Something that happens when you have a chronic condition is that many people want to give you ideas on possible treatments: diets is a big favourite (paleo, vegan, raw, gluten-free etc), alternative/complimentary treatments is another (reiki, homeopathy etc) and then there are types of exercise (especially yoga) and general lifestyle things (from cocoa before bed to moving to another country). Sometimes it’s a tentative suggestion, sometimes full-on old-school Jehovah’s Witness zeal that’s hard to refuse. I know you mean well, but I’m still not going to try it, and here’s why:
I want to get better more than anything, but…
There is no scientific proof that the thing works
This is usually the case, otherwise I’d have tried it already. Yes, there probably are people on the internet who think it’s a miracle, but it’s going to take more than that. People often think we should try everything that might possibly work, but that’s when these factors come into play:
I don’t have time
This may seem strange but people without a chronic illness don’t realise how much time it takes up. There’s time spent in flare-up, when you can’t do anything much productive. There’s time buying equipment or pain relief and maintaining and replacing your special products. Time attending appointments and chasing them up. Time getting your prescription each month. Often pain or lack of energy just makes everything take longer. And we need days off too! There often just isn’t space for attending regular sessions of yoga/acupuncture/homeopathy/reiki, especially when there’s no convincing proof that it will help us.
I don’t have the emotional energy to try it
Trying potential treatments can be really draining. You get your hopes up, sometimes you invest a fair bit of time and money, then it doesn’t work and you feel really disappointed. Imagine riding that emotional rollercoaster ten, twenty, thirty times. On top of which are the difficulties that chronic illness can bring to relationships, friendships and work. I don’t want anyone to think I don’t care about cures, to think I’m enjoying my situation, but please understand I can’t try every suggestion!
It’s too impractical
This is often the case with diets where you’re already on a very restricted diet (or even tube feeding) and for suggestions such as moving abroad or going abroad for treatment, or a treatment suggestion that you know will be extremely painful or exhausting for you, again without proven effects.
I can’t afford it
I already spend a fair bit on medicinal products and equipment. When I went through a more hippy phase, I spent a fortune on herbs and tinctures as well as alternative treatments. The wallet can only take so much.
I’ve tried it already
And it didn’t work. Awkward, since you’ve just told me how wonderful it is. Now I feel like a failure.
So should I just keep my suggestions to myself?
Unless I’ve expressed an interest in trying new treatments, and unless you’re my doctor, yes please. From what I gather, most of us with a chronic condition have the internet and have googled our condition or symptoms many a time. If we want to try a new treatment or diet and we have the time, money and emotional energy, we will.
I know people are being nice and trying to be helpful, but sometimes it can really take over conversations, which are already often about our health.
If you found this post interesting, check out these:
I often get “hits” on this site from people searching for information relating to Louise Hay. One of my most frequently viewed posts is about her claim that you can heal all diseases by using affirmations.
The post asks why Louise Hay — despite possessing a “miracle cure” for every known illness — chose surgery to get rid of a few wrinkles, instead of using her own teachings. If affirmations cured her cancer (where medical science failed), then surely her affirmations can also maintain the health of cells in the epidermis — far less complicated than altering the growth cycle of cancerous cells.
But it seems it’s only her customers who have the honor of testing out her miracle cures. And there’s no evidence that she even had cancer in the first place, let alone cure it.
Since I wrote that post, a slow but regular stream of Hay’s fans…
This post is a kind of short follow-on from my first post on the law of attraction, which examines what it is and whether or not it is plausible. You can find that post here. This post addresses the argument that goes along the lines of “well, even if it’s not that scientifically plausible, isn’t it a good thing to believe in?”
Apparently “Creative visualization is a cornerstone of using the Law of Attraction” . Psychologists seem to vary on whether visualisation boards are a good thing or not . They are commonly suggested by self-help books and even at school or college courses though the Law of Attraction site goes further by suggesting spending 10-15 minutes on this every day. While it can be a good thing to visualise where you want to get to, most psychologists seem to suggest that you do need to then plan concrete steps to get you to your goal such as enrolling on courses, joining a dating site, money management etc. .
Affirmations: not always a good thing
Affirmations (another major part of the Law of attraction) can also be a double-edged sword, as research has shown that uttering affirmations that we don’t truly believe can actually reduce our self-esteem . As an aside, I will add that personally I’m a fan of affirmations but it does make sense to stick to things that either are true or that we can easily believe are true.
Being in full control of life: a good thing?
The Law of attraction suggests that “your entire future is yours to create”  . Well, how lovely. But being told life is entirely in our control can be crushing if things go wrong and we feel that it is all our fault; and even minor failings to achieve our ‘dream life’ are likely to weigh on us if we feel everything is in our control, as Alain de Botton points out here .
And how realistic is it that everything is in our control? What about earthquakes and wars, trains going off the rails and terrorist attacks?
The law of attraction tells us “Be happy, for the universe is always on our side!” Maintaining law of attraction beliefs in the face of rape, loss of your home etc. is going to require quite some mental gymnastics. And is it going to encourage us to speak up in the face of injustice or to try to reduce famine, war and abuse? Probably not, if we think that these things are happening “for a reason” or because of people thinking negatively.
“Treat The Universe Like Your Personal Supermarket”
This is one of the principles stated on the law of attraction website. Hmm. Even if it were plausible that a somewhat demented Santa figure is in charge of granting our wishes if we order them correctly, how beneficial is such a belief? Isn’t it rather self-centred? And why hasn’t anyone wished for world peace? Numerous psychologists and philosophers have pointed out that actually we are often at our happiest when serving others and when we lose the heavy sense of our personal weighty existence, be it when ‘in flow’ during a hobby, immersed in a vast landscape, star-gazing or volunteering and immersed in helping others .
There is a questionnaire used to supposedly identify ‘fear of movement’ called the Tampa Scale. While I would certainly agree that it is worth identifying which patients have wrong beliefs about their condition and the effects of exercise, I also have serious concerns over some of the elements of this questionnaire. It just doesn’t seem like a rational questionnaire, and yet is very widely used and, it seems, rarely questioned.
I’m going to start with my suggested alternative, then go over the items on the original Tampa scale that I think are not going to help identify mistaken beliefs that could be causing a patient to avoid exercise and activity.
Suggested alternative to the Tampa Scale (for identifying mistaken beliefs − obviously some are true and some untrue as in the original):
1. I need to move as little as possible to avoid injury
2. Just because something aggravates my pain that usually does not mean it is dangerous
3. Sometimes it is a good idea to exercise even though it’s painful
4. When people with pain gradually increase their level of activity, they often don’t experience increased pain
5. Although my condition is painful, I would probably be healthier if I were more physically active
6. Even though something is causing me a bit of pain, I don’t think it’s actually dangerous
7. Some people with chronic pain find that exercise reduces their pain levels
8. If I exercise less, I’ll get weaker and am then likely to experience more pain
9. Worries about injury put me off exercising
10. Pain always means I have injured my body
11. Pain always means I have injured my body
12. Simply being careful that I do not make any unnecessary movements is the safest thing I can do to prevent my pain from worsening
Now for my analysis of the original
The ones that make sense (ish):
3. My body is telling me I have something dangerously wrong. (I suppose ‘dangerously’ suggests an element of dramatization if the problem is not life-threatening etc… though surely more a sign of ‘catastrophising’ than movement avoidance?)
Similar to: 11. I wouldn’t have this much pain if there weren’t something potentially dangerous going on in my body.
7. Pain always means I have injured my body.
(Probably the most useful one in my view, as this is definitely false and a harmful view.)
8. Just because something aggravates my pain does not mean it is dangerous. (Very similar to number 7. Patients need to be informed this is true, if they are not aware it is. Though I would suggest amending it to ‘Just because something aggravates my pain usually does not mean it is dangerous’ because sometimes pain is a sign of danger, obviously! Pain can warn us we are about to tear or break something.)
10. Simply being careful that I do not make any unnecessary movements is the safest thing I can do to prevent my pain from worsening. (Does sound a bit extreme, and shows lack of awareness that inactivity may increase pain long-term.)
Related to: 17. No one should have to exercise when he/she is in pain. (Quite moralistic but I suppose passible. ‘Sometimes it is a good idea to exercise even though it’s painful’ would be better.)
14. It’s really not safe for a person with a condition like mine to be physically active. (Probably a wrong belief in most cases where the questionnaire would be used, so fair enough.)
The ones that are problematic either in general or for some conditions (such as Ehlers Danlos):
2. If I were to try to overcome it, my pain would increase. (Sounds like an unhealthy battle that might well happen that way! Pacing and acceptance of pain are surely more accepted approaches? How about ‘Gradually increasing my level of activity often doesn’t lead to increased pain’?)
5. People aren’t taking my medical condition seriously enough. (No comment needed surely?! Whoever thought that was a sensible one?)
4. My pain would probably be relieved if I were to exercise. (For many people this won’t be true, so strongly disagreeing is the rational option.)
The same goes for: 12. Although my condition is painful, I would be better off if I were physically active. (What does ‘better off’ mean? Why not say ‘healthier’? That would be true in more cases. Being physically active – another subjective term – might make some people less happy due to the increased pain and fatigue and so ‘better off’ might not feel appropriate to them.)
6. My accident has put my body at risk for the rest of my life. (Ambiguous. Surely accidents do create a greater risk of re-injury in many cases? Or does it mean at risk of death, which probably would be a wrong belief?)
See also: 1. I’m afraid that I might injure myself if I exercise. (In some cases this might be highly unlikely, in other cases quite likely e.g. if you have EDS and are prone to dislocations and sprains, even during very mild exercise).
The same applies to: 9. I am afraid that I might injure myself accidentally.
A related one is: 13. Pain lets me know when to stop exercising so that I don’t injure myself. (Again, is this really unreasonable in all cases? Since when was completely ignoring pain a good idea?)
And: 15. I can’t do all the things normal people do because it’s too easy for me to get injured. (People with EDS are generally advised to avoid contact sports, for example, so again this is not going to be unreasonable in all cases.)
Also: 16. Even though something is causing me a lot of pain, I don’t think it’s actually dangerous. (Are we really advocating that people do things that cause a lot of pain? I’ve generally not been advised to do that, and indeed if something does cause a lot of pain that could be a sign you are about to or have injured yourself.)
Are you a medical practitioner or patient? I’d love to hear your views!
(This post is especially relevant to doctors and physiotherapists and others who work with those in chronic pain)
What many physiotherapists and doctors don’t understand about chronic pain
In medical jargon there is the expression kinesiophobia, ‘fear of movement’. I’ve always found this an odd concept. It is said that many chronic pain patients experience a fear of movement because of associating movement with pain. So, the assumption is that they fear pain. Those with chronic pain are, by definition, those who live with the most pain. It doesn’t seem natural to me to talk of fearing something that is already a major part of your life. If you wear a suit to work every day – you may dislike it, sure, but you wouldn’t fear it, would you? You might wear it only when obliged to do so, and wear super-casual clothes the rest of the time i.e. you may well limit your exposure to it, but fearing it would be unusual.
Chronic pain is something only those who experience it can truly understand. It isn’t accurate to think ‘well, I know what pain is, so chronic pain is just having that a lot of the time’ (which those without chronic pain tend to think either sounds awful or not too bad at all). Prior to getting chronic pain I regularly played full-contact rugby. I loved it. I loved tackling people. I didn’t mind the bloody lip, the bruises and feeling a bit battered. Doing this once a week was, however, NOT a taste of chronic pain in any way. Nor was ju-jitsu, or taekwondo, or boxing. Nor was period pain, or toothache, or a headache. The relentlessness (and total pointlessness of the pain) is not possible to imagine until it happens to you.
Imagine you enjoy sitting out in the garden when it’s sunny. One day it’s raining and someone asks you why you’re not sitting in the garden. Er, duh. It’s not much fun in the rain. Do you fear rain? No, it’s just not enjoyable sitting out when it’s raining. So why do some medical professionals really have a problem understanding that people’s preferences change when they live with chronic pain? If anyone wants me to live like I did prior to chronic pain, I want them to sit out in the rain, and enjoy it.
Movement avoidance isn’t necessarily due to fear of harm either
Now imagine you’re someone who enjoys going on walks and also reading. Imagine that you have the option to either read for a while or go for a walk while someone repeatedly stabs you in the neck with a fork, and you can’t stop them. I think I can guess what you’d choose. And what if someone tells you that, although the fork stabbing might be unpleasant, it’s not harmful. You’re still choosing reading, right?
Now what do you think about patients who avoid some pain-inducing activities, choosing to do something else instead?
Only when someone tells you that if you don’t choose the walk you’ll get unfit and get stabbed with a fork during even more activities would you reconsider.
A common belief is that patients avoid movement because they believe pain signifies damage to the body. Well, I’m sure some people do, and it’s certainly right to point out that pain can be completely meaningless and unhelpful, as is often the case with chronic pain.
But that’s not necessarily going to make someone start being as active as they used to be, because some activities are just not appealing any more, or not as appealing as pain-free options. I get headaches watching films, so don’t do it as often as I used to, but have gained a great love for podcasts and audiobooks. I’m not scared of the pain watching a film brings on… I’d just rather do something else.
Of course, what really is an issue and what patients do need to know is that if they avoid all physical activity, they’ll lose muscle tone and may experience more pain in the long run. Knowing this will potentially reduce ‘movement avoidance’ in patients who are motivated by long-term goals; perhaps not so much others.
Also, I’ve come across a few things recently suggesting the role of physiotherapists when dealing with chronic pain patients is to get them moving more. Hmm. Well, if that’s what the patient wants, fine. I’m not totally sure, however, that everyone goes to a physiotherapist wanting to be persuaded to sit out in the rain more, or spend more time getting stabbed with a fork, to continue the metaphors.
More exercise doesn’t always mean less pain long term
As far as I’m aware, it has not been proven that people with all types of chronic pain will be able to get back to their previous level of activity if they do it gradually. I’ve really tried, both with sudden increases in activity and the opposite, gradually increasing walking time by just one minute per month. In neither case did my pain levels decrease and in neither case was I able to keep up the increase, as the increased pain interfered too much with my sleep. I recognise that many people may find that doing more activity builds muscle and enables them to do more with less pain: but it can’t be the case for absolutely everyone.
For me and for many others, limiting movement is about keeping pain levels bearable and being able to work, sleep and enjoy life as much as possible. It’s not always about fear or a poor understanding of pain, or even poor motivation levels. It is a way of coping and it is a pain management system. It might be the best option for some of us, and though exercise-loving physios may struggle to understand, life’s not all about physical activity. Since developing chronic pain, I’ve really enjoyed doing more art, writing, reading and listening to the radio. I do what exercise I can each day, ideally a short walk in my area looking at the nice gardens and the wonderful lake, and sometimes chores and a few all-body exercises. Chronic pain sometimes requires adaptation and change, and perhaps medical professionals should take the time to delve a little deeper into why a patient is avoiding some things, what could help them to do it again, and whether they have found any alternatives.
For me, whenever I consider any religion, two big questions arise: 1. Is it plausible? and 2. Is it helpful? I think the law of attraction is a new religion that is steadily growing, largely unnoticed, and it’s about time we all had a good look at it. This post will cover ‘Is it plausible?’ and in a future post I will look at the second question.
What is the law of attraction?
The basic principle of the law of attraction is that you tell ‘the universe’ what you want in a specific way, and it will be delivered to you. In their words:
‘Visualize your message as a letter with ‘The Universe‘ printed on its envelope as an address… If you were waiting for new shoes, perhaps you would make space in your shoe rack. Likewise, make space in your life for the order that you have placed with the universe….Speak, walk, talk and breathe as if your reality has already changed for the better, and your original message will be delivered.’ 
It falls in a category involving a host of other beliefs such as belief in chakras and ‘energy therapies’.
A new religion
The United Kingdom has, of late, very much become the land of atheists or, at least, those who identify as having no religion (48.5% in 2014, outnumbering the 43.8% who define themselves as Christian). And yet I have become increasingly aware of a new religion, one that many might not call a religion but which I suggest should be seen as one: the law of attraction. It requires faith and something similar to prayer. It offers to its followers rich rewards. And it has a community of followers with their own online and real-life groups where they meet up and talk about using the principles of this ‘law’ in their lives (at the time of writing, on Meetup alone, law of attraction groups have over 1 million members!).
‘The Secret’ by Rhonda Byrne is a book on the Law of attraction that is, according to the book’s website, a worldwide best seller available in 50 languages with over 20 million copies in print. 
Its followers may well disagree with me and say ‘a religion? Oh no, it’s just another law of the universe like gravity’. But this is not very different to how followers of other religions will also tell you that God is real, a fact. The only difference is that churches don’t necessarily try to convince you God is real by reference to quantum physics (though a few probably do).
I had a message once from someone renting out rooms who thought I might like to live there. Based on me having said meditation is one of my interests, this home-owner told me that he and other persons in the house were law of attraction believers and another person there was a ‘heretic’. A jokey remark, of course, but, I think, hinting at a deeper, and more disturbing, reality.
While most religious people nowadays are aware that others may not believe in God and are usually quite discreet about their beliefs, the same can’t always be said about law of attraction followers. Those who believe that the law of attraction is a real phenomenon can say things such as “I know a great person who can really help with blocked energies”. They don’t realise that the existence of personal energies has not been proven or they assume that for some reason you will share their beliefs (e.g. because you both like meditation). I am constantly coming across law of attraction believers, and it’s time to speak out.
The essence of the law of attraction is as follows: ‘Whether we are doing it knowingly or unknowingly, every second of our existence, we are acting as human magnets sending out our thoughts and emotions and attracting back more of what we have put out.’  ‘When we fill ourselves with negative energies and emotions such as fear, anger, sadness or general pessimism, our frequency is lowered and the universe can only expand on this, promoting greater negativity in our lives.’
As with all religions, no hint of doubt in the phrasing there. But is this real science?
I have been unable to find any genuine, qualified scientist supporting the proposition that we send out different vibrations according to how we feel. And, even were that the case, it would need to be proven that such vibrations attract things to us such as new jobs, new partners, money, illness, etc.
Some refer to experiments on water: however, these are by no means accepted by the scientific community, may not have followed scientific methods, and the ‘scientist’ who carried them out is not well qualified or widely respected . It is also unclear how these ‘experiments’ (where people acted in various ways towards water: really!) could prove the idea that we can send out ‘positive vibrations’ to bring us what we want.
While most of us rely on Google as our main signpost to sources of knowledge, this is not necessarily wise. The top links resulting from a Google search are, presumably, usually companies who have hired a search engine optimisation firm to get them there. Life coaches and energy medicine practitioners need you to find them in a Google search and, as a result, if you search for ‘human energies’ or such, you will find material from those who rely on such pseudoscience to make money.
Really the only major balance to all of them is https://sciencebasedmedicine.org, which clearly states ‘Scientists can detect and measure minute energies down to the subatomic level, but they have never detected a “human energy field.”’  This website contains articles written by qualified scientists who expose the pseudoscience so commonly used by practitioners of ‘energy medicine’ such as reiki. While believers of the law of attraction may not also believe in ‘energy medicine’ and vice versa, there is often an overlap and ultimately both rely on similar claims (e.g. that energy can be purposely sent out from our body to do things like order us new shoes or heal someone’s bad back).
Writers at the New York Times, Psychology Today and some other sources have also refuted the law of attraction .
But what about anecdotes where it has ‘worked’?
The law of attraction and the philosophy around it share some similarities with common sense psychology, and so may sometimes appear to work. Psychological studies have long acknowledged the ‘self-fulfilling prophecy’ whereby, for example, someone who is always told they are bad at maths may indeed do badly in maths exams due to their poor self-confidence . Likewise those with good self-confidence will probably achieve most in life due to their willingness to try new things and their belief that their endeavours are worthwhile and will pay off. There is nothing radical about this. Believing goals are attainable is crucial to keep us motivated and determined, and believers of the law of attraction are likely to have such a belief.
Elements of the law of attraction are backed up by fact or simply obvious, such as this statement taken from thelawofattraction.com home page:
‘A key part of the Law of Attraction is understanding that where you place your focus can have an intense impact on what happens to you. If you spend your days wallowing in regrets about the past or fears of the future, you’ll likely see more negativity appearing, but if you look for the silver lining in every experience then you’ll soon start to see positivity surrounding you every day.’
People who want to see positive change in their lives don’t need to consult the law of attraction website, books or groups. There are plenty of other sources that can help people and which don’t rely on fake science. Not only that, but there are sources of help that have been tested by eminent psychologists (such as Martin Seligman, Rick Hanson and others), unlike the law of attraction. The law of attraction can actually lead people to worse mental health, as will be discussed in my next post.
As for ‘energy medicine’, it can work by causing relaxation and stress relief and due to the placebo effect. So, yes, it may help but it may also cost people a lot of money and cause them to fail to pursue more useful (and more scientific) remedies.
Left unchallenged, these beliefs will spread. After centuries of truth-seeking and moving away from believing the earth is flat and lightning is God’s wrath, we are at risk of slipping back into superstition and investing great time and money in such beliefs. Google isn’t helping. The internet is awash with support for this theory and proper analysis is hard to find. The same is true for energy medicine. Next time you meet someone who assumes you are a believer, please show you aren’t. Please share this post, or one in the related links below, and help us keep on the path of truth and wisdom.