watchdog wrote: brotherbock wrote: watchdog wrote: brotherbock wrote: ayoung98683 wrote: brotherbock wrote:
But the placebo effect can be both real and an effective treatment. Even when you have read things like the above.
Yeah, so placebo with a bag of M&M's rather than rewarding snake-oil ;-)
If only it worked that way.The fact is that medical professionals are starting to recognize the placebo effect as a legitimate treatment option. If Product X works for me, even though I have seen data that it doesn't work better than a placebo--it still works. (and M&Ms won't) Why not use it?
it's more complicated than that.
http://skepdic.com/placebo.html
Of course it's complicated, it's science. But the point that many researchers are trying to make now is this:In a blind study, you compare the results of your treatment to the results of a placebo treatment. What usually does *not* happen is that the placebo has no effect across the study population, while the drug either does or doesn't. The placebo treatment will almost assuredly have some kind of effect.
The point of the link is that the very concept of the placebo effect is controversial, with many studies and meta study analysis indicating that the improvements attributed to the placebo may in fact be due to other causes in many cases.
The problem with the suggestions in the link is that they are narrowly defining the effect in order to cast some skepticism. A reduction in disease effect due for example to subject expectancy and conditioning is *part* of the placebo effect. When a researcher determines that a particular treatment does no better at say alleviating pain than a placebo, they aren't talking about the intentionally ineffective medication or treatment given. The classic sugar pill came into use because it was known that the pill, by itself, does nothing. But what was quickly discovered was that things like conditioning and stress relief can have an effect. And those are *part* of the 'placebo effect'.
So for the author to claim that the placebo effect isn't real because any effects caused may be caused by the things listed is to mislabel what you're calling the placebo effect.
It's true enough that some of the factors listed are not part of a placebo effect on a given patient. False reports given (the subject saying they aren't feeling pain anymore in order to please the doctor, when they are still feeling pain), misquotation, etc. But others are. A subject actually feeling a reduction in symptoms of a disease *because they are conditioned to feel better when a doctor gives them a pill* is *exactly* the placebo effect in action. That's conditioning.
The claim made in the link regarding pain--that placebos don't lessen the pain, they lessen the emotional response to the pain, betrays an incomplete understanding of pain. Take a subject, John, who says "I'm feeling a lot of pain in my arm, it's a 9 out of 10." Doctor gives him a pill. Later the doctor asks if he's feeling pain. John says "Well, I can feel that there's something wrong with my arm still, but it's not so bad anymore. 7 out of 10." How are we supposed to interpret that? A nice fMRI maybe and we still see the same nervous system activity as we did when he claimed a 9 out of 10. Is it correct to say "No, you're still feeling a 9 out of 10 pain"?
Part of the 'feeling' of pain just is the emotional response to the physical feeling. I worked as a cook right out of high school. Used to burn myself all the time, hazard of the job. I eventually got to a point (have since lost it) to 'shut off' the pain of a burn. I would get burned, feel the pain, feel the emotional "aww dammit" with it. And then I would just mentally 'flick a switch', a very deliberate thing. I could still feel the burn as a thing that was there, a feeling. But I wasn't 'worried about it' anymore. I was able to operate as if it wasn't there--I exhibited no 'pain behavior', although I could still 'feel' a burn feeling. The pain, for lack of a better way of putting it, didn't hurt.
Now, is that a 'reduction in pain', or just a reduction in my emotional response to the pain? I argue for the former. I was actually in less pain, because pain is not just physiological but mental as well. For the authors of the piece to reject the placebo effect because some cases only deal with the emotional part of pain is to not capture what pain really is.
They're right to be skeptical of some claims, but they are casting too wide a net.