So-called complementary and alternative medicine (CAM) is largely philosophy-based medicine rather than science based. There are a few core concepts that are endlessly recycled in various forms, but it is mythology and culture, not grounded in the rigorous methods of science that allow us to tell the difference between our satisfying fantasies and hard reality. Sometimes proponents of such philosophies try to cloak their beliefs in the appearance of science, resulting in what we simply call pseudoscience.

Harriet Hall coined an excellent term to refer to such pseudoscience –” Tooth Fairy science.” In her metaphor, pseudoscientists sometimes act like scientists by describing the details and statistics of their claimed phenomenon (such as examining all the details of the Tooth Fairy phenomenon) without ever testing the reality of the phenomenon itself. The fundamental concept at the core of their belief is never challenged, or only superficially so, and they proceed prematurely from their faulty premise.

Another term that I find extremely apt is “Cargo Cult science,” a term coined by Richard Feynman. This is a reference to the cargo cults of New Guinea – the pre-industrial tribes were observed building straw mock-ups of control towers, planes, and runways in hopes that the planes they observed flying over head would deliver their cargo to them. In other words – the cargo cults mimicked the superficial appearance of an aviation infrastructure but had none of the real essence or function (because of lack of understanding). This is a perfect analogy to much of what passes for science within the world of CAM.

Not that we need another analogy, but I have often described such pseudoscience as being lost in the noise. In any endeavor to detect something there is the issue of the signal to noise ratio.  Often the core challenge of scientific research is pulling the signal out from the background noise, or (more to the point) deciding if there is a signal in the noise, or if the information represents pure noise. In this analogy “noise” refers to any randomness in the data or interference from effects other than the alleged signal of interest. What I find is that pseudoscientific investigations of tooth fairy phenomena are completely lost in the noise of data, seeing whatever phantom “signals” support their philosophy. Elaborate but entirely illusory constructs are often crafted (or retrofitted to) these phantom signals.

Energy medicine is a perfect example of cargo-cult, Tooth Fairy, noise-based pseudoscience.

Energy medicine began its life as a philosophy-based notion, and is still philosophy-based, but many of its modern practitioners are desperate for the respectability that science has to offer. Some have therefore erected a pseudoscientific facade for this pre-scientific superstition.

One example I was recently asked to investigate is the Heartmath institute., which promotes an energy-medicine based claim that the heart sends out “energy” waves that regulate the body, including the brain. According to proponents, the heart has its own memory and emotion and the health and functioning of the body depend upon the energy rhythms generated by the heart. Heartmath explains:

Most of us have been taught in school that the heart is constantly responding to “orders” sent by the brain in the form of neural signals. However, it is not as commonly known that the heart actually sends more signals to the brain than the brain sends to the heart! Moreover, these heart signals have a significant effect on brain function—influencing emotional processing as well as higher cognitive faculties such as attention, perception, memory, and problem-solving. In other words, not only does the heart respond to the brain, but the brain continuously responds to the heart.

The noise that is the basis of their “research” is heart rate variability (HRV) – the beat-to-beat variability in the time between successive heart beats. Proponents claim that there is an optimal HRV for mental and physical health, sometimes called “coherence” (because pseudosciences need to have their own fake jargon). Negative emotions cause chaotic HRV which then negatively affect the brain and rest of the body, while happy emotions result in HRV coherence and health.

I could not find any published peer-reviewed studies that establish any of these premises. I did find one recent review of coherence and HRV therapy for anxiety and depression, which concluded:

Our literature search focused on 1) the assumption that poor mental health is definitely linked to deviant heart rate variability, and 2) the assumption that optimising heart rate variability leads specifically to a reduction of complaints and symptoms.

There is insufficient evidence to support these two assumptions.

Slow breathing and heart coherence training probably achieve their effects as a result of non-specific psychological mechanisms.

The last statement assumes that any effects are achieved, a question which was not the focus of this review. Any feedback type intervention likely results in a degree of relaxation and stress reduction, however – the non-specific effects referred to above. Of course, HeartMath assures us (without evidence) that coherence is not simply relaxation.

Heartmath sells a machine, the emWave, that measures the heart rhythm (it seems as if it is measuring the pulse, although this is not explicitly described), and also breathing. This creates lots of data in the form of waves, which can either be smooth or chaotic looking:

As I sated above, there are multiple sources of “noise” in data, including simple random variation and interference from effects other than the effect of interest. The pulse waves above are not correlated with an EKG (at least not  in the material provided), but it would certainly be interesting to see the heart rhythm that accompanies the above pressure waves. The assumption being made is that the top pressure wave (during frustration) is real and not due to technical interference, but that would be the most probable cause. It is common to measure pulse waves in the hospital, so I am used to looking at them displayed on a monitor. The top tracing looks to me like technical interference, such as from moving or tensing the muscles. In other words – this is likely literal noise, not a true measure of anything physiological. This is the equivalent of interpreting pigeons nesting on the radio dish as alien signals.

The breathing tracings are even worse – one would have to believe the subject when not in “coherence” is hyperventilating and on the brink of passing out to believe the tracings are real and not artifactual.

That is it  – that is the core evidence for the entire premise of Heartmath, bad tracings, technical artifacts, and noise. Everything else is just mythology and storytelling – a tale woven from intertwining threads of pre-scientific superstition and some modern jargon and concepts.

Weaving in some actual science is also a common ploy of pseudoscience. The best lies have a kernel of truth at their center. For example, in the documentary linked to above we are told that the heart generates the largest electromagnetic field of anything in the body. This is mostly true, because the heart is regulated by an internal electrical system and muscles in general are electrical tissue. The heart puts out the largest signal while the body is at rest. When engaging in physical activity, the muscles put out large amounts of electrical signals as well on the same order of magnitude as the heart. But all of this has nothing to do with the claims of Heartmath and coherence – it’s just a science factoid used to make it seem as if the energy medicine claims are based on science when they aren’t.

The documentary goes on to say that the pulse (what they are measuring with their emWave) is not a result of blood flow but of an energy wave from the heart. This is patently false – the pulse can be interrupted by blocking blood flow. But this bit of error is necessary for the Heartmath construct – that their emWave is not simply a pulse meter prone to noise, but is measuring energy from the heart that is magically communicating to the brain and the rest of the body. They start with a trueish but irrelevant fact, then leap off the cliff.


For many pseudosciences, when you dig down to the core of their claims you will find there either nothing, or simply noise – some source of random or artifactual signals that generate data to feed into the predetermined conclusions of the pseudoscience. Energy medicine in general, and Heartmath in particular, are excellent examples of this phenomenon.

What you do not find are rigorous scientific studies that are designed to test the core premises of the pseudoscience – designed so that they are capable of disproving their premises or distinguishing the new effect they are claiming from existing known effects. In other words – you will not find any actual science, just the “cheap imitation” of cargo-cult, tooth fairy science.

Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the president and co-founder of the New England Skeptical Society, the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also contributes every Sunday to The Rogues Gallery, the official blog of the SGU.