Vitamin E (300 milligrams of synthetic ox-tocopherol per day) showed no effect on the frequency of major fatal and non-fatal cardiovascular events in a controlled, randomized (but not double-blind) prevention trial on 4,495 men and women 50 years of age or greater with one or more cardiovascular disease risk factors. The study, which was called the Primary Prevention Project (PPP) also tested aspirin in the prevention of adverse cardiovascular events. Compared to patients who were not assigned to receive aspirin, patients who received daily treatment with 100 milligrams of enteric-coated aspirin had a significantly lower risk of cardiovascular death and total adverse cardiovascular events (e.g., angina pectoris and nonfatal myocardial infarction).
The researchers (the Collaborative Group of the Primary Prevention Project) ended the trial earlier than originally planned (a mean of 3.6-years) because of ethical considerations. Evidence had emerged from two other major studies that aspirin provided clear excess benefit consistent with interim findings of the PPP. The Collaborative Group judged that for the vitamin E regimen to have any chance of showing benefit "would have implied an unrealistically long follow-up."
The PPP study was published in the January 13, 2001 issue of The Lancet (357:89-95). The researchers concluded that "at best, there are no real reasons for including antioxidants [e.g., vitamin E] among recommendable prevention strategies [for cardiovascular diseases]." In an editorial in the same issue of The Lancet (p. 84-85) Walter W. Rosser of the University of Toronto Department of Family and Community Medicine commented: "What general practitioners can confidently advise their patients is that any beneficial effect that vitamin E might have is weak and awaits discovery."
Comment: Consumer demand for vitamin E supplementation has been fueled by advertising and publicity about vitamin E's antioxidant properties, its apparent absence of side effects, and by observational studies linking vitamin E supplementation to reduced risk of heart health problems. However, the long-term safety of vitamin E supplementation has not been established; because vitamin E supplementation can reduce blood coagulation and alter immune system function, it may not be as benign as reputed. Observational study findings provided only suggestive evidence of the value of vitamin E supplementation to prevent heart disease; they never provided a solid basis for recommending supplemental vitamin E.
The Primary Prevention Project did not focus on patients already diagnosed with cardiovascular diseases. Regarding such patients, an American Heart Association Science Advisory [published in Circulation 99:591-595s, 1999] stated that "results from clinical trials of vitamin E have been encouraging, and if further studies confirm these findings, consideration of the merits of vitamin E supplementation in individuals with cardiovascular disease would be warranted."
As part of a special section on herbal medicine published in the Fall/Winter 2000 issue of The Scientific Review of Alternative Medicine (SRAM), Varro E. Tyler, Purdue University distinguished professor emeritus of pharmacognosy explains how reports in prestigious medical journals on botanical treatments often lack adequate product definitions. According to Tyler, because of the lack of herbal product quality standards in the U.S. and many other countries, herbal medicine researchers need to report: (1) "Latin binomial names followed on the first citation by the name of the author who assigned that designation;" (2) specification of the part of the plant used; (3) a profile of the principal constituents; (4) composition of dosage form; (5) method of administration; (6) dissolution time of compressed tablets; (7) properties of tablet or capsule coatings. Tyler discusses inadequate product definitions in reports about a multi-ingredient Chinese herbal formula, St. John's wort, varlerian root extract, steam-distilled garlic oil, Garcinis cambogia Desr., scullcap and valerian, Siberian ginseng, and PC-SPES, the eight-herb formula which has been promoted for the treatment of prostate cancer.
In another SRAM article, Willem Betz, MD, who practices general medicine in Brussels, Belgium, reviews the 1991 epidemic of kidney damage among mostly young women due to aristolochic acid in Chinese herbal treatments administered at a "natural" slimming clinic. "The problem was discovered only through scientific, reality-based medicine," explained Betz. "[Traditional Chinese medicine] has no knowledge of, or any system for, long-term follow-up of the adverse effects of its therapeutic products."
Not until June 2000 did the U.S. Food and Drug Administration warn physicians about the dangers of Asian herbal treatments.
Products containing Aristolochia continue to be sold over the Internet.
An SRAM paper by Bill Burley identified problems with Chinese herbal products such as: (1) inclusion of animal substances; (2) one name applied to several substances; (3) substitution of herbs on the label with herbs presumed to have similar physiological effects; and (4) products contain combinations of several herbs.
Additional problems with medicinal plant products were identified in an SRAM paper by a team from the University of Guelph Department of Plant Agriculture led by Susan J. Murch: (1) variability in individual plants and yearly harvests; (2) adulteration of medicinal preparations with misidentified plant species; and (3) contamination of plant materials and the resulting preparations with insects, bacteria, fungi, and environmental pollutants. The authors note the need for technologies "which allow for the large-scale production of optimized, intact plant tissues in a sterile, controlled environment."
Many proponents of "alternative" healthcare promote much more than dubious methods of treatment, prevention, and diagnosis. They also make dubious claims about what threatens the health of the public. A symposium edited by NCAHF president William M. London and past president William T. Jarvis, PhD, was published on this subject in The Scientific Review of Alternative Medicine and Aberrant Medical Practices [5(1):12-53, 2001]. It includes Jarvis's overview of "Alternativism and Public Health" along with papers that critically examine two "alternative" disease entitites-multiple chemical sensitivity (MCS), which has recently been termed idiopathic environmental tolerances (IEI) and subluxation-and "alternative" claims that three types of exposures-vaccines, fluoride in drinking water, and amalgam fillings-are significant causes of disease.
Jarvis explains how alternativists undermine public health advances made in the 20th century. He describes alternativism as "a way of thinking that holds that science and technology degrade our lives." He discusses how alternativists have opposed community water fluoridation, pasteurization, vaccination, modern agricultural techniques, food irradiation, "anything that is 'man-made,' 'synthetic,' 'artificial,' 'chemical,' or technological.
A paper by Edward R. Friedlander, MD shows how Internet Web sites opposing childhood immunizations contain citations to scientific papers that misrepresent their contents.
Michael W. Easley, DDS, MPH discusses "strategies, techniques, and extremist measures employed by those opposed to fluoridation in order to undermine its adoption and implementation: (1) neutralizing politicians, (2) the big lie, (3) half-truths, (4) innuendo, (5) quoting of inaccurate statements, (6) the use of statements taken out of context, (7) quoting of experts, (8) conspiracy gambit, (9) scare words, (10) debate ploy, (11) use of contrived organizations, (12) subversion of the media, (13) commandeering established organizations, (14) misuse of electronic publishing, and (15) commandeering meetings."
John E. Dodes, DDS notes that dental silver-amalgam fillings, which contain elemental mercury, have saved millions of teeth from extraction with the advantages of low cost, ease of placement, strength, longevity, and resistance to corrosion by food, drink, and saliva. Despite media reports suggesting that the release of mercury from amalgam fillings poses dangers necessitating removal of amalgam fillings, the Public Health Service found "scant evidence that the health of vast majority of people with amalgam is compromised, nor that removing amalgam fillings has a beneficial effect on health." Dodes notes that dentists who promote amalgam filling removal use invalid methods to screen for toxic levels of chemical exposures and health problems.
Ronald E. Gots, MD, PhD and D. V. Hamilton discuss the problems of viewing MCS as an organic disease resulting from exposure to low-level chemical exposures rather than as a psychological phenomenon. Three case reports from Dr. Gots illustrate how physicians who diagnose MCS cause disabling psychological harm to suggestible patients by confirming their false beliefs about their vulnerability in many environments.
Samuel Homola, DC, author of Inside Chiropractic (1999), which is available through NCAHF Book Sales, notes that chiropractors have historically opposed immunizations including polio vaccines in the late 1950s. It's not surprising that many chiropractors continue to oppose immunizations. Dr. Homola explains that chiropractic colleges still teach that "correction of vertebral subluxations will boost the immune system as well as restore and maintain health." Subluxation remains a "mysterious and elusive" phenomenon defined by chiropractors in many ways and under more than 100 different names. Homola views subluxation theory as a threat to the health of the public. He argues:
Unless the chiropractic profession abandons the subluxation theory and evolves into a properly limited specialty in the use of manual therapy and other physical treatment methods in the care of musculoskeletal problems, inappropriate use of spinal manipulation will continue. And chiropractors will continue to order unnecessary x-ray examination and maintenance care that requires use of unproven and possibly harmful treatment methods.
On the 20th of April Connell Watkins, 54, a pioneer in the treatment of "attachment disorder" in children, and her associate, Julie Ponder, 40, were found guilty of reckless child-abuse resulting in the death of 10-year-old Candace Newmaker during a "rebirthing" session. They will be sentenced on June 18th. Each faces 16 to 48 years in Colorado state prison. In addition, Watkins was convicted on a second felony, criminal
impersonation, which carries an additional 12 to 18 months of prison time, and on two misdemeanors-obtaining a signature by deception and unlawful practice of psychotherapy. Two assisting "therapy parents," Brita St Clair and Jack McDaniels, face identical charges. For her role in the session, Candace's adoptive mother, Jeane Newmaker, faces a lesser charge of negligent child-abuse carrying a possible 4 to 16 years of jail time, to be tried in the fall.
The convictions came almost a year to the day after a video camera recorded the four Colorado therapists killing Candace, while Jeane Newmaker, a pediatric nurse practitioner from Durham, NC, watched. The therapists required Candace to assume a fetal position on the floor, wrapped her in a flannel sheet, piled on a dozen or so thick pillows, and pushed against the 75-pound girl with a combined weight of 673 pounds. At one point, the adults can even be heard grunting with effort.
In a voice filled with panic, Candace repeatedly screamed that she couldn't breathe, couldn't move, and couldn't find the way out. Her struggle was so intense that she kicked a 31-inch tear in the sheet. In time her protests got weaker and eventually only labored breathing could be heard from her. Fifty minutes into the session, Candace went completely quiet. The therapists taunted her with "quitter, quitter, quitter" and sat on top of her for another twenty minutes before unwrapping the sheet. Candace was discovered blue and lifeless. Paramedics called to the scene were able to coax a heartbeat from her, but her pupils were fixed and dilated. She was pronounced dead the next morning from cerebral edema.
Rebirthing, the practice of reenacting the birth experience, is a product of neo-Freudian and neo-Jungian pseudo-psychology. It is one of several proposed modalities to treat a relatively new, vague, and controversial psychopathology known as "attachment disorder" (AD). This disorder, which is not recognized in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), is supposedly characterized by an inability to form appropriate relationships with others. Attachment therapists view lack of continuous, loving eye contact as the most important diagnostic sign. They believe in a multitude of mental disorders and behavioral problems stemming from wounds created by perinatal trauma. Nowhere is the resulting damage more evident, they say, than with children who have been abandoned or rejected by their birth mother. They consider fetuses to be super-aware beings, more aware of their environment than at any other time of life. They believe a fetus is capable of reading its mother's mind and of storing hurt and fear everywhere in its body. They even refer to the "trauma of conception," which they view as a contributor to attachment disorder.
Attachment therapists claim to create a loving, emotional bond between a problem child and the parents. They assume that the problem is with the child. They treat even very young ones as manipulative sociopaths. The parents and the therapists often regard themselves as victims.
Rebirthing is an attempt to regress the "unattached" child back to the time of birth by re-inflicting the physical distress of the birth process. Experiencing this trauma is supposed to recover repressed memories of the original horror of birth: the pain of contractions, the supposed suffocating passage through the birth canal, and the struggle to be born. By the end, in confronting the trauma, a child is supposed to exit the flannel womb able to trust, love, and surrender authority to the hopeful parents waiting nearby.
We were in the courtroom when the jury and 65 other people watched and listened to the videotape of Candace's "rebirthing" session was played during the trial. Tears still well up for us when we recall what we saw on the tape. We will never be the same again.
We saw how the rebirthers instructed Candace to try to come out of her flannel "womb" and then frustrated her efforts to comply. They blocked her movements, retied the ends of the sheet, shifted their weight, and ignored her cries for help. They ignored her pleadings, at least 34 times. They continued the session even when Candace complained of nausea, the need to defecate and a lack of air, and even after she urinated. She specifically said seven times that she felt like she was going to die, to which Ponder once replied, "Go ahead, die right now." Her adoptive mother repeatedly inquired, "Baby, do you want to be reborn?" Candace weakly replied, "No." She never spoke again. Shortly afterwards, even her labored breathing could no longer be heard on the tape.
We watched 10 more hours of videotapes showing Candace enduring cruel, degrading, and disgusting practices in what were called "holding" sessions. In just one two-hour session, for example, Candace had her face grabbed with enforced eye contact 90 times and her head violently shaken 309 times. She was screamed at just inches away from her face 68 times. All the while Jack McDaniels sat on her legs. Other "therapy" sessions were all just variations on this theme. In one, Candace's obese mother lay on top of her for an hour and 42 minutes, and licked her face 21 times. In another, Candace had her treasured long hair hacked off into a short, ragged mop. In still others, she was required to kick her legs in scissors fashion until she was exhausted.
For numerous periods the rebirthers required this naturally energetic10-year-old to sit absolutely motionless for 10, 20, and 30 minutes at a time. The last image of Candace we were shown in the courtroom was of her sitting cross-legged, staring blankly at the camera, her face, though still lovely, showing nothing of the smiling, apparently confident girl seen in her fourth-grade class photo.
Court testimony revealed the elements of quackery behind the torture of Candace: (1) the bogus diagnosis of "attachment disorder"; (2) the unrealistic expectations of hopeful adoptive parents; (3) the hopelessly unscientific, intellectually vacuous, ethically bankrupt, and perversely sadistic beliefs and practices collectively called "attachment therapies";(4) the motley collection of egomaniacs, sociopaths, charlatans, wannabes, failures, and hangers-on that comprise the "attachment therapy" community; (5) the network of public and private social agencies, licensed and unlicensed social workers, self-promotional workshops and conferences, pseudo-professional cross-referrals, private clinics and residential facilities that use fear, hype, and hope to seduce desperate (or unrealistic) parents and their children. The evidence in this case showed a pipeline sending North Carolina children to Evergreen, Colorado, for victimization.
The prosecutors in this case, Laura Dunbar and Steve Jensen, provided a model for handling pseudoscientific offerings of evidence. They repeatedly prevented the defense lawyers from introducing scientifically invalid testimony about the efficacy of the methods used on Candace. When the defense finally got someone accepted as an expert on psychology, the prosecution made mincemeat of his testimony, revealing the absence of scientific support for the practices at issue. And when the defendants testified that they used therapies without scientific basis, the prosecution used the defendants' own codes of ethics, which explicitly require scientific validation of their practices, against them. Whenever a witness would admit a procedure was unsubstantiated, the prosecution would label it experimental and question the ethics of conducting experiments on unwilling children.
The following exchange was common in the courtroom:
Some commentators have noted the arrogance of the two defendants, particularly in their own testimony. They "knew" what Candace's real problem was. They just "knew" what she needed to get better. They "knew" her cries were lies or manipulation. They just "knew" she had enough air to breathe. Many practitioners and advocates of attachment disorder/attachment therapy (AD/AT) have been trying to put distance between themselves and rebirthing, in general, and Candace's killers in particular. But while there are comparatively few attachment therapists doing rebirthing of children, nearly all share the same unscientific premises and employ similar forms of abusive and dangerous restraint.
Preceding the reckless abuse of Candace were numerous cases of children being killed by the most common attachment therapy, "holding therapy." In holding therapy the child may be restrained in a parent's and/or therapist's lap with one or both arms pinned or put on the ground with one or two adults lying on top. The intent is always to induce rage and terror. If the child does not show sufficient distress, the therapist provokes it with any number of noxious ploys, e.g., rubbing the child's ribs, tickling, jerking the child's head, or yelling abuse. Therapists report at conferences that victims typically rage for two hours or more before becoming exhausted and being reduced to an infantile state-helpless in the face of the power, control and authority of the parent or therapist. At this point, several "reparenting" practices are introduced, such as bottle-feeding, breast-feeding, or feeding the child baby food, kissing and stroking the child's face, playing with infant toys, and talking baby talk.
Critics have charged that such tactics are indistinguishable from brainwashing. One therapist has shot back, "Some of these kids need to have their brains washed!"
Candace's pleas for her life fell on her adoptive mother's apparently deaf ears. Why would any truly loving parent allow such sadistic treatment of her own child, much less participate in it? One answer is that therapists use scare tactics about the nature of unattached children. They compare untreated children to Hitler, Saddam Hussein, Ted Bundy, and the Columbine High School murderers. (Candace was killed in the same county as Columbine.) Parents are also advised to confront their own alleged birth trauma. Eventually, parents may respond with exhausted acceptance of the authority of the therapist.
Candace's rebirthing was part of a typical two-week "intensive" program during which children live apart from their parents and with "therapeutic foster parents." Jeane Newmaker paid up front the $7,000 cost of the program, but many others pay with phony insurance claims. It is not uncommon for children who do not respond to AT to be left for months or years with the therapist after the intensive at a cost of $5,000 to $8,750 a month. Based on evidence presented at the trial, we believe this would have been Candace's fate had she survived.
Once parents have gotten with the program, they take home a variety of "therapeutic parenting" techniques that continue the attempted control of a child's every move and even every word. Parents are taught to require children to respond to demands with precisely worded replies or face punishment. Children may be taken out of school and isolated from all others except the mother. They are taken to farms to shovel manure all day or set to sweeping a few steps over and over for 18 hours. Testimony revealed Candace was taught "basic German shepherd" by St Clair-to respond rapidly to commands such as "come, sit, stand."
Parents also learn that food is an important weapon in their arsenal. On the one hand, therapists instruct parents to feed their child lots of sugar-"bonding food," they call it-to make up for the lactose the child supposedly didn't get as an infant. On the other hand, parents learn to withhold food from children to achieve compliance.
In a case near Austin, Texas, a father and stepmother were convicted in May of abuse through negligence for nearly starving their 7-year-old daughter to death. Prosecutors showed photos of the girl looking like a Holocaust survivor at 38 pounds. The adults claimed the child had attachment disorder and was attempting to starve herself to death. They said they didn't notice it at the time. The stepmother admitted to being familiar with AT parenting methods. Terry Levy, an attachment therapist from Evergreen, Colorado, was brought to Texas as an expert witness for the defense, but ultimately was not called to the stand.
Medical standards set by the Joint Commission of Accreditation of Healthcare Organizations (JCAHO) ban the therapeutic use of restraint and allow containment only when there is imminent danger of injury to self or others. These rules are incorporated into Colorado law, but apply only to regulated institutions, such as hospitals. Unlicensed therapists, and those working out of private offices and clinics, are not covered by the law. That may soon change, as some concerned lawmakers meet this summer to draft new legislation. We will be involved as well.
Colorado has responded to Candace's tragedy by adopting "Candace's Law," which outlaws any practice of rebirthing involving restraint with a risk of physical injury or death. The law was passed unanimously in both houses of the legislature (something rare in a bill of substance) and signed a day later by Governor Bill Owens during the trial of Candace's killers.
Editor's note: Larry Sarner and Linda Rosa testified and lobbied extensively for the passage of "Candace's Law." Sponsors of the law described them as "instrumental" in achieving effective wording.