A recent article inThe Independent (UK) concerning homeopathy and state funding caught our attention. The UK Government has continued funding of homeopathic medicine on the National Health Service despite advice from its own medical committee not to do so. This link between “scientific proof”, common practice and government funding is of great interest to us ELT practitioners given the relative lack of “scientific consensus” over ELT methodology. Of course, the lack of “scientific consensus” in ELT has not prevented the expansion of ELT or the practice of various and conflicting methodologies within ELT. Similarly, ELT has been both directly and indirectly subsidised by nation states throughout the world. Maybe, therefore, there is something we can learn from this debate which we can apply to ELT.
Doctors in Revolt.
Whilst homeopathy has enjoyed considerable growth in Western Europe over the last 30 years, there has also been a movement to establish an evidence approach to medicine which subordinates individual medical judgement to larger statistical analysis of widespread trials. Given that there are few such trials on the efficacy of homeopathy and what has been done is subject to considerable dispute and controversy, it is little wonder that, by adopting this approach, the scientific body recommended the Health Service stops paying for homeopathic treatments. Already in 1997 the Lewisham and Southwark Health Authority in London, who had been referring over 500 patients a year to the Royal Homeopathic Hospital, decided there was insufficient medical evidence for doing so and ceased all referrals. The main charge of the medical committee against homeopathy is that there is little proof that these treatments have any effect other than as a placebo. By placebo effect we mean an intervention which causes a person to believe/experience an improvement in their physical condition despite their being no practical basis for this other than deception/self-deception.
Indeed, the principles of homeopathic medicine, namely
a form of alternative medicine first proposed by German physician Samual Hahnemann in 1796, in which practitioners use highly diluted preparations. Based on an ipse dixit axiom formulated by Hahnemann, which he called the law of similars, preparations which cause certain symptoms in healthy individuals are given in diluted form to patients exhibiting similar symptoms. Homeopathic remedies are prepared by serial dilution with shaking by forceful striking, which homeopaths term succussion, after each dilution under the assumption that this increases the effect. Homeopaths call this process potentization. Dilution often continues until none of the original substance remains.
go directly against doctor’s training and there is some considerable hostility within the profession towards homeopathy (as the video here demonstrates). Junior doctors were particularly angered by being asked to assimilate such unproven medicine within their training (never mind how small a part it might represent). The Lancet (UK medical journal), published a meta-analysis of homeopathy trials in 2005 concluding there was nothing but a placebo effect with an editorial in the same edition calling for “the end of homeopathy”,
Homeopathic practitioners, however, claim that that they are being discriminated by the dominant scientific paradigm. That the measurements used by allopathic medicine do not fit neatly with the holistic approach of homeopathy and when there is evidence in support of such treatments, this is minimised or rejected because it does not agree with the dominant paradigm.
Most tellingly, however, they draw on the experience of practitioners and patients to claim that the large numbers of patients reporting improvements in their condition is evidence enough of its efficacy. As Kate Chatfield argues:
In 2005 the results from a six-year outcome study at the Bristol Homeopathic Hospital were published (Spence et al 2005). This was an analysis of over 23,000 outpatient consultations from 1997 to 2003. Over 70% of follow-up patients reported clinical improvement following homeopathic treatment, clearly demonstrating the clinical effectiveness of the homeopathic intervention. Whilst this extensive study can tell us that homeopathy was largely effective for this particular group of people, what it cannot demonstrate is that this was not simply placebo effect.
However, if homeopaths can facilitate a placebo-induced healing response in over 70% of people who visit them, many of whom have previously not been helped by various types of allopathic intervention, then surely homeopaths should be highly revered and re-labelled ‘miracle workers’.
Were the Government to have followed its own medical committee’s proposals then it would have been denying choice to millions of people in the UK who feel homeopathy has something to offer the National Health Service. It would have been an unpopular decision indeed and it appears that objection to the use of homeopathy in the NHS (admittedly on a very small scale) is largely on the part of significant numbers of doctors rather than the general population (at the moment). We must also remember that the vast majority of patients referred for homeopathic treatment have not responded well, or at all, to “conventional” medical interventions.
Lessons for ELT
Not surprisingly, there are few large scale studies of various practices in ELT. The exception would appear to be around use of the mother tongue in ELT instruction. This is largely down to the states interest in various forms of education and the particular needs of the “immigrant population”. The debate about bilingual education is indeed hotly contested and there are considerable studies available from which conclusions can and are being drawn. This is not to say that other smaller studies are not carried out on other areas of ELT but that the studies have very small samples and it is difficult to generalise from one study, (say a group of male and female teenagers attending a private English academy in a wealthy suburb of Athens) to another (say a group of young girls aged between 9 and 15 studying English in an NGO run school).
Many ELT institutions have neither the will nor the resources to carry out large scale studies from which statistical meta-trends can be identified. Indeed, the popular concept of action research fits more neatly into the methodology applied by homeopathic practitioners (and indeed allopathic practitioners in the 17th and 18th centuries) than the “scientific rigours” of government funded science committees.
The proof of ELT it seems rests in the customer satisfaction of the learner or grades achieved in TOEFL, IELTS or First Certificate. However, both of these are problematic for a number of reasons but principally because we don’t know what variables were at play and whether the same could be achieved following a different set of variables. Indeed, students throughout ELT history, and with alarming regularity, have continued to attend classes, follow different and conflicting methodologies, pass exams and report high satisfaction levels. Exams have changed to reflect and consolidate new approaches and these changes, we would argue, have reflected wider changes in society. Indeed, we can easily cross-reference jargon used in post-war Human Resources with that used in ELT (indeed the rise of both, we would argue, is intimately related).
Towards a Science (or not) of ELT
We have not commented here on the relative merits of allopathic medicine versus homeopathic medicine. Instead, we have merely wanted to draw parallels between the popularity of a form of medical treatment lacking firm “scientific foundations” and English Language Teaching. Both practices seem to be doing rather well without such “scientific underpinnings” and both practices anyway would generally challenge the method of collecting data used by the dominant scientific paradigm. We might say both are “holistic” as they seek to deal with the whole person, in a special practitioner/ patient or practitioner/student relation which can not be readily reduced to a form of disconnected data available for statistical analysis.
This does not mean, however, interest in homeopathy might not decline rapidly or students demand greater proof of the efficacy of certain types of methodologies in ELT. There is clearly, a remarkable decline in students enrolling in Japanese ELT academies (employing methodologies popular on many teacher training courses) and this would cast doubt on their popularity and effectiveness. Moreover, in what sense is it satisfactory to base decisions of treatment or teaching on popular conceptions/misconceptions? Surely, progress is achieved by challenging popular beliefs and putting them to some type of rigorous examination.
We have not provided any answers here simply because the topic is so big. We will, however, quote from the French philosopher, Michel Foucault, in The Archaeology of Knowledge whose quote on the sciences of Man may be equally applicable to ELT theory:
If those arrangements were to disappear as they appeared, if some event of which we can at the moment do no more than sense the possibility – without knowing either what its form will be or what it promises – were to cause them to crumble, as the ground of classical thought did, at the end of the eighteenth century, then one can certainly wager that man would be erased, like a face drawn in sand at the edge of the sea” (p. 387).
In short, ELT did not, like the resurgence of homeopathy, arise out of opposition to anything mainstream but the practical problems of integrating new communities and preparing people for greater spatial and temporal mobility. It is, like homeopathy, sunk within deep institutional roots which determine its scientific (non-scientific) rationale. Maybe, if medicine became more holistic ( and here we mean emotions, housing, work, family, and leisure rather than the trite holistic claims of homeopathy), homeopathy might too disappear. Similarly, maybe our need for scientific rationalisations of ELT might disappear if we lived in a truly international world where personal growth and social need triumphed over profit. Maybe.