Opinion: In the wellness industry, your mental health is for sale

Jonathan N. Stea is a practising clinical psychologist, an adjunct assistant professor in the department of psychology at the University of Calgary, and the author of Mind the Science: Saving Your Mental Health from the Wellness Industry, from which this essay has been adapted.

In 2018, millions of subscribers to Goop – Gwyneth Paltrow’s wildly successful natural lifestyle company – were introduced to a new promoted product: the Implant O’Rama, a do-it-yourself coffee-enema device. The product’s website claimed that coffee enemas “can mean relief from depression, confusion, general nervous tension, many allergy related symptoms, and most importantly, relief from severe pain.” The company told its consumers: “Ask not what your colon can do for you, but rather, what you can do for your colon.” Coffee enemas were even endorsed on Goop by seemingly respectable physicians: namely, a cardiologist, Alejandro Junger, identified as an “adrenal fatigue expert,” and “holistic psychiatrist” Kelly Brogan in her New York Times bestseller, A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies to Reclaim Their Lives.

What’s the problem? Well, it turns out that shooting coffee up your bum will not help with depression or any other health concern. Coffee enemas have a long history in the alternative-medicine community despite their lack of credible evidence. They were first introduced as a part of the Gerson Therapy, which was developed by a physician, Max Gerson, in the 1930s for the treatment of degenerative diseases, including cancer. Modern proponents of the therapy still claim that coffee enemas work by helping with liver and in­testinal detoxification. The scientific reality is that there is no medical theory or body of research supporting the use of coffee enemas, and in fact they can be quite dangerous and result in burns, inflammation, bacteria in the blood­stream, and even death.

Goop subscribers who purchased Ms. Brogan’s book about depression were introduced to even more products, services and “natural treatments for whole-body wellness” beyond coffee enemas. They were told in Ms. Brogan’s book that a laundry list of supplements was critical to their health and that “un­less you are growing your own organic food in a bubble hermetically sealed from the ravages of the modern industrial world, strategic supplementation is almost always going to help you get better and stay better.” They were recommended to doubt whether the scientific construct of depression was even real and were warned about the purported dangers of antidepressant medication, Advil, Lipitor, Prilosec, fluoride, fragrances, genetically mod­ified foods (GMOs), antibiotics, vaccines and birth-control pills. In short, they were sold a cornucopia of misinformation.

There exists little evidence to support the vast majority of Ms. Brogan’s claims. For example, in the American Psychological Association’s official clin­ical practice guidelines for the treatment of depression – which were de­veloped by health professionals from psychology, psychiatry and primary care, as well as community members who self-identified as having had depression – it’s recommended that depression be treated with evidence-based psychotherapies and antidepressants. After reviewing the science, the guidelines don’t recommend anything resembling Ms. Brogan’s unnecessary and expensive testing and supplementing or dietary plan. And of course, there’s no mention of coffee enemas.

This problem, of course, is much larger and older than coffee enemas, Ms. Brogan and her book. Snake-oil salesmen have been around forever, but it was in the late 19th and early 20th centuries that a guy named Clark Stanley sold actual “snake oil liniment” as a cure-all for various health conditions – incidentally, it didn’t work, and it didn’t even contain actual snake oil.

The problem is that snake-oil salesmen, in the spirit of Clark Stanley, never went away. In the world of mental-health care, scientists have estimated that there are at least 600 “brands” of psychotherapy, an unreasonably and quickly growing number, many of which are ineffective and could be harmful. Beyond that world exist countless unregulated providers of mental-health-related services in the wellness industry and alternative-medicine community who market themselves as “life coaches,” “wellness consultants” and – depending on particular countries and jurisdictions – other various non-legally protected titles, such as “therapists,” “psychotherapists,” “counsellors” and “practitioners.”

As a clinical psychologist, I have encountered many patients who received pseudoscientific assessments and treatments for their mental-health concerns. The tidal wave of pseudoscientific mental-health practices originates both within and outside of the mental-health professions. The global health and wellness industry has an estimated value of more than US$5.6-trillion, which includes legitimate sources of health – such as club memberships and exercise classes – as well as alternative-medicine products and services that purport to improve health, based on baseless or exaggerated claims and questionable evidence of safety and effectiveness.

At the end of the day, your mental health is on the line. And your mental health is precious. You need it to experience joy. You need it to live with purpose, to function in society and to be there for your loved ones. There’s no price tag high enough to measure its value.

Yet, in the wellness industry, your mental health is for sale. You’ve been told you lack it and it’s available for purchase. You just need to buy the latest book with the latest 30-day diet plan, swallow 15 supplements “they” don’t want you to know about, cleanse the toxins from your body by following “10 easy steps,” spiritually awaken on a five-day wellness retreat, or undergo the revolutionary new therapy that most doctors haven’t heard about. That cheapened, commodified version of mental health is a wolf in sheep’s clothing. It’s sexy. It’s alluring. And it’s a sham. It will take you down a yellow brick road paved with pseudoscience, leaving your mental health for dead.

What’s the solution? Pseudoscience and wellness aren’t going anywhere, but it’s rejuvenating to know that we can affect their demand. While it’s the mandate of regulatory bodies of various health professions to protect the public from harm, a vitally important, perhaps counterintuitive lesson is this: We cannot rely merely on care providers and regulatory bodies to protect our mental health. The onus is also on us to empower ourselves with knowledge, such that we can protect ourselves from mental-health scams, charlatanry, and poor or misguided health practices. A person who views their mental health with a scientific lens is advantaged. Grifters hold less power over those who can see through their charades.

Providers that advertise their services to address mental-health concerns but that do not value, respect or understand the role of science in mental-health care risk compromising the safety of patients. And unfortunately for patients, it can very much be a buyer-beware approach to their mental health, both within our health care systems and in the unregulated space where mental-health care is marketed and sold. Improving the science and mental-health literacy skills of both the general public and health care professionals can help mitigate this alarming problem. In part, this involves learning how to spot and avoid false information and pseudoscientific practices.

Unlike rocket science, each of us has experience with the topic of mental health, which makes it easier to believe we can assess claims made without evidence and make claims of our own without expertise. But false information is worse than no information – and without science, it prevails.