Are the flower remedies for psychological ailments real, or are they nothing more than pretty placebos?
When I purchased a health-food store several years ago, I left behind a career as a psychology professor that spanned 23 years and more than 60 publications - or at least I thought I had. One of the things I "inherited" with the store was a small collection of Bach Flower Remedies. These tinny dark bottles carried familiar names, such as walnut, vine, beech, and pinne, as well as the less familiar cerato, clematis, and mimulus. The bottles contained water supposedly collected from the dew on certain flowers diluted in pure water to the point that little or nothing of the flower remained. Each bottle also contained about one-fourth alcohol. I didn't know what these elixirs were supposed to do and I didn't think much about them until recently, when I stumbled across a paperback called Bach Flower Essences for the Family (Wigmore 1993).
I have become accustomed to seeing claims like "Vitamins A, C, and E will reduce your risk of heart problems" and "Garlic can lower your cholesterol." In an health-food store most of the claims are for physiological benefits. But the flower-remedies booklet made psychological claims, often bold and sweeping ones: "Mustard can make you more cheerful." "Olive will give you peace of mind." "Rock rose will reduce night terrors in children." "Insomnia sufferers need only take vervain." "Got an addiction? Walnut will take care of it." "Want a warmer relationship with others? No problem, just get out the water violet." I counted 238 psychological claims, an average of 6.26 for each of the 38 remedies. To become a marvelously well-adjusted person just add a few drops a day to a glass of water or juice.
To understand how this bizarre system "works" it is necessary to discuss the life of its founder, Edward Bach. Bach was a British physician who even as a medical student "spent little time with his books" (Weeks 1973:16) because he was convinced that his own intuition was superior to the knowledge found in print. After receiving his medical degree he practiced conventional medicine for a while, but his distaste for scientific methods coupled with his eccentric inclination nled him into conflict with the medical establishment. His eccentricities included the belief that heart disease is caused by the failure to develop love for humanity (Bach 1977a), the notion that bathing in hot water opens the skin and allows dirt inn n(Bach 1977a), and his warning that gland graftinng is "ten thousand times worse than any plague" (Bach 1977a:45). In nthe late 1920s he became convinced that "sund warmed dew absorbs vital healing powers from plants" (Tyler 1993:214). He spent the remaining years of his life identifying plants that he felt were capable of changing human behaviour for the better.
Conflicting information makes it difficult to identify the real Edward Bach. On the one hand we are told that he was always short of funds, but we are also told that he allowed the local football club to use his field next to his house and that he regularly bought drinks for everyone at the local pub (Weeks 1973). He was alleged to be a boxer as well as an oarsman, both of which demand excellent physical health, but was also described as being very sickly for long periods of time (Weeks 1973). His friends reffered to him as a "leader of scientific research" (Weeks 1973:42), yet he encouraged others to keep his work free from science (Wheeler 1977). Bach (1977b) tells us that his system was "divinely revealed" to him, but one of his leading disciples claims that there was careful testing and that "plants producing side effects were quickly discarded" (Kasloff 1988:5). His intuition "always led him aright" (Weeks 1973:39), but he "saw" the spirit of a drowned man hovering over the man's body and insisted that artificial respiration be continued for eight hours. The man died anyway (Weeks 1973).
One fact that no one disputes is that Bach died in 1936 at the age of 50, following a prolonged illness (Wigmore 1993). If he really did know the disease of the next patient, "hours before that patient reached his house" (Weeks 1973:116) and really did possess "miraculous" healing powers, as was alleged, why was he so frequently ill and why couldn't he heal himself?
There are other logical problems with his system. In spite of Bach's claim that he was divinely inspired, a close look shows that onne of his sources of inspiration was an ancient false belief called the Doctrine of Signatures. Accordinng to this doctrine the form and shape of a drug source determine its therapeutic benefit (Tyler 1993). Thus, in Bach's system, essence of the flower impariens is prescribed for impariens, oak and rock rose give to those who wish to be strong, water violet is offered to the aloof (shringking violet?), and whild oat is just the thing for the unconventional (sowinng one's wild oats?). A few hundred years the Doctrine of Signatures might have been appealing, but with the many advances in nthe science of psychology it seems as outdated today as the practice of chaining mentally ill people to institutional walls.
Bach wrote (1976:109): "As all these remedies are pure and harmless, there is no fear of giving too much or too often. Nor can any remedy do harm should it prove to not be the one needed for the case." Were it not for the high alcohol content I would wholeheartedly agree with these statements - a placebo can't do any harm. But if we suspend good judgment for a moment and assume that his remedies actually work, then why wouldn't something that has the potential to heal also have the potential to harm. For example, what if a person who is nearly without fear ingests mimulus? Couldn't she become so fearless that she might attempt to stop an armed robbery? What about the person who already harbors few regrets? If he takes honeysuckle, which supposedly reduces regretful feelings, might he not increase the risk of developing into a full-fledged psychopath? That which has the power to help also has the power to harm. Why should the Bach Flower Essences be any different in nthat respect from automobiles or nuclear power?
We are told that after discovering the thirty-eighth remedy Bach knew there were no more discoveries to be made (Weeks 1973). Nearly all had been found within a few miles of Bach's living quarters. There are a huge number of flowering plants in the world, and since 1936 some of them have been determined to be usefull. Yet, to the best of my knowledge, Bach's followers have never attempted to explain why their system still has found only 38 essences that have psychological usefulness. Nor have they, as far as I know, attempted to explain the coincidence that placed nearly all of these within a few miles of Bach's house.
Logical inconsistencies are not the only problem inherited by Bach's disciples. Many of them took too seriously his advice to keep the remedies free from science. I called two leading manufacturers of homeopathic products and asked to speak with their research experts. One had "no idea if it worked or not," and he said that he was unaware of any relevant research. The other researcher didn't know of any studies either but opined that it might "work on the surface" (whatever that means). A recent search through Psychological Abstracts using "Bach" and "flowers" as key woards yielded nothing from 1963 to 1993. Apparently, not one psychologist has seen fit to do any research on this topic in the past 30 years.
I believe there is little reason to continue the literature search prior to 1963, because only one of the books I read by Bach or his disciples listed any scientific research at all. Kaslof (1988) cited a dissertation written bei Weisglas (1979). That study compared two treatment groups and one placebo group on each of about 300 dependent variables - so many that it would have been almost impossible not to find that the remedies worked for something. By analogy, try to imagine 300 different lotteries in which each ticket has a one-in-a-hundred chance to win. These odds are not too good, but suppose you had two tickets for each one. Under these conditions your chances of winning are twice as good. In fact, in Weisglas's lottery the Essences "won" five times. Ironically, one of the differences favoring the essence groups, "being sexcuality", was not predicted by Bach. The placebo group either did not "win", or, if it did, it was not mentioned in the abstract. Kaslof briefly mentioned another study, but did not list it in the references. It is so vaguely described that nothing can be concluded from it. I sent a stamped, self-addressed envelope to Kaslof asking for a more detailed description, but have received no reply.
It appears as though the only "evidence" to support the many psychological claims made by Bach and his followers are testimonials or case histories (Chancellor 1971; Weeks 1973; Wheeler 1977). For example: "I used to get these mysterious pains in my lower back. Nothing the doctor prescribed did me any good. Someone told me about the Bach Remedies and now I take onne every time my back starts acting up. Works like a charm." These kinds of accounts are easy to find in the books by Bach's faithful. They are also easy to dismiss.
Testimonials should not be taken too seriously. For one thing they are too easily faked. But even if we assume that every testimonial is strictly legitimate, they should not be allowed as substitutes for scientific evidence. For every person who claims that product X is marvelous, there may be ten who feel that it is either worthless or nearly so. The company that manufactures product X is certainly not going to publicize the stories of those who felt that it was useless. But even if there were completely unbiased in their publicity they would probably get fewer complaints than compliments. Unless they feel the product is harmful, consumers asually don't complain; they simply try something else. In other words, testimonials are useless because we have no way of knowing how many people were helped by a particular product. Some of the people who were not helped by the Bach Remedies might have felt so foolish about having taken flower essences as a remedy for serious psychological problems that they wouldn't want anyone to know.
Any favorable results stemming from the use of the BAch Flower Remedies are probably the result of nothing more than a placebo effect. As most readers of the Skeptical Inquirer know, a placebo is not a biologically active ingredient, but it often "works" because the person who takes it believes that it is effective. Placebo effects have been demonstrated time and time again and have been found in a wide variety of situations involving a large number of psychosomatic disorders. Bach was apparently an individual with excellent language skills and a great deal of confidence in his ability to heal. He was probably adept at convincing patients that they were going to get better. He was certainly charismatic enough to attract a loyal band of followers. Ironically, onne of these stalwarts provided an anecdote that lends itself nicely to a placebo interpretation. In describing her hero's healing powers, Weeks (1973:120) noted that the Bach FLower Remedies seemed to work best for those who had traveled a very long distance to be treated by the master. It is reasonable to think that those who traveled a long way on English roads in the 1930s to see doctor might have been highly motivated to improve - so motivated that they might have been especially susceptible to the belief that this charismatic doctor and his unusual treatment would bring them relief from their troubles.
In summary, there seem sto be no reliable, unambigous evidence to support any of the multitude of claims made by Bach and his followers. The Bach Remedies that I "inherited" when I bought my health-food store are currently under the counter where they can't be seen. If people come in and ask for them I will sell them, but I don't intend to reorder; and I have instructed my employees to make no claims whatsoever about their usefulness. Perhaps the time has come to wake up and stop smelling the flowers.
Bach, E. 1977a. "Heal Thyself." In The Bach Flower Remedies. New Canaan, Conn.: Kears. Originally published by C.W. Daniel, Essex, England, 1931.
---, 1977. "The Twelve Healers." In The Bach Flower Remedies. New Canaan, Conn.: Kears, Originally published by C.W. Daniel, Essex, England, 1933
Chancellor, P. M. 1971, Handbook of the Bach Flower Remedies. London: C. W. Daniel.
Kaslof, L. J. 1988. The Bach Remedies: A Self-help Guide. New Canaan, Conn.: Kears.
Tyler, V. E. 1993. "Paraherbalism Is a Pseudoscience." In The Health Robbers, ed. by S. Barret and W.T. Jarvis. Buffalo, N.Y.: Prometheus.
Weeks, N. 1973, The Medical Discoveries of Edward Bach, Physician. New Canaan, Conn.: Kears. Originally published in 1940. Weisglas, M. S. 1979. "Personal growth and conscious evolutionn through Bach Flower Essences." Dissertation Abstracts International, part B, p. 3614 (1981).
Wheeler, E. J. 1977, "The Bach Remedies Repertory." In The Bach Flower Remedies. New Canaan, Conn.: Kears. Originally published by C. W. Daniel, London, 1952.
Wigmore, 1993. Bach Flower Essences for the Family. London: published by author.