How to support a friend when you disagree with their choices?

Question

Background

I (M) have a very close friend (F) who has recently been affected by an autoimmune disorder. Doctors' responses have been, essentially, 'well, we don't know why this happened but this is your life now... don't kill yourself, find a support group'.

My friend has decided that the medical community does not know anything and has thus launched into 'alternative medicine' - paying to go see acupuncturists, naturopaths, chinese medicine practitioners, etc. and reading blogs and watching videos of people who have supposedly 'cured' themselves of any and all problems/diseases by eating this food or following this diet, or getting this treatment, etc.

I believe that most 'alternative medicine' is useless at best and individual stories like 'I cured my diabetes with acupuncture and this herb!' are due to other factors unknown to or hidden by the person doing the telling. We have had several discussions about this before (pre-diagnosis) and we both know I am in the 'science only' camp while she is in the 'only natural things in my body' camp.

Problem

My beliefs put me at odds with my friend and any time I inquire as to her health and progress, it devolves into a shouting match with her telling me I 'don't understand' and that I am 'simple and closed minded', while I try to say that none of the 'treatments' or other things she's trying have proven to be effective beyond random chance.

I do not want to anger her, but when she says 'I'm going to try X' and I respond 'Ok, give it a shot, I hope it works', she gets angry saying I clearly don't believe it will work (I don't), I'm being condescending (possibly) and I'm not being supportive (also possible).

I usually try to disengage at this point (changing the subject, leaving), but she's clearly hurt, sometimes in tears, and I feel terrible.

I understand this is a very difficult time for her and I would like to support her because she is very depressed, but I also want to help her avoid spending thousands on 'cures' and being disappointed.

How can I properly support my friend if I don't believe in anything she's trying?

Answer 1

I thought I'd start with some things you might want to consider about "alternative" medicine as these might help you get your friend's point of view a little better.

Firstly, even if you believe alternative medicine is useless (as do I, for the record), it is only really "dangerous" if it replaces conventional medical practice. If the patient views it as "complementary" as many do, then it is usually harmless, provided that there are no active ingredients which would interfere with the conventional medication they may be taking. In the case of things like homeopathic remedies, it is scientifically proven that they have no active ingredients whatsoever and are nothing more than sugar and water. The danger comes in when people place false hopes in alternative medicine and disregard their conventional treatment.

The "placebo" effect is also not to be overlooked. Most drug trials include a selection of patients on placebos and the percentage of disregard on the final results for the placebo effect is often higher than you'd imagine - in some cases nearly 10%. I can't explain it - perhaps when someone is mentally fighting something they are physically stronger? My point is that even conventional medicine accepts that there are some positive effects from patients believing they are getting help.

Of course, the internet is full of people who claim to have got better from this kind of treatment alone. But if there are around 10% of people who get better from the placebo effect then these cases can be explained that way. In a clinical trial, the other 90% of people got the right treatment or will get it eventually because they didn't choose a placebo. In real life though, the other 90% will not get better at all. If I was given a medicine that offered a 10% chance of survival I would not be optimistic.

Given the above, if you think that your friend's choices may enhance her recovery or wellbeing even a tiny bit then perhaps you can find a way to be a little more supportive, providing she keeps up with her regular therapy. Perhaps something like say:

I support your choices. Just keep up with your doctor's advice as well so that you have the best chance of being well.

If you think that your friend might be open to some reasoning and could change her view, perhaps a different approach might work. Instead of attacking what she already believes, try to put in place new, well-supported ideas that are stronger. People will hold dear to what they already know and believe and defend it; however, when they accept something new that conflicts with what they already know then they are more likely to disregard the incorrect idea themselves.

For example, here is someone attacking another person's belief:

Person 1: "I like McDonald's burgers"
Person 2: "McDonald's burgers are rubbish!"
Person 1: "No they aren't!"

But what if they took a different approach:

Person 1: "I like McDonald's burgers"
Person 2: "Try this burger I made myself from 100% real steak"
Person 1: "Mmm... that is so much nicer!"

This approach may help you - try to introduce your concerns as "new" thoughts rather than attack her existing beliefs. You could say:

I've been reading about this [conventional approach] and it appears the statistics of patients improving are very good. [show evidence]

Possibly one of my favourite websites ever in the history of the internet is How Does Homeopathy Work? Once you get past the brilliant first page there are links to some scholarly articles and also an experiment conducted by the group behind the page. In one experiment, 350 people simultaneously "overdosed" on homeopathic belladonna (a poisonous plant) to prove that, while belladonna may have been used in the preparation of the product, there is absolutely no trace whatsoever of any active ingredient in the product after the preparation. Scientifically it cannot possibly do anything.

Answer 2

I do not want to anger her, but when she says 'I'm going to try X' and I respond 'Ok, give it a shot, I hope it works', she gets angry saying I clearly don't believe it will work (I don't), I'm being condescending (possibly) and I'm not being supportive (also possible).

At this point, I think it's time for a response something along the lines of:

What matters is whether it works. What I believe doesn't matter. I do want you to get well. I really do. I don't have anything better to offer, so all I can do is stand by you. So that's what I'm trying to do.

I've had too many conversations like this in my life, but as I have more of them, I find I am getting better at them. It seems like the two biggest factors in my getting better is having a way to getting to supportive wording quickly, and giving the response in a defeated tone. I find the second one is certainly getting a lot easier to manage quickly.

I would still pay attention to the sorts of things she's doing, but for the moment, you may not have enough reputation with her to matter much, even if her latest fad treatment is really bad. I'd personally still try to say something if it was, but I wouldn't have much hope of it working.

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It could also be helpful to be more traditionally supportive something cheap and harmless to try, to indicate you've come around to her way of thinking. One area to suggest if she's not gone there already: dietary changes that aren't ridiculous. Rekesoft mentioned the cutting out of dairy from the diet can be helpful. There's other things like that, such as spicy foods, which we don't need in our diet and they are sometimes known to make allergic reactions worse. I've also heard good things about an anti-inflammation diet that seemed harmless.

Science doesn't tend to get into our diet too much, because omnivorous diets are insanely complicated, especially for the masters of the world who can get food from all parts of the globe. There are definite things science has figured out about diet, of course, but the point is there's a lot of unknowns, and it takes long enough to investigate that will probably be true for all of my lifetime.

Science has figured out allergies to some specific foodss, but if it's not a very serious reaction, it can take them a really long time. My ex apparently has one they're still working on figuring out. As such, this is more an area of uncertainty than the usual alternative crap.

Note that I'm not trying to push a specific diet, or even trying to say that you should necessarily suggest one. I'm just trying to suggest something that you could try to be directly supportive of to show a change of heart if you were so inclined. I don't know any other harmless things to try that have at least the remotest chances of working, otherwise I'd list some other options. I also wouldn't want to suggest you prompt her with more alternative medicine ideas than she's already gotten on her own, unless she's asking for them.

Answer 3

I don't how how serious is your friend's condition, but it look like she's experiencing a process of grief. If, as you say, the doctors have said to her "there is nothing more we can do" it's not strange - it's even logical - she's trying to find answers somewhere else. No matter what you do, she's going to go through all the stages of the process, and since they are not exactly linear nor chronological, there's a bit of every one of them going along at at time - so you are seeing examples of denial (of modern medicine), bargaining (if I change my lifestyle I may improve) and anger (in this case, directed at you, but it's mostly a feeling of hers she can't control).

Now, you have to ask yourself some questions. What do you want to achieve? Do you want to support her? Do you want her to stay out of alternative medicine? Do you want her to avoid wasting money on useless therapies? If you want to comfort her I'd suggest to do exactly that. Even if you don't believe in alternative medicine - neither do I - is worth to remember that "real" medicine has practically evicted her. Modern medicine does not know all. For example, there are some statistical evidences that milk and dairy products can worsen allergic conditions, so an autoinmune syndrome could benefit from a lactose-free diet. Who knows? Even if it's only placebo effect, you can't deny her anything that makes her feel better, or provides some hope; if she were resorting to praying and attending more religious events, would you try to talk her out of it? Preaching your values against hers in a moment when she's at her knees is not going to help.

If you're worried about her wasting her money, you should point tactfully that, if you know she's gonna try some really expensive therapy. Or same thing if you think this treatment can worsen her health or meddling with whatever actual medicine she's taking, if any. Aside of that I'd rather express some sympathy for her choices. If you can't have "an open mind", pretend you can.

Friend: I'm going to try a new acupunture/reiki/homeopathy treatment next week to treat my XXXX.

You: Oh, you know I'm not that into those things, but I do hope it works!

Sometimes it's better being a friend than being right. When you are talking about an ill, depressed friend is one of those times.

EDIT: you mention that when you say "ok, give it a shot" she gets angry. This is probably because she clearly sees you don't believe what you're saying. If you can't disguise this, you could try suggesting alternatives "have you told your doctor about that pain? Maybe he/she could give you something" or if not, say nothing and try to comfort her just by listening to her and being by her side. In any case, until she gets to the "acceptance" state she's not going to be able to prevent this events of rage. You can try to not provoke them, but in the end they are not about you.

Answer 4

Help her by bringing science to the table on her behalf, and with her own experience.

From your friend's perspective, she's been diagnosed with a difficult condition, has no "official" hope for recovery or (possibly) even improvement, and has therefore latched onto even slim hopes for a better future. That's pretty understandable.

Your counterarguments are modestly inconsistent-- you appear to be arguing from a fundamental efficacy position (treatment X produces effect Y in a statistically meaningful proportion on a precisely constituted study population Z), but your actual arguments (as posted here) admit that treatments might work, just for unknown reasons in an unpredictable subset of the population. I can predict which of those your friend is emphasizing more.

Even if her position is only a psychological veil to keep despair at bay, that's not nothing even though it's not a path to a cure or mitigation of symptoms. Further, the placebo effect is a real thing-- a treatment doesn't necessarily need to "work" to make her feel better. If that attitude leads her to reject necessary steps in treating her condition, standing aside might not be feasible. But if she's just spending her time wearing special bracelets or stickers (both real pseudo-scientific "treatments" I've seen), then it may be totally harmless with some upside potential.

Presumably you are not a certified expert in a relevant field (else you wouldn't be defaulting to arguments from basic scientific validity of claims), so what she's primarily hearing from you (regardless of your phrasing or tone) is probably along the lines of:

Your situation is hopeless, your life will never improve, and thinking otherwise proves that you're a fool.

That sucks. It may be what she needs to hear (learning to live with an illness can be hard when you're dreaming all day of an unrealistic, imaginary future in which it's cured), but she's not listening to it right now.

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So, what can you do to support her when you obviously don't buy into these science-free schemes? You can help her evaluate these purported treatments.

By that I don't mean "automatically reject them out-of-hand without several published, high-quality studies already existing". But if you've the background knowledge to do so (and if you're presenting yourself as "science only", you should) you can help your friend develop ways to plan, track, and analyze the effects of different alleged "cures". You can suggest something like:

I don't know much specific information about [approach X], so I don't know if or how well it might work. But to help find the most effective option for you, we could draw up a plan for tracking things like how you're feeling, and when it might be time to give up on one treatment or when it's too early to tell if it's working or not. There are a lot of potential options out there, and a methodical approach will help to sift through them.

That might involve drawing up a budget for how much she can spend on these things. There will always be another brand of snake oil, so it's not going to be feasible for her to try them all. But if she has a budget that only allows $200 per month for this, you can be more confident that she won't be spending herself into penury over wild goose chases. She can at least see how spending money on these things fits into her overall financial situation, and appreciate how much she's already spent on do-nothing products and ideas.

If and when she does choose an approach to try, you can help her to evaluate the effects in a more scientific manor. It won't be a double-blind clinical trial, but a sound methodology will help her understand what effect each "cure" has, if any. Possible benefits include knowing when to stop with a specific effort, identify how well promised results match actual results, (possibly) more faith on her part in the scientific method for learning true information, and more.

The best part is that this allows you to not buy into a given "cure" while still accepting the possibility that it will work for her (the methodical approach is how she can be sure for herself and also convince you!). It allows you to be involved and help her throughout her efforts without rendering any judgments in advance (you've laid out what you would consider to be positive and negative results in advance, so the evidence dispassionately either meets or fails to meet the criteria in a fixed period of time). It allows you to bring the best of your philosophical position to your friend in a productive way, rather than just telling her that "science", monolithically, promises that she's doomed.

So you can tell her that you're skeptical of any given idea, but you really want to help her figure out what improvements might be out there. The specifics of how you'd do this sort of observational testing will depend on what each treatment consists of, but even something as simple as keeping a calendar and describing how she's feeling (in terms of her illness) several times per day from a baseline scenario versus over the course of each treatment can be informative, particularly if you're able to operationalize information well (again, specific-situation dependent).

The single, best defense against quackery is a combination of clear definitions of success and failure determined a priori and sound, methodical data. Bringing those to your friend, who may lack them on her own here, can be a great way of supporting her.

For completeness' sake, I will mention that when I've tried this approach (with fad diets, not intractable illnesses), I've not actually had anyone take me up on it-- those people simply weren't interested in tracking that sort of information, for reasons I can only guess. Nonetheless, it did demonstrate my interest in helping rather than judging. It also generally stopped those people from bringing the topic up in conversation, except for the occasional casual mention.

Answer 5

Disbelief in natural remedies is due to ignorance, not reality. Most people won't make the immense investment of time to learn how to use natural remedies, and money to purchase them.

The Internet is of zero help in gaining useful information on alternative healing. If you put gallbladder into Google combined with any food, nutritional supplement, or alternative therapies, you will get links that say it's good for the gallbladder and links that say the opposite.

And it's the same way for every illness, disease, or malady. Alternative healing is very effective for many problems, but most people just want to feel like they're doing something to help themselves rather than expending the effort required to actually do anything truly beneficial.

I have spent 34 years of study, insisting on quality clinical trials to demonstrate the effectiveness of any remedy, along with selecting high-quality supplements and using a sensible dosage.

I also hire medical doctors to monitor my health, and administer treatments when necessary. My doctors learn a lot from me.

So, show this answer to your friend, so she knows she is totally unqualified to treat herself in an effective way unless she is willing to thoroughly investigate the remedies she uses, from a clinical standpoint, filter out the BS, take a meaningful dosage, procure the highest quality products, eat a healthy, balanced diet that is conducive to lessen her suffering, take full advantage of the medical establishment, and make a significant investment of time and effort in her health.

She is using you to convince herself that she is on the correct path. If she can convince you, then she'll believe she's doing the right thing.

The only way you can help is to procure reliable information, on your own time, on natural remedies that have evidence backing their effectiveness in combatting her condition.

Believe me. I have a lot of experience advising people on wholistic strategies to combat mental and physical ailments.

Answer 6

The world of alternative medicine is actually quite large, and encompasses more healing modalities than there are within the western world. This is because the world is much larger than the Euro-American "West". I am a Physician Assistant, so I am very entrenched in the Western Medical World, and I will say that it is not the be-all end-all of healing modalities. If you are a believer in evidence-based practices, then you might benefit from doing a bit of research into which "alternative" modalities are evidence-based and which are not. I am not a believer in homeopathic medicine, but there are other non-western treatments that do have evidence at this point to back them up. This includes some Chinese medicine practices such as acupuncture. I'm sure there are many other non-western modalities that have been studied and shown to be effective, I just don't know all of them, obviously. Additionally, it's important to note that much research in the US is funded by large pharmaceutical corporations, and there is a lot more money to be made when you can sell a product at the end of the research, rather than telling people about the inexpensive pharmacopeia which exists in nature all around us. I'm not saying that instead of taking an aspirin, we all sip willow bark tea, but I am saying that willow bark tea may have been called an old wives' tale until some white scientist sat down and studied the effects of this tea in comparison to aspirin.

Beyond all of that, I think it makes sense to feel a sense of frustration if you see your friend doing something that you think won't be effective. I think it could be beneficial to consider what several of the other responders have said - it makes a lot of sense for a person to go through all possible available options when told there is nothing to be done by the mainstream providers. And I think there are healing modalities out there that actually understand the human body and the human condition better than western medicine. A lot of things that Western medicine originally calls quack later are found to be effective healing modalities. That's why you named acupuncture as an alternative modality above alongside homeopathy - I think these get shuffled together far too much in my opinion.

All that to say, keep your mind open, but maintain a healthy skepticism, and if she's not asking for your opinion, then don't give it. Just respect that she's doing what she believes is best for herself with the information she has available to her at at the moment. And if she changes her mind down the line, don't be the one to say "I told you so" - it might feel good, but it really puts up people's barriers, puts them on the defensive. Just offer empathy and validation that she made the best decisions she could for herself at the time. And if you really want to offer feedback, you can ask first if she's open to hearing your opinion on the matter. If she says no, then respect that answer.