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David Satcher, M.D.
The Surgeon General of the United States
Office of the Surgeon General
5600 Fishers Lane, Room 18-66
Rockville, MD 20857
Dear Dr. Satcher,
As academic psychologists and other . . . professionals who specialize in the scientific evaluation of controversial and currently unsubstantiated treatments, we are writing to express our profound concerns regarding the White House Commission on Complementary and Alternative Medicine Policy. As you know, this Commission was appointed by former President William Jefferson Clinton in March of 2000 to generate recommendations regarding future governmental policies on alternative and complementary medical practices. It is our understanding that this commission will issue its formal policy recommendations sometime later this year. Before outlining our serious reservations concerning the current status of this commission, we should note that the opinions expressed in this letter are solely those of the co-signers, and do not necessarily represent the opinions of the institutions with which they are associated. We believe that our opinions are extremely well founded and are consistent with the overwhelming body of scientific evidence regarding complementary and alternative approaches to both medical and psychological disorders.
At the outset, it is crucial to point out that many alternative and complementary medical practices, such as homeopathy and chelation therapy, have repeatedly been shown to be ineffective in controlled studies by independent investigators. Still other alternative and complementary medical practices have the potential to cause physical harm, and to lead individuals to forgo treatments that have been demonstrated to be effective. As a consequence, many of these practices subject the American public to considerable physical, financial, and emotional risk. For these reasons, we believe it is essential that the United States government receive the best available scientific information regarding the current status of alternative and complementary medical practices from objective researchers who have no personal or financial stake in their efficacy. Such researchers must remain open to the possibility that some presently unsubstantiated medical practices may ultimately be shown to be effective. But these researchers also must subject all novel and still largely untested claims to careful and impartial scrutiny using the best scientific methods available.
It is with these considerations in mind that we wish to raise serious concerns regarding the present composition of the White House Commission on Complementary and Alternative Medicine Policy. In particular, we are deeply troubled that the Chairperson of this important commission is Dr. James S. Gordon, a psychiatrist whose expressed views regarding alternative and complementary medicine practices bespeak an extreme absence of objectivity regarding the scientific status of these practices. Moreover, Dr. Gordon's background, writings, and public statements point to a clear lack of commitment to a scientific approach regarding the causes and treatment of medical and psychological disorders.
For example, shortly following his graduation from Harvard Medical School in 1967, Dr. Gordon became a major proponent of the theories of Scottish psychiatrist R.D. Laing, a fringe thinker who argued that schizophrenia and other severely disabling mental conditions not are illnesses at all, but rather "voyages of discovery." According to Laing, schizophrenia is a perfectly sane response to an insane world. Gordon himself asserted that schizophrenia and related mental disorders "did not seem like diseases to me" and are "instead like different ways of being." Indeed, during his psychiatric residency Dr. Gordon attempted to put a number of Laing's therapeutic recommendations into place on a psychiatric unit in New York City. It is crucial to emphasize that Dr. Gordon has apparently persisted in these views despite the fact that they have been convincingly discredited by psychiatric and psychological researchers. For example, an enormous body of well controlled data demonstrates that schizophrenia is a substantially genetic condition characterized by numerous pathological changes in brain structure and functioning. In addition, there is no evidence that it is scientifically useful to schizophrenia as a voyage of discovery, a view about which Dr. Gordon spoke approvingly in a 1996 interview. This view implies that administering medications to individuals with schizophrenia will often interfere with their natural healing processes. To the contrary, the research data suggest that the longer schizophrenics go untreated without medication the more their condition is likely to deteriorate.
Importantly, in a 1978 report to President Carter ("The President's Commission on Mental Health of the Special Study of Alternative Mental Health Services"), Dr. Gordon spoke positively of a number of alternative and almost entirely untested approaches to the causes and treatment of schizophrenia. For example, in this report Dr. Gordon asserted that "there is no reason, 'scientific' or otherwise (quotation marks in original), why a neurochemical level of analysis should be more likely to lead to the biological basis or correlates of schizophrenia than say, an analysis undertaken at the level of energy balance in the acupuncture meridians." This statement is deeply troubling. Even 23 years ago, there was plentiful research evidence indicating that schizophrenia was accompanied by various biochemical (e.g., neurotransmitter) abnormalities. In contrast, there has never been the slightest evidence for the existence of acupuncture meridians. It is highly scientifically improper, in our view, to imply that most or all perspectives to psychological disorders are equally valid or worthy of attention. Instead, responsible scientists must carefully ascertain the relative merits of different research approaches based on the best available evidence and offer recommendations accordingly. Personal opinions or preferences must not be allowed to come into play.
Dr. Gordon's other views and endeavors are equally unsettling. For a period of time in the 1970s and 1980s, he experimented with many scientifically unsubstantiated psychotherapies, including "rebirthing," as well as treatments involving various levels of violent interaction. The dangerous nature of these treatments was very recently illustrated by the tragic suffocation death of Candace Newmaker, a 10 year old girl who was subjected to rebirthing by two psychotherapists in Colorado. "Rebirthing" is an entirely unsubstantiated treatment that relies on the premise - which has been repeatedly refuted by well controlled scientific studies - that adults who are hypnotized or placed in an altered state of consciousness can psychologically "relive" the trauma of birth and free themselves of the emotional pain produced by this trauma. Dr. Gordon spoke positively of his own rebirthing experience in a book. For many years, Dr. Gordon was closely associated with (and apparently became a devotee of) the Bhagwan Shree Rajneesh, who endorsed such practices as Dynamic Meditation (which involved intense dancing during altered states of consciousness), primal scream therapy, and rebirthing therapy. Dr. Gordon's book, "The Golden Guru" contains many highly complimentary passages concerning the Bhagwan Rajneesh and his therapeutic methods. As you may know, Rajneesh took over the town of Antelope, Oregon, and bused in and exploited a number of homeless individuals in order to do so (he was finally deported for immigration fraud).
Incidentally, this book also contains passages praising the therapeutic practices of Dr. Wilhelm Reich, a pseudoscientific theorist who propounded the use of "Orgone Therapy" to treat psychological and medical disorders. According to Reich, "orgone," which purportedly is the energy released during the human orgasm, is the vital "life force." Proponents of Reichian therapies attempt to amass orgone energy in accumulators (e.g., orgone boxes) and to heal human ailments by ensuring that affected individuals receive sufficient amounts of orgone. Dr. Gordon has continued to speak at Orgonometry conferences, which are devoted largely to discussing the scientifically discredited work of Reich and his followers. Dr. Gordon's association with the Reichians raises serious questions concerning not only his scientific judgment but also his theoretical views regarding the causes of mental and physical disorders.
More recently, Dr. Gordon has defended many of the therapeutic practices of Dr. John Mack of Harvard University, a psychiatrist who advocates using hypnosis and other highly suggestive therapeutic techniques to recover purported memories of alien abductions in his clients. Mack and his followers believe that these clients' alien abduction reports are very likely to be genuine. Nevertheless, Mack and his followers neglect the substantial body of psychological research demonstrating that memory is a highly fallible and reconstructive process that can be readily shaped by therapeutic suggestion. According to Dr. Gordon, Mack "has performed a valuable and brave service, enlarging the domain and generosity of the psychiatric enterprise." Moreover, Dr. Gordon is a member of the Scientific Advisory Board of John Mack's Program for Extraordinary Research (PEER), which was established primarily to investigate alien abduction reports and related phenomena.
Dr. Gordon has also endorsed a number of pseudoscientific and otherwise scientifically questionable notions that are popular among "postmodern" thinkers. For example, in a 1996 interview he maintained that "we're just beginning to think about how to apply some of the ways of looking at things that come out of the new physics, such as understanding the influence of the observer on the observed." In fact, it is widely accepted among experts in quantum physics (e.g., Dr. Victor Stenger of the University of Hawaii) that the influence of the observer on the observed (known in physics as the "Heisenberg Uncertainly Principle") is relevant only at the subatomic level and bears no relevance whatsoever to phenomena (e.g., medical practices) above this level. Dr. Gordon's assertion reflects a widespread and fundamental misunderstanding of modern physics and its application to alternative medicine.
It is also worth noting that Dr. Gordon testified as a defense expert witness on behalf of convicted mass murderer Terry Nichols in the Oklahoma City bombing trial. During this trial, Dr. Gordon recommended that Nichols be given only a short prison sentence. According to Dr. Gordon, his reading of letters by and about Nichols convinced him that Nichols was not violent and did not pose a serious threat to society. Dr. Gordon wrote that "it is extremely difficult to believe that he intentionally took anyone's life or indeed took part in any activity which might conceivably take someone's life." Aside from the fact that Dr. Gordon's views regarding Nichols are markedly at odds with those of most other experts, it is disconcerting that he rendered a strong judgment concerning Nichols' potential for violence largely on the basis of written correspondence by and about Nichols. It is well established that mental health professionals are often quite poor at predicting violence (and nonviolence), even from standardized and well researched psychological tests. These findings make Dr. Gordon's psychological inferences from written correspondence all the more problematic from a scientific perspective.
Perhaps most troublesome of all from the standpoint of his Chairpersonship of the White House Commission on Complementary and Alternative Medicine Policy is the fact that Dr. Gordon has been a longstanding and highly partial advocate for untested and unsubstantiated medical practices. We agree with Dr. Gordon that certain novel treatment practices particularly that show scientific promise be subjected to open-minded investigation. But it is essential that individuals not draw conclusions regarding the efficacy of these practices on the basis of scientifically inadequate data. In many cases, it is evident that Dr. Gordon has done just that. For example, Dr. Gordon has referred to traditional Chinese medicine as "a whole other system of medicine operating under completely different laws." In fact, there is no scientific evidence for this extreme claim, which implies that Chinese and Western medicine are governed by entirely different sets of scientific principles. Moreover, this statement neglects the fact that the efficacy of many traditional Chinese medical practices (e.g., acupuncture) has been called into question in many carefully controlled studies. Dr. Gordon has also defended the efficacy of homeopathy, a bizarre medical treatment that has repeatedly been shown to be ineffective in controlled investigations. In addition, Dr. Gordon has been a leader in fostering various alternative and still unsubstantiated medical treatments for cancer. Of course, scientists are entitled to their own opinions and interpretations of research data. But we are deeply troubled by the fact that Dr. Gordon's assertions regarding the efficacy of alternative and complementary medical practices often go well beyond the available scientific evidence, and in some cases run directly counter to such evidence.
Finally, it is worth noting that to our knowledge, none of the other individuals on the White House Commission has expressed skepticism concerning the efficacy of alternative and complementary medical practices. Indeed, all of these individuals appear to be either active practitioners of alternative medical techniques (e.g., acupuncture, chiropractic, herbal remedies) or strong proponents of these techniques. Some have even been key lobbyists for alternative medical practices over the years.
We acknowledge that the scientific status of some of these techniques (e.g., acupuncture, certain herbal medicines) remains controversial, and we certainly encourage further controlled investigation of such techniques when merited. Nevertheless, we are disturbed that the commission does not include a single scientific expert on alternative and complementary medical practices who has expressed informed doubts regarding the efficacy of these practices. This void is especially disconcerting given that such doubts (most of which are founded on carefully collected scientific data) are widespread in the informed scientific community. For example, none of the more than 45 editorial board members of the prestigious Scientific Review of Alternative Medicine (edited by Dr. Wallace Sampson of Stanford University) was invited to serve on this commission, despite the fact that this journal is the only peer-reviewed scientific publication that provides objective scrutiny of alternative and complementary medical practices. This journal has been endorsed by the Council for Scientific Medicine, which consists of numerous distinguished scientists, including five Nobel Laureates. Many of the editorial board members of this journal have published extensively on the efficacy of novel and largely untested medical practices and would have provided an invaluable perspective on the current scientific status of alternative and complementary medicine. Their absence renders it very unlikely that the policy recommendations of the White House commission will be objective, informed by research, or representative of the broader views of the informed scientific community.
In sum, it is clear that Dr. Gordon has a lengthy history of endorsing a wide variety of psychological and medical practices that are either poorly substantiated or entirely unsubstantiated, and that he has a strong commitment to the efficacy of alternative and complementary medical practices even in the absence of adequate evidence. Moreover, the other members of the presidential commission similarly appear to have a longstanding personal (and in some cases, financial) commitment to the continued viability of alternative and complementary medical practices. It is therefore crucial to emphasize that this commission cannot be regarded as an impartial scientific panel.
We therefore urge you in the strongest possible terms to call for the disbanding of this commission as it presently stands and to reconstitute it with a group of respected researchers and practitioners (including recognized scientific experts in medicine, physiology, biochemistry, nutrition, psychology, research design, and statistical methods) who can provide you and others in the federal government with objective and well informed policy recommendations concerning alternative and complementary medical practices. We believe that such experts should ideally have neither a direct personal nor financial investment in the efficacy of alternative and complementary medical practices, and be capable of providing open-minded and balanced scientific evaluations of these practices. We would be more than happy to provide you and others with a list of suggested commission members upon request.
We thank you very much in advance for your attention to this matter, which we hope you will agree bears extremely important implications for the health and welfare of the American public. We look forward to hearing from you.
Scott O. Lilienfeld, Ph.D.
Associate Professor, Department of Psychology, Emory University
Editor, The Scientific Review of Mental Health Practice
Wallace Sampson, M.D.
Emeritus Professor, Stanford University School of Medicine
Editor, The Scientific Review of Alternative Medicine
Timothy Gorski, M.D.
Private Practice and Associate Clinical Professor
University of North Texas Health Science Center
Associate Editor, The Scientific Review of Alternative Medicine
James D. Herbert, Ph.D.
Associate Professor, Department of Clinical and Health Psychology
MCP Hahnemann University, Philadelphia
Associate Editor, The Scientific Review of Mental Health Practice
Timothy Moore, Ph.D.
Professor of Psychology, Glendon College, York University, Toronto, Canada
Associate Editor, The Scientific Review of Mental Health Practice
John P. Kline, Ph.D.
Assistant Professor, Department of Psychology, Florida State University
Associate Editor, The Scientific Review of Mental Health Practice
Donald McBurney, Ph.D
Professor of Psychology,
University of Pittsburgh
F. Dudley McGlynn, Ph.D.
Professor, Department of Psychology
David F. Tolin, Ph.D.
Assistant Professor, Department of Psychiatry
University of Connecticut School of Medicine
Anthony R. Pratkanis, Ph.D.
Professor, Department of Psychology
University of California at Santa Cruz
Howard Eisman, Ph.D.
Psychologist, Coney Island Hospital
Gerald R. Rosen, Ph.D.,
Private Practice and Department of Psychiatry
University of Washington
John Winston Bush, Ph.D.
Clinical Psychologist, Private Practice, Brooklyn, New York