What if the Placebo Effect Isn’t a Trick?

[Sanguine]

New research is zeroing in on a biochemical basis for the placebo effect — possibly opening a Pandora’s box for Western medicine.

The Chain of Office of the Dutch city of Leiden is a broad and colorful ceremonial necklace that, draped around the shoulders of Mayor Henri Lenferink, lends a magisterial air to official proceedings in this ancient university town. But whatever gravitas it provided Lenferink as he welcomed a group of researchers to his city, he was quick to undercut it. “I am just a humble historian,” he told the 300 members of the Society for Interdisciplinary Placebo Studies who had gathered in Leiden’s ornate municipal concert hall, “so I don’t know anything about your topic.” He was being a little disingenuous. He knew enough about the topic that these psychologists and neuroscientists and physicians and anthropologists and philosophers had come to his city to talk about — the placebo effect, the phenomenon whereby suffering people get better from treatments that have no discernible reason to work — to call it “fake medicine,” and to add that it probably works because “people like to be cheated.” He took a beat. “But in the end, I believe that honesty will prevail.”

Lenferink might not have been so glib had he attended the previous day’s meeting on the other side of town, at which two dozen of the leading lights of placebo science spent a preconference day agonizing over their reputation — as purveyors of sham medicine who prey on the desperate and, if they are lucky, fool people into feeling better — and strategizing about how to improve it. It’s an urgent subject for them, and only in part because, like all apostate professionals, they crave mainstream acceptance. More important, they are motivated by a conviction that the placebo is a powerful medical treatment that is ignored by doctors only at their patients’ expense.

And after a quarter-century of hard work, they have abundant evidence to prove it. Give people a sugar pill, they have shown, and those patients — especially if they have one of the chronic, stress-related conditions that register the strongest placebo effects and if the treatment is delivered by someone in whom they have confidence — will improve. Tell someone a normal milkshake is a diet beverage, and his gut will respond as if the drink were low fat. Take athletes to the top of the Alps, put them on exercise machines and hook them to an oxygen tank, and they will perform better than when they are breathing room air — even if room air is all that’s in the tank. Wake a patient from surgery and tell him you’ve done an arthroscopic repair, and his knee gets better even if all you did was knock him out and put a couple of incisions in his skin. Give a drug a fancy name, and it works better than if you don’t....

https://www.nytimes.com/2018/11/07/magazine/placebo-effect-medicine.html

@roamer_1, I thought you might be particularly interested in this one.  It provides an explanation as to why western medication might work well for some and not so much for others.  Pretty interesting if you can make it through the dense prose of a NYT article. 

[roamer_1]

@roamer_1, I thought you might be particularly interested in this one.  It provides an explanation as to why western medication might work well for some and not so much for others.  Pretty interesting if you can make it through the dense prose of a NYT article.

“We’re dancing with the devil here,” Kaptchuk once told me, by way of demonstrating that he was aware of the risks he’s taking in using science to investigate a phenomenon it defined only to exclude.

Good morning @Sanguine
It is a beautiful day here in NW Montana - Blowy and snowy... and not much for sun this morning while I took my coffee outside... An act which has bearing upon this article, as I will explain later...

Thanks for the ping.

Indeed, it’s exactly that yearning that sickness seems to awaken and that our healers, imbued with the power of science, purport to provide, no imagination required. Armed with our confidence in them, we’re pleased to give ourselves over to their ministrations, and pleased to believe that it’s the molecules, and the molecules alone, that are healing us. People do like to be cheated, after all.

It is amusing to me that the 'dense prose' (neatly described, btw) of the article all but avoided the one thing they are attempting to describe - Faith - Which is in all likelihood, more of a healer than the molecules they'd prefer. That would neither surprise me, nor would it be particularly unexpected... Faith is always ignored by Man, more so since the supposed enlightenment.

Some things, I would posit, are effected by the very act of scrutiny.

As an aside, I did find quite a bit of humor in the description of acupuncture as a placebo - A practice which has proven effective for a thousand years, preemptively assumed to be placebo - The hubris of these people leads them astray. Like unto chiropractic care which, while unmentioned by this article, is also described as quackery, but which is a practice that anyone who works for a living can readily attest to as massively effective. In part, I would propose, that blinding hubris is passively described, and massively attested in this work.

I am however, mildly attracted to the notion of ritual as healing... I think there is something to that.

In my last business, the stress was killing me.  I woke up every morning barfing blood, and donned the pressure of that job every day. It was desperately debilitating... But I found the oddest thing:

Every day, at precisely 10 am, I would find a pretty place in my travels, shut off my phone, remove my watch, retrieve my gear, and retire to the tailgate. There I would prepare something akin to high tea, in its more rudimentary sense. It wasn't about taking a break ~Time ceased~ It was about lighting off the stove... and then the boil... and then the steep... and then the cooling... Even the fancy cookie (strictly limited to one or two) had its place. I found such peace in this little ritual that my health improved dramatically, and the stresses of my daily work became manageable.

Likewise today - Since my illness, I have had the worst time maintaining circadian rhythm. Pain has wholly removed it from me, too sore to sleep when I should, leading to a crash-and-burn in the middle of the day... treating this medically has been unproductive to say the least. What has treated it is again, ritual. There is something healing in an old routine I have recently rediscovered.

Up sometime between 6 and 7am, the coffee is on (another ritual thing, that making of coffee in the morning), There is peace in putting on winter gear - something I have done a million times - stepping into my muks like I always have (walking out to the barn for chores most of my life) - And me and the dog stepping out into the brisk pre-dawn... He for his morning constitutional, and me to sit on the tailgate and watch the sun come up. Turns out this simple thing, so often practiced, has been the only thing to anchor my rhythm. and what a wonderful, peaceful time.

I wonder if that is why I find natural medicines to be far more effective - The preparation, somewhat like the anticipation being the first 'bite' of cookies when you smell them in the oven - Perhaps that preparation adds authenticity to the medicine that merely opening a pill bottle does not fulfill.

I don't think that is exactly right - A healer would tell you that the medicine gives the body the tools it needs, but it is the spirit (faith) that does the healing. Something I intuitively understand, the way I was raised up.

[Sanguine]

Roamer, I doubt that the idea of faith ever occurred to the writers.  It just isn't in their belief system.

I do this "read the Bible every year" thing.  Been doing it for probably 5 or 6 years now. I pick a different translation every year.  This year is the NKJ.  For some scheduling reasons, I had stopped for the last couple of months.  Not related to the readings, and because of some personal family issues, I found myself grumpy, a bit angry and not at all settled.  Very unusual for me for the past several years. And, then I found that picking up the habit, the ritual that I had temporarily abandoned restored my "rightness" with the universe. 

Your weather sounds beautiful.  It's mid-70's here and rainy.  Temp should drop again this afternoon and we'll get back to our normal winter weather.

[thackney]

Good morning @Sanguine
...I did find quite a bit of humor in the description of acupuncture as a placebo - A practice which has proven effective for a thousand years, preemptively assumed to be placebo....

We, and many others, have used acupuncture on horses with significant back pain.  Before a massive flinch when pressed in the sore spot.  Immediately afterwards, little to no reaction when pressed in the same spot.  No way the horses are falling for a placebo.

And I agree greatly with your perspective of faith in healing.

[roamer_1]

Roamer, I doubt that the idea of faith ever occurred to the writers.  It just isn't in their belief system.

That is very probably well said. 

I do this "read the Bible every year" thing.  Been doing it for probably 5 or 6 years now. I pick a different translation every year.  This year is the NKJ.  For some scheduling reasons, I had stopped for the last couple of months.  Not related to the readings, and because of some personal family issues, I found myself grumpy, a bit angry and not at all settled.  Very unusual for me for the past several years. And, then I found that picking up the habit, the ritual that I had temporarily abandoned restored my "rightness" with the universe. 

Thanks for that reminder. I quite often get buried in religious study and forgo the devotional, with much the same result... The two are wholly different things. And I am rather fond of NKJV... My preferred version for devotionals and ease of reading.

Your weather sounds beautiful.  It's mid-70's here and rainy.  Temp should drop again this afternoon and we'll get back to our normal winter weather.

It was magnificent this morning... Cold and crisp... The Carhartts stiff and almost creaking with the cold... the wind stealing the steam from a speckled blue camp cup, held by a leather glove... there is something that the smell of oiled leather does to the taste of coffee. It is a good thing... Collar turned up against the wind... The ol Bailey pulled down low, with the hurricane strap out forward instead of thrown out back as usual... though not quite windy enough to cinch it down... Dark and cold, hoarfrost on the trees, and snow dancing in patterns from the sky...

All it was missing was the nicker and nudge of an impatient horse, tying on the bedroll, shoving the 30/30 into it's scabbard, and stepping into the saddle to wander off into misty mountain trails...

It gave me an itch, it did. 

[roamer_1]

We, and many others, have used acupuncture on horses with significant back pain.  Before a massive flinch when pressed in the sore spot.  Immediately afterwards, little to no reaction when pressed in the same spot.  No way the horses are falling for a placebo.

That's right. I think it a massive blind spot that western med has - That which it can't scientifically explain is automatically denigrated and assumed to be ineffective.

And I agree greatly with your perspective of faith in healing.

 

[Sanguine]

Sometimes you sound like Louis L'Amour's grandson.

[roamer_1]

Sometimes you sound like Louis L'Amour's grandson.

I will take that for a compliment :)

[Sanguine]

I will take that for a compliment :)

Absolutely.