Health

IT COULD HARDLY BE MORE CONVENTIONAL:

Some therapists now offer unconventional form of treatment with surprising benefits: ‘It connects me to being human’ (Jenny Allison, March 21, 2024, The Cool Down)

Over the last several decades, but particularly the last several years, more and more psychotherapists, psychiatrists, therapists, counselors, and social workers have begun incorporating nature into their treatments. These approaches range from simply conducting talk therapy sessions outdoors to going hiking, going skiing, and even building fires. […]

Therapists agree — the technique shows promise, especially for people who are hesitant about traditional therapy or interested in something that doesn’t feel one-size-fits-all. It’s the reason why groups such as Maryland’s Center for Nature Informed Therapy or New York’s Boda Therapy have been growing in recent years.

“By blending the healing properties of the natural world with proven modalities such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), Nature Informed Therapy addresses a wide range of mental health concerns, promoting overall well-being, life satisfaction, and a harmonious relationship with the environment,” the Center for Nature Informed Therapy’s website explains.

The benefits aren’t just anecdotal, either. A 2023 study of forest bathing, the Japanese practice of taking a mindful stroll in the woods, found that taking such walks significantly reduced symptoms of depression and anxiety. In fact, simply just hearing birdsong has been shown to soothe anxiety.

Get out of your own head.

I DON’T THINK WE’RE IN HAVANA ANYMORE:

Long COVID patients report improvements following self-regulation therapy, study finds (Will Houston, 3/13/24, UCLA Health)

Clinical psychologist Dr. Natacha Emerson, the study’s lead author and assistant clinical professor in the UCLA Department of Psychiatry and Biobehavioral Sciences, said her study sought to test whether biofeedback would improve both the physical symptoms associated with long COVID and the psychological distress that often accompanies untreated chronic symptoms. While biofeedback has been established for chronic somatic symptoms, this is the first study to explore its effects in long COVID.

Immediately following the six-weeks of treatment, participants self-reported significant improvements in physical, depression and anxiety symptoms as well as in sleep and quality of life. The benefits were also sustained three months later without further intervention.

IT’S LONG COVID IN FANCY DRESS:

In Havana syndrome patients, NIH scientists find no physical trace of harm (Jon Hamilton, 3/18/24, NPR)

…but they do feel like dancing…

ODD TO BE BEHIND EUROPE:

The ban on puberty blockers was long overdue (Jo Bartosch, 13th March 2024, spiked)

NHS England has banned the use of puberty blockers to treat children struggling with their gender. Although the health service hasn’t quite admitted that it was wrong to prescribe these drugs in the first place, it has probably got about as close as the lawyers will let it. Yesterday, a spokesperson confirmed: ‘We have concluded that there is not enough evidence to support the safety or clinical effectiveness of puberty-suppressing hormones to make the treatment routinely available at this time.’

LIKE “LONG COVID”:

The Placebo Effect’s Evil Twin (Michael H. Bernstein, 3/11/24, Quillette)

The term “nocebo effect” derives from the Latin word nocere, which translates roughly as “to harm” (as in the Hippocratic injunction, primum non nocere—first, do no harm). Whereas the better-known placebo effect is typically positive (the alleviation of pain or malaise through treatments that otherwise have no inherent therapeutic value); the nocebo effect is negative, often manifesting as headache, skin irritation, or nausea.

No surprise, then, that the nocebo effect has been called “the placebo effect’s evil twin.” It can be more formally summarized as “the occurrence of a harmful event that stems from conscious or subconscious expectations.” Or, more simply: When you expect to feel sick, you are more likely to feel sick. […]

The mind’s unfortunate ability to create suffering ex nihilo can sometimes affect large groups of people though a process of social contagion (or, in the more indelicate language of the past, hysterical contagion). One such example, known as “The June Bug,” occurred in a U.S. textile mill in 1962. Many employees began to feel dizzy and nauseous. Some vomited. Rumors of a mysterious bug that was biting employees began to circulate, and eventually 62 workers became ill. Yet a subsequent Centers for Disease Control and Prevention investigation determined that no bugs could be identified. Nor could investigators find any other physical cause of the illnesses. This type of phenomenon is now referred to as psychogenic illness—sickness caused by belief.

Over the course of history, there have been countless other examples of psychogenic illness, with symptoms ranging from hysterical laughter to seizures. Aldous Huxley, the famed author of Brave New World, described one such seventeenth-century example in his lesser-known historically-based novel, The Devils of Loudun. In the 1630s, as Huxley documents, an entire convent of Ursuline nuns in the western French community of Loudun became convinced that they’d been demonically possessed (complete with convulsions, and other symptoms recognizable to any connoisseur of the modern exorcism-themed horror-movie genre) due to the unholy machinations of a (genuinely licentious) local priest named Urbain Grandier.

Could such a mass outbreak occur today, in an era when few believe in demonic spirits? Consider that during 2016 and 2017, no fewer than 21 American diplomats serving in Cuba reported a range of bizarre neurological symptoms that later came to be collectively described as “Havana Syndrome.” News of the outbreak spread globally through American diplomatic networks, and eventually more than 200 U.S. diplomats became ill. One leading theory was that the Russian government was attacking American embassies and consulates with microwaves.

ALL IN YOUR HEAD:

Psychiatrist said he would lose 75% of his patients if people made these two lifestyle changes (CASSIDY MORRISON, 3/04/24, Daily Mail)

A combination of regular exercise and cognitive behavioral therapy – a psychological treatment to help people understand how thoughts drive emotions and behaviors – can treat depression as well as any pharmaceutical, multiple experts have said.

THANKS, DARPA:

Progress Deferred: Lessons From mRNA Vaccine Development (Tim Hwang, 2/20/24, IFP)

One institutional reform that may have alleviated this issue would be to use mechanisms that encourage funders to make higher variance, heterodox bets against this kind of scientific consensus. This might include “golden ticket” mechanisms that allow reviewers that feel strongly about a research proposal to fund a project even against the consensus of their peers.52 Similarly, funding programs might be launched to deliberately offer “last shot” funding for potentially high-impact areas that see a period of declining funding and researcher activity.53 These might counter a natural risk-aversion that leads researchers to abandon problems too early in the face of high-profile failures, as they arguably did in the mRNA case. These mechanisms might have particular applicability in cases parallel to mRNA, where expert judgments are based more on analogies to similar problems and where the technology in question would have a major social impact if viable.

The merit of such an approach is bolstered by examining the funders that unusually did choose to fund mRNA research, even during the period in which it faced major skepticism. These organizations did so in part because they were free to prioritize more speculative, high-risk exploration. The specific reasons for this vary. Dan Wattendorf – who led the DARPA ADEPT program that funded mRNA work in the 2010s – attributes the agency’s willingness to support mRNA work to an organizational norm of providing managers like himself free rein to direct their programs.54

The Bill and Melinda Gates Foundation was also an early supporter of mRNA vaccines, providing a $20M grant to Moderna in 201655 and later $55M to BioNTech in 2019.56 These investments were based in part on the personal interest of Gates in advancing vaccine technologies, and since the foundation prioritized finding promising but overlooked methods in related fields. BioNTech had begun working on mRNA therapeutics to address cancer, but was supported by the “[Gates] Foundation [because it] often looked at ‘adjacent’ scientific disciplines whose innovations might help fight infectious diseases…‘We were doing a lot of horizon-scanning to see what the trends were, what was changing, and who were the cutting-edge people,’ Stuart [a director at the Gates Foundation] says, ‘and BioNTech clearly surfaced.’”57

Intervention 2: Address market failures in the “scientific marketplace”

Established pharmaceutical companies were well-positioned to accelerate the development and deployment of mRNA vaccines. These companies possessed the necessary research talent, financial resources, and practical mass production know-how to transform the technology into a workable product.

Despite being well-positioned to lead the way, pharmaceutical companies did not.

The government is a market force.

FIRST, DO NO HARM:

Treatment can do more harm than good for prostate cancer (Jinping Xu, 1/26/24, The Conversation)

Although about 1 in 8 men in the U.S. will be diagnosed with prostate cancer during their lifetime, only about 1 in 44 will die from it. Most men diagnosed with prostate cancer die from other causes, especially those with a low-risk prostate cancer that usually grows so slowly it isn’t life-threatening.

However, until about a decade ago, most men diagnosed with low-risk prostate cancer were immediately treated with surgery or radiation. […]

Due to widespread PSA screening in the U.S., over half of prostate cancers detected through screening are low-risk. Concerns about overdiagnosis and overtreatment of low-risk cancers are the main reasons why screening is not recommended unless patients still want to be screened after discussing the pros and cons with their doctor.