Tanveer Ahmed: Converting disbelievers

IF asked about the biggest clash between reason and faith in our lifetime, most of us will think of terrorism. But a troubling battle is also playing out in modern medicine with a growing number of people who are greatly suspicious or antagonistic about its status.

This year has seen a great deal of debate surrounding groups who refuse to vaccinate their children, with most of the response from commentators and experts focusing on the quality of the evidence for vaccination and calling for unvaccinated children to be kept out of schools and childcare centres.

While for the most part this is appropriate — for the public health dangers we face from unvaccinated children are considerable — the dismissive response towards those who stand against the authorities of science and medicine misses the point that the nature of distrust has more to do with faith than reason and must be engaged as such.

As a psychiatrist, I often have to engage with patients and their families who are deeply religious. Many such patients, when first presenting with troubling symptoms varying from depressed mood, hearing voices or debilitating anxiety, may not view their problems through the lens of mental health.

It is not my job to bash their belief system but to find ways they might accept that the treatment I offer — be it therapy or medications — is not diametrically opposed to their religious beliefs.

I consider these to be adjunct treatments. For example, the priest might be engaged to discuss with the patient how diseases of the mind, while certainly encompassing a spiritual or existential component, might also have a physiological aspect treatable with medicine.

This is not just a religious problem. Greens member of the NSW Legislative Council John Kaye touched on a similar dilemma when he suggested an inquiry to clearly illustrate the benefits of fluoride in dental health in response to antifluoride protests on the NSW North Coast (also a key location of antivaccine campaigners).

Kaye was rapidly howled down by fellow Greens, government and opposition members. But he identified a problem — the growing number of people who are deeply suspicious of the authority of medical science. His mistake was to offer them more of the same.

In the past, many people sought relief for many of their problems in the medical profession and in organised religion. Now doctors are seen as too distracted and technically oriented to care about patients’ everyday troubles, while organised religion is seen as irrelevant and antiquated.

Alternative medicine covers a wide range of disciplines, most of which are rooted by the belief that the human body is not just a material reality. The thinking is that the human body has an energy to it that can be guided by external manipulation, much the way that matter and tissues are influenced by chemicals and radiation in conventional medicine.

Much of alternative medicine relies on physical practices commonly used in conventional medicine — pill-taking, needle-poking, and the application of heat and pressure, thus giving it the cloak of science.

The market is estimated to be worth more than $4 billion a year and it is among the fastest growing segments in the health sector.

According to the National Institute of Complementary Medicine two in three Australians use complementary medicines each year and spend almost four times as much on the out-of-pocket expenses for these medicines as they do on pharmaceuticals. In most cases, the use of vitamins or supplements is unwarranted in healthy people.

Years ago, many people wore garlic around their necks to ward off disease. My patients would baulk at this idea, but when garlic is crushed, put into capsules and swallowed, they are convinced their actions are in keeping with science.

But berating or labelling people as stupid is not going to convince skeptics to embrace modern medicine.

I regularly spend several sessions with a growing proportion of my patients building their trust in my job and chemical wares before they, reluctantly, will accept my authority and treatments. They usually present only at the behest of desperate relatives.

The doubters need to have their beliefs acknowledged, but require gradual convincing that their beliefs do not need to be diametrically opposed to medical science. There also needs to be an admission of the power of placebo, the inherent doubts that are part and parcel of health care, and that the veneer of omniscience within the medical profession is, in part, charade.

For the growing proportion of the populace who channel a religious impulse through their consumption of health care, it is modern medicine that needs to become the adjunct or complementary treatment.
 

Dr Tanveer Ahmed is a Sydney psychiatrist, author and local government councillor.

Dr Ahmed has given an assurance to MJA InSight that this is his original work.