993; 1: 32–33. 11. Boon H. Canadian Naturopathic practitioners: holistic and scientific world views. Soc Sci Med 1998; 46: 1213–1225. 12. Ernst E, Resch K-L, White A. Complementary medicine: what physicians think of it: a meta analysis. Archives of Internal Medicine 1995; 155: 2405–2408. 13. Furnham A, Vincent C. Reasons for using complementary and alternative therapy. In: M Kelner, B Wellman eds. The challenge of CM. London: Harwood Academic Publisher, 2000. 14. Skrabenek P. Paranormal health claims. Experimential 1988; 44: 303–309. 15. Stalker D, Glymore C, eds. Examining holistic medicine. New York: Prometheus Books, 1989. 16. Furnham A. Flight from science: alternative medicine, postmodernism and relativism. In: R Fuller, P Walsh, P McGinley eds. A century of psychology. London: Routledge, 1997: pp171–191. 17. Astin J. Why patients use alternative medicine: results of a national study JAMA 1998; 279:1548–1553. 18. Gray R. Four perspectives on unconventional therapy. Health 1998; 2: 55–74. 19. Furnham A. The perceived of various future-ologies and complementary medicine. J Altern Complement Med 2000; in press. 20. Furnham A. How the public classify complementary medicine: a factor analytic study. Complementary Therapies in Medicine 2000; 8: 82–87. 21. Watson D. A dictionary of mind and body. London: Andre Deutsch, 1995.
Does experience of the ‘occult’ predict use of complementary medicine? Experience of, and beliefs about, both complementary medicine and ways of telling the future A. Furnham Department of Psychology, University College, London, UK
SUMMARY This study looked at the relationship between ratings of the perceived effectiveness of 24 methods for telling the future, 39 complementary therapies (CM) and 12 specific attitude statements about science and medicine.A total of 159 participants took part.The results showed that the participants were deeply sceptical of the effectiveness of the methods for telling the future which factored into meaningful and interpretable factors. Participants were much more positive about particular, but not all, specialties of complementary medicine (CM).These also factored into a meaningful factor structure. Finally, the 12 attitude to science/medicine statements revealed four factors: scepticism of medicine; the importance of psychological factors; patient protection; and the importance of scientific evaluation. Regressional analysis showed that belief in the total effectiveness of different ways of predicting the future was best predicted by beliefs in the effectiveness of the CM therapies.Although interest in the occult was associated with interest in CM, participants were able to distinguish between the two, and displayed scepticism about the effectiveness of methods of predicting the future and some CM therapies. © 2000 Harcourt Publishers Ltd
INTRODUCTION
Professor Adrian Furnham Department of Psychology, University College London, 26 Bedford Way, London WCI, UK. E-mail: [email protected]
There seems little doubt that there is a considerable rise in public and research interest in complementary medicine (CM).1,2 One index of this is the theme issue of the Journal of the American Medical Association (JAMA)3 which included results of a follow-up study looking at trends in America. Extrapolating to the population as a whole, they found a 47.3% increase in total visits to CM practitioners from 427 million in 1990 to 629 million in 1997 exceeding visits to primary care physicians. A number of studies have focused on doctors’ (general practitioners and specialists) perceptions
Complementary Therapies in Medicine (2000), 8, 266–275
© 2000 Harcourt Publishers Ltd
of CM,4–7 as well as the beliefs of medical students8–10 and CM practitioners themselves.11 These studies did not compare the results from the different groups and were nearly all descriptive but they did show that both orthodox medical students and trained practitioners were positive and openminded about CM. Naturally, CM practitioners held positive attitudes about their own and other CM specialties. Ernst, Resch and White12 reviewed 12 other surveys done in six different countries and report remarkable similarity between them. However, they did not find a trend to suggest that complementary medicine is increasingly perceived as useful or effective. 266
Does experience of the ‘occult’ predict use of complementary medicine?
Furnham and Vincent13 have argued that there are two fundamental research questions with regard to CM: does it work? Why do people choose it? The first requires careful, expensive, double-blind, placebo-controlled, randomized studies to demonstrate efficacy. In some cases this has been achieved. The latter, in a sense, requires little investigation if the answer to the former, is unequivocably positive but this is clearly not the case. Hence the second revolves around why patients pay for, and apparently enjoy and benefit from those treatments whose effectiveness is not proven or indeed proven to be ineffective save for possible placebo effects. It is possible that attitudes to science are part predictors of why people deliberately choose or avoid CM. This study goes some way to exploring this issue. Attacks on CM come from many quarters. Skrabenek14 claimed that it is often difficult to evaluate any complementary practitioner’s health claims because they lack a clear diagnosis. He attacked homoeopathy for treating not the disease but the problem; his complaint against osteopathy was poor reliability and diagnosis; while his attack on acupuncturists was based on the idea that its success is due entirely to the placebo effect. Stalker and Glymore15 were particularly critical of the ‘holistic’ theories which they claim contain a ‘reactionary impetus to turn the practice of medicine to the practice of magic and to replace logic and method with occultism and obfuscation’ (p.23). They do view the implicit belief that all states of health are psychosomatic as simply wrong, but even if it were so, it would simply call for the scientific method to investigate the claim. One theme of those that attack from the biomedical perspective is that a belief in CM is a flight from, or rejection of, science16. However, the notion that belief in CM represents a rejection of science was not supported by a study by Astin.17 At the academic level this is usually at the heart of a debate between empiricists and realists or between those who support a biomedical versus post-modern perspective. Gray18 has, in fact, pin-pointed four quite different approaches to CM two of which are the biomedical approach which is deeply critical of CM and postmodernists who tacitly support it. The Biomedicine Perspective is concerned with the curing of disease and control of symptoms where the physician–scientist is a technician applying high level skills to physiological problems. This approach is antagonistic toward and sceptical of CM, believing many claims to be fraudulent and many practitioners unscrupulous. Physicians and medical scientists within this camp often believe CM patients are often naïve, anxious and neurotic. However, the competitive health care market place has seen a shift even in the attitudes of ‘hardliners’ to be more interested in, and sympathetic to unconventional therapies. The Postmodern Perspective approach enjoys challenging those with absolute faith in science, reason
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and technology and deconstructing traditional ideas of progress. Followers are distrustful of, and cynical toward science, medicine, the legal system, and institutionalized religion and even democracy. Many believe orthodox practitioners to be totalitarian persecutors of unconventional medicine. However, because many CM practitioners can be theoretically convinced of their position and uncompromising, they can also be subject to postmodern scepticism. The assumption underlying these debates is that a rejection of, empiricism – positivism affects all aspects of one’s perception of the world. This idea, fits in with the scathing criticism of some from the biomedical perspective who see people who advocate, believe in, or use (non-proven) CM therapies as rejecting science and no doubt believers in other equally bogus and non proven ‘belief systems’ like astrology etc. Indeed this study sets out to test the assumption that the rejection of science relates to interest in CM and other non-proven belief systems. Furnham19 investigated part of this claim by looking at people’s perception of various future-ologies concerned with either personality assessment and/or predicting the future and various CM therapies. He found participants were able to clearly differentiate between the two and that whereas the CM therapies (particularly osteopathy) were rated as moderately effective in doing what they claimed to do, most future-ologies (particularly tasseography) were rated as ineffective. He also found belief in the efficacy of CM was best predicted by gender (female), increased familiarity with a range of CM therapies and less familiarity with future-ology practices. This study replicates the above study by looking at the association of beliefs in very different non-medical and CM systems. It extends the previous study by increasing the number of both types of systems examined with 24 ‘predictive systems’ (astrology, tarot cards) looking at both the less and more well known. It also increases the number of CM therapies considered to a fairly comprehensive list of 39 in total from the very familiar to the less familiar. One aim of the study was to investigate the perceived underlying structure of both lists of systems. Second, it also examines attitudes to (modern) medicine using the questionnaire developed by Vincent and Furnham2 which showed logical relationships between attitudes to modern medicine and the perceived efficacy of CM therapies. Third, it looks at the best predictors of belief in the two types of system. It was predicted that interest and belief in the efficacy of various CM therapies would be systematically related to beliefs about science, attitudes to ways of predicting the future and to demographic differences. Specifically that the more participants had heard of, and believed in future-ologies, the more sceptical they were about medical science and the less well educated they were, the more they would be interested in, and believe in the efficacy of CM.
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METHOD
RESULTS
Participants
There was a 98% response rate with nearly all questionnaires correctly completed.
There were 69 males and 90 females: 35.1% were students; 34.2% in professional jobs and 30% in skilled employment. Their income ranged from under £10 000 to over £65 000 p.a. Their mean age was 26.25 years (SD = 9.04 years) with ages ranging from 17 to 81 years. In all, 27% were single while the remainder were married or divorced. Asked about mothers’ occupation 23% put housewives, while 71.2% had working mothers. In all, 86% of the respondents had working fathers nearly all in middle class professions. In total, 51% reported themselves in excellent health while 47.7% said they were in good health. Most 91.9%, had English as a first language. Half of the group (80) were recruited by a market research agency while half were found among a university department subject panel. The former were contacted from an extensive mailing list, the latter by advertisements and personal contacts. Overall, there was a 98% response rate. Participants were debriefed where possible.
Questionnaire This was divided into three parts: 1. Ways of predicting the future. This questionnaire described 24 different methods to predict the future (Table 1). Each had a short, one-sentence description. They were taken from various books on the topic.21 Participants made four ratings on each: had they heard of it (yes/no) (overall alpha 0.88); do they think they know how it works (yes/no) (overall alpha .90); have they tried this particular technique (yes/no) (overall alpha 0.91) and do they believe it is effective at curing and alleviating symptoms (doing what it says it does) (1–10) (overall alpha 0.95). 2. Complementary medicine. The Research Council for Complementary Medicine (RCCM) in London provided a list, in alphabetical order, of therapies relatively widely known and practiced in the UK (Table 2). The list is fairly comprehensive though a case could be made for the inclusion of various other therapies. Each therapy was listed alphabetically and required the same four ratings as above. Again alphas were all above 0.85. 3. Attitudes to medicine. This was a 12-item questionnaire2 that required responses on a 7point agree-disagree scale (Table 2). Of the 12 items, four expressed a positive attitude to ‘scientific medicine’; four the importance of psychological factors in medicine; and four expressed opinions around the possible harmful effects of modern medicine.
Beliefs about predicting the future Table 1 shows the mean results for the ratings of the 24 personality assessment methods. Most of the participants had heard about astrology (96%), palmistry (93%), tarot (93%), clairvoyance (90%), graphology (88%), oriental astrology (85%), dowsing (78%) and necromancy (78%). On the other hand, very few had heard of aeromancy (4%), geomancy (11%), hydromancy (11%) and molescopy (13%). With regard to the numbers of participants who thought they knew how the techniques worked, the highest figures were for astrology (42%), dowsing (46%), graphology (54%) and palmistry (39%). Large numbers had no idea how the technique supposedly worked: scrying (70%), pyromancy (68%), augury (67%), cartomancy (65%), molescopy (65%), metoposcopy (65%) and numerology (65%). Also, participants had tried very few of these: astrology (62%), palmistry (49%) and Tarot (41%). Less than 10% had tried aeromancy, augury, geomancy, hydromancy, molescopy, metoposcopy, phrenology, physiognomy, pyromancy and scrying. Those techniques rated as most effective were graphology (4.40) and dowsing (4.01) while those rated least effective were augury (1.53), aeromancy (1.56) and hydromancy (1.61). Not one of the techniques got a score of even 5.00 on the 10-point scale indicating that the participants seemed extremely sceptical about all of them. The next task was to attempt to determine how these 24 techniques ‘clustered’ based on the responses of the participants. To explore this question two factor analyses were done, first on the ‘heard of it’ ratings (yes/no) and then on ratings of the perceived efficacy of the technique (1–10). Five factors emerged which, in total, accounted for nearly half the variance. In the first factor analysis the first factor contained four systems which where each quite well known and well documented with a long history (tarot, clairvoyance, palmistry, astrology). The second factor contained six methods which use analysis of dreams, crystal balls, casting lots, playing cards, fire and handwriting to tell the future. The third factor contained six lesser-known methods of predicting the future based on an analysis of such things as water, wind, sand as well as moles on the body, lines in the forehead and facial features. The penultimate factor contained two oriental systems (I Ching and oriental astrology) and the final factor a mix of well known (dowsing) and unknown (augury) methods. The meaningfulness of the second, fourth and fifth factors is far from clear.
Does experience of the ‘occult’ predict use of complementary medicine? Table 1
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Simple results for the first part of the questionnaire on future
Technique 1. Aeromancy: the prediction of the future by the study of wind conditions 2. Astrology: explores the effects of the sun, moon and eight of the planets upon the future and individual personality 3. Oriental Astrology: the belief that we obtain various animal characteristics according to the year in which we were born 4. Augury: divination by Roman Augurs who consulted omens to ascertain the wishes of the Gods on proposed plans of action 5. Biorhythms: belief that we can plot the rise and fall of three inter-related cycles—physical, emotional and intellectual to predict peak days and critical days 6. Cartomancy: prediction of the future using modern playing cards 7. Clairvoyance: ‘means clear seeing’. Divination by seeing the future ahead of time 8. Dowsing: a technique used for finding water in arid areas. Also used to locate mineral deposits and even dead bodies 9. Graphology: used to make an assessment of personality from individuals handwriting 10. Geomancy: prediction of the future by interpretation of patterns in sand or soil 11. Hydromancy: the prediction of the future by the study of water 12. I Ching: series of Chinese symbols used as a means of prediction as well as offering wisdom on how to cope with your future 13. Moleoscopy: prediction of future and assessment of personality from moles on the body 14. Metoposcopy: the assessment of individual’s character by the reading of lines on the forehead 15. Necromancy: the questioning of the dead about events in the future. Commonly achieved by using a Ouija board 16. Numerology: interpretation of numbers to obtain an individual character analysis and potential in the future 17. Oneiromancy: the prediction of future events by analysis of dreams 18. Palmistry: personality assessment and prediction of the future by the reading of lines on the hand 19. Phrenology: the evaluation of an individual’s character by examination of the shape of the skull 20. Physiognomy: character analysis from the physical appearance of facial features 21. Pyromancy: the foretelling of the future by reading images in fire 22. Scrying: predicting future events by gazing into a reflecting surface or through the use of crystal balls 23. Sortilege: prediction of the future by casting or drawing of lots i.e. tossing a coin to make a decision of drawing straws to select a person 24. Tarot: the reading of cards bearing occult symbols to predict events in the future
Heard of ** Yes No
Works Yes No
Tried Yes No
Effective X SD
R*
7
150
8
97
2
110
1.56
(1.10)
97
155
2
68
82
100
53
3.38
(2.42)
144
136
23
38
100
59
84
2.64
(2.00)
132
46
111
10
108
4
121
1.53
(1.12)
105
102
56
49
83
23
119
3.45
(2.34)
119
84
73
24
105
21
115
1.96
(1.94)
117
145
14
55
87
28
122
3.16
(2.55)
122
125
33
75
70
24
123
4.01
(2.75)
123
142
17
87
58
50
102
4.40
(2.39)
135
25
133
10
102
4
112
1.90
(1.56)
100
19
137
8
102
2
116
1.61
(1.25)
100
68
90
32
94
18
122
2.62
(2.32)
110
22
136
8
105
7
118
1.71
(1.52)
103
132
25
9
105
5
121
2.00
(1.61)
104
125
32
50
85
40
102
2.91
(2.44)
118
83
74
23
105
27
107
2.20
(1.95)
115
117
40
55
76
48
91
2.50
(2.43)
121
150
7
63
85
79
75
3.05
(2.49)
136
101
54
29
100
8
131
2.17
(1.83)
109
61
92
28
94
11
122
2.37
(2.08)
111
49
105
12
109
4
127
1.50
(1.20)
108
110
43
20
112
6
133
1.60
(1.30)
108
85
68
43
83
48
86
2.51
(2.45)
115
149
7
59
90
66
88
2.99
(2.47)
129
*Response rate to this question: people never completed the row if they did not answer yes to the first question. **Frequently the total does not add up to 159 because of missing data.
Because the above factor analysis was based on a two point (yes/no) rating scale it was thought to be sensible to redo the factor analysis on the 10 point efficacy rating which should yield a more robust factor structure. The results of this analysis indicate one very large factor that accounted for nearly half of the variance. Eight methods loaded on it as varied as biorhythms and tarot. Compared with most of other methods these seemed fairly well known and among the most effective. It should be borne in mind that still the overall mean was less than 3.00 on a 10 scale (where 10 is very effective). Three other factors emerged. The second factor also contained a number of relatively well known methods like clairvoyance, palmistry and numerology. The third factor had six methods loading on it which were all rated as essentially ineffective. The same
was true of the fourth factor which accounted for just over 5% of the variance (details of both factor analyses available from the author).
Beliefs about CM Table 3 shows the raw data of the ratings of the 39 CM therapies. The most well known therapies were acupuncture, hypnosis, herbal medicine, homoeopathy and traditional Chinese medicine, where around 90% or more of the sample had heard of them. The five least well known were autogenic training, biochemical tissue salts, chelation and cell therapy, ozone therapy and ayurveda. When asked if they thought they knew how the therapy works over 100 of the sample (nearly 75%) said they thought they knew how magnetic therapy,
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Table 2 Therapy
Results from the four ratings of the 39 therapies Heard of Yes/No
1. Acupuncture 155/3 2. Acupressure 112/45 3. Alexander technique 90/86 4. Aromatherapy 153/4 5. Art therapy 94/64 6. Autogenic Training 12/144 7. Ayurveda 40/117 8. Bach flower remedies 73/83 9. Biochemic tissue salts 19/138 10. Biorhythms 97/60 11. Chiropractic 137/19 12. Chelation and cell therapy 23/132 13. Colonic irrigation 128/29 14. Colour therapy 82/73 15. Crystal and gem therapy 82/74 16. Dance movement therapy 90/68 17. Healing 130/24 18. Herbal medicine 151/6 19. Homeopathy 144/13 20. Hypnosis 152/13 21. Magnetic therapy 64/93 22. Massage 149/9 23. Meditation 154/4 24. Music therapy 118/39 25. Naturopathy 53/105 26. Nutritional therapy 97/60 27. Osteopathy 128/28 28. Ozone therapy 23/133 29. Reiki 45/113 30. Reflexology 141/17 31. Relaxation 146/11 32. Shiatsu 106/51 33. Spiritual healing 133/23 34. Talk therapies and counselling 142/15 35. Traditional Chinese medicine 144/13 36. Therapeutic touch 72/84 37. Visualization 68/89 38. Voice and sound therapy 57/100 39. Yoga 151/7
Works Yes/No
130/19 87/46 61/66 116/33 64/65 10/95 27/82 48/74 12/90 44/81 91/48 14/93 81/53 46/72 62/61 58/76 114/36 105/45 99/48 28/94 136/14 136/14 127/22 83/49 28/91 75/52 83/52 13/92 21/86 85/55 125/20 61/59 57/75 116/29 75/64 27/86 41/72 23/88 116/32
massage, acupuncture, relaxation, aromatherapy, talk therapies (counselling) yoga, healing and herbal medicine worked. Less than 20 participants said they knew how autogenic training, biochemical tissue salts, chelation cell therapy and ozone therapy worked. The figures for the column concerning whether participants had actually tried any of the therapies showed a dramatic difference from previous columns. Forty per cent or more of the participants had tried aromatherapy, massage and relaxation and less than 20% had tried 26 of the 39 different therapies. However, probably the most interesting column were ratings of efficacy. Six treatments got ratings of > 6.00 on a 10 point scale. They were in descending order: massage, talk therapies, relaxation, music therapy, acupuncture and yoga. On the other hand seven therapies received ratings of < 3.00 indicating participants thought they were particularly ineffective. These were autogenic training, ozone therapy, crystal and gem therapy, cell therapy, colour therapy, biochemical tissue salts, and reiki.
Tried Yes/No
23/132 22/117 17/121 76/76 19/115 3/115 12/107 35/96 6/110 14/121 34/115 1/119 8/134 18/110 12/119 19/115 25/118 64/89 61/92 27/125 7/126 105/47 70/83 33/110 9/117 29/104 33/105 3/114 9/112 35/111 91/54 24/106 16/125 69/81 29/121 7/116 22/103 9/115 63/91
Effective (1 = not effective, 10 = very effective) Mean SD 6.11 4.96 4.93 5.08 4.55 2.14 3.13 3.81 2.56 3.10 5.26 2.45 3.86 2.53 2.44 4.20 4.15 5.52 5.02 5.21 3.37 6.79 6.18 5.38 3.27 5.31 5.48 2.37 2.74 4.63 6.20 4.87 3.89 6.22 5.07 3.49 3.76 3.33 6.08
(2.28) (2.57) (3.04) (2.73) (2.62) (1.99) (2.57) (2.86) (2.25) (2.32) (2.60) (2.05) (2.55) (2.53) (2.09) (2.65) (2.85) (2.56) (2.68) (2.46) (2.76) (2.34) (2.45) (2.57) (2.62) (2.88) (2.79) (2.36) (2.34) (2.80) (2.81) (2.99) (2.90) (2.62) (2.61) (2.71) (2.84) (2.56) (2.43)
No. of responses 132 110 94 132 99 63 70 94 64 99 118 64 111 89 81 92 104 132 129 121 78 137 136 107 75 99 113 63 72 116 132 91 105 133 118 83 80 69 133
As before, a factor analysis was done on the effectiveness ratings, which revealed four factors which in total accounted for nearly 60% of the variance. The first main factor clustered together 17 different therapies and what they had in common was that all were rated as fairly ineffective by the participants. The second factor had eight treatments loading on it relating to art, dance, music, talk therapies and relaxation. These may involve a creative element and allow the expression of emotional issues. The third factor had seven of the most familiar and established CM therapies loading on it. The final factor contained six therapies half of which were in some sense herbal/chemical and others about healing but no obvious interpretation of why these therapies loaded on the same factor. This analysis showed that it was the therapies loading on the second and third factor that were rated as modestly effective while those (nearly half) loading on the first factor were rated as generally ineffective.
Does experience of the ‘occult’ predict use of complementary medicine? Table 3
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Factor analysis (VARIMAX rotated) of efficacy (1 = not effective, 10 = very effective)
6 Autogenic training 7 Ayurveda 25 Naturopathy 28 Ozone therapy 9 Biochemical tissue salts 12 Chelation and cell therapy 29 Reiki 10 Biorhythms 36 Therapeutic touch 21 Magnetic therapy 37 Visualization 38 Voice and sound therapy 8 Bach flower remedies 3 Alexander technique 14 Colour therapy 13 Colonic irrigation 26 Nutritional therapy 34 Talk therapies (counselling) 24 Music therapy 16 Dance therapy 23 Meditation 31 Relaxation 32 Shiatsu 22 Massage 5 Art therapy 11 Chiropractic 27 Osteopath 1 Acupuncture 4 Aromatherapy 30 Reflexology 39 Yoga 2 Acupressure 17 Healing 18 Herbal medicine 33 Spiritual healing 19 Homoeopathic 35 Traditional Chinese medicine 20 Hypnosis
0.81 0.80 0.76 0.75 0.75 0.74 0.72 0.69 0.66 0.64 0.64 0.60 0.60 0.58 0.55 0.51 0.40
α .89 Eigenvalue 16.36 Variance 42.0% Mean 3.44
α .81 Eigenvalue 3.06 Variance 7.9% Mean 5.54
0.73 0.65 0.63 0.61 0.61 0.58 0.57 0.51
Attitudes to medicine In the third part of the questionnaire participants were required to rate 12 attitude statements about medicine. Results are shown in Table 4. Of the 12 statements participants seem to agree fairly strongly with three (> 5.50 on a 7.00 scale). All in fact loaded on the second factor and indicated the importance of psychological factors (state-ofmind) in health. Participants strongly disagreed with one statement (4) which loaded with one other statement (12) on the final factor, which questioned the exclusive value of ‘scientific medicine’. Participants tended to show slight agreement with four statements that loaded on the first factor. They were all concerned with the potentially negative side-effects of orthodox medicine. Participants also slightly agreed with the two items that loaded on the third factor both of which concerned the scientific evaluation of treatments. The alpha coefficients indicate clearly the coherence of these four factors which were all interpretable and similar to the factor analysis of Vincent and Furnham20.
Predictors of attitudes A central concern in the study was the relationship between attitudes to, and experience of, both
0.78 0.66 0.64 0.55 0.55 0.53 0.52
α .80 Eigenvalue 1.76 Variance 4.5% Mean 5.37 0.77 0.69 0.61 0.54 0.39 0.36
α .70 Eigenvalue 1.69 Variance 4.3% Mean 4.81
predicting the future and CM. Despite the interpretability of the factor analyses for reasons of parsimony it was decided to examine the internal coherence (alpha) of the four ratings (heard of it; know how it works; tried it; perceived efficacy). The measures are internally coherent with the lowest alpha being 0.79 and the highest 0.96. This suggests that when looking at for instance CM therapies, people tend either to know about, to try and to rate efficacious many or a few rather than be particularly differentiating. Given the size of these alpha coefficients it seems quite reasonable to combine each into a single score. Following this, a series of regressions were computed. They addressed the central question of what were the best predictors of attitudes to, and beliefs about, future-ologies and CM. In each of the regressional analyses it was decided to investigate which of a set of factors best predicted the four outcome measures. First five demographic factors were examined which had previously been shown to be related to experience of CM. Then the four clear attitudes to medical science factors were considered as predictor variables. Thirdly the four ‘ways of predicting the future’ variables were regressed on to each of the four CM variables and vice versa. Table 5 shows the results of the four regressions onto the four scores derived from the ‘ways of
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Table 4 Means, standard deviations and factor analytic results for the 12 attitudes to medicine statements Statements
Mean
SD
Loading
1. Patients are sometimes operated on when they do not need it 2. Psychological treatment (e.g. relaxation, counselling) should not be used more widely 3. The side-effects of modern drugs are often severe and sometimes dangerous. 4. Treatments which are not based on modern scientific discoveries are worthless 5. Being fit and well depends as much on your state of mind as on the functioning of your body 6. People sometimes feel worse rather than better after orthodox medical treatments 7. Every treatment should be thoroughly tested by doctors and scientists before people are allowed to try it 8. Many forms of medical treatment do more harm than good 9. Complementary (alternative) therapies should be scientifically evaluated 10. The ‘will to live’ can be a significant factor in whether people recover from a serious illness or injury 11. State of mind is a crucial part of achieving better health; positive thinking can enhance physical health 12. Medicine is a science and should be based on rigorous scientific principles
5.31 5.59
(1.80) (1.40)
0.70
5.65
(1.36)
0.71
2.28
(1.46)
5.92
(1.27)
5.36
(1.45)
5.09
(1.68)
4.15 5.04
(1.75) (1.57)
6.21
(0.99)
0.76
6.24
(0.98)
0.87
4.52
(1.68)
Eigenvalue Variance α
0.56
0.82 0.70 0.78 0.85 0.78 0.78
0.65 2.87 1.82 1.64 23.9% 15.2% 13.7% 0.72 0.72 0.63
1.12 9.4% 0.91
7 = strongly agree; 1 = strongly disagree.
predicting the future’. The pattern is very clear. Whilst each regression was significant and could account for between 16 and 35% of the variance it was only the four CM factors that were significant predictors. Thus, the more that people claimed to have heard of each of the future-ology methods, the more they had heard of CM therapies. Claimed knowledge of how future-ology methods worked was best predicted by whether the participant had tried CM therapy and their ratings of their efficacy. The best predictor of whether participants had tried any future-ology methods was both the extent to which they had heard of, and believed they knew how CM therapies worked. Finally, the simple and most powerful predictor in the efficacy of the combined future-ologies was the extent to which participants rated the combined efficacy of the CM therapy. The final analyses looked at the four CM factors and identical regressional analyses were run but with the four future-ology factors as independent variables. There were two significant predictors of the extent to which participants had heard of complementary therapies—they were the extent to which they had heard of the various futurologies specified and believed they knew how they worked. The only predictor of the extent to which participants claimed they knew how the many different CM therapies worked was whether they had ever tried using the futurologies. There were two predictors of the variable which looked at how many of the CM therapies people had tried—it was the extent to which they believed psychological factors influenced health and the number of futurologies they tried. Finally, the only variable, accounting for
nearly a third of the variance, that predicted participants ratings of the overall efficacy of the various methods of CM was the efficacy of methods aimed at predicting the future.
DISCUSSION With few exceptions (astrology, palmistry, clairvoyance, graphology), the participants were relatively ignorant of most methods of predicting the future listed in this study. They also claimed by-and-large not to know how they worked, had never tried them nor indeed thought them effective. Clearly these four issues are related: if one believes a treatment or method of prognostication is successful one is tempted to try it, read up about it and try to understand how it works. The precise causal pathway is not clear however. Certainly in all instances more people had heard about than tried, any of these methods of telling the future. The most frequently tried (astrology and palmistry) could be done by many methods (reading newspapers, popular books) without consulting practitioners or taking the process very seriously. The pattern was very different for the CM therapies. Many more were heard of than in the case of the future-ologies although often very small numbers claimed they had tried the various technique. Ratings of efficacy of the 39 CM therapies were from ineffective to comparatively effective with 6 (15%) getting a score of > 6.00 on a 10 point scale. Clearly the participants were more aware of, and sympathetic to, CM therapies than ways of telling
Does experience of the ‘occult’ predict use of complementary medicine?
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Table 5 Regressional Analysis examining the best predictors of experience of, and attitude to, ways of predicting the future
Independent variable Sex Smoker Religious Vegetarianism Health Scepticism Psychology Protection Research HCM WCM TCM ECM
Heard of β –09 –00 00 00 08 11 –01 –03 –05 0.47 00 00 07
F(13,145) R square
Tried β
t –1.21 –0.11 0.00 0.08 1.08 1.49 –0.22 –0.46 –0.68 5.56*** –0.08 0.05 0.95
02 08 –02 02 08 06 01 –04 –08 08 13 25 19
Works how β t
t 0.31 1.07 –0.25 0.26 1.11 0.80 0.15 –0.55 –1.19 1.00 1.43 2.95** 2.51**
=4.52*** 25
–00 12 –04 –04 –03 –07 04 –09 –01 0.32 0.20 –05 07
–0.09 1.52 –0.53 –0.62 –0.44 –0.87 0.43 –1.11 –0.13 3.61*** 2.09* –0.61 0.84
5.45*** 0.27
Efficacy β –10 –02 00 10 03 02 07 –12 –05 12 10 00 50
t –1.58 –0.39 0.00 1.47 0.49 0.30 1.07 –1.79 0.78 1.59 1.31 –0.09 6.70***
3.32*** 0.16
5.45*** 0.27
**P<0.01. ***P<0.001.
Table 6
Regressional analyses examining the best predictors of experiences of, and attitudes to CM
Independent variable
Heard of β
Sex Smoker Religious Vegetarianism Health Scepticism Psychology Protection Research HPF WPF TPF EPF
–09 –00 10 05 02 11 06 –05 –02 38 24 04 –04
F(13 145) R square
0.30
t 1.37 0.00 1.40 0.77 0.28 1.51 0.77 –0.72 –0.23 5.13*** 3.02** 0.48 –0.46
Tried β 10 –04 09 –04 00 00 0.15 –08 –07 05 15 19 12
=6.35***
t 0.21 –0.80 –0.02 0.44 –0.54 0.00 1.78 –1.04 0.07 1.10 –0.05 4.02*** –0.09 =4.28** 0.21
Works how β t 02 –06 00 03 –04 00 14 –08 00 09 00 40 –00
0.21 –0.80 –0.02 0.44 –0.54 0.0 1.78 –1.04 –0.07 1.10 –0.05 4.02*** –0.09 =3.50*** 0.17
Efficacy β t 09 11 06 –13 03 00 08 07 –05 –02 –11 05 56
1.34 1.59 0.97 1.47 0.50 0.01 1.22 0.93 –0.65 –0.35 –1.49 0.57 6.40*** =7.35*** 0.34
**P < 0.01. ***P < 0.001.
the future. Results from studies using the same questionnaire but with a larger sample tell essentially the same story.20 In this study those therapies that participants said they thought they ‘know how it worked’ included acupuncture (83.7%) aromatherapy (75.2%), herbal medicine (74.3%), homoeopathy (85.9%), hypnosis (70.9%), massage (84%), meditation (72.8%), relaxation (78.0%), counselling (70.6%) and yoga (73%). This is not surprising given the number of books and popular media reports on them. A number of therapies were little understood – the following are percentages of people who believed ‘they worked’: autogenic training (3.9%), ayurveda (7.6%), biochemic tissue salts (8.9%), chelation (6.9%), magnetic therapy
(15.1%), naturopathy (10.3%), ozone therapy (4.0%), reiki (10.1%) and voice/sound therapy (13.9%). Again this is reflected in the number of books and articles on these particular therapies. However, these results differ from country to country where various therapies have been widely known and well practiced. Furnham20 found the percentage of people who had tried the various therapies was much lower Nearly 50% had tried aromatherapy, 36% herbal medicine, 61% massage and 50% relaxation. Less than 10% had ever tried: acupuncture, acupressure, the Alexander technique, art therapy, autogenic training, ayurveda, biochemic tissue salts, biorythms, chelation, colonic irrigation, colour therapy, cystal/’gem therapy’, dance/movement therapy,
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magnetic therapy, naturopathy, nutritional therapy, ozone therapy, reiki, shiatsu, therapeutic touch and visualization. Again the results from Furnham20 with a population nearly four times the size of this study yielded similar results to those of this study. Rated on the 10 point efficacy scale the top five were massage (7.04), relaxation (6.42), counselling (6.31), acupuncture (6.30) and yoga (6.17). Those rated as least effective were autogenic training (2.87), ozone therapy (2.82), chelation (3.18), ayurveda (3.20) and reiki (3.26). Clearly there is a close relationship between knowledge of a technique and belief in its efficacy. Although factor analysis of various ratings produced interpretable structures it was found that when the internal reliabilities were calculated they tended to be high. What this indicated was that participants tended not to differentiate closely between different methods. Participants tended to give similar ratings to all therapies, that is, the they tended either to be believers or non-believers, sceptics or enthusiasts. However, the factor analysis of the 12 attitudes to medicine revealed four clear independent factors. it showed the participants were wary of orthodox medicine and concerned by its potential sideeffects. It also showed that they believed psychological factors to be very important in determining scientific evaluation of practice or what one may call evidence-based medicine. Perhaps the most interesting and important part of the analysis was the regressional analysis shown in Tables 5 and 6 which tested the central hypotheses in this study. They showed that interest in both future-ologies and CM therapies was best predicted from each other. There were no significant demographic predictors. That is, despite the observation that women are more interested in, and more likely to be users of CM than men, none of the variables examined was significant in the eight regressions performed. Nor were four beliefs about medicine significant predictors with one exception. This maybe due to the size and representativeness of the sample in this study or may simply indicate that there are few demographic correlates of these ratings. It is however surprising that attitudes to science and orthodox medicine had no statistical impact. In the earlier study of this topic Furnham19 found that attitudes to science and medical treatment were powerful statistical predictors of the perceived efficacy of future-ologies. The results from the regressions did, however, indicate that the best predictors of attitudes to and knowledge of, ways of predicting the future were attitudes to, and knowledge of, CM and vice versa. Even more specifically the best predictor of the extent to which participants had ‘heard of’ the 24 ways of predicting the future was the extent to which they had ‘heard of’ the 39 CM therapies. The same was true for ratings of efficacy which accounted for most of the variance. This indicated
quite clearly that the higher one rated the efficacy of the futurologies, the higher one rated the efficacy of CM. These results may be interpreted as confirming beliefs that interest in the occult is related to interest in CM therapies. These results do indicate that taking an active interest in, and trying, scientifically dubious ways of telling the future is indeed related to taking an active interest in and trying CM. But it would be incorrect to suggest that the results indicate that participants were unable to distinguish between the two. It was obvious from an analysis of the sample means as well as the factor analytic results that participants made clear and logical distinctions both within and between ways of predicting the future and the CM therapies. It was clear that participants were deeply sceptical about the efficacy of the ways of predicting the future and furthermore equally sceptical about many of the CM therapies. Nevertheless, it was the case that the one score did predict the other. This suggests that sympathy for, and scepticism of, non-scientifically orthodox procedures may co-occur. One implication is that expressed interest in any set of alternative and complementary treatment is fairly predictive of interest in others. What these results seem to suggest is that Gray’s four academic philosophical perspectives on CM may apply equally to lay people.18 That is, those who support the biomedical perspective, would be strongly against both unproven and often bogus ways of telling the future and CM. Equally it may well be that those who are sympathetic to CM maybe more willing to explore some of the older, better known, ways of predicting the future. Reliance on the clinical experience of practitioners rather than scientific data is indeed the evidence of efficacy claimed by both some CM and futureology practitioners. However the pathways by which people come to CM therapies may be the best predictors of their world view.2 Some are attracted by the theory and philosophy of different therapies and may get involved and interested out of sheer curiosity. Hence they read widely and may even try treatments out of little more than curiosity. On the other hand there are those who come out of desperation having been disappointed by orthodox medicine. Those who ‘lose their faith’ in orthodox medicine and are suffering from a chronic illness may embrace alternative therapies and world views quite differently than those who are simply ‘shopping for health’ or are interested in life-style issues. Future research would benefit from longitudinal research on a representative sample whose medical history was known. This would overcome the limitations of this research and help understand causality in the development of beliefs about CM and related issues. Thus it could be that a chronic illness which seems unresponsive to orthodox medicines leads a desperate patient to seek out a CM treatment
Does experience of the ‘occult’ predict use of complementary medicine?
and in doing so his/her attitudes and beliefs become changed about health. It may for instance make them less cynical even sceptical about CM and thus open to more interest of and experience with other forms of CM and about science in general. ACKNOWLEDGEMENT This research was supported by a grant from the Homoeopathic Trust, based in London.
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