Bach flower remedies: more than placebo?

When I started using Bach flower remedies about eight years ago, purely out of curiosity, I did not really expect them to work. I held the widespread, but misguided, belief that if the mode of action of a therapy cannot be explained by current scientific knowledge it cannot be more than a placebo. The ‘placebo effect’ is a good thing, because it stimulates the potential for self-healing, but for a treatment to be accepted as valid it has to do better than placebo.

I was so surprised when I observed how well my friends and relatives responded to the remedies that I went on to qualify as a practitioner. After treating my first 100 clients I carried out a simple audit. Follow-up information was available in 94 cases. Two clients had discontinued treatment due to ‘healing reactions‘. Three said there was no change in their presenting complaints. Three did not take the remedies, but said they had improved after expressing and reframing their problems during the interview. All the other 86 clients reported some improvement in their emotional and/or physical symptoms, and in 33 of them the response was judged (by me) to be very good or excellent. Clients in this group spontaneously said that they felt calmer, more balanced, lighter, more joyful, more peaceful or more in control, usually within the first week of treatment.

While this can no way claim to be a thorough objective evaluation, its results are impressive. Other descriptive reports have also shown positive effects. However, these carry little weight among orthodox healthcare professionals compared with randomised clinical trials, of the kind used to test new drug treatments. A recent review of seven studies which had used this method concluded that ‘the most reliable clinical trials do not show any differences between flower remedies and placebos’.

Do these trials provide a fair test of the remedies? With respect to their authors – for I know from my previous career in academic medicine that carrying out a good research study is not easy – I think the answer is no. Many of them used a standard combination of flowers, usually the Rescue Remedy, instead of an individualised mixture chosen for each subject through discussion with a practitioner. Many of them were carried out on healthy populations, such as students preparing for exams, some of whom probably did not need any remedies and were unmotivated to take them. This is reflected in high drop-out rates, which detract from the validity of the results.

I am convinced from my own experience that wider use of Bach flower remedies could help a great many people, and reduce the over-prescription of pharmaceutical drugs, but they will not be accepted in conventional medical settings until there is more formal evidence that they work. Future research designs need to reflect the way the remedies are used in practice. The participants should have actually requested treatment for the condition under study: anxiety disorder or chronic pain, for example. Personalised remedy mixtures should be given, selected on the basis of the interview discussion which forms an important part of this therapy. Giving placebo alone would not be ethical, but the remedies could be compared with an established treatment such as medication or cognitive behaviour therapy. I would be pleased to hear from any colleagues who are interested to discuss setting up such a study.