TL;DR: There is probably some costly problem in your life right now that you are not even aware of. It is not that you are procrastinating on solving it. Rather, this problem has gradually blended into your environment, sinking beneath your conscious awareness to the degree that you fail to recognize it as a problem in the first place.
This post is partially an elaboration on Ugh fields, but there are some decisive differences I want to develop. Let me begin with an anecdote:
For about two years I've had a periodic pain in my right thigh. Gradually, it became worse. At one point I actually had a sort of spasm. Then the pain went away for a few weeks, then it came back, and so forth. All the while I rationalized it as something harmless: "It will probably just go away soon," I would think, or "It only inhibits my mobility sometimes." Occasionally I would consider seeking medical help, but I couldn't muster the energy, as though some activation threshold wasn't being reached. In fact, the very promise that I could get medical help whenever convenient served to further diminish any sense of urgency. Even if the pain was sometimes debilitating, I did not perceive it as a problem needing to be solved. Gradually, I came to view it as just an unfortunate and inevitable part of existence.
Last Monday, after hardly being able to walk due to crippling pain, I finally became aware that "Wow, this really sucks and I should fix it." That evening I finally visited a chiropractor, who proceeded to get medieval on my femur (imagine having a sprained ankle, then imagine a grown man jumping on top of it). Had I classified this as a problem-needing-to-be-solved a few months earlier, my treatment period would probably be days instead of weeks.
Simply, I think this situation is of a more general form:
You have some inefficiency or agitation in your life. This could be solved very easily, but because it is perceived as harmless, no such attempt is made. Over time your tolerance for it increases, even if the problem is worsening (Bonus points for attempts at rationalizing it). This may be due to something like the peak-end rule, as the problem doesn't cause any dramatic peaks that stick out in your memory, just a dull pain underlying your experience. Even if the problem substantially lowers utility, your satisficing lizard brain remains apathetic, until the last moment, when the damage passes a certain threshold and you're jolted into action.
While similar to procrastination and akrasia, this does not involve you going against your better judgement. Instead, you don't have a better judgement, due to the blinding effects of the problem.
Possible Solutions:
I didn't solve my problem in a clever way, but I've begun employing some "early warning" techniques to prevent future incidents. The key is to become aware of the worsening inefficiency before you're forced to resort to damage control.
- Do a daily/weekly/monthly reflection. Just for a few minutes, try writing out in plain text what you currently think of your life and how you're doing. This forces you to articulate your situation in a concrete way, bypassing the shadowy ambiguity of your thoughts. If you find yourself writing things about your life that you did not previously know, keep writing, as you could be uncovering something that you'd been flinching from acknowledging (e.g. "Obligation X isn't as rewarding as I thought it would be"). A more elaborate formulation of this practice can be found here.
- I kind of feel that "mindfulness" has become a mangled buzzword, but the exercises associated with it are quite powerful when applied correctly. I've found that following my breath does indeed induce a certain clarity of mind, where acknowledging problems and shortcomings becomes easier. Using your own thought process as an object of meditation is another excellent method.
- While the previous two examples have been personal activities, other people can also be a valuable resource due to their uncanny ability to be different from you, thus offering multiple perspectives. However, I doubt expensive talk-therapy is necessary; some of my most useful realizations have been from IRC chats.
One approach is to say: "Hey, this location feels off. If I do technique X this location doesn't feel off anymore and the person feels better. They aren't in pain anymore and their symptoms disappear." It's another problem to figure out the underlying biology and be able to say exactly what's happening. That takes certain skills that usually don't go hand in hand with being able to perceive locations that are off.
It's also next to impossible to get funding for that kind of research. I know someone who does her PHD at using the kinect to do computer modeling of an proven physical intervention used by some physical therapists. There's little grand money available for that kind of research. Most of the grant money goes to cell biology and biochemistry. Universities have to seek external funding these days and big pharma has money to throw around. Some science that is in principle doable isn't done because there nobody to fund it.
I do think that risk of interventions is a concern but I don't think it's the driving force for mainstream beliefs about chiropractors. Given the inherent risk, it makes more sense to start with lower risk interventions.
As far as potential harm from interventions from physical therapists the risk is likely less, but I would be surprised if there's no physical therapists that messed someone up.
Your arguments against doing science in this case seem fully general to me. They could be used by anyone promoting their brand of alternative medicine no matter how bizarre their claims would be.
What are your suggestions for how to most reliably evaluate anecdotal data? Would it be possible to do some sort of meta-science on this topic? How would you evaluate placebo effects? (Note that I think utilizing placebo too is important.)
I understand many medical treatments aren't RCT based either but the fact that many are kind of makes me trust the mindset of health care professionals more.