Homeopathy helps – as a ritual

Homeopathic high potencies do not contain any active substances (and certainly no energy) and accordingly cannot have their own and immediate effects. However, the administration of medicines – this also applies to homeopathic high potencies – is a ritual that unfolds an indirect effect. This ritual effect requires trust of the – let me call it this way – “recipient” in the “giver”. And it is also true that the effect of the ritual medication diminishes when the trust in the ritual is gone. In the case of homeopathic high potencies without an immediate pharmacological effect, there is not much effect left when the trust in the ritual “giving of homeopathic remedies” is also lost and the ritual medication no longer even shows an indirect effect.

But even a “long” and detailed anamnesis is a ritual with its own indirect effect. This is so even if the anamnesis collects data that are irrelevant for a correct medical diagnosis and are only plausible from the point of view of homeopathy.

Should we not then, in the knowledge of these ritual effects, renounce any criticism of homoeopathy? Should we not much more strengthen the confidence in homeopathy and thus the effectiveness of the ritual treatments? Is it not counterproductive if critical education and information diminish the confidence in the homeopathic high potencies and thus also the confidence in the whole direction of therapy? And: Can a homeopathic anamnesis alone have any ritual effect at all if the homeopathic therapy subsequently fails or is deprived of its effect by education?

The implied conclusion from these questions, namely that the homoeopathic anamnesis actually remains ineffective if it has no consequences in the sense of dispensing homoeopathic remedies (drops or globules), may sound plausible – but we consider it flawed and unsubstantiated.

Anamnesis and homeopathic medication are two separate rituals that are in principle independent of each other. The conclusion that a homoeopathic anamnesis must necessarily entail a homoeopathic remedy application because only the two can work together is a logical fallacy. A homoeopathic anamnesis does indeed have an effect even if no homoeopathic medicines are subsequently prescribed. (1)

There are several points that require closer consideration. The effect of the ritual “homeopathic medication” is a placebo effect. It works just as well or as badly with “homeopathically processed” sugar as with “non-processed” sugar; this has been proven by studies. The placebo effect – incidentally also proven in children and animals – is reduced by the information that a remedy is a placebo, but not cancelled! The placebo effect cannot be erased even by relentless disclosure of the facts.

Secondly, there are other factors that create a sense of efficacy. The most important are: Spontaneous healing, spontaneous progression with regression to the centre, selective perception and wishful thinking. These components work independently of the ritual of “homoeopathic medication” and cannot be erased by a ruthless disclosure of the facts either.

Thirdly, the ritual effect is of course also present when, instead of content-less globules, effective medicines are applied that have proven their effectiveness with studies before the licensing authority. Not only the pseudo-medical prescription is a ritual – the medical prescription is too. There is no question that the combination “ritual and effective medicine” works better than the combination “ritual and ineffective medicine”.

The same applies to anamnesis: not only the pseudo-medical anamnesis is a ritual – the medical anamnesis is too. We doctors recognise without envy that homoeopaths (can) take more time than we do and that the ritual effect of the homoeopathic anamnesis can thus be superior to a normal medical anamnesis (I write “can” and not “is”, because apart from the criterion of “length of conversation” there are also aspects of the content of an anamnesis which are recognisably of varying value even to medical laymen).

And from these points of view, the question whether one has to give homeopathic remedies after a homeopathic anamnesis can no longer be answered with “yes”. It is clear that the ritual treatment with homeopathic remedies demands trust from patients – trust that is not justified. Treatment with homeopathic remedies is based on deception of patients, at least as a result of – and in combination with – self-deception of the homeopath.

We do not want to ban homeopathy at all, but we want to inform about the mechanisms on which homeopathy is based. In contrast to 200-year-old homeopathy, medicine today is also more advanced in terms of medical ethics: we have long regarded our patients as partners. We refuse to want to achieve therapeutic successes that can only be achieved through the use of authority – authority that must not be questioned if it does not want to remain ineffective.

Demanding recognition of a therapeutic authority – keyword “eminence-based” instead of “evidence-based” medicine – may well generate patient satisfaction in the area of harmless disorders of well-being. The danger, however, lies in the limitlessness! Anyone who experiences success with harmless disorders – whether as a homeopath or as a patient – is difficult if not impossible to convince that the same therapeutic approach is ineffective and thus dangerous in the case of serious illnesses – which, from the point of view of the scientific findings to date, cannot change in the future.

A renunciation of exaggerated and non-indicated treatment measures for harmless disorders of well-being is not criticised by medicine – and explicitly also by us critics of homeopathy – but is advocated. The medically correct treatment method in these cases is to inform the patient about the nature of the harmlessness of the condition and about general measures to alleviate the symptoms. This is time-consuming and is even often met with rejection. It is much easier for the homeopaths, who do not have to provide explanations, do not have to face any discussions and instead simply reach into the “toolbox” of homeopathy and demand the ritual cure with pompous gestures “ex cathedra”. And woe betide the patient who does not follow them …

And woe betide homeopaths or patients, or both, who do not know the limit and demand or expect healing in equal measure for serious illnesses – just as they have subjectively experienced it for harmless illnesses: Then there is danger to the health and life of the patient.

We think it is not only allowed but even required to inform patients about the possibilities and impossibilities of homeopathy. If one deliberately deprives patients of a pharmacological drug effect and leaves them in the dark that it is only the “therapeutic setting”, the “therapeutic spectacle” that works – and only as a rite that is much inferior to the effects of full-fledged medical therapies – one incapacitates one’s patients. The role of a “demigod in white” may have been an ideal conception among the doctors of that time 200 years ago – today medicine is further away from this understanding of the role than ever before. In homeopathy, however, the therapist still has the decisive role of the sole treatment leader, whose decisions and authority must not be questioned.

As a patient or as a homeopath it is easy to say: “I have experienced healing myself”. But how complex are the processes that produce such an “experience of healing without healing”. And how important it is to realise that “processes generating healing experiences” are something fundamentally different from effective – sometimes quite unpleasant – therapies with real life-prolonging or healing effects.

Author: Dr. Wolfgang Vahle

(1) One of the few studies to date that investigated different effects of homeopathic consultation and remedy administration was that of S. Brein et al : Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial.
Rheumatology (Oxford). 2011 Jun; 50(6): 1070–1082.
Published online 2010 Nov 8. doi: 10.1093/rheumatology/keq234

The title already contains the result: The effects of a homeopathic treatment that are indeed achieved are attributable to the consultation process (the homeopathic “setting”) and not to the homeopathic remedy.