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Placebo Effect

PlaceboGoogle [Treating Depression: Is there a placebo effect? – CBS News] for an interview with Irving Kirsch, a scientist at the Placebo Studies Program at Harvard Medical School. Kirsch, who’s been studying placebos for 36 years, says “sugar pills” can work miracles. He has found that the drugs used to treat depression for most people are effective due to the placebo effect, not the active ingredient. Here are a few excerpts that stand out for me:

Kirsch: Placebos are great for treating a number of disorders: irritable bowel syndrome, repetitive strain injuries, ulcers, Parkinson’s disease. Even traumatic knee pain. In this clinical trial some patients with osteoarthritis underwent knee surgery. While others had their knees merely opened and then sewn right back up. And here’s what happened. In terms of walking and climbing, the people who got the placebo actually did better than the people who got the real surgery.

It’s not all in your head because the placebos can also affect your body. So if you take a placebo tranquilizer, you’re likely to have a lowering of blood pressure and pulse rate. Placebos can decrease pain. And we know that’s not all in the mind also because we can track that using neuro-imaging in the brain as well.

The doctors who prescribe the pills become part of the placebo effect. A clinician who cares, who takes the time, who listens to you, who asks questions about your condition and pays attention to what you say, that’s the kind of care that can help facilitate a placebo effect.

Physical exercise, especially when paired with fitness apps like the free tdee calculator, is another treatment prescribed for the mildly depressed. By the end of 10 weeks, you get just as good a change in their depression scores, as you do at the end of 10 or 12 weeks with an antidepressant.

First, what is the likelihood of the placebo effect working on non-human animals… if at all? I don’t see how it could, so I suspect that the placebo effect is actually an intuitive phenomenon that helps compensate for something out of whack in our species. The major difference between humans and other animals is cognition followed by civilization.

Cognition keeps us constantly on edge relative to “dumb animals”. Thought enables us to worry about what may never happen, desire that which is impossible to obtain, and plan for the un-plan-able. (See Let Sleeping Dogs Lie, p.169.) Nature abhors a vacuum and so it naturally fills the mind’s vast inner space with anything available, whether facts or imagined mountains out of molehills. (See Thinking Clouds Consciousness, p.119.)

If we were actually making physical mountains out of molehills, there would be no disconnect from reality. This correlates to Kirsch’s data that shows physical exercise, which may be accompanied by products like uneekor, treats mild depression as well as antidepressant drugs. Chapter 15 hints at this grounded humility…

He prepares as if fording a river in winter; as if in fear of neighbors;
Solemn such as allows; vanishing as if ice melting away;
Honest such as simple; broad such as the valley;

Our mind’s immense inner space keeps us rather high-strung. That interferes with an ability found in other animals to respond spontaneously to problematic situations. Our responses are much more complex for they take place in the backdrop of all the worries and desires we haul around through life. This easily causes us to stress out, over react and then swing between extremes.

All this combines to create an overall sense of disconnection. This imbalance is a natural result of our dipolar-like perception (see Yin Yang, Nature’s Hoodwink, p.35). Our cultural shift from the egalitarian ways of our ancestors to the hierarchical social structure of civilization further increased this disconnection. (See The Tradeoff, p.549). This matches Kirsch’s data that shows a clinician who cares, takes the time, and listens to you helps facilitate a placebo effect. The doctor becomes a path of reconnection.

Considering the placebo effect from a symptoms point of view (p.141) reveals the underlying cause—the disease we have—that makes the placebo effective. As chapter 71 bluntly states, Realizing I don’t’ know is better; not knowing this knowing is disease (See also Religion the Best Placebo, p.30.)

May 4, 2012 by Carl Abbott
Filed Under: Observations Tagged With: desire, imagination, placebo effect, worry

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