Uri Geller: Self-Proclaimed ‘Psychic’

A flash-back to 1975 when Uri Geller came to town.  Super-psychic or super-charlatan? Who to Believe?

On the one hand, a scientific report published in Nature verifying Geller’s psychic abilities under supposedly cheat-proof conditions, and on the other, a highly speculative but critical attack published simultaneously in New Scientist. While Targ and Puthoff’s reply … would seem to invalidate his explanations of their significant results, it is difficult to disregard the doubts Hanlon has raised about the “circus atmosphere” that he believes surrounded the SRI experiments. Frankly, at the end of 1974, we were puzzled and confused. Weighing all the evidence available at that time, it seemed impossible to decide whether Geller was a genuine psychic or an ingenious and highly skilled hoaxer. Clearly, the Geller effect had to be taken seriously as, in either case, there would be much of interest to learn about the mechanics of psychic performance. Clearly, what was needed was more experimentation.

First Encounter

Our first live encounter with Geller was accidental. On 23 March 1975 Geller arrived in New Zealand from Australia to begin a series of four “lecture-demonstrations” of his psychic powers. To facilitate communications, I ( David Marks) checked into the same hotel as Geller in the Dominion capital, Wellington. Hopefully we could obtain a sufficient level of cooperation to complete a series of laboratory tests. I left a letter for Geller at the hotel reception inviting his participation in some experiments.

I had been told by Geller’s local agent, Bruce Warwick, that Geller was due to arrive on the ten o’clock plane, and so an arrangement was made to talk with Geller the next morning after a press conference. At eight o’clock on the evening of the 23, I went down to dinner in the almost empty hotel restaurant. At about nine o’clock a party of noisy, flamboyant people sat down at the table next to me in the quiet dining room. From their accents, some were obviously Americans, others Australians, and others sounded like Americanized Israelis.

Suddenly, as I idly scanned their faces, to my utter amazement, I saw Uri Geller. Apparently, he had materialized himself into New Zealand prior to the aircraft’s arrival! He was sitting with his back to me, not more than ten feet away, opposite a woman with blond hair who spoke loudly and clearly with a distinct American accent.

Geller’s Faux Pas

Although I was dying to meet Geller, my first reaction was to leave, as the last thing I wanted to do was invade Geller’s privacy. However, it was I who had been there first, and they had sat next to me, not vice versa, so I decided to finish my dinner and then leave.

To this day I can still hardly believe what took place in the next few moments. The American woman (whom I knew later to be Miss Solveig Clark, one of Geller’s personal assistants) asked Geller in a clear and distinctive voice whether he had “read the letter from Dr. Marks.” Like most other people, I find it hard not to tune in to a conversation when my name is mentioned. I heard Geller reply: “Keep that guy away from me; he’ll pick up the signals (sic).”

No words can describe how I felt at that moment. What signals? Could these be the signals described in the New Scientist? Who was Geller’s female confidante? Was Puharich there, or Shipi Shtrang? Although I couldn’t answer all these questions, Geller had already told me more than I ever imagined would be possible. Yet Geller was blissfully ignorant of this major faux pas. I couldn’t help feeling that if Geller were truly psychic, he’d certainly have sensed my presence and avoided giving away trade secrets!

Postscript:

No question about it, from that moment I sensed that Uri Geller was nothing more than a not-so-clever trickster.

Anybody can bend a spoon, as long as you have a firm grip. Try it without touching, however, and its a very different story.

Geller successfully conned pretty much the whole world into believing he had special powers.

He does. It’s called sleight-of-hand!

Flashback: an extract from “The Psychology of the Psychic”.

Special issue on the PACE Trial

We are proud that this issue marks a special contribution by the Journal of Health Psychology to the literature concerning interventions to manage adaptation to chronic health problems. The PACE Trial debate reveals deeply embedded differences between critics and investigators. It reveals an unwillingness of the co-principal investigators of the PACE trial to engage in authentic discussion and debate. It leads one to question the wisdom of such a large investment from the public purse (£5million) on what is a textbook example of a poorly done trial.

The Journal of Health Psychology received a submission in the form of a critical review of one of the largest psychotherapy trials ever done, the PACE Trial. PACE was a trial of therapies for patients with myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS), a trial that has been associated with a great deal of controversy (Geraghty, 2016). Following publication of the critical paper by Keith Geraghty (2016), the PACE Trial investigators responded with an Open Peer Commentary paper (White et al., 2017). The review and response were sent to more than 40 experts on both sides of the debate for commentaries.

The resulting collection is rich and varied in the perspectives it offers from a neglected point of view. Many of the commentators should be applauded for their courage, resilience and ‘insider’ understanding of experience with ME/CFS.

The Editorial Board wants to go on record that the PACE Trial investigators and their supporters were given numerous opportunities to participate, even extending the possibility of appeals and re-reviews when they would not normally be offered. That they failed to respond appropriately is disappointing.

Commentaries were invited from an equal number of individuals on both sides of the debate (about 20 from each side of the debate). Many more submissions arrived from the PACE Trial critics than from the pro-PACE side of the debate. All submissions were peer reviewed and judged on merit.

The PACE Trial investigators’ defence of the trial was in a template format that failed to engage with critics. Before submitting their reply, Professors Peter White, Trudie Chalder and Michael Sharpe wrote to me as co-principal investigators of the PACE trial to seek a retraction of sections of Geraghty’s paper, a declaration of conflicts of interest (COI) by Keith Geraghty on the grounds that he suffers from ME/CFS, and publication of their response without peer review (White et al., 4 November 2016, email to David F Marks). All three requests were refused.

On the question of COI, the PACE authors themselves appear to hold strong allegiances to cognitive behavioural therapy (CBT) and graded exercise therapy (GET) – treatments they developed for ME/CFS. Stark COI have been exposed by the commentaries including the PACE authors themselves who hold a double role as advisers to the UK Government Department of Work and Pensions (DWP), a sponsor of PACE, while at the same time working as advisers to large insurance companies who have gone on record about the potential financial losses from ME/CFS being deemed a long-term physical illness. In a further twist to the debate, undeclared COI of Petrie and Weinman (2017) were alleged (Lubet, 2017). Professors Weinman and Petrie adamantly deny that their work as advisers to Atlantis Healthcare represents a COI.

After the online publication of several critical Commentaries, Professors White, Sharpe, Chalder and 16 co-authors were offered a further opportunity to respond to their critics in the round but they chose not to do so.

After peer review, authors were invited to revise their manuscripts in response to reviewer feedback and many made multiple drafts. The outcome is a set of robust papers that should stand the test of time and offer significant new light on what went wrong with the PACE Trial that has been of such high significance for the nature of treatment protocols. It is disappointing that what has been the more dominant other side refused to participate.

Unfortunately, across the pro-PACE group of authors there was a consistent pattern of resistance to the debate. After receiving critical reviews, the pro-PACE authors chose to make only cosmetic changes or not to revise their manuscripts in any way whatsoever. They appeared unwilling to enter into the spirit of scientific debate. They acted with a sense of entitlement not to have to respond to criticism. Two pro-PACE authors even showed disdain for ME/CFS patients, stating: We have no wish to get into debates with patients. In another instance, three pro-PACE authors attempted to subvert the journal’s policy on COI by recommending reviewers who were strongly conflicted, forcing rejection of their paper.

The dearth of pro-PACE manuscripts to start off with (five submissions), the poor quality, the intransigence of authors to revise and the unavoidable rejection of three pro-PACE manuscripts led to an imbalance in papers between the two sides. However, this editor was loathe to compromise standards by publishing unsound pieces in spite of the pressure to go ahead and publish from people who should know better.

We are proud that this issue marks a special contribution by the Journal of Health Psychology to the literature concerning interventions to manage adaptation to chronic health problems. The PACE Trial debate reveals deeply embedded differences between critics and investigators. It also reveals an unwillingness of the co-principal investigators of the PACE trial to engage in discussion and debate. It leads one to question the wisdom of such a large investment from the public purse (£5 million) on what is a textbook example of a poorly done trial.

ME/CFS research has been poorly served by the PACE Trial and a fresh new approach to treatment is clearly warranted. On the basis of this Special Issue, readers can make up their own minds about the scientific merits and demerits of the PACE Trial. It is to be hoped that the debate will provide a more rational basis for evidence-based improvements to the care pathway for hundreds of thousands of patients.

References

Geraghty, KJ (2016‘PACE-Gate’: When clinical trial evidence meets open data access. Journal of Health Psychology 22(9): 11061112Google ScholarSAGE JournalsISI
Lubet, S (2017Defense of the PACE trial is based on argumentation fallacies. Journal of Health Psychology 22(9): 12011205Google ScholarSAGE JournalsISI
Petrie, K, Weinman, J (2017The PACE trial: It’s time to broaden perceptions and move on. Journal of Health Psychology 22(9): 11981200Google ScholarSAGE JournalsISI
White, PD, Chalder, T, Sharpe, M. (2017Response to the editorial by Dr Geraghty. Journal of Health Psychology 22(9): 11131117Google ScholarSAGE JournalsISI

The Editorial has been abridged and the photograph of Dr. Keith Geraghty added.

The PACE Trial: A Catalogue of Errors

What was the PACE Trial?

Rarely in the history of clinical medicine have doctors and patients been placed so bitterly at loggerheads. The dispute had been a long time coming. Thirty years ago, a few psychiatrists and psychologists offered a hypothesis based on a Psychological Theory in which ME/CFS is constructed as a psychosocial illness. According to their theory, ME/CFS patients have “dysfunctional beliefs” that their symptoms are caused by an organic disease. The ‘Dysfunctional Belief Theory’ (DBT) assumes that no underlying pathology is causing the symptoms; patients are being ‘hypervigilant to normal bodily sensations‘ (Wessely et al., 1989; Wessely et al., 1991).

The Psychological Theory assumes that the physical symptoms of ME/CFS are the result of ‘deconditioning’ or ‘dysregulation’ caused by sedentary behaviour, accompanied by disrupted sleep cycles and stress. Counteracting deconditioning involves normalising sleep cycles, reducing anxiety levels and increasing physical exertion. To put it bluntly, the DBT asserts that ME/CFS is ‘all in the mind’.  Small wonder that patient groups have been expressing anger and resentment in their droves.

Top-Down Research

‘Top-down research’ uses a hierarchy of personnel, duties and skill-sets. The person at the top sets the agenda and the underlings do the work. The structure is a bit like the social hierarchy of ancient Egypt. Unless carefully managed, this top-down approach risks creating a self-fulfilling prophecy from confirmation biases at multiple levels. At the top of the research pyramid sits the ‘Pharaoh’, Regius Professor Sir Simon Wessely KB, MA, BM BCh, MSc, MD, FRCP, FRCPsych, F Med Sci, FKC, Knight of the Realm, President of the Royal College of Medicine, and originator of the DBT.  The principal investigators (PIs) for the PACE Trial, Professors White, Chalder and Sharpe, are themselves advocates of the DBT.  The PIs all have or had connections both to the Department of Work and Pensions and to insurance companies. The objective of the PACE Trial was to demonstrate that two treatments based on the DBT, cognitive behavioural therapy (CBT) and graded exercise therapy (GET), help ME/CFS patients to recover. There was zero chance the PACE researchers would fail to obtain the results they wanted. 

Groupthink, Conflicts and Manipulation

The PACE Trial team were operating within a closed system or groupthink in which they ‘know’ their theory is correct. With every twist and turn, no matter what the actual data show, the investigators are able to confirm their theory. The process is well-known in Psychology. It is a self-indulgent processes of subjective validation and confirmation bias.  Groupthink occurs when a group makes faulty decisions because group pressures lead to a deterioration of “mental efficiency, reality testing, and moral judgment” (Janis, 1972). Given this context, we can see reasons to question the investigators’ impartiality with many potential conflicts of interest (Lubet, 2017). Furthermore, critical analysis suggests that the PACE investigators involved themselves in manipulating protocols midway through the trial, selecting confirming data and omitting disconfirming data, and publishing biased reports of findings which created a catalogue of errors.

‘Travesty of Science’

The PACE Trial has been termed a ‘travesty of science’ while sufferers of ME/CFS continue to be offered unhelpful or harmful treatments and are basically being told to ‘pull themselves together’. One commentator has asserted that the situation for ME patients in the UK is: The 3 Ts – Travesty of Science; Tragedy for Patients and Tantamount to Fraud” (Professor Malcolm Hooper, quoted by Williams, 2017). Serious errors in the design, the protocol and procedures of the PACE Trial are evident. The catalogue of errors is summarised below. The PACE Trial was loaded towards finding significant treatment effects.

A Catalogue of Errors

The claimed benefits of GET and CBT for patient recovery are entirely spurious. The explanation lies in a sequence of serious errors in the design, the changed protocol and procedures of the PACE Trial. The investigators neglected or bypassed accepted scientific procedures for a RCT, as follows:

Error Category of error Description of error
1Ethical issue: Applying for ethical approval and funding for a long-term trial when the PIs knew already knew CBT effects on ME/CFS were short-lived. On 3rd November 2000, Sharpe confirmed: “There is a tendency for the difference between those receiving CBT and those receiving the comparison treatment to diminish with time due to a tendency to relapse in the former” (www.cfs.inform/dk). Wessely stated in 2001 that CBT is “not remotely curative” and that: “These interventions are not the answer to CFS” (Editorial: JAMA 19th September 2001:286:11) (Williams, 2016).
2Ethical issue: Failure to declare conflicts of interest to Joint Trial Steering Committee.Undeclared conflicts of interest by the three PIs in the Minutes of the Joint Trial Steering Committee and Data Monitoring Committee held on 27th September 2004.
3Ethical issue: Failure to obtain fully informed consent after non-disclosure of conflicts of interest.Failing to declare their vested financial interests to PACE participants, in particular, that they worked for the PHI industry, advising claims handlers that no payments should be made until applicants had undergone CBT and GET.
4Use of their own discredited “Oxford” criteria for entry to the trial.Patients with ME would have been screened out of the PACE Trial even though ME/CFS has been classified by the WHO as a neurological disease since 1969 (ICD-10 G93.3).
5Inadequate outcome measures.Using only subjective outcome measures.The original protocol included the collection of actigraphy data as an objective outcome measure. However, after the Trial started, the decision was taken that no post-intervention actigraphy data should be obtained.
6Changing the primary outcomes of the trial after receiving the raw data. Altering outcome measures mid-trial in a manner which gave improved outcomes.
7Changing entry criteria midway through the trial. Altering the inclusion criteria for trial entry after the main outcome measures were lowered so that some participants (13%) met recovery criteria at the trial entry point.
8The statistical analysis plan was published two years after selective results had been published. The Re-definition of “recovery” was not specified in the statistical analysis plan.
9Inadequate control Sending participants newsletters promoting one treatment arm over another, thus contaminating the trial.
10Inadequate controlLack of comparable placebo/control groups with inexperienced occupational therapists providing a control treatment and experienced therapists provided CBT.
11Inadequate controlRepeatedly informing participants in the GET and CBT groups that the therapies could help them get better.
12Inadequate control Giving patients in the CBT and GET arms having more sessions than in the control group.
13Inadequate controlAllowing therapists from different arms to communicate with each other about how patients were doing.

14

Lack of transparency

Blocking release of the raw data for five years preventing independent analysis by external experts.

Cover-Up

Blocking release of the raw data for five years and preventing independent analysis by external experts was tantamount to a cover-up of the true findings. An editorial by Keith Geraghty (2016) was entitled ‘PACE-Gate’. ME/CFS patient associations were rightly suspicious of the recovery claims concerning the GET arm of the trial because of their own experiences of intense fatigue after ordinary levels of activity which were inconsistent with the recovery claims of the PACE Trial reports. For many sufferers, even moderate exercise results in long ‘wipe-outs’ in which they are almost immobilized by muscle weakness and joint pain. In the US, post-exertional relapse has been recognized as the defining criterion of the illness by the Centers for Disease Control, the National Institutes of Health and the Institute of Medicine. For the PACE investigators, however, the announced recovery results validated their conviction that psychotherapy and exercise provided the key to reversing ME/CFS.

Alem Matthees Obtains Data Release

When Alem Matthees, a ME/CFS patient, sought the original data under the Freedom of Information Act and a British Freedom of Information tribunal ordered the PACE team to disclose their raw data, some of the data were re-analysed according to the original protocols. The legal costs of the tribunal at which QMUL were forced to release the data, against their strenuous objections, was over £245,000. The re-analysis of the PACE Trial data revealed that the so-called “recovery” under CBT and GET all but disappeared (Carolyn Wilshire, Tom Kindlon, Alem Matthees and Simon McGrath, 2016). The recovery rate for CBT fell to seven percent and the rate for GET fell to four percent, which were statistically indistinguishable from the three percent rate for the untreated controls. Graded exercise and CBT are still being routinely prescribed for ME/CFS in the UK despite patient reports that the treatments can cause intolerable pain and relapse. The analysis of the PACE Trial by independent critics has revealed a catalogue of errors and provides an object lesson in how not to conduct a scientific trial. The trial can be useful to instructors in research design and methodology for that purpose.

Following the re-analyses of the PACE Trial, the DBT is dead in the water. There is an urgent need for new theoretical approaches and scientifically-based treatments for ME/CFS patients. Meanwhile, there is repair work to be done to rebuild patient trust in the medical profession after this misplaced attempt to apply the Psychological Theory to the unexplained syndrome of ME/CFS. The envelope theory of Jason et al. (2009) proposes that people with ME/CFS need to balance their perceived and expended energy levels and provides one way forward, pending further research.

Ultimately, patients, doctors and psychologists are waiting for an organic account of ME/CFS competent to explain the symptoms and to open the door to effective treatments. Patients have a right to nothing less.

An extract from: David F Marks et al. (2018) Health Psychology. Theory, Research & Practice (5th ed.) SAGE Publications Ltd.