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Author Topic: Strange subtleties of the Placebo Effect  (Read 7607 times)

mouser

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Strange subtleties of the Placebo Effect
« on: February 20, 2011, 09:51:33 AM »
Most people are familiar with the idea of the "Placebo Effect", where a pill with no medical benefits can make people feel better.

But many people are unaware of the deep and fascinating study that has gone into this effect, and the fascinating and subtle discoveries made about how things like shape, color, context, delivery device, etc. effect how well it works.

Here's a great video taking you on a tour of some of the strangeness of it all.


nudone

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Re: Strange subtleties of the Placebo Effect
« Reply #1 on: February 20, 2011, 11:19:44 AM »
Fascinating.

MilesAhead

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Re: Strange subtleties of the Placebo Effect
« Reply #2 on: February 20, 2011, 03:22:53 PM »
I'm skeptical. A Genuine Placebo Aphrodesiac never did a damn thing for me!


timns

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Re: Strange subtleties of the Placebo Effect
« Reply #3 on: February 20, 2011, 03:35:32 PM »
I'm skeptical. A Genuine Placebo Aphrodesiac never did a damn thing for me!



It would be hard to see if it's working  :eusa_dance:

MilesAhead

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Re: Strange subtleties of the Placebo Effect
« Reply #4 on: February 20, 2011, 03:40:34 PM »
I'm skeptical. A Genuine Placebo Aphrodesiac never did a damn thing for me!



It would be hard to see if it's working  :eusa_dance:

Like Carson used to say, "I ain't touchin' that straight line with a ten foot pole!" :)

MilesAhead

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Re: Strange subtleties of the Placebo Effect
« Reply #5 on: February 20, 2011, 03:43:23 PM »
For a tried and true traditional example of the Placebo Effect(tm) just go to any barber shop and find a chair with a nearly bald guy.  Barbers did "air scissors" way before we ever did "air guitar."


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Re: Strange subtleties of the Placebo Effect
« Reply #6 on: February 20, 2011, 03:48:17 PM »
That was very interesting.

What I find disturbing isn't "placebos", rather the general inability of people to "connect the dots" and follow the implications. e.g. "The Secret" and similar things. If you believe it, it will happen, etc. Skeptics generally jump on top of stuff like "The Secret" and lambaste it, but don't have a problem with placebos, which is pretty bad logic. What skeptics should be doing is... well... that's a bit long... Suffice it to say that most "skeptics" are most certainly NOT skeptics.

I'd like to see information that follows the implications for the placebo effect with respect to "self-help", religion, and spirituality. That would be interesting.
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JavaJones

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Re: Strange subtleties of the Placebo Effect
« Reply #7 on: February 20, 2011, 04:33:34 PM »
"The Placebo Effect" is indeed fascinating, but there are several aspects to how it "works" which are important to consider, and highly relevant to the "skeptics" view.

At the simplest and most broad level, there is observer bias - the fact that you think something will or should happen will make you more likely to either see that thing, or to think something you did see *is* that thing (e.g. UFOs). This is what many skeptics hinge their arguments on and it's very valid in many cases when considering externally observable, real-world phenomena.

Then, there are the subtler internal effects generally particular to medical placebos, where actual physical effects can be seen, e.g. your cancer goes away (this stuff is the most interesting to me, because it actually affects reality). In many cases this is also mixed with some amount of observer bias, e.g. take a pain reliever placebo, "How do you feel?" "I feel much better."; the pain may not really be dulled at all in a physical sense, but since pain is perceived in the brain, the brain has the power to turn it off as well, in theory. But it also can have actual apparent physical effects.

So in regards to physical effects, from all I have seen these are confined to the individual physical body, which makes sense as we have a very complex body governed in large part by unconscious parts of our brain. The placebo effect may simply be linking conscious feeling with unconscious bodily action. Your immune system working better when you believe it will because you're not releasing stress hormones for example. That's all pretty much theoretical though as far as explanation goes, we don't really know how most of it works.

Definitely fascinating. And good video! The geographical differences were especially odd.

- Oshyan
« Last Edit: February 20, 2011, 04:35:21 PM by JavaJones »

MilesAhead

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Re: Strange subtleties of the Placebo Effect
« Reply #8 on: February 20, 2011, 06:22:22 PM »
Speaking of bias, let's not forget the fact that research often produces the results the sponsors paid for.  You're likely to get different research results on the harmful effect of tobacco if Philip Morris paid for it than if the research was sponsored by NORML.

Another "placebo effect" is the physician sticking a stethoscope on you can tapping around like it means something. In that vein I guess I'd agree with the video that the placebo is more effective if the gadget is bigger(e.g. MRI machine.)

cranioscopical

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Re: Strange subtleties of the Placebo Effect
« Reply #9 on: February 20, 2011, 10:21:18 PM »
Following the tenor of this discussion I'd like to point out another phenomenon, which is that the individual bursts into song. This is known as the Placebo Domingo Effect.

nosh

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Re: Strange subtleties of the Placebo Effect
« Reply #10 on: February 20, 2011, 10:40:30 PM »
I'm a firm believer in the placebo effect and the power of thought. I attended a boarding school situated in a mountainous region. It took seven hours to get to the city by road, three of them through winding mountain roads. The first time I took the trip I was badly carsick. At that age the journey seemed torturous and never ending. I've gotten over the motion sickness but that trip still rates as one of the most agonizing experiences of my life. On subsequent trips, I would start feeling ill the night before the journey. By morning I would be pretty f*****, and that's before the buses had even entered the school premises!
« Last Edit: February 20, 2011, 10:42:01 PM by nosh »

MilesAhead

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Re: Strange subtleties of the Placebo Effect
« Reply #11 on: February 21, 2011, 12:53:07 AM »
Following the tenor of this discussion I'd like to point out another phenomenon, which is that the individual bursts into song. This is known as the Placebo Domingo Effect.

Just be careful with those fake aphrodisiacs. You could end up singin' soprano.


Renegade

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Re: Strange subtleties of the Placebo Effect
« Reply #12 on: February 21, 2011, 01:28:10 AM »
+1 for Oshyan -- Important distinctions there.
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Paul Keith

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Re: Strange subtleties of the Placebo Effect
« Reply #13 on: February 22, 2011, 02:11:11 AM »
Quote
Skeptics generally jump on top of stuff like "The Secret" and lambaste it, but don't have a problem with placebos, which is pretty bad logic. What skeptics should be doing is... well... that's a bit long... Suffice it to say that most "skeptics" are most certainly NOT skeptics.

Not really. People have problems with propaganda. They don't have problems with contextual ads/funny biased political TV or the ever so charismatic message of "Hope and Change" during election years.

Quote
I'd like to see information that follows the implications for the placebo effect with respect to "self-help", religion, and spirituality. That would be interesting.

The information is all found in marketing or the oft famous "snake oil salesmen". I don't have any authoritative research articles but the general implication is that people tune out.

People get into religion - people find that religion is wrong - people find another form of belief - people become agnostic but fearful of being punished by God - people become spiritual - people find out that being spiritual is either un-rewarding or overrated - people become atheistic but they sought something to explain miracles - people look for the next modern day authority be that medicine, science or technology

Of course this is over-stereotypical but it's this same stereotype that makes placebos work better or work worse. It's not just belief. It's the source and revelation of certain beliefs combined with the knowledge and the feeling of assurance from having that knowledge.

Quote
At the simplest and most broad level, there is observer bias - the fact that you think something will or should happen will make you more likely to either see that thing, or to think something you did see *is* that thing (e.g. UFOs). This is what many skeptics hinge their arguments on and it's very valid in many cases when considering externally observable, real-world phenomena.

Personally I feel word of mouth and argument from authority works better than observer bias.

If you hear about it before you see it - once you see it, you have a lower skeptical barometer unless it's dead/inactive/just a piece of photo.

Contrast this to seeing it before you hear about it - then you're just wondering if your eyes are playing tricks on you until you start believing it.

I think this is an important distinction because without the mystique behind medicine, a medicinal placebo would mostly work less effectively than a magic spell.

Quote
Another "placebo effect" is the physician sticking a stethoscope on you can tapping around like it means something. In that vein I guess I'd agree with the video that the placebo is more effective if the gadget is bigger(e.g. MRI machine.)

I think another important distinction that should be made is that not everything can be placebos.

I could be wrong but I certainly haven't heard anything about a miracle stethoscope incident. Same thing with the gadgets. How exactly does one go about inducing a placebo in an MRI machine which is not a masses understood technique compared to a pill or an injection?

Quote
I'm a firm believer in the placebo effect and the power of thought. I attended a boarding school situated in a mountainous region. It took seven hours to get to the city by road, three of them through winding mountain roads. The first time I took the trip I was badly carsick. At that age the journey seemed torturous and never ending. I've gotten over the motion sickness but that trip still rates as one of the most agonizing experiences of my life. On subsequent trips, I would start feeling ill the night before the journey. By morning I would be pretty f*****, and that's before the buses had even entered the school premises!

Sorry if this is a joke and I just didn't get it.

That actually sounds more like Anchoring. http://en.wikipedia.org/wiki/Anchoring

Placebos don't work that way but again I don't even know the barest of placebos.

Anyways I think Placebos aren't that mysterious. They are an interesting research topic but almost all placebos seem to just need the participants to lower their defense mechanism. (but not be lied to)

From Wikipedia:

Quote
Level 1 - Pathological   

Delusional projection · Denial · Distortion · Extreme projection · Splitting

^ When lowered increases courage and confidence, reduces stress, unlocks self-help "Secrets"

Quote
Level 2 - Immature   

Acting out · Fantasy · Idealization · Passive aggression · Projection · Projective identification · Somatization


^When lowered means healing, pain reduction, peace of mind.

Note that before you get to level 2, you would have an increased rather than a decrease of these mechanisms so you have to re-lower them.

Note also that reduced fantasy doesn't mean increased reality but can just as mean reduced degree of separation. I.E. going berzerk in real life versus playing as a berserker in an rpg while staying in-character

Quote
Level 3 - Neurotic   

Displacement · Dissociation · Hypochondriasis · Isolation · Intellectualization · Rationalization (making excuses) · Reaction formation · Regression · Repression · Undoing

Decrease in this means that the person would be willing to keep repeating the induction of the placebo with lesser doubts and thus retaining the effects of the placebo despite prolonged usage. (Also means what it means by opium of the masses - false sanity thanks to group insanity working in a social structure)

Quote
Level 4 - Mature   

Altruism · Anticipation · Humour · Identification · Introjection · Sublimation · Thought suppression

Decrease in this might not increase "medicinal" placebos but certainly increases sociopathic placebo the likes which allow a normal man to become socio-superior in many cases.

Quote
Others   
Compartmentalization · Exaggeration · Minimisation · Postponement of affect

Decrease of this means better conformity. The placebo of camaraderie if you may:

Foes working together in a sports team in the name of a metal trophy.

Friends seducing their friends to more brain draining games on Facebook thinking they are not harming them.

Married women thinking they love or should love their husbands and thus becoming a loyal wife through wanting to live a stable life as a mother or a caretaker.

What's especially unique about this other category is that this is the exact opposite of the 1st stage so in many ways this is the skeptics' placebo.

A global clear cut example of this is how the smartest atheists can write about a scientific book debunking religion but they are only up in arms against religion if it's invading their perceived field and they do not respect certain things to "have an effect" despite it being clearly shown that it has.

In technology, this can also be attributed to the large disparity between Apple haters and Apple supporters. Not because there's a placebo happening to the supporters as much as there's a placebo happening to the dissenters in that they often write as if "they don't just get it" why people would want something like an IPad when it has barely little or worse effect on them. After that of course it's fill in the blanks but in that middle stage it's very impenetrable. You could predict it correctly and these people would just re-rationalize it as luck and their confirmation bias would just further fill in the blanks of why they are not wrong or why this is a limited incident or why they only switched because the item improved rather than say peer pressure or initial placebo rejection against those tactics until it wore down on them.

If it sounds confusing (and really I'm not referring to any research I've read but just conjuring my own opinion), those falling into the reduction of these other categories basically have rebellion placebos. Like single issue voters can be smart except for one issue. People would rebel if their internet was taken away from them but would be able to just tune out every other greater crimes. One could even dub it as the soldier placebo. You are able to reject corruption, to have a moral fiber, to have a long tolerance for being lead by a politician but as soon as you are able to outline your thoughts - exaggerate and see the vast implications of your actions - maximize the outcome and feel there's a deadline to the future - your shield placebo breaks down and you become either more human (in the empathic sense) or more animal (in the fight or flight sense)
« Last Edit: February 22, 2011, 02:22:57 AM by Paul Keith »

nosh

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Re: Strange subtleties of the Placebo Effect
« Reply #14 on: February 22, 2011, 03:19:48 AM »
Paul, I realize that wasn't an example of a placebo, I didn't say it was. It was an instance of one's preconception of what was going to occur having a physical effect on the body.

Paul Keith

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Re: Strange subtleties of the Placebo Effect
« Reply #15 on: February 22, 2011, 03:25:55 AM »
Yeah, that's why I wrote this in the beginning:

Quote
Sorry if this is a joke and I just didn't get it.

I just didn't understand your post. Thanks for clarifying.

housetier

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Re: Strange subtleties of the Placebo Effect
« Reply #16 on: March 30, 2011, 08:00:50 AM »
I have heard of studies showing the placebo medicine works even when the subject KNOWS it is a placebo. I'll try to find those; but I have a lot of feeds related to science...

Paul Keith

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Re: Strange subtleties of the Placebo Effect
« Reply #17 on: March 30, 2011, 04:07:09 PM »
I wouldn't doubt that. People tend to doubt their skepticism if they don't know how to verify it.

Often times it's easier to hope on a cure (assuming taking it means little to no cost plus massive gains)

We see this all the time with health drinks, religious atmosphere and even productivity systems. (and hell...web marketing)

Renegade

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Re: Strange subtleties of the Placebo Effect
« Reply #18 on: March 30, 2011, 11:03:01 PM »
I wouldn't doubt that. People tend to doubt their skepticism if they don't know how to verify it.

Often times it's easier to hope on a cure (assuming taking it means little to no cost plus massive gains)

We see this all the time with health drinks, religious atmosphere and even productivity systems. (and hell...web marketing)

I make $50,000 a day working at home for 5 minutes a day and you can too! Send me $50,000 and I'll tell you how! :P
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MilesAhead

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Re: Strange subtleties of the Placebo Effect
« Reply #19 on: March 31, 2011, 04:34:12 PM »
I have heard of studies showing the placebo medicine works even when the subject KNOWS it is a placebo. I'll try to find those; but I have a lot of feeds related to science...

The thing you have to watch out for are counterfeit placebos!! I hear IBM is going to bar code every pill and log it into a world wide database to ensure only genuine placebos are distributed in the third world.


thebaglady608

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Re: Strange subtleties of the Placebo Effect
« Reply #20 on: April 01, 2011, 10:01:07 PM »
I have heard of studies showing the placebo medicine works even when the subject KNOWS it is a placebo. I'll try to find those; but I have a lot of feeds related to science...

I believe the paper you're looking for is here.  There's a pretty good summary of the general media attention that the paper generated here (Dr. Gorski is a big skeptic of "complimentary and alternative medicine", so that flavors his reply).

I found the study interesting, but Gorski does have a huge point:  if you tell someone that a placebo has been "shown in rigorous clinical testing to produce significant mind-body self-healing processes", then you are NOT giving them a real placebo.  You're giving them something that, in their minds, might very well make them feel better, just like every other blinded placebo-based study.  Essentially, you're telling them that this "placebo" may have an active ingredient.  So, basically, the study is a demonstration of placebo effects...but probably not a study of what happens if you tell people the real truth about their placebo pill (ie, that there is no physical reason a placebo should make you feel better).