Medicine and magic

Thousands of people wear a lucky T shirt in exams, blow on dice before rolling them, and cross their fingers for good luck. Yet how many people believe that these little rituals can have a palpable effect on health? Clare Hughes and Chris French think that the inadvertent health effects of superstitions should not be overlooked

Unlucky AP PHOTO ILLUSTRATION/DON HEUPEL

Superstition can trigger unusual and life threatening events. Researchers from Mid Downs Health Authority, Sussex, found that drivers are more than 50% more likely to have a road accident on Friday the 13th than on any other day.¹ They discovered that despite a smaller volume of traffic on the M25, accident rates were significantly higher on this day: they recommend staying at home.

Some people are wildly superstitious: they believe in the evil eye, ouija board, palm reading, or demonic possession. Save your breath trying to convince them otherwise, as they will think you are either hopelessly ignorant and doomed or, under some evil influence, trying to lure them away from the truth.

Most peoples beliefs lie between the highly superstitious and hardcore rationality: they would be offended to be labelled superstitious but still touch wood when they mention something they do not want to happen.

The future is in your hands

Many psychological factors contribute to beliefs, and one of these is uncertainty.² Magical rituals or superstitious beliefs fill in gaps where knowledge falls short and where people need to find answers to uncertainties.

In occupations where the outcome does not depend entirely upon the skills of the performer—for example, sport—superstitious tendencies may be resorted to. Jim Kelly, former quarterback with the Buffalo Bills, made himself vomit before every game, a ritual he maintained since childhood.³

Another psychological factor is operant conditioning. Superstitious behaviour starts with coincidence: there is a strong tendency to repeat any response that is coincident with reinforcement.³

Piaget found that children often confuse names of objects with objects themselves, and they expect names and thoughts to be connected with objects, thereby influencing real world events. He called this nominal realism.³ This tendency is not restricted to childhood and could explain the practice of divining (searching for underground water or minerals) by dangling a pendulum over a map instead of the land itself.

People with scientific brains are often the most sceptical: after all, the cycle of formulation, prediction, and falsification (or proof) is at the core of human scientific activity, and the very nature of a superstition is that it cannot be tested by scientific method.

All humans believe that things are connected, and it is this belief that permeates both science and superstition. Science identifies true connections: those that are proved and defined, causal relationships where A precedes B.

The general structure of superstition is that B causes A, through an unknown mechanism.⁴ Only the results can be witnessed, but the fact that we cannot learn about the hidden connection should not automatically imply that it does not exist.

Superstitions tend to have many origins. It is said that fear of the number 13 is as old as the act of counting. Primitive man only had 10 fingers and two feet to use as counting units so what lay beyond—the number 13—was a frightening mystery. (I wonder whether primitive man had toes?)

Friday is named after a Norse deity worshipped on the sixth day: either Frigg (goddess of marriage and fertility) or Freya (goddess of sex and fertility). Freyas sacred animal was a cat, and so in folklore she was cast as a witch and her day became associated with evil doings. As the legend goes, 12 witches of the north gathered with their cats in a cemetery to observe their sabbath. One night, Freya appeared before the witches and gave them a cat, forming a coven of 13, making Friday 13 the unluckiest days of the year.⁵

Chinese and Japanese people associate “shi”—the number four—with death because the two words are pronounced the same. A shocking repercussion of this superstition is that Chinese and Japanese people are seven times more likely to die from a cardiac event on the fourth day of the month than on any other day, even though this date is not consistently associated with changes in the physical or medical environment.⁶

This finding suggests that psychosocial factors hasten death: stress or anxiety causes an increase in adrenaline secretion, which could adversely affect the heart, particularly in people with a history of heart disease.

If people believe that something is going to happen then they can make it happen. Anxiety can reduce driving abilities, or a rise in blood pressure can induce a heart attack. These symptoms happen only to people who are superstitious, who believe in the power of unlucky numbers or are convinced by a horoscope that warns of some disaster.

There is nothing paranormal about these self fulfilling prophecies. They work by the same principle as the placebo effect, which can be very strong.⁷ The opposite of this is the nocebo effect.⁸ If you give someone a pill and tell them it will cause them pain they often report that they feel that pain.

The use of many complementary therapies could be regarded as being based on superstition, because usually there is no scientific evidence for their effectiveness. These therapies may eliminate the subjective experience of ill health, but broken bones dont tend to respond too well.⁹

In most cases the lack of scientific proof does not bother patients. After all, if complementary therapies seem to speed recovery from a cold, thats great. If someone with a more serious condition, however, is persuaded to avoid more conventional treatment by using complementary therapy as an alternative, then this can be dangerous.

Most of the time superstitions are harmless, but when the stakes are high, choosing magic over science holds great risks: patients may pay for their decisions with their good health and sometimes their lives.

Clare Hughes, intercalating medical student, University of Westminster
Email: clare.a.hughes@kcl.ac.uk

Chris French, head of anomalistic psychology research, Goldsmiths College, London


studentBMJ 2002;10:131-170 May ISSN 0966-6494

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