The deep significance of the placebo effect

[Nikolai1]

The truth that mind can and does influence matter is strongly recognised by modern medicine. Tell a patient that the sugar pill you give them is powerful medicine and it shall heal them of what you tell them it shall heal. It is called the placebo effect and it is real. In the second world war, surgeons discovered that when morphine stocks ran out, they could perform pain-free amputations simply by injecting their patients with salt water.

 

If we believe we shall be healed then that healing shall come to pass. Likewise, if our doctor tells us we are ill, then, like a voodoo curse, our belief in his words shall create actual bodily suffering.

 

Is it not surprising that something so utterly miraculous as this is happening before our eyes?

 

We imagine that the purported healing power of old religious relics is something belonging to the superstitious past, and yet the most prestigious peer-reviewed medical journals would not publish a clinical trial unless the voodoo magic intervention is included as a control.

 

All this shows that the healing powers of medical drugs are not contained within themselves. Any power they hold is precisely what we give to them through our original beliefs.

 

But what happens to the person who has no beliefs?

 

What happens to that person who understands that the drug has no power beyond what we give it? The person who has 'seen through' all their beliefs.

 

If we are no longer naive to the truth then the placebo cannot work for us, nor the religious relic, nor any of the manifold things in this world that we normally will give us what we believe we lack.

 

When we understand through the notion of the placebo that our beliefs can create our reality there is no way of knowing whether all our reality is not set-created. And yet we can not voluntary choose our beliefs. Such chosen beliefs have no power, no conviction, they seem arbitrary. We no longer have a very solid world 'out there' with its own laws that we can believe in unequivocally. Our beliefs are suddenly very weak and first and do not have the power to create our reality.

 

This is why we defend ourselves against this painful truth. It leaves us ungrounded, and paradoxically leaves us less empowered than we were before. Without the laws of nature to believe in, there is nothing else that gives us the power of conviction?

 

And yet neither can we go back to where we were. Our old beliefs, once exposed as ungrounded, no longer fill us with conviction either.

 

We are stranded, and yet filled with a painful realisation. We must truly create our own future, for ourselves, by ourselves and without the comfort of external constraints.

 

But this isn't as hard as it first looks. We do not have to pluck a future arbitrarily from the air. What happens is that conviction comes to us once again, only this time it is not belief based as before, but based on the direct power of revelation. We find that somehow we KNOW what should happen, what will happen, and how to act. This has been called the voice of the holy spirit, or wuwei, or simply spontaneous living.

 

Unlike the lawfulness of the world, and the everyday people that live in it, the person living spontaneously is hard to predict. The familiar reasons and methods don't apply. And neither can they account for themselves. Do not ask them to predict anything. They are an enigma even to themselves, and yet their actions are not random. They are appropriate and skilful. It seems they are guided by God himself!

 

Best wishes guys!

[thelerner]

The placebo effect is powerful indeed. Medical testing has to be double blind, because doctors knowing who is getting real from placebo effects the test. So even if people don't know, just the doctors knowing is enough to change results.

 

It makes good sense to empower our medicine (and food) with mental good wishes. In Roman times physicians had prayers that accompanied the medicines they gave out. Its worth noting the placebo effect is unpredictable, sometimes it works, sometimes it doesn't, sometimes its partial. It can be great (sometimes) for pain, even inflammation but shouldn't be trusted for conditions that require antibiotics.

[Nungali]

I saw a doco where people were told it was a placebo and for some it still worked. One woman even came back for more as it worked so well (she went to t e chemist to try to get more placebos but ... ) . The scientists told her it was a placebo - a sugar pill. She said "I know, but it worked, now I have stopped talking them the symptoms have returned. "

 

So that seems to totally wipe out the 'belief in' theory, the idea that if you know it is a fake, it wont work.

 

So ... IMO this is wrong : "What happens to that person who understands that the drug has no power beyond what we give it? The person who has 'seen through' all their beliefs.

If we are no longer naive to the truth then the placebo cannot work for us, nor the religious relic, nor any of the manifold things in this world that we normally will give us what we believe we lack." *

 

Alao I think this is a inaccurate : " The truth that mind can and does influence matter is strongly recognised by modern medicine."

 

It is not 'matter' as such it is an internal system (subjective) within the person themselves. There is no evidence (on the same scientific level as the placebo experiments ) that a person can effect matter 'outside' of themselves, in the objective world.

 

That requires another test. Something like - people are given an electronic vermin repeller to test how well they work (in lab condiitons. Some are fake and dont work but the testers do not know this. Then collate the results.

 

The next level would be to get people to test them and inform them who has a real one and a fake one, and then collate those results.

 

I am a firm believe that the power of the mind can make changes within the 'mind's system. but it has yet been shown IMO that the mind can alter objective reality. .

 

* " The study’s results shocked the investigators themselves: even patients who knewthey were taking placebos described real improvement, reporting twice as much symptom relief as the no-treatment group. That’s a difference so significant, says Kaptchuk, it’s comparable to the improvement seen in trials for the best real IBS drugs."

 

http://harvardmagazine.com/2013/01/the-placebo-phenomenon

 

 

" Placebo treatment can significantly influence subjective symptoms. However, it is widely believed that response to placebo requires concealment or deception. We tested whether open-label placebo (non-deceptive and non-concealed administration) is superior to a no-treatment control with matched patient-provider interactions in the treatment of irritable bowel syndrome (IBS)."

 

"

Placebos administered without deception may be an effective treatment for IBS. Further research is warranted in IBS, and perhaps other conditions, to elucidate whether physicians can benefit patients using placebos consistent with informed consent."

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015591

Edited January 18, 2015 by Nungali

[Nikolai1]

Hi Nungali

 

 

So that seems to totally wipe out the 'belief in' theory, the idea that if you know it is a fake, it wont work.

 

The important ingredient is the belief that the pill you are about to take will help. If the researcher says, as they did in the study you cited, "what we are giving you is a placebo", your own prior understanding in the power of placebo will heal you as much as a medicine.

 

If the researcher had said, "this is is just a sugar pill, it cannot and will not help you" then that will prevent the pill from working, even if it has the a supposed active ingredient. Medical ethics will prevent this from being tested.

 

The question I posed in the OP was about those people who understand that it is the belief that is the important thing. Those people who 'know' that the placebo and the active ingredient are identical and only have as much power as our beliefs give them.

 

Such people are left beliefless, and therefore with the burden of consciously choosing their outcome. They become immune to all suggestions given by the medical profession, they have transcended it. Their health must therefore be maintained through their own suggestions. I propose that these suggestions come in the form of revelation, and feel to originate from a transcendent source. I remember watching a documentary about a native Amazon Indian tribe who knew what plants were medicinal because the plants 'spoke' to them. A similar intuitive understanding is the only method available to those highly intelligent members of our society who have transcended the superstitions of modern medicine.

 

 

It is not 'matter' as such it is an internal system (subjective) within the person themselves. There is no evidence (on the same scientific level as the placebo experiments ) that a person can effect matter 'outside' of themselves, in the objective world.

 

When I talked about mind over matter I meant intellectual belief creating changes in the physical body. A blindfolded person who believes their skin is stroked from poison ivy will come out in a rash. Sugar pills restore the body to health through the reduction in whatever pathogens cause the disease.

 

If you accept that belief can change the physical body then you start to open up the possibility that mind has primacy over matter and is the progenitor of all that manifests physically. The more this conviction grows the more will the mind's sphere of influence grow on the world.

 

The only evidence for this is that those spiritual geniuses who preach this message are so often surrounded by seemingly miraculous occurrences.

Edited January 20, 2015 by Nikolai1

[Brian]

In clinical studies, new chemical entities are tested in comparison to placebos and have to demonstrate efficacy statistically greater than placebo-effect. This doesn't discount the power of mind-body effects but instead validates it. On the other hand, it also demonstrates that modern pharmacology is not belief-oriented.

[soaring crane]

On the other hand, it also demonstrates that modern pharmacology is not belief-oriented.

 

Not to my complete satisfaction, it doesn't. How many of the participants in a study group who are given the active ingredient are atually cured by the mind and not the substance? At least as many as in the placebo group, one has to assume. And how much does the mind boost (or deter) the effectiveness of the substance? There's no way to tell.

 

I can tell you that the placebo effect is a HUGE problem in pharm research, much moreso than is generally publicized.

 

And the cynic in me says that these people have, over the decades, learned ways to trigger self-healing without synthetics, but they sit on the information because it would ruin them. Same as herbal remedies. You can't patent a an herb, so they don't reveal what they learn in their studies of plants.

[Brian]

 

Not to my complete satisfaction, it doesn't. How many of the participants in a study group who are given the active ingredient are atually cured by the mind and not the substance? At least as many as in the placebo group, one has to assume. And how much does the mind boost (or deter) the effectiveness of the substance? There's no way to tell.

 

I can tell you that the placebo effect is a HUGE problem in pharm research, much moreso than is generally publicized.

 

And the cynic in me says that these people have, over the decades, learned ways to trigger self-healing without synthetics, but they sit on the information because it would ruin them. Same as herbal remedies. You can't patent a an herb, so they don't reveal what they learn in their studies of plants.

Here's the way it works, s c.

 

A population group is selected (target depends on which phase the study is in) and some are given the active molecule while others are given the placebo. Neither the test subject nor the clinician knows who gets which but the this information is tracked. After the study is complete, the subjects' results are analyzed AND the active/placebo data are reintegrated. In this way, it is very straight-forward to compare the results for those who were given the active molecule with the results for those who were given the placebo.

 

Yes, there will be people given the placebo who think they were given the active molecule as well as people given the active molecule who think they were given the placebo. In a well-designed study, the randomness of these distributions should wash out, leaving behind a differential of net positive (or negative) effect from the active molecule vs. the placebo.

 

The pharmaceutical companies have a HUGE financial incentive to make sure these clinical studies are sound because the cost of bringing a new product to market is mind-boggling -- and much of that cost is on the back-end. Well-designed phase 1 & phase 2 studies identify with a relatively small number of subjects efficacy vs. placebo-effect and provide a baseline safety analysis. Based on these initial results, the company determines whether the molecule should move on to wider (and substantially more expensive) phase 3 clinical trials.

 

This is not to say that "big pharma" is innocent, selfless or totally humanitarian in nature because that is certainly not the case -- there's too much money at stake and too many political strings -- but there is a deep & sincere desire and intent to do good science and to produce good medicine.

 

I worked for 13 years in the multinational pharmaceutical industry so I have some insider knowledge here...

[soaring crane]

But that still doesn't account for the placebo effect in the participants who receive the active ingredient. It's assumed that effects seen in participants who receive the active substance are a result of the substance. Assumed. That's my point. Remember Felix Unger?

 

To filter out that effect would require a test over a very long period in which the placebo and the target substance are alternated multiple times. Do they do that?

[Brian]

No, the placebo effect is subtracted out. The control group which receives the placebo is assumed to be statistically equivalent to the test group so that the placebo effect in both groups will be the same. If the control group shows a 25% efficacy, for instance, and the test group shows a 60% efficacy, it can be assumed that the difference of 35% is the result of the molecule, not the full 60%.

 

Make sense?

[Brian]

First phase (NCE/FIM = New Chemical Entity/First In Man) is with a small subject population in what approximates an Intensive Care Unit environment. Next phase is with a slightly larger of paid volunteers (often college kids) and primarily looking for uptake and side-effects. Next phase is with selected clinics across the country (or across several nations) with a much larger population. And so on.

 

Typically, five phases of clinical trials are conducted (after all the analytical work has been done in the lab and the methods development, formulation, etc.), including trials which continue well after the drug has been approved and released, each expanding in population (both size and generality), duration and nuance. Stability studies continue for a long time, too.

[dust]

This is not to say that "big pharma" is innocent, selfless or totally humanitarian in nature because that is certainly not the case -- there's too much money at stake and too many political strings -- but there is a deep & sincere desire and intent to do good science and to produce good medicine.

 

Certainly most people who go into working for pharmaceutical companies are just trying to do a job and make money -- and we assume that much of the time they have chosen this area in the hope that their work might help people. I agree that there must often be a sincere intent to "do good science and to produce good medicine".

 

Not to take this too off-topic, but.. if I were to criticize Big Pharma, it would be

 

[a] criticizing it at the same level as people criticize any multinational corporation and the "evils" that go with them -- including, as you say, the political and economic issues

 

criticizing the long-term negative effects of championing pharmaceuticals as the answer to life's problems

 

I think that is something everyone needs to take a certain amount of responsibility for. We can and should blame large corporations for many things, but if people just used common sense, eating well and not sitting around all day, they'd rarely have the need for drugs.

[Brian]

I would add a few more criticisms to the list but this shouldn't be a "what's wrong with western medicine?" thread.

 

There is too much influence by big pharma on the healthcare industry in general. One of the big problems now (in the US, anyhow) is the pressure placed on physicians indirectly through advertising. Patients walk into their offices already "knowing" which drug will be their magic bullet and too many physicians simply give it to them. Doing so feeds the placebo effect (to tie this back to the original topic) but also exposes people unnecessarily to side-effects. This will get worse as current changes in US healthcare continue to blossom, I'm afraid.

[Nikolai1]

There is no need to turn this into a criticism of big pharma. Placebos are real and effective treatments and are exactly the thing that most people need.

 

 

The science of creating medicines is nothing other than the art of getting people to be convinced.

 

 

The supposed clinical difference between the placebo and the active ingredient is a benign illusion that is based on several factors.

 

 

Firstly let's not forget that the two pills are different. They are different colours, shapes, and most importantly they taste different. A pill made of corn starch or sugar will not inspire a persons belief as readily as a pill that tastes bitter or foul in some other way. Since time immemorial people have instinctively know that a medicine is best if it is foul tasting. This perhaps feeds into peoples atavistic notion that for healing to occur there must be a sense of sacrifice or pain.

 

 

Nowadays, the same effect is achieved through subtle side effects such as digestion issues, skin outbreaks or psychotropic sensations such as feeling 'spaced out'.

 

 

And trust me, inventing a drug that is simultaneously benign yet capable of creating bodily feedback is no easy matter. The side effect and the main effect are one and the same thing.

 

 

Beyond this, there are political issues that allow a drug to seem clinically different to placebo. This is today with subtle manipulation of participant recruitment, data processing ,selective publication of positive results, and finally plain chance. A one in a hundred outcome is considered statistically and clinically significant.

 

 

But anyway, let's not get critical of big pharma because they are the vehicle of helping that we as a whole society create, believe in and therefore need.

Edited January 20, 2015 by Nikolai1

[soaring crane]

No, the placebo effect is subtracted out. ... Make sense?

 

Yeah, ok, that does sound good, thank you. I've been under the impression that it is not subtracted ever since a similar discussion/argument (might have been at this website) years ago, where someone made a strong case that the placebo effect is not accounted for (or perhaps only minimally accounted for) in the active ingredient group. Paradigm shift, woah.

 

Doesn't change my opinion on the motives of the industry, though. The patent remains the holy grail in the pharmaceutical world. And for the handful of truly wonderful or just plain effective drugs they bring to market, there are bucket loads of redundant, questionable products in their catalogs. And don't get me going on their marketing and lobbying practices ...

[soaring crane]

There is no need to turn this into a criticism of big pharma. Placebos are real and effective treatments and are exactly the thing that most people need.

 

Sorry to be contributing to the derailment of your thread, Nick. But I think was inevitable that it would take this direction.

 

So, you wrote : If we are no longer naive to the truth then the placebo cannot work for us, nor the religious relic, nor any of the manifold things in this world that we normally will give us what we believe we lack.

 

Which seems to be the crux of your post. For me personally, this seeing the pathetic little man behind the curtain of the wise and powerful Oz has a very comforting effect. It brings me closer to my own middle, to my self. I have no problem at all with having my beliefs stripped away. In fact, see my previous post ^^

[Brian]

 

Yeah, ok, that does sound good, thank you. I've been under the impression that it is not subtracted ever since a similar discussion/argument (might have been at this website) years ago, where someone made a strong case that the placebo effect is not accounted for (or perhaps only minimally accounted for) in the active ingredient group. Paradigm shift, woah.

 

Doesn't change my opinion on the motives of the industry, though. The patent remains the holy grail in the pharmaceutical world. And for the handful of truly wonderful or just plain effective drugs they bring to market, there are bucket loads of redundant, questionable products in their catalogs. And don't get me going on their marketing and lobbying practices ...

Yeah, the double-blind placebo-controlled clinical trial has been standard for at least a couple decades, especially in what are called Phase 2 & Phase 3 studies, which are the two progressively larger-scale studies in which effectiveness and side-effects are determined. These precede approval and it is only after approval that factories are tooled for mass production and marketing begins. Until approval, small lot sizes are produced (often by a third-party company), typically in which both active and placebo are packaged the same (same form-factor, same containers, etc.) -- primarily to eliminate bias by the clinician (if the person delivering the meds thinks they know which is which, that skews the results, too...) A well-designed study takes this so far as to make sure the labeling on the packages doesn't give any indication or even false clues (like a "P" in a lot number on a box which someone might think indicates "placebo").

[dust]

The supposed clinical difference between the placebo and the active ingredient is a benign illusion that is based on several factors.

 

Well... no...

[vonkrankenhaus]

Re:

-----

"But anyway, let's not get critical of big pharma because they are the vehicle of helping that we as a whole society create, believe in and therefore need."

-----

 

That seems like a "placebo effect" right there.

 

This "vehicle of helping" is the #1 cause of death right now.

 

"We" did not just suddenly decide to believe - we were systematically educated and programmed for decades to do so.

 

"We" did not create that industry, except as workers and consumers. Government programs and associated reimbursements drive or make possible this. It is a rigged game, with other possible modes constantly marginalized into doubt.

 

And people believe in many things they do not need. Otherwise, controlling them with money would be very difficult. The guns would come out, and the whole thing made "too obvious".

 

In my observation, the "placebo effect" happens because "matter" exists inside "mind".

 

It may even be crude of us to merely think in terms of "placebo" vs "real" effects, because so much more than that kind of simple assumption of polarity is really what's going on.

 

-VonKrankenhaus

[Vanir Thunder Dojo Tan]

I voluntarily took a thought placebo; SOME people call it a god complex.

So far: good physical results, difficult psychological effects, inconclusive divinity...

[Brian]

Divinity is difficult to measure accurately in a clinical setting...

 

[Vanir Thunder Dojo Tan]

it's a really complex and involved joke: Only those who have passed on ever come into contact with the punchline!

I jsut happen to have inside info that the puinchline is that "all are divine/deity/god/nature/universe/creator/spirit/worshipee".

Also read as: That which you think [of] the most Is your God.

[Nungali]

I thought placebo effects only showed a decrease in symptoms and not particularly causes.

 

 

(O - Oh ! 'causes' ... now I have done it ! )

[wilfred]

if the oft-touted placebo effect does indeed point to mind over matter, surely that points strongly to the possibility of something going on beyond the material realm. are there many scientists open to this possibility or is the conclusion generally along the lines of humans are stupid creatures?

 

that's kind of why i'm averse to 'placebo' effect being thrown out everywhere, it's used to bolster existing views, particularly in medicine, instead of dismantling them.

[blue eyed snake]

if the oft-touted placebo effect does indeed point to mind over matter, surely that points strongly to the possibility of something going on beyond the material realm. are there many scientists open to this possibility or is the conclusion generally along the lines of humans are stupid creatures?

 

I admit to a suspicion that scientists in general think along the lines of humans are stupid creatures.

 

But what I miss in talking about the placebo-effect is that it is not limited to the person who gets it described. The family and friends are involved in it.

 

simple example, worried mom goes to family-doctor with very sick small child. Doctor has a comforting attitude, describes medicine, now you'll get well.

Worries mum are lessened and this will surely have an effect on the child.

[Nikolai1]

The art of being a physician is the art of maximising the placebo effect at all stages in the consultation. The drugs are just the icing on the cake and will not be effective if the doctor hasn't first endorsed them. Of course the opposite is also the case. In the Nocebo Effect a doctor may inadvertently give his patient an illness through a wrong diagnosis. The medical literature is full of these cases.