By David Tuller, DrPH
The Lightning Process was founded more than two decades ago by Phil Parker, a British Tarot reader and specialist in auras and spiritual guides. The LP, as it is often called, could be described as €œa neuro-physiological training programme based on self-coaching, concepts from Positive Psychology, Osteopathy and Neuro Linguistic Programming,” as Parker and colleagues did in a 2018 paper. It could also be described as a potpourri of woo-woo. Take your pick.
For its purported healing powers, the LP has attracted a major following in the UK, Norway, and other countries. To anyone in the US of a certain age, think something like est (full name; Erhard Seminars Training)–one of those change-your-life weekend experiences that swept across the American zeitgeist in the ‘7Os and ’80s.
In the UK, LP practitioners have promoted the program as a treatment for all sorts of serious medical conditions. Advertising regulators have warned them against making these unwarranted medical claims. The LP has become known among patients with myalgic encephalomyelitis or chronic fatigue syndrome or what has become known as ME/CFS, who are often desperate for answers after having pursued lots of different treatment avenues without much success.
The Romanian Perspective on the Lightning Process
Two years ago, Parker and two colleagues published a paper called “Understanding the Lightning Process approach to CFS/ME; a review of the disease process and the approach.” This paper appeared in the Journal of Experiential Psychotherapy. For those unfamiliar with it, the Journal of Experiential Psychotherapy is published by the Romanian Society of Experiential Psychotherapy in partnership with the University of Bucharest’s Personal Development, Counseling and Experiential Psychotherapy Center.
According to its home page, the Journal of Experiential Psychotherapy €œvalorizes and releases studies, original research, Romanian and international scientific contributions in the field of personal development, experiential counseling and psychotherapy, therapy of unification (T.U.) €“ a Romanian humanistic-experiential method of standard and experiential psychodiagnosis, applied in the assistance offered to adults, children, couples, families, transgenerational relationships, organizations and communities.€
Ok, then. I have no reason to doubt that the Journal of Experiential Psychotherapy commands great respect in Romanian experiential psychotherapy circles and also therapy of unification circles.
Parker has recently built upon this scientific foundation with a new paper: “A Systematic Review of the Evidence Base for the Lightning Process.” This one was published by Explore: The Journal of Science & Healing, a journal in the Elsevier stable. Per its website, the journal €œaddresses the scientific principles behind, and applications of, evidence-based healing practices from a wide variety of sources, including conventional, alternative, and cross-cultural medicine.” That sounds a bit more promising, although Wikipedia expresses some reservations about the journal–not that I’m citing Wikipedia as a valid reference or anything.
Parker has been enabled in this further effort to glaze the LP with a scientific-sounding veneer by senior author Lisa de Rijk, a visiting research fellow at King’s College London as well as a Neurolinguistic Programming “master trainer,” change consultant, and applied psychologist, according to her Linked In profile. The third author of the new review has a KCL degree but does not appear to have a current affiliation.
These ties between a prestige institution like KCL and the unproven LP are not surprising. Professors Sir Simon Wessely and Trudie Chalder, both among KCL’s leading lights, have spent years–decades, really–spouting unproven claims about the powers of CBT and GET to cure patients with what they have preferred to call CFS. These two experienced investigators recently collaborated on yet another problematic and deceptive study. As Virology Blog reported earlier this month, this study made causal inferences about the effectiveness of CBT while noting that the lack of a control group made it impossible to make causal inferences about the effectiveness of CBT. Among other methodological problems.
Professor Chalder was also part of a team that studied CBT to treat so-called dissociative seizures, that is, seizures with no identified organic cause. The intervention had null results for its primary outcome of seizure reduction at 12 months. The KCL press release touted the study as a success based on secondary outcomes of questionable meaning and did not mention that the primary outcome failed. In the same press release, Professor Chalder hailed the intervention’s €œeffectiveness€, a misrepresentation of the findings.
I could go on, but I won’t. The point is that an affiliation with KCL is no guarantee of academic rigor or intellectual integrity. At least in the domain of psycho-behavioral research on complex illnesses, the KCL brand seems more likely to signify poor methodology, ethical lapses, and willful misinterpretation of unimpressive data. UC Berkeley epidemiology students who turned in work of such low caliber would get smacked down pretty quickly.
Have Americans Heard of the Lightning Process?
I could be wrong–I often am!–but I think Americans are generally unaware of the LP. None of the friends I’ve asked have heard of it. I first did a few years ago when I read about the trial being conducted by Professor Esther Crawley, Bristol University’s methodologically and ethically challenged pediatrician and rainmaker. This disaster of a trial, for adolescents with chronic fatigue syndrome, was published three years ago by Archives of Disease in Childhood, a major BMJ journal.
I have known people who have felt energized and gained self-confidence from intensive training programs not all that different from what the LP sounds like–weekend workshops that integrate slices and nuggets from wise and not-so-wise medical, spiritual, psychological, marketing, religious, philosophical, and self-help traditions into a single dazzling whole. Some find the self-affirmations of most value, others the personal disclosures and sharing of secrets or the breathing techniques or the mind-body theorizing or the exercises on replacing unpleasant thoughts with pleasant ones.
Whatever the particulars, many report improved mood and reduced anxiety after such experiences, at least in the short term. As far as I know, none of these programs has yet been proven to reverse or cure Parkinson’s, multiple sclerosis, schizophrenia, cancer, and other chronic diseases. When it comes to the LP, online personal testimonials from self-described recovered CFS or ME patients are as convincing as online personal testimonials usually are. Personal anti-testimonials from ME patients who suffered severe relapses after going through the LP and pushing themselves beyond their limits are also easy to find.
Testimonials and anti-testimonials aside, here’s what Professor Brian Hughes, a psychologist at the National University of Ireland, Galway, has written about the LP: €œIt has no scientific plausibility; it exists because commercially-minded providers of pseudoscientific treatments have successfully identified a market for it. In that regard, it occupies the same space as, say, crystal therapy.€
When it comes to the LP, if someone wants to spend hundreds of dollars and stand in circles on the ground and yell €œNo!€ to their disease, it’s ok with me. If engaging in these and other activities makes them feel better for a while or in control of their health over the long term, that’s terrific. But eliciting positive responses after providing people with a product they know is expected to work, especially when they are so starved for good news, cannot be equated with sound and robust scientific research.
Because the LP is a proprietary program, we know little officially about what goes on during the training. Participants have reported that it involves discouraging them from acknowledging the impact or reality of their disease and its accompanying symptoms. Assuming that is the case, then it seems likely that some or many would be reluctant to admit on questionnaires or surveys that they still suffered from the disease or symptoms they are not supposed to acknowledge.
Under the circumstances, subjective responses on questionnaires and surveys are hard to interpret and cannot be taken at face value–even more so without objective measures documenting improvement in a clinical trial. And that would mean a clinical trial that does not violate core scientific principles–unlike Professor Crawley’s.
Review Relies on Unethical Clinical Trial
In the new review, Parker and his two KCL-affiliated co-authors describe the 14 studies they found after a search of the literature. Six were identified as surveys, three as qualitative studies, two as (non-survey) quantitative studies, one as a case report, one as a €œproof-of-concept€ study, and one as a randomized clinical trial. Six of them were identified as having been peer-reviewed.
According to the conclusions, the review “identified an emerging body of evidence supporting the efficacy of the LP for many participants with fatigue, physical function, pain, anxiety and depression. It concludes that there is a need for more randomised controlled trials to evaluate if these positive outcomes can be replicated and generalised to larger populations.”
Parker has the right to review the LP literature and make his case, although that case must be assessed in the context of his self-interest in documenting the claimed benefits of his trademarked mind-body experience. To their credit, he and his co-authors acknowledge some of the limitations of this research. Unfortunately for their argument, those limitations undermine the claim that this “emerging body of evidence” supports “the efficacy of the LP” in doing anything other than producing changes in how some participants respond to some questions about how they feel. The evidence of purported efficacy presented is simply not convincing.
The review’s narrative culminates with what the authors call €œa well-conducted€ clinical trial, meaning, of course, Professor Crawley’s big mess. The trial would likely never have been published had Professor Crawley and her colleagues been honest about their methodology. They recruited more than half of the sample before trial registration, swapped outcome measures after collecting data from these early recruits, and failed to disclose these highly salient details in the published paper. Such actions arguably meet standard definitions of research misconduct.
Instead of retracting the paper, BMJ decided to double down. It republished the original findings with a 3,000-word correction/clarification and a 1,000-word editor’s note explaining why the paper wasn’t retracted. Any study with a 3,000-word correction/clarification and a 1,000-word editor’s note explaining why it wasn’t retracted is not likely to meet legitimate criteria for having been “well-conducted,” notwithstanding Parker’s opinion on the matter.
In not retracting the study, BMJ placed its reputational interests above its obligation to safeguard the medical literature and the health of children. That failure led to Virology Blog’s open letter to BMJ’s editorial director, Dr Fiona Godlee, decrying her decision to let the findings stand. More than 70 experts from Harvard, University College London, Columbia, Berkeley and other leading institutions signed the open letter.
The new review’s deployment of these tainted findings to bolster the argument for more clinical trials of the LP demonstrates the weakness of the claims being made. This paper feels geared toward generating support for the Norwegian LP proponents seeking to launch their own proposed trial…but that’s another story for another day.