Feb 04 2020

New York Times Goop Fail

This has to be the worst opinion piece I have read in a major news outlet in a long time. The authors, Elisa Albert and Jennifer Block, leave behind them a killing field of straw men and empty containers of metaphorical “Kool Aid.” Here is the short version – they are defending Gwyneth Paltrow’s Goop and the recent Netflix series Goop Lab with all the tropes of pseudoscience they can muster. They wrap them all up in a narrative of female empowerment, and dismiss out-of-hand all the legitimate criticism of the dangerous advice Goop sells as a conspiracy of the “patriarchy.”

Ironically, and sadly, I would argue that Paltrow, and by extension Albert and Block, are exploiting women, making them more vulnerable, and depriving them of true empowerment – which is knowledge. When you give someone misinformation, you are taking away their ability to have informed consent. This is what con artists do. Alternative medicine is frequently a double-con, in which those who promote it are themselves deceived and are just paying the deception forward.

All the talk about the “patriarchy” is also just another version of a conspiracy theory, in which all legitimate counter arguments and evidence are dismissed as part of the conspiracy (as I am sure some will do with this very blog post). Conspiracy theories work best if they contain a kernel of truth, or if they are built around a legitimate historical grievance, as in this case. All you have to do is wipe away all the nuance, and cherry pick the details that serve your narrative.

Let’s dig in to some of the details of the article. They start with a rather blatant straw man:

The show would surely promote “dangerous pseudoscience,” peddle “snake oil,” and be “undeniably awful for society.”

Six episodes of the show finally dropped late last month, and so far civilization seems to be more or less intact.

Right, so because civilization did not instantly collapse, none of the warnings about the dangers of pseudoscience are valid. But they were just getting started and this was a mere warm up. The next paragraph frames the discussion:

The show explores cold therapy, energy healing, longevity diets, and therapeutic use of psychedelics, all of which may sound esoteric to the uninitiated, but none of which actually lack sound evidence of benefit. The episode on female pleasure, led by masturbation queen Betty Dodson, is downright radical, featuring a vulva montage, naked women of various shapes and ages talking openly about their bodies, and a woman bringing herself to orgasm so that other women might learn how. “We’re very dangerous when we’re knowledgeable” says Ms. Dodson. Ms. Paltrow nods: “Tell me about it.”

They are consciously pairing alternative medicine pseudoscience, with fringe but not necessarily wrong science, with female empowerment. If you doubt any of the mentioned therapies, you are just “uninitiated”. That is a shockingly patronizing comment in an article that makes such a show of being offended at patronizing attitudes. It is also a very common trope of the pseudoscientist – my bizarre claims only sound bizarre because you lack intuition, or faith, or “true” knowledge. Come, drink deep, and all will be revealed.

But the core claim here is that the mentioned modalities are backed by “sound evidence of benefit” – except that they aren’t. Let’s focus on energy healing, as later in the article they specifically endorse Reiki:

Reiki is not proven to shrink tumors in any double-blind trials, but it, along with yoga and mindfulness and acupuncture, is being used in integrative cancer therapy at major institutions all over the world, because there is evidence that it has benefits, and no adverse side effects.

They have a link to their “evidence” which is a single review article by a proponent in a alternative medicine journal. This is a cherry picked and hardly unbiased source. This is also a great representation of the difference between their straw man version of criticism of Goop and real scientific criticism. After several decades of promoting Reiki, which is a form of “healing touch” in which non-existent and poorly defined “energy” is alleged transferred from the “healer” to the client to promote “healing”, proponents have precious little evidence to support their claims. This Cochrane review of Reiki for anxiety and depression is typical:

Very few people with anxiety or depression or both have been included in randomised studies. This means there is insufficient evidence to make any comment about the usefulness of Reiki for the treatment of anxiety and depression.

At best, the quality of the evidence is moderate which, on top of a dearth of evidence, weakens the findings further.

The same is true for pain or other alleged uses. There are few low quality studies, mostly unblinded, with weak results. Of course, they are exactly the kind of studies that are useful to proponents, because small weak studies tend to have weakly positive findings due to researcher bias and placebo effects. This is hardly compelling evidence for efficacy, in fact it is no evidence at all. Any treatment in this stage of research will produce the same weakly positive findings, so they have almost no predictive value at all. At best they show that the treatment is not immediately harmful – but no one is claiming that it is, only that it does literally nothing.

The same is true of acupuncture, except worse, because there are literally several thousand clinical trials of acupuncture and still fail to show efficacy for any indication. They dipped their toe in high quality double-blind trials, but they were frustratingly negative, so proponents largely went back to small preliminary trials because they are better for promotion. Mindfullness has been soundly criticized by experts for lacking even a specific definition, which is a prerequisite to scientific study. Yoga is fine, as long as it is done safely and not combined with dangerous gimmicks like “hot” yoga – but it’s stretching and exercise. And because yoga is actually doing something – it is clearly not without adverse side effects.

But don’t let me muddle your empowering narrative with all these facts. You have your alternative facts.

The authors make a direct appeal to “intuitive” knowledge and other ways of knowing, reminding us of the ways science was abused in the past and how deeply mysterious human physiology remains. Of course, history is full of examples of actual patriarchical abuse, sexism, marginalizing women, and horrible exploitation and abuse of women. Absolutely. I don’t know of any of the modern critics of medical pseudoscience who would deny that for even a moment. But that doesn’t mean that any current criticism of Goop, or the wellness industry, is akin to or based on that historical abuse. That is their narrative, not ours. This is the branding and the deception. You can, for example, take any pseudoscience and proclaim it an African American treatment, and promote it with African American spokespeople, and then tie any criticism of it to historical racism.

Better yet – take an actual historical belief of any oppressed people, and then declare the belief valid because of that oppression, and tie any facts, evidence, or logic brought to bear to argue that the belief is not entirely valid to that historical oppression.

The bottom line is that – none of this matters. It doesn’t matter if the person making an argument is a jerk, if one side is historically oppressed, if in the past the institutions involved did bad things – none of it. All that matters to whether or not a claim is true is the facts and evidence, logical consistency, and scientific plausibility.

Further, the authors, like alternative medicine in general, want to have it both ways. They will cite cherry picked scientific evidence when it suits them, then denigrate science as a male conspiracy (or whatever) when science is inconvenient to their position.

The end result is more exploitation of women, which is the great irony of this article and the opinions it expresses. Women are not empowered to take control of their health by misinforming them about the evidence, by denigrating science, or by selling them snake oil with a compelling narrative. By tying science to historical male oppression, you are denying women the most powerful (and empowering) tool humanity has developed. You are relegating women to the ghetto of pseudoscience, and making them vulnerable to every con artist out there. Women (and men) are literally dying because they rely on these narratives over science-based information.

Of course, not all women fall for this nonsense. There are plenty of women criticizing Goop also – those women empowered by actual critical thinking and an understanding of how good science informs our choices. In fact, I will let the awesome Jen Gunter have the last word:

“…the vulva, vagina, cervix, and uterus are not intuition repositories and neither are they sources of “power” or “wisdom.” If fact, I find that assertion insulting. Do you really mean a woman who does not have a uterus is less effective? Is a woman without a vagina less intelligent?  Is a woman who had a vulvectomy due to cancer less creative?”

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