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Criticisms of The Gupta Program
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==Lack of empirical evidence== Within pseudoscience there is often scientific evidence to validate the given theories but in reality this is not rigorous and sufficient evidence it just sounds good. We find this with the Gupta Process yet there is often a lack of scientific or philosophical training within the community to understand whether the evidence is conclusive and justified. It also gives cause and strength to the wishful thinking of those that want it to work. So let us examine the scientific proofs given by Gupta and their criticisms. In 2018, the UK's Advertising Standards Agency (ASA)<ref name="ASA400324">{{Cite web | url = https://www.asa.org.uk/rulings/harley-street-solutions-ltd-a17-400324.html | title = Harley Street Solutions Ltd | last = Committee of Advertising Practice | first = | authorlink = | date = | website = Advertising Standards Authority| archive-url = | archive-date = |url-status = | access-date=2022-03-07}}</ref> investigated the claims and evidence presented by the Gupta program. When asked for a response the Amygdala Retraining/Harley St Solutions claimed they had conducted clinical trials on their protocol and it could substantiate it could be used to support CFS/ME and Fibromyalgia. They produced two published studies and a draft manuscript for the third study. The first study was on [[fibromyalgia]] and CFS and was peer reviewed in a journal focused on complimentary medicine. It was a single-blinded study and compared the efficacy of amygdala retraining alongside 'standard care' – which was a 1.5 day course in CBT and GET. Over half did not complete the study so out of the total 44 participants only 21 completed it, and only 7 from the amygdala retraining group did. This shows significant limitations with such a small case study. The ASA concluded that the study did not substantiate claims the amygdala retraining could treat Fibromyalgia or CFS. The second study was for CFS only and was an internal clinical audit. It was published in a peer reviewed journal focused on complimentary medicine. As a clinical audit it was not controlled, randomised or blinded. It was authored by the Director of Harley St Solutions (Ashok Gupta) who described the outcome of a one year program, 27 people completed the course. Again, we have a very small case study, researcher bias, and those who had invested financially in a program who were also biased. The ASA stated that due to the limitation of an internal clinical audit the claims that the Amygdala Retraining process could not be substantiated. The draft manuscript was from a Spanish randomised controlled trial which wasn’t published so it was not subject to peer review. The treatment delivery did not replicate the method of the Amgydala retraining course advertised. There were 64 participants, 22 in the relevant group and only 19 completed the study. Again this is a small sample size and it was not able to control for the possible influences of the individual therapist in each group. Again the ASA ruled that the trial did not substantiate claims made by Harley St Solutions. The study in September 2010 in the Journal of Holistic Healthcare is not a high enough quality treatment trial, there was no randomisation, no control group, no controlling for other treatments or blinding to prevent researcher and sample bias. The Gupta Program is claiming to be backed by scientific studies but under closer examination the studies were not found be sufficient enough be used as evidence. This is very concerning for the general public who may not have a science background and are being fooled into thinking what they are doing has genuine empirical evidence behind them. It is telling that the program thinks that it can bring forward and back its claims with scientific evidence where anyone with any scientific training would know that these studies are not sufficient in the least. Combined with the claims that the Gupta Program could reduce your chance of catching the coronavirus by 80% I would conclude that Ashok Gupta is not a reliable source of information or evidence for his own program.{{citation needed | date = 2022}} In 2020 Gupta published an article on his website "New Study Shows Neuroplasticity 'Brain Retraining' program is an Effective Treatment for Fibromyalgia"<ref name="causes">{{Cite web | url = https://www.guptaprogram.com/causes | title = Research and Causes | last = | first = | authorlink = | date = 2020 | website = The Gupta Program|language=en-US| archive-url = | archive-date = |url-status = | access-date=2022-03-07}}</ref>. But on examination we find that this is the same study that was presented to the ASA as evidence. There was a draft manuscript that hadn't been published and is the Spanish study. The ASA concluded that the study did not replicate the method of the Gupta Program; it was a small case study – 19 completed the study; and it did not control for the possible influences of the individual therapist in each group. The ASA have said that this paper does not give enough evidence to claim to treat or cure Fibromyalagia. The study "Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomised Controlled Trial"<ref name="MAIR2020"/> in the Journal of Clinical Medicine. I would begin with saying the sample size of 19 is far too small to make claims that GP is an effective treatment for Fibromyalgia. The patients also continued to take their normal drug routine so we do not know if over this period they showed improvement from their other medical treatments. One of the major issues though is that we have two psychological treatments bundled together, [[mindfulness]] and [[Amygdala and Insula Retraining]]. This means we cannot know which is causing the effect. “Patients completed some practices included in the [[mindfulness-based stress reduction]] (MBSR) program that were added to the amygdala and insula retraining techniques (AIR)”. Gupta's method is based on Amygdala retraining this is the basis of his hypothesis and ‘cure’. If the study had just been done with Amygdala and Insula Retraining then it would give us a clear indication. This is a logical fallacy: A+B→C, therefore A→C. The researchers of the paper were contacted and had no knowledge of the Gupta Foundation claiming that their paper gave credence to the Gupta Program. Dr [[Juan Luciano]], lead researcher of the paper, replied: {{Quote frame|text=I am really sorry to read this. We had no idea that Mr. Gupta was using our study for commercial purposes. On behalf of my colleagues, I can only assert that there is no personal relationship with Dr. Gupta nor commercial or financial interests with his program. That said, it's really difficult to force him to retract. In my opinion, any legal intervention against Mr. Gupta is in the hands of the UK authorities. We are only academics/researchers attempting to provide the best empirical evidence of available treatments for fibromyalgia, CFS and other central sensitivity syndromes." | author = Juan Luciano{{citation needed}}}} Ashok Gupta claimed it is "our study" "Our Ground-Breaking Study on the Gupta Programme Published In The Prestigious Journal of Clinical Medicine. Giving Hope To Millions of Fibromyalgia Sufferers, as the First Randomized Controlled Trial Ever Published on a Neuroplasticity Program!". It is clear from Dr Luciano that the study is not based on the Gupta Program and does not have any connection to the organisation.{{citation needed | date = 2022 | reason=Website has since changed}} :What is the study actually reporting? It says that 2 psychological techniques have been shown to improve psychological factors such as anxiety and mindfulness after 3 months. “The positive effects of MAIR were also observed in a wide range of clinical measures and salutary cognitive variables such as mindfulness, psychological flexibility and self-compassion.” I would suggest that including mindfulness with AIR would likely increase mindfulness we do not have any clarity on whether AIR does. What is very clear is that it does not include clinical factors such as ‘clinical severity’ and ‘health-related quality of life’. The paper itself states that “Significant decreases in pain catastrophizing and psychological inflexibility and improvements in clinical severity and health-related quality of life were found at follow-up, but not at post-treatment.” Therefore, it does not reduce pain and it does not offer a cure for the underlying disease mechanism. “There were no significant differences between the groups in hs-CRP, TNF-α, [[Interleukin 6|IL-6]], and [[Interleukin 10|IL-10]] at post-treatment”. “However, no significant effect of MAIR on [[cytokine]] and hs-CRP levels was detected”. It might make you feel better about yourself and your illness, but it is not clear which psychological technique causes this change. Whether Gupta has any formal training in [[mindfulness]] in a spiritual or secular form is not made clear – no qualifications are given. I would suggest that charging patients and teaching them mindfulness without any qualification is unethical and possibly dangerous. The study was for 8 weeks and Gupta claims on his website “so we expect even better results when used for a longer period”, but there is no proof of this. This is actually a problem of replication as the study was not under the same conditions as the Gupta Program and other factors and conditions of the experiment might affect the results. We also have the very relevant issues of trying to treat illnesses such as ME or Fibromyalgia with psychological methods<ref name="Samulowitz2018">{{Cite journal | title = "Brave Men" and "Emotional Women": A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain | date = 2018-02-25 | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845507/|journal=Pain Research & Management|volume=2018 | pages = 6358624 | last = Samulowitz|first = Anke | last2 = Gremyr | first2 = Ida | last3 = Eriksson | first3 = Erik | last4 = Hensing | first4 = Gunnel|doi=10.1155/2018/6358624|pmc=5845507|pmid=29682130|issn=1203-6765}}</ref> and treating women with pain issues with only emotional and psychological techniques is troubling<ref name="pain-and-prejudice">{{Cite book | title = Pain and Prejudice: A call to arms for women and their bodies | date = 2019-11-14| publisher = Little, Brown Book Group|isbn=978-0-349-42453-8|language=en | url =https://books.google.com/books?id=3YKaDwAAQBAJ&printsec=frontcover&dq=pain+and+prejudice+a+call&hl=en | last = Jackson | first = Gabrielle}}</ref>. Funding and focus into actual [[biomedical research]] would be healthier and prevent the long-standing issues with this tendency. Seeing the large scale failure of the PACE trial I would be hesitant to repeat any such medical abuse with the sufferers of fibromyalgia. There is a case for psychiatrists and psychologists to stay away from the medical fields such as ME, Long Covid, Fibromyalgia if they are offering cures after the damage done to previous patients. Just because a condition is not understood doesn’t mean it needs to be treated with emotional methods. What is needed is better research from Immunologists, Virologists and other medical fields that might be able to shed a light on the understanding mechanism. There is also self-reporting which is problematic and that the nature of the study is psychological. We do not know how open the participants were to researcher bias or bias to report improvement because they were taking part in a study. Measuring psychological factors is by its nature subjective and we have no empirical, measurable data available from this study. There is great excitement on the Gupta website about the decreased levels of BDNF in the MAIR group. Yet remember again we are dealing with a very small sample size and the paper states that “However, divergent results have been obtained regarding the role of BDNF in FM, with, Studies finding a lack of association between BDNF and patients’ clinical complaints or finding comparable levels between FM and healthy subjects” “It is also worth mentioning that low serum levels of [[Brain-derived neurotrophic factor|BDNF]] have been found to be a characteristic of [[depression]]; in this regard, one could expect that after an intervention with a positive effect on depressive symptoms (as it was the case of MAIR), increases in BDNF levels should be observed. However, we did not find such increases as a significant decrease in the levels of this biomarker was found after MAIR. Our findings may be partially explained by the fact that the study sample showed mild depressive symptoms at baseline (with mean depression scores based on HADS around the minimum cut-off point for caseness of 8 points), thus patients having a major depressive disorder should be a minority in our study.” Therefore there is no clinical clarity of what this means for the reduction of BNDF. The blood samples were also taken after a period of night fasting from 8pm – 8.30am. [[Intermittent fasting]] which is relevant from not eating from 12 hours effects the BDNF levels. Although this was done to limit the circadian variability of immunological markers its impact on [[Brain-derived neurotrophic factor|BNDF]] is not mentioned. The study also presents some of its limitations: *“ small to generate strong conclusions.” *“ the possible influences of therapist variables were not controlled, making it impossible to recognize their effect on treatment” *“the intervention was not compared with other psychological treatments that have demonstrated effectiveness for FM (e.g., CBT or [[acceptance and commitment therapy]] (ACT)) or with aninactive control group alone” *“the treatment components (mindfulness and amygdala and insula retraining) were not evaluated independently, and therefore their specific effects with respect to the combination could not be compared” *”it was not possible to follow-up the levels of the biomarkers.” *“exploratory and preliminary in nature” Other key questions are is the study replicable and open to falsification? The concern is that on the Gupta Foundation Website this published study is everywhere and it clearly does not contain sufficient scientific grounds that the Gupta program is a legitimate treatment or cure for Fibromylagia. It should not be up to the patient to have to read and analyse scientific papers. Just because one study is published does not mean a method is scientifically backed – this is classic pseudoscience and overjustification. It is an attempt to give more medical and scientific authority to a still unproven and dubious method. It is highly likely that more people will be sucked in thinking that there is scientific justification where there isn’t. The ASA were contacted regarding the publishing of this study as “proof” of treatment and they responded: “We’ve assessed the ad you highlighted and from the information we have, we think the ad is likely to have broken the Advertising Codes that we administer and therefore will be taking steps to address the issue. We will explain your concerns to the advertiser and provide guidance to them on the areas that require attention, together with advice on how to ensure that their advertising complies with the Codes.” The current research in Fibromyalgia seems to be changing radically at the moment with it being recognised as an immune condition and not originating the brain. Like other conditions with ineffective treatment methods (Long Covid, ME/CFS, Lyme disease) there is a growing pressure from society and the medical community for them to be more thoroughly researched, more effective care given and for physical biomarkers and treatments to be found. We need to move away from giving psychological primary care and actually funding and researching these chronic conditions that create years of pain and suffering to mainly women who have been ignored. Let’s be on the right side of history and do everything we can to move away from the psychogenic paradigm and actual take these conditions seriously – this means not supporting and backing any form of primary psychological therapies including brain retraining in whatever form it takes.
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