Placebos

[Lost in Translation]

From an article I just ran across:

 

Quote

It wouldn’t be the last time science would turn its focus to the placebo effect only to quarantine it. At a 1955 meeting of the American Medical Association, the Harvard surgeon Henry Beecher pointed out to his colleagues that while they might have thought that placebos were fake medicine — even the name, which means “I shall please” in Latin, carries more than a hint of contempt — they couldn’t deny that the results were real. Beecher had been looking at the subject systematically, and he determined that placebos could relieve anxiety and postoperative pain, change the blood chemistry of patients in a way similar to drugs and even cause side effects. In general, he told them, more than one-third of patients would get better when given a treatment that was, pharmacologically speaking, inert.

 

If the placebo was as powerful as Beecher said, and if doctors wanted to know whether their drugs actually worked, it was not sufficient simply to give patients the drugs and see whether they did better than patients who didn’t interact with the doctor at all. Instead, researchers needed to assume that the placebo effect was part of every drug effect, and that drugs could be said to work only to the extent that they worked better than placebos. An accurate measure of drug efficacy would require comparing the response of patients taking it with that of patients taking placebos; the drug effect could then be calculated by subtracting the placebo response from the overall response, much as a deli-counter worker subtracts the weight of the container to determine how much lobster salad you’re getting.

 

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

 

(Emphasis is mine)

 

Given that the placebo effect is real, and that people given a placebo often are healed, at least partially, then there is an undeniable truth to placebo medicine. I found it quite astute to realize there is a placebo effect even among actual medicine! In other words, some get better faster and more thoroughly than others. The placebo effect is part of the bona fide cure, not just part of the sugar pill.

 

Mind blown! - It's obvious in hindsight, but wow.

 

And now here is my corollary: If the placebo effect can sure, can it not also injure? Can one get sick by placebo in the same way one can get healed by placebo?

 

Quote

Kaptchuk, who before joining Harvard had been an acupuncturist in private practice, wasn’t particularly disturbed by the finding that his own profession worked even when needles were not actually inserted; he’d never thought that placebo treatments were fake medicine. He was more interested in how the strength of the treatment varied with the quality and quantity of interaction between the healer and the patient — the drama, in other words.

 

So the drama between the healer and the patient matters. People crave the ceremony of the witch doctor. How does this portend with modern medicine where doctors increasingly minimize their patient time just long enough to prescribe a pill?

 

Quote

The findings of the I.B.S. study were in keeping with a hypothesis Kaptchuk had formed over the years: that the placebo effect is a biological response to an act of caring; that somehow the encounter itself calls forth healing and that the more intense and focused it is, the more healing it evokes. He elaborated on this idea in a comparative study of conventional medicine, acupuncture and Navajo “chantway rituals,” in which healers lead storytelling ceremonies for the sick. He argued that all three approaches unfold in a space set aside for the purpose and proceed as if according to a script, with prescribed roles for every participant. Each modality, in other words, is its own kind of ritual, and Kaptchuk suggested that the ritual itself is part of what makes the procedure effective, as if the combined experiences of the healer and the patient, reinforced by the special-but-familiar surroundings, evoke a healing response that operates independently of the treatment’s specifics.

 

 

 

[wandelaar]

As far as I know the placebo effect is acknowledged to exist by the medical sciences. Nothing new here. The opposite effect is called the nocebo effect, see: https://en.wikipedia.org/wiki/Nocebo

 

It is partly because of the placebo effect that medical science needs the complicated research methodology that is used.

 

Edited November 12, 2018 by wandelaar

[Lost in Translation]

4 hours ago, wandelaar said:

The opposite effect is called the nocebo effect

 

I did not know this. Thank you.