Health

Wellness Trends Represent an Erosion of Critical Thinking

Tim Caulfield explores our attraction to detoxes and other alternative health practices in ‘A User’s Guide to Cheating Death.’

by Shayla Love
Oct 1 2018, 6:21pm

When I first began to grapple with my skepticism about the wellness world—green juice, turmeric powder, coconut oil and all—some light googling led me to Tim Caulfield. Officially, he's a professor on the Faculty of Law and the School of Public Health at the University of Alberta in Canada, and unofficially, he's emerged as a voice of reason when it comes to questioning health trends and fads. His book, Is Gwyneth Paltrow Wrong About Everything?: When Celebrity Culture and Science Clash, came out in 2015, well before the infamous jade egg swept the nation.

On September 28, the first season of his documentary series, A Users' Guide to Cheating Death, began streaming on Netflix (it previously aired in Canada). Season 2 will stream October 19. Each episode of the show examines some type of health trend or concept, and then seeks out the evidence for or against it. Beyond tackling topics like detoxes and the word "natural," he also looks for the truth behind other complicated health issues: weight loss, stem cell therapy, the hygiene hypothesis, and more.

I caught up with Caulfield and we spoke about his goals behind moving this dialogue to Netflix, and whether he felt the pull from any of these practices after doing them himself.

For those who don't know: Who are you? Why are you producing a show about this topic?

I am a health and science policy researcher. I've been doing it for decades. In my academic life it became increasingly obvious that popular culture was having an impact on how the public and policy makers—and even healthcare providers—were thinking about health and science. I started doing more research on how science is represented in the public sphere, and what we could do from the policy perspective to fight misinformation. That brought me into this world of popular culture and trying to fight misinformation.

Why is the show a guide to "cheating death" versus something like "living well?"

So much of what is pushed out there in popular culture, let's be honest, is about cheating death or trying to avoid death. So we thought that might be an interesting way to introduce the topics. Plus, we wanted to have a little bit of fun, right? And the show does try to have fun. We do try to make sure there are elements of humor in every episode, so I think the title helps to convey that a little bit also.

In addition to that, and I hope this is what makes the show somewhat unique, it's not just a debunking show. We don't try to make fun of people that have strange beliefs. We really also try to understand the perspectives that allow these beliefs to thrive. What attracts individuals to all these different kinds of practices and beliefs? The other thing that's important to know is that we also tackle a lot of high-tech stuff like genetic testing, stem cell research, and the microbiome, because there's a lot of misinformation in that space too.

What are some topics covered in the first couple of episodes?

The first season starts with detox and cleansing. We thought that was a really good place to begin because, think about it: Detoxing and cleansing has become, I think, a multi-billion dollar industry, right? If you include juicing and detox diets and detox exercises and detox supplements. There's so many products out there and so many beliefs that are centered on this false idea of detoxing. There is no evidence to support the idea that we need to detox. It's not even really scientifically plausible, but it still remains a big part of pop culture. So we thought it would be a good place to start. And of course I try a bunch of different detox approaches and we talk to people that have tried a whole bunch of stuff, and we even talked to someone who is struggling with cancer who is using detoxing as one way for her to deal with her disease.

What's the motivation for you to try the stuff yourself? Is there some part of you that's curious?

Even when I've written books I thought it was important to try it, because I think it's very valuable to get a sense of what it's like to use these procedures. What is it like to go to these different practitioners? What's it like to try these high-tech therapies? Then it gives you some insight into what attracts people to this. I'll give you one example, I tried cryotherapy in an episode, and as you probably know, it's become very popular. Even since we shot it I think it's become more mainstream. You know you're in minus 152 degrees Celsius—so really, really cold. It's this extreme experience and you can understand why people think it works. It's a fancy machine, incredibly cold, your adrenaline is rushing, and there is pretty dramatic placebo theater at play. So I think it's worthwhile to experience that yourself.

Other times I've gone to alternative practitioners, and they spend like an hour with you, talking to you and going over your concerns and your problems, and it's by and large a pretty pleasant experience. I get it. Despite what the evidence says, despite what the science says, I kind of get it.

I'm glad you say it's not only a debunking show, because I think some of the problems we have around the wellness space is people take on that debunking role and it's always critical. It leaves people feeling kind of hopeless. If none of these things work, then what do we do? Do you also talk about stuff that does work on the show? Or were you surprised by something that actually did have effect?

I think you raised two really important points there, the first one about the debunking aspect of it. Because the worry also is that you end up just talking to the converted. It becomes like a club. It's hard because you want to draw people in and you want to invite people to think critically about this stuff. Not just about whether it works or not, but also think critically about what's going on in our society that draws people to these therapies.

In season two we take on mindfulness and things like that. I think there's a lot of mindfulness hype out there and I think that we need better clinical trials, but I think there's something there. Something that's worth investigating. I got to meditate with a Buddhist monk at this ancient beautiful temple in Kyoto, Japan, and it was a pretty powerful experience. So you can understand why, even if there's sort of no good clinical trials to validate it's use—and that stuff is emerging, by the way—you can understand why people are attracted to something with these deep roots to it.

Another good example is forest bathing, I don't know if you've heard of that.

I have not heard of that.

We also try that. The idea is it's closely aligned with mindfulness and the idea that humans benefit from being in nature. And we kind of study that, but what are you studying? It is very nice and it's fun to walk in the woods, and I believe it's probably beneficial, but what exactly is the intervention? So it really shows how there may be things out there that are beneficial, but it's hard to quantify. And yet they're trying to do that and study it and validate it. We have a whole episode where we try to explore that tension, which I think is kind of unique.

Some people might ask—why can't you just let people do this stuff? Who cares if people are bathing in the forest? But you and I have talked about this before: It's not just that some people are saying it's a pleasant thing. They're saying, "Oh, it's good for your lymphatic system," or, "It activates this part of your brain." Products and influencers co-opt scientific language for those practices. And if they're going to do that then we need to look at them scientifically as well.

I think you're exactly right. I think that increasingly it becomes kind of easier to critique a lot of this stuff because it is being presented to the public as if it is scientifically valid. They're not saying 'This is a different world view,' or 'This is a spiritual practice.' They're saying 'This works in a measurable way, this has an impact on a very particular disease or part of your body or symptom.' When you present it that way it is entirely appropriate to critique it based on the principles of science, right?

That is one of the reasons why it's important to do that. I also think that this is a concern that stretches well beyond health: It's this erosion of critical thinking that is problematic. So like I said before, you know we hope to show it in a fun and entertaining way, and invite people to think about the world a little bit more critically, still with an open mind, but think about things more critically.

Do you think that's happening a little bit? I feel like I've started to see signs of people taking things a little more critically. Like Goop had to pay their first settlement because somebody said, "This thing doesn't work the way you said it did." Do you feel good when you see that? Do you feel like it's moving in the right direction?

I think there are signs that people are getting frustrated with the misinformation out there. You know there seems to be more legal actions. We recently saw the FDA, for example, come out and make a pretty explicit statement about IV vitamin therapy, right? Saying it's nonsense. That is a really popular alternative therapy. Soon we might see more actions like that. I agree with you; you're starting to see the word "wellness" is almost a punchline now.

But at the same time, I worry that the wellness punchline will polarize. So you have these communities that are still ignoring that. I've started to see this on my social media feed: [Accusations] that I have been bought out by big pharma or big agriculture, or conflicts of interest in pharmaceutical research that lead to public distrust. We have a long way to go. The good news is I think you are starting to see more critical dialogue in the popular press.

Let's say somebody watches your show and they begin to think critically about a particular wellness practice. How would you recommend them to then help their friends think about the same topic critically? How can we talk to our friends without just telling them something doesn't work and having them be completely turned off?

It's hard, right? I think you do have to pick your time. There's actually interesting research on this. You should emphasize the scientific consensus; I think that's still valuable despite the whole deficit model concern—that's the idea that more information alone won't change people's minds. There is evidence that emphasizing a scientific consensus in a respectful way can help, but I think more broadly, it's to talk about these practices in the context of critical thinking.

A study that came out just days ago suggested that if you debunk something, and then provide the alternate scientific perspective, you're more likely to sway opinion. So you don't want to say, "This doesn't work, this is nonsense." You say, "This doesn't work, the body doesn't work this way. In fact, you want to get your nutrients from the food that you eat." There's some evidence that doing that is more likely to sway opinions.

As you know as well, for some people—you are never going to change their minds. So increasingly the discussion, and where a lot of this literature comes from, is about those people that are on the fence, or interested about what the evidence really says. The distribution is probably a bell curve so that's the vast majority of people.

You mentioned earlier about rather than spending all our time talking about why, say, activated charcoal isn't a good idea, we should try to get at the underlying reasons why somebody would want to take activated charcoal pills. The kind of underlying social or emotional desires that wellness trends fulfill. I'm wondering if you have any insight about that after trying a lot of this stuff. We talked about cheating death, but is there something more going on besides just this fear of dying?

A recent study asked: Who do you think is a credible source of information? And people will say, "Experts are." But in addition to experts is someone like them. Someone who shares their values, who has a similar world view. I think we can learn a lot from that. Why is someone interested in these therapies? What's going on in their life? I think that framing the information in the context that's relevant to people I think is really important.

The other thing is—and we heard this a ton on the show, it's a really common thing—people are frustrated with the conventional healthcare. They feel like they're not being listened to. You know, there is that study that said that doctors stop listening to a patient at 11 seconds. Patients sense that, right? And it frustrates them. I think we can learn from that. What's missing in conventional healthcare that needs to be fixed? I heard people saying, "My problems aren't being taken seriously. My doctor doesn't listen to me." That matters, I think that drives people to these other practices.

I saw a study in Social Psychology that said that people who think the world is governed by secret forces are more likely to trust alternative medicine. Is it just a more magical world to live in than our cruel, harsh scientific world where we don't know anything and it feels like we don't know how to be well?

I think it is, and I'm going to give anecdotes as my response. I often have people say, "Keep an open mind. Oh you're so negative. You don't think anything works." And I do think that skeptics and people who are critical thinkers who are science-based often get that label and I think it's entirely wrong. I think science is fantastically magical. It's not a cold way to see the universe, but it's often portrayed that way. Having said that, I do think that some people who speculate, like Alan [Levinovitz], that some of these practices do serve as almost a secular spirituality. It gives people community, it gives people a world view, and it gives people a degree of comfort.

I guess what's important is you could really enjoy having crystals in your house, but just not claiming that they do more than what they're capable of.

Yeah, that's right. They're not emitting special energy that's aligning your, I don't know, your chakra or whatever it is, your chi.

Who is this show for? Is it for somebody who is deep in the wellness world, can somebody who has never heard of Goop watch this?

We hope that this show is for everyone. I think it's going to resonate with people who see the world critically. I also hope it's for people who are on the fence. Who are thinking about these practices and want to hear what the science says but also get a sense of the perspectives and concerns that are driving the uptick of these practices.

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