How do skeptics account for the placebo effect?

[Moochie]

Hello,

It seems to me that the apparent success of much of the woo-woo crowd hinges on the placebo effect.

How do skeptics account for this?

How shall we explain the often dramatic results achieved by placebos to people steeped in religious doctrine and the like?

Can "placebo" be explained in religious terms?

Cheers,

Moochie

[John Jackson]

Could you clarify what you mean by the placebo effect?

Placebo effects and other confounding factors are the explanation for why so much alternative medicine appears to work.

The placebo effect is an entirely natural, psychological response to treatment. There’s nothing magical or mystical about it.

[drkitten]

Originally posted by Moochie

It seems to me that the apparent success of much of the woo-woo crowd hinges on the placebo effect.

How do skeptics account for this?

How shall we explain the often dramatic results achieved by placebos to people steeped in religious doctrine and the like?

Can "placebo" be explained in religious terms?


There seems little need to explain the placebo effect in religious terms per se; much of the placebo effect can be explained in terms of simply psychology.

First, people have an inherent confirmation bias; they notice things that they want to believe, and tend not to notice the rest. So if you are suffering intermittent pain, and I give you a sugar pill and tell you you will be feeling less pain, you will notice the times that you feel less pain more, and notice the times you are feeling more pain less. Ergo, you "think" you are feeling less pain and will report pain relief.

This confirmation effect can even apply to third parties as well; if I can convince you that your pet is, in fact, feeling better, you will notice an improvement. Ask any vet (I suggest Rolfe, on this forum).

Second, there is a very real mind-over-matter effect in people's abilities to control their bodies. Just as a quick example -- can you get angry "on command," by thinking of something that makes you angry? Most people can -- and the effects of this anger (pulse, blood pressure, respiration, adrenalin levels, &c) are quite "real."

Any doctor will tell you that they don't cure people; what modern medicine does is allow people to cure themselves through the body's natural healing processes. If I can give you a sugar pill and put you in a mental state that enhances healing, your healing will be enhanced.

[Ashles]

Originally posted by new drkitten
If I can give you a sugar pill and put you in a mental state that enhances healing, your healing will be enhanced.
I thought Rolfe posted some studies that showed tht this wasn't actually true - that your healing is the same regardless of mental state (obviously not including the negative effects of emotional states such as stress which have real negative physical impact).

Placebo dosn't have any real curative effect, it merely alters how we perceive sensations - pain might feel alleviated, breathing might seem easier etc.
And any physical change in symptoms that might have occured naturally may be falsely associated with the placebo.

I wasn't under the impression that there were any real measurable effects from taking a placebo, other than those that could be psychologically induced.

[Jeff Corey]

Wasn't there a reference on here recently to the release of endorphins being produced by placebos?
To me, that would imply classical conditioning, where effective painkillers would be the unconditioned stimuli and the sight, feel and act of swallowing the pill conditioned stimuli.

[CFLarsen]

Originally posted by Jeff Corey
Wasn't there a reference on here recently to the release of endorphins being produced by placebos?
To me, that would imply classical conditioning, where effective painkillers would be the unconditioned stimuli and the sight, feel and act of swallowing the pill conditioned stimuli.

It would. Man, much of psychology is sooooo basic, isn't it?

[Rolfe]

Coincidental recovery. Wishful thinking (rose-coloured spectacles, if you like). That's about your lot.

The rest is nothing but marginal and mostly imaginary scratching round the edges of oh look, I stuck an acupuncture needle in this guy's hand and a bit of his brain lit up on fMRI. Well, duh!

Consider that (subjectively, I can't prove this) the placebo effect seems to work if anything even better in animals. Why? Well, because it's a lot easier to smile through those rose-coloured glasses if it's not you personally who's feeling the pain!

Another thing. The placebo treatments that seem to persist all have a high input from a guru of some sort. When the public is simply sold something that's supposed to be a cure-all, and left to get on with it (Perkinism, for example), it tends not to last, as without someone explaining how to interpret subsequent events in the light of the assertion that the treatment is doing something, people usually start to notice that the alleged treatment isn't actually having a consistent effect. But add in a homoeopath (or a homoeopathy book) or an acupuncturist, telling the patient how much better he looks, or how this "aggravation" is great because it shows the remedy is "really" working, and frankly the nonsense gets swallowed hook, line, sinker and rowboat.

Try this article for a slightly different take on it (http://www.badscience.net/?p=164). Also this thread about the article (http://forums.randi.org/showthread.php?s=&threadid=61873), with an excellent (unprinted) letter from BSM near the bottom.

Now, about those often dramatic results achieved by placebos to people steeped in religious doctrine How about some evidence that any such results have ever happened? I'm religious myself, and I think this is baloney.

Also, some evidence forthe release of endorphins being produced by placebos would also be nice. I've never seen any reliable data on that. I could be wrong, I'm open to correction, but the way it seems to have gone is this. Some placebo treatments (like acupuncture) actually interact with the body. So it's not such a huge leap of faith to imagine that maybe there's the possibility of an actual effect. Phew, gasps the timid sceptic, here's a methodology that I might actually not have to slag off, if I can make some case for it actually doing something. This will get me so many Brownie points with that vocal alt-med mob, who currently hate my guts because I just pointed out how it's totally impossible that homoeopathy or radionics could have any effect! OK, maybe it could work, because maybe it might induce endorphin secretion!

And before you know where you are, you have the altmeddlers declaring that medical science has confirmed that acupuncture is effective because it promotes endorphin secretion.

Never been a single publication even trying to demonstrate the pesky things though, so far as I know.

Rolfe.

[Jeff Corey]

Originally posted by CFLarsen
It would. Man, much of psychology is sooooo basic, isn't it?
Does the name Pavlov ring a bell?

[Rolfe]

Originally posted by Jeff Corey
Does the name Pavlov ring a bell? I'm still looking for evidence that there's any such effect involved.

Rolfe.

[pjh]

Does the name Pavlov ring a bell?
Stop that! You're making me hungry.

[Jeff Corey]

Originally posted by pjh
Stop that! You're making me hungry.
I'll bite.
What for? Salad with Russian dressing?
Or Korean boshintang (http://koreananimals.org/news2.htm#chain), in a red wine sauce with capers and a hint of garlic?

[El_Spectre]

Originally posted by pjh
Stop that! You're making me hungry.

(from Pavlov's hidden cat studies)
"Day 4: Cat rang bell... I ate food..."

(Thanks eddie)

[Open Mind]

Surely it is obvious to all, that to some degree emotion, particularly stress, has significant effects upon health and disease Or are skeptics now in denial over this or do they believe stress is temporary unpleasant sensation that the body handles just as well as no stress? :)

The placebo effect is more than just patient delusion. However the beneficial placebo effect is usually lower than ideal (i.e. less than a cure) and usually beaten by a drug (to get on the market), which is usually less than a complete cure too although better.

Some skeptics believe the placebo is only useless component. To do this they claim a placebo is all spontaneous remission, regression to the mean , symptom detection ambiguity, etc. …. …and no doubt these are occurring factors to some degree ........ however I believe a real beneficial placebo effect is also occurring even if often masked by the misinterpretation of other explanations (just like real PSI! which I also believe is a real but weak effect, often mixed in with sensory clues, most believers miss the sensory clues and most skeptics by focusing on sensory clues misses the real weaker psi effect (e.g. parapsychology trials with suggestions of unproven sensory leakage) …. But I will not wander off topic further :) )

As posted earlier, just some suggestive evidence of placebos potentially being of benefit. .........

~~~~~~~~


(1) http://www.jneurosci.org/cgi/content/full/23/10/4315

(2) A. Steptoe, 'Placebo responses: An experimental study of psychophysiological processes in asthmatic volunteers,' British Journal of Clinical Psychology, 1986, 25, 173-183.

(3) 'Effects of suggestion and conditioning on the action of chemical agents in human subjects: The pharmacology of placebos/ Journal of Clinical Investigation, 1950, 29,100-109.

……………………………..

An interesting theory concerning placebo effect is based on ‘neuropeptides’

( C. B. Pert, M. R. Ruff, R. J. Weber, and M. Herkenham, 'Neuropeptides and their receptors: A psychosomatic network/ /. Immunol., 1985, 35(2), 820s-826s.)

Neuropeptides can trigger emotion .... but of more significance to understanding the placebo effect emotion can produce neuropeptides (mind/body bi-directional process) ....... neuropeptides are involved in a whole array of different bodily functions, from hormone regulation, to protein manufacture, to cellular repair upon injury, to memory storage, to pain management.

...... neuropeptides have receptors all over the body…… the whole body therefore is psychosomatically wired to emotion to some degree?

PET Scans have showed placebo triggered neuropeptides in the brain. (Science 2002, 295, 1737-1740)

Also of possible emerging interest is …… ‘Psychosocial Genomics’
http://www.ernestrossi.com/about_ps..._expression.htm


~~~~~~~~

If skeptics will forgive me for saying so, I do think they prefer to diminish the placebo effect to just a worthless psychological effect because they often are campaigning against alternative/complimentary medicines that are probably making use of placebo like effects to significant extent. If they acknowledge the placebo as somewhat beneficial, even if lacking or small, the campaign against alternative therapies is somewhat less effective?

If we take an antidepressant (e.g. Prozac) it hardly beats a placebo ….. a meta-analysis of published clinical trials of antidepressants indicated that 75 percent of the response to antidepressants is duplicated by placebo. Either that means antidepressants are not really doing anything much or a placebo is also nearly as effective against depression ...... either way it works effectively on patients. Placebos (e.g. salt water) in some trials have also done well in comparison to some painkillers in past .. again .. according to news report http://www.detnews.com/2005/health/0508/28/C01-291098.htm

Perhaps it would be fairer in trials to compare a drug to not just a placebo but also to no treatment at all so we can watch the placebo out perform no treatment? This is actually important as a safe check too, whereas an antidepressant fractionally beating an effective placebo works, another drug for another condition beating a very ineffective placebo fractionally may render the drug result rather useless in practical terms.

Also have placebo effects being properly researched? It would be logical to assume the active ingredients of a drug will give it a great difference over placebo in the short term but have the long term trials been properly done? For example if today you were to eat a lot of junk food, perhaps due to guilt, you would feel much worse - we could perhaps dismiss that as a psychological placebo like (i.e. nocebo like) effect? Yet few today would argue that a long term change of diet is not of vital importance (at least 1/3 of cancers are diet related according to one leading cancer research charity ... and this viewpoint has increased over the years, could it be higher still?). Very long term trials comparing placebo to drug, no treatment or change of diet have rarely been done properly, since the pharmaceutical company goal is one to show the effectiveness (or failure) of the drug against the seemingly useless placebo.

Then there is an ethical consideration, if the placebo effect within complimentary medicine is beneficial even to a small degree, skeptics claiming placebos have no benefit is actually creating a nocebo like effect upon those trying complimentary medicine? ;) Hmm .... .... who knows yet ...... perhaps old snake oil doesn’t work anymore because we no longer believe it can possibly work anymore? :) In one trial placebo effectiveness varied with colour of pill.

[Rolfe]

I would agree that in conditions where there is a significant contribution of anxiety in the presentation, then soothing the patient down by making them believe they are being helped may provide a real benefit. However, this is only going to be inasmuch as the lessening of the anxiety response may affect the way the patient feels. It can't possibly do anything for a real physical illness where anxiety isn't a contributory factor.

One thing I think argues against this as a major explanation, though. The frequent claims that "it works on animals".

No matter how much you may soft-soap an animal's owner, and tell them how effective this remedy is, and how much better the pet is looking, and all the usual waffle, this is only going to affect the owner, not the animal. Some have suggested subliminal effects of decreasing owner anxiety on the well-being of pets, but that is so tenuous you really can't get it to fly.

When you examine alternative medicine for animals, it's very clear that the effect is on the owner. In fact it's easier to make this work by proxy as it were, as it's easier to believe there's been an improvement if it's not you personally who is ill. What I'm saying is, if all this removing of anxiety were having a significant physical effect on the patient, rather than just changing their outlook on the situation, then you'd expect it to go away when applied to animals. It doesn't. Which suggests that the effects are entirely acting on the subjective impressions of the person paying the bill.

Maybe you can argue that anything that makes a human patient declare that he or she feels better is a good thing, because by definition the patient does feel better. My point is that manipulating the perceptions of animal owners so that they're convinced the animal is better when it isn't, may rake in the money, but it doesn't do a damn thing for the poor bloody animal.

Rolfe.

[drkitten]

Originally posted by Open Mind


If skeptics will forgive me for saying so, I do think they prefer to diminish the placebo effect to just a worthless psychological effect because they often are campaigning against alternative/complimentary medicines that are probably making use of placebo like effects to significant extent. If they acknowledge the placebo as somewhat beneficial, even if lacking or small, the campaign against alternative therapies is somewhat less effective?


I don't see how this follows at all. Most of the campaign against "alternative medicine" is based on fraud on the part of the proponent -- they claim that their treatment is effective against a particular disease or syndrome, when it is demonstrably no better than a placebo, and usually substantially more expensive (how much does a sucrose tablet cost? How much does a homeopathic tablet of anything cost?)

Alternative medicine is fraud, pure and simple.

If the alternative medicine proponents were selling "Placebenol -- proven to be exactly as effective as a placebo," there would be a lot less campaign against the snake oil peddlers and a lot more clamouring for public education about exactly what "placebo" meant.

[tsg]

Originally posted by Moochie
Hello,

It seems to me that the apparent success of much of the woo-woo crowd hinges on the placebo effect.

How do skeptics account for this?

How shall we explain the often dramatic results achieved by placebos to people steeped in religious doctrine and the like?

Can "placebo" be explained in religious terms?

Cheers,

Moochie

I suggest you look here for a detailed explanation: http://www.quackwatch.org/04ConsumerEducation/placebo.html

The Placebo Effect, simply, is the result of "feeling better" after having received no treatment that could account for it. There are a couple of reasons that this can happen like spontaneous remission (most diseases will get better all by themselves) and the patient's belief that he feels better.

Placebos are used as controls in testing. They are not intended to have any healing properties whatsoever. But, in drug testing in particular, some of the control patients will show improvement despite not having had any treatment. In order for a treatment to be shown effective, it must perform significantly better than the control group. The term "placebo effect", when attributed to a treatment, is essentially the same as saying "no effect attributable to the treatment". In other words, the same effect could be acheived by not doing anything at all. There is no significant difference in effect between taking the medicine and not taking it.

I work in Air Conditioning. We have occassionally placed fake thermostats (a placebo thermostat, if you will) in areas where the occupants are complaining about the temperature[1]. It has stopped some of the complaints, but the conditions that it does work are very specific. In all cases, there isn't actually a problem with the air conditioning. In most cases, the occupant is complaining because he feels he lacks control, not because he is uncomfortable temperature-wise. And, in some cases, the "placebo" works for about a week by which time the occupant has figured out that it doesn't really do anything. It helps if there are no temperature indicators in the room (out of sight, out of mind). But, in all cases, it is "treating" a problem with the occupant, not the air conditioning.

A placebo thermostat will not fix a temperature control problem.

The same effect can probably be observed by using placebos as a treatment in medicine[2]. I would imagine that if it was to be effective there would be a number of conditions that would have to be met. What they are, exactly, I can't say. But I highly doubt a patient could be cured of a real disease like cancer or tuberculosis simply because he believes he is being treated. Mind over matter may allow you to ignore pain from muscle strain in your arm, but I doubt it's going to kill off an infection.

As far as "dramatic results achieved by placebos to people steeped in religious doctrine and the like", I'm not aware of any short of anecdotes.

[1] These are areas that are temperature controlled, but the thermostat for that area is in another room off the same unit. The placebo thermostat is a real thermostat but isn't connected to anything.

[2] There are certainly a good number of anecdotes claiming this, but I have no idea if it's actually been studied (episodes of MASH don't count).

[Rolfe]

There's a lot of misunderstanding about this though. The page I linked to above (http://www.badscience.net/?p=164) contains a daft post from a girl bemoaning that homoeopathy cured her friend's eczema, by the placebo effect of course, and isn't it a bummer that it wouldn't work for her because she doesn't believe in it.

Total kookiness. Wrong end of the stick, grasped in a death-grip. But a lot of people seem to hold this view.

Rolfe.

[Blondin]

Perhaps it would be fairer in trials to compare a drug to not just a placebo but also to no treatment at all so we can watch the placebo out perform no treatment? This is actually important as a safe check too, whereas an antidepressant fractionally beating an effective placebo works, another drug for another condition beating a very ineffective placebo fractionally may render the drug result rather useless in practical terms.

I confused about this. Isn't the whole point of the placebo in controlled testing that it's a way of doing nothing without the subjects knowing who is or isn't getting the real deal? Don't they usually already have baseline statistics on incubation periods, survival rates, duration of symptoms, healing times, etc before starting a DBT? How would you evaluate any results if you didn't have baseline stats as well?

[Open Mind]

Originally posted by Rolfe
There's a lot of misunderstanding about this though. The page I linked to above (http://www.badscience.net/?p=164) contains a daft post from a girl bemoaning that homoeopathy cured her friend's eczema, by the placebo effect of course, and isn't it a bummer that it wouldn't work for her because she doesn't believe in it.

Total kookiness. Wrong end of the stick, grasped in a death-grip. But a lot of people seem to hold this view.

Rolfe.

But is it really 'kookiness' ? It may well be the case that placebos are far more effective on just some people than others, as drugs also seem to be more effective on some people than others? For example people with similar levels of blood pressure may need a lower level of active drug than others?

Also when drugs are compared to placebos in trials, as far as I know (and I am open to correction) pharmaceutical companies do not supply a list of possible side effects (that is supplied with medicine when finally put on market). So there could be an nocebo (counteracting) effect upon drugs total effectiveness that is absent from original trials declared effectiveness, that just cannot apply to placebos (or homeopathy) since these are inactive substances ;) Is the gap further reduced in real life practise than in trials?

Now, if a drug is more prone to produce a side effect than a placebo, could supplying a list of possible side effects in trials for both the active drug and inactive placebo, increase the side effects of the drug more than the placebo? :eek: :)

I take the viewpoint, perhaps we should have positive expectation from our pills even in conventional medicine, every little helps, perhaps greater still over the long term,

[Open Mind]

Originally posted by Blondin
I confused about this. Isn't the whole point of the placebo in controlled testing that it's a way of doing nothing without the subjects knowing who is or isn't getting the real deal? Don't they usually already have baseline statistics on incubation periods, survival rates, duration of symptoms, healing times, etc before starting a DBT? How would you evaluate any results if you didn't have baseline stats as well?

I think the question is whether a placebo also beats these estimations, yet trials are aborted when a drug effectiveness is proven to be siginifcantly beyond placebo or other rival drug being compared. The trials are seldom designed to test how well the placebo is actually doing ... and as you suggest it is complex to do so.

[Open Mind]

Originally posted by new drkitten
[B]
Alternative medicine is fraud, pure and simple.

If the alternative medicine proponents were selling "Placebenol -- proven to be exactly as effective as a placebo," there would be a lot less campaign against the snake oil peddlers and a lot more clamouring for public education about exactly what "placebo" meant.

Possibly but if the largest component in any antidepressant effectiveness is a placebo effect (75%) should such packaging say so? :) If Prozac said on packaging ' the major benefit of this medication is your belief in it, in trials this medicine works just a little better than placebo' ... would it still work as effectively? I don't know :D Perhaps to test this they should have told the patients the anti-depressant is a placebo and the placebo is a drug, might have been interesting? :)

[Moochie]

Originally posted by new drkitten
There seems little need to explain the placebo effect in religious terms per se; much of the placebo effect can be explained in terms of simply psychology.

First, people have an inherent confirmation bias; they notice things that they want to believe, and tend not to notice the rest. So if you are suffering intermittent pain, and I give you a sugar pill and tell you you will be feeling less pain, you will notice the times that you feel less pain more, and notice the times you are feeling more pain less. Ergo, you "think" you are feeling less pain and will report pain relief.

This confirmation effect can even apply to third parties as well; if I can convince you that your pet is, in fact, feeling better, you will notice an improvement. Ask any vet (I suggest Rolfe, on this forum).

Second, there is a very real mind-over-matter effect in people's abilities to control their bodies. Just as a quick example -- can you get angry "on command," by thinking of something that makes you angry? Most people can -- and the effects of this anger (pulse, blood pressure, respiration, adrenalin levels, &c) are quite "real."

Any doctor will tell you that they don't cure people; what modern medicine does is allow people to cure themselves through the body's natural healing processes. If I can give you a sugar pill and put you in a mental state that enhances healing, your healing will be enhanced.


Heh heh heh -- that's as close to "miraculous" as we dare get, eh?

Regards,

Moochie

[Bronze Dog]

Somewhere, I remember hearing about a planned study on pain relief that was going to be placebo vs. no treatment. Think it was in Sweden. Anyone know if they went through with it?

[drkitten]

Originally posted by Moochie
Heh heh heh -- that's as close to "miraculous" as we dare get, eh?

Sort of. You see, that's as close to "miraculous" as is scientifically supported, philosophically well-grounded, logical, testable, or (dare I say it) true.

I have this aversion to making claims that I believe to be untrue. You may, if you like, chalk that aversion up to a lack of courage. Certainly I have known a number of theists -- particularly Young Earth Creationists, but others as well -- who had no particular fear of knowingly telling lies in the name of the Greater Good and of Moral Behavior.

[drkitten]

Originally posted by Open Mind
Possibly but if the largest component in any antidepressant effectiveness is a placebo effect (75%) should such packaging say so?

I don't see any reason for this.

[Rolfe]

It seems to me that we're just back in that tired old rut of paranormal assertions that "placebo" has an active physiological effect (above and beyond anything attributable to a decrease in anxiety), set against the obvious fact that everything reported is easily explained as either coincidence or observer bias.

Bored now.

Rolfe.

[Moochie]

Originally posted by Rolfe
It seems to me that we're just back in that tired old rut of paranormal assertions that "placebo" has an active physiological effect (above and beyond anything attributable to a decrease in anxiety), set against the obvious fact that everything reported is easily explained as either coincidence or observer bias.

Bored now.

Rolfe.

Yet no one seems able to explain how/why some people get better regardless of the treatment (or lack of) they receive.

I think such recoveries, especially if they are from verified diseases such as cancer, deserve the appellation "paranormal," don't you?

[tsg]

Originally posted by Open Mind
But is it really 'kookiness' ? It may well be the case that placebos are far more effective on just some people than others, as drugs also seem to be more effective on some people than others? For example people with similar levels of blood pressure may need a lower level of active drug than others?

Human physiology is different from one person to the next. How one person responds to a drug will likely differ to how another responds to the same dosage of the same drug. But these differences are ususally a direct cause of some difference in the physiology (including metabolism and weight) of the two people.

The "placebo effect" in clinical drug trials is simply an effect not resulting from the tested treatment. What makes people respond to placebos is not fully understood and may have very many different and possibly indirect causes. The conditions that make one person respond to a placebo better than another may not even be quantifiable. Unless we can determine what makes a person more likely to respond to a placebo, we're left with prescribing placebos to everyone and seeing if it works. The problem with that is, for the people that it doesn't work, it is delaying effective treatment.

Until we know what causes people to respond to placebos, I am a little reluctant to suggest deceiving patients about their treatment on the hope that it will work. The whole thing reminds me of the claim motivational speakers are fond of: "Whether you think your will succeed or fail, you're right." It is entirely too simplistic and completely ignores other influences that may affect the outcome including, ironically, overconfidence.

But, besides that, if a clinical drug trial shows a drug to be significantly more effective than a placebo, shouldn't that be the first choice? Why use an alternative treatment that is less effective?

[tsg]

Originally posted by Moochie
Yet no one seems able to explain how/why some people get better regardless of the treatment (or lack of) they receive.

Actually, they can. The human body has natural defenses and healing processes that are pretty well understood by biologists.

I think such recoveries, especially if they are from verified diseases such as cancer, deserve the appellation "paranormal," don't you?

Hardly. Most acute diseases and many injuries will go away all on their own without intervention. Treatment of these is largely to alleviate discomfort, speed the healing process and prevent complications from arising later. Have you never had a cold? A cut?

Cancer has been known to go into spontaneous remission. It is not entirely understood why this happens. But that just means they don't know, not that there is anything magical or paranormal about it. It is simply, as of yet, unexplained, not unexplainable.

[Rolfe]

Originally posted by Moochie
Yet no one seems able to explain how/why some people get better regardless of the treatment (or lack of) they receive.

I think such recoveries, especially if they are from verified diseases such as cancer, deserve the appellation "paranormal," don't you? No, I don't. And if you knew anything at all about medicine, neither would you.

If "nobody seems to be able to explain this", I suggest this is simply that you have not been capable of understanding, or not wanted to understand, the explanations.

The mammalian body is a marvellous organism, capable of absolutely stunning feats of self-repair. Most injuries heal, most illnesses get better. Even diseases which are frequently fatal, have their exceptions. Nobody has ever shown that giving a "placebo" in any way influences the occurrence of such exceptions.

Rolfe.

[John Jackson]

I have looked into the placebo effect and what I found was that:

It is fundamentally a psychological response to treatment. It is the perceived improvement in symptoms that characterises it; it’s not the physiological cure caused by “mind over matter” that many people believe it to be.

There’s probably a conditioned response we have which is triggered by our belief that medicine makes us better, so when we are given medicine (real or sham) the response is invoked. This may include the release of endorphins, the body’s own morphine-like painkillers, which explains why perceived pain can be reduced by placebo treatments.

Believing that we are receiving treatment can reduce stress and anxiety. This can give the illusion of ailments that are exacerbated by stress and anxiety, such as eczema, being improved by sham treatments.

Placebo responses, such as feeling less pain or more energy, do NOT affect the actual course of the disease. Thus placebo responses can obscure real disease, which can lead to delay in obtaining appropriate diagnosis or treatment.

Placebo responses are invoked by all treatments; not just sham ones. This is why for a drug to be called efficacious; its effects must be above and beyond the placebo control.
Yes, there are one or two weasel words in there, but we have to remember that exactly how and why the placebo effect works is still not fully understood; although hopefully, that’s a reasonably close account.

My main bugbear when people talk about placebo effects is that they think it’s a “mind over matter” thing. I even had one crackpot telling me that if we all learned yogic practises we could do away with medicine altogether as mind over matter (his version of the placebo effect) could cure all disease.

His proof: yogic masters can ingest snake venom without being poisoned. :rolleyes:

[drkitten]

Originally posted by John Jackson
My main bugbear when people talk about placebo effects is that they think it’s a “mind over matter” thing.

Unfortunately, that's because partly it is.

I'd be hard pressed to describe how, for example, how anxiety levels exacerbating eczema, can be anything other than "mind over matter." Anxiety is a (rule-8) mental state.

Now, as it happens, it's a mental state we have some understanding of the biochemistry behind, and equally we have some knowledge of the physicological process by which stress levels influence the presentation of eczema. But that doesn't make it less a "mind over matter" thing.

If you want an even simpler example, look at how looking at certain kind of photographs affects blood flow in human (males); if you don't know what kind of photographs I'm talking about, turn off your spam filter for a few minutes. Then tell me there isn't a "mind-over-matter" effect going on there.

The problem is when the believers' get their teeth into a phrase like "mind over matter" and try to run with it beyond what can be physiologically and experimentally supported. But this is no different in principle from the damage they can do when let loose with phrases like "chaos theory," or "quantum," or "uncertainty principle."

[Orangutan]

Originally posted by Moochie
Yet no one seems able to explain how/why some people get better regardless of the treatment (or lack of) they receive.

I think such recoveries, especially if they are from verified diseases such as cancer, deserve the appellation "paranormal," don't you?

No one would argue that in the majority of cancer cases, without treatment people die. However there are a few cases where people have gone into remission.

Why you jump to the conclusion that the recovery of those patients is due to a paranormal event, and I assume you are thinking God as you talk about miricals, I don't understand.

If we assume you are right then there would be no reason to investigate what makes those people special. That would exculde an avenue to explore in the search for a cure for Cancer. Just because science can't explain it does not make it paranormal.

I am not a specialist in any medical field by the way, the same argument can be applied to lots of areas. Saying 'God did it' or 'It must be paranormal' just shows lack of imagination.

O.
:)

[Mojo]

Originally posted by Open Mind
Also when drugs are compared to placebos in trials, as far as I know (and I am open to correction) pharmaceutical companies do not supply a list of possible side effects (that is supplied with medicine when finally put on market). So there could be an nocebo (counteracting) effect upon drugs total effectiveness that is absent from original trials declared effectiveness, that just cannot apply to placebos (or homeopathy) since these are inactive substances ;) Is the gap further reduced in real life practise than in trials?

Now, if a drug is more prone to produce a side effect than a placebo, could supplying a list of possible side effects in trials for both the active drug and inactive placebo, increase the side effects of the drug more than the placebo? I would have thought that it would actually be the other way around: if no list of possible side-effects is provided, the subjects won't know what side-effects to expect, so any side-effects reported can't be caused by the placebo/nocebo effect, and they are therefore unlikely to be reported at all by the control group (unless, of course, by coincidence, members of the control group spontaneously develop the side-effect symptoms during the trial). If both groups are given a list of possible side-effects, the control group is likely to report feeling these effects even though they've been given a placebo. I take the viewpoint, perhaps we should have positive expectation from our pills even in conventional medicine, every little helps, perhaps greater still over the long term, I certainly don't take pills unless I have positive expectations about their effect!

[billydkid]

Originally posted by Moochie
Hello,

It seems to me that the apparent success of much of the woo-woo crowd hinges on the placebo effect.

How do skeptics account for this?

How shall we explain the often dramatic results achieved by placebos to people steeped in religious doctrine and the like?

Can "placebo" be explained in religious terms?

Cheers,

Moochie I am skeptical of the placebo effect itself. The only circumstance I am aware of where it can reasonable be argued that there is a placebo effect are the sorts of cases where the experience of such an effect is a purely subjective one. It has never been demonstrated that sugar pills can cure a physiological condition.

[Rolfe]

Originally posted by new drkitten
Unfortunately, that's because partly it is.

I'd be hard pressed to describe how, for example, how anxiety levels exacerbating eczema, can be anything other than "mind over matter." Anxiety is a (rule-8) mental state.

Now, as it happens, it's a mental state we have some understanding of the biochemistry behind, and equally we have some knowledge of the physicological process by which stress levels influence the presentation of eczema. But that doesn't make it less a "mind over matter" thing.

If you want an even simpler example, look at how looking at certain kind of photographs affects blood flow in human (males); if you don't know what kind of photographs I'm talking about, turn off your spam filter for a few minutes. Then tell me there isn't a "mind-over-matter" effect going on there.

The problem is when the believers' get their teeth into a phrase like "mind over matter" and try to run with it beyond what can be physiologically and experimentally supported. But this is no different in principle from the damage they can do when let loose with phrases like "chaos theory," or "quantum," or "uncertainty principle."I think accepting that a reduction in anxiety can produce an actual physical benefit insofar as a clinical condition is influenced by anxiety is perfectly reasonable. It's when the woos start asserting that it's possible to influence conditions which are primarily physical that the trouble starts.

And the trouble gets a lot worse when woo vets go about applying anxiety-reduction methods to the owners of the animals, who then claim that the animal is better.

As I tried to say (maybe my explanation of this one needs work), the fact that we so often hear that "it works on animals" suggests that a real physical improvement secondary to anxiety reduction is not a frequent explanation for what happens in placebo treatment. The idea that the rituals of the homoeopaths (or even worse, the acupuncturists) can do anything meaningful to reduce stress levels in animals, is ludicrous. If a real physical effect of stress reduction was a huge part of placebo response, we'd see it fall off very significantly as soon as it's applied to animals. (A sugar pill isn't going to do anything that a pat on the head and a calming word won't do, and that's a part of every treatment.) However, we see no such thing. In fact, subjectively, I think it's even easier to invoke a "placebo" response in an animal, where the effects are being filtered through a third-party observer. Convincing the third-party observer that the animal appears better is easier than convincing the actual person in pain that the pain is better.

The constant assertion that placebo-methods "work just as well in animals" is a very strong pointer to the conclusion that the bulk of the placebo effect acts on the perceptions of the person paying the bill.

Rolfe.

[Soapy Sam]

I wonder- do they work as well in infants?

Or is the response of the adult human to the suffering of it's offspring in any way different from his response to the suffering of his dog?

(The above question is rhetorical. )

[Mojo]

Originally posted by Soapy Sam
I wonder- do they work as well in infants? Well, the first application of the placebo effect most of us experience is probably "mummy'll kiss it better." A screaming infant wants attention, and having a parent apparently do something about whatever the problem is addresses that particular need, even if it does nothing about any underlying problem (I assumed that it was only the second question that you were describing as retorical).

[Moochie]

Originally posted by Orangutan
No one would argue that in the majority of cancer cases, without treatment people die. However there are a few cases where people have gone into remission.

Why you jump to the conclusion that the recovery of those patients is due to a paranormal event, and I assume you are thinking God as you talk about miricals, I don't understand.

If we assume you are right then there would be no reason to investigate what makes those people special. That would exculde an avenue to explore in the search for a cure for Cancer. Just because science can't explain it does not make it paranormal.

I am not a specialist in any medical field by the way, the same argument can be applied to lots of areas. Saying 'God did it' or 'It must be paranormal' just shows lack of imagination.

O.
:)


Hi,

I was refering to "paranormal" in the loose sense of "Not in accordance with scientific laws." And to some people, spontaneous remission does seem "miraculous" -- one can say these things without believing in woo-woo nonsense or some hirsute traffic director in the sky.

Besides, we all know that the FSM is responsible... Or do we?

Regards,

[Z]

My Ed, you folks don't watch much television, or many movies, do you?

Dumbo: The mouse gives Dumbo the 'magic feather', which gives Dumbo the confidence he needs to fly. Placebo effect.

Star Trek "Mudd's Women": Kirk swaps Mudd's miracle drug for simple gelatin tabs, and the three girls spontaneously get better. Placebo effect (and an effective demonstration of how 'quack medicine' really works).

The Birdcage: The housekeeper has been feeding 'Pirin' tablets to the drag queen to keep her going - which is just 'aspirine' with the A. and the S. rubbed off. Placebo effect.

There are countless other examples in our popular media; I wish I could remember, there was one example, in which, even after having it revealed that he was being helped by placebos, the person in question still demanded his fix. This is what I see from folks like Open Mind, et. al... a complete misunderstanding of what a placebo is and why it works at all.

The point of a placebo is simple, and well understood by anyone who does legitimate science: in any scientific experiment, you MUST - absolutely MUST - reduce or eliminate all variables except the one you are testing for. When experimenting with humans, this becomes madly difficult, especially in a society obsessed with racial and gender equality.

Ideally, an initial test for any given drug would include a large number of identical clones, and subsequent tests would spread out across genders, subraces, etc. But practically speaking, that's not going to happen.

So the test group and the control group have to be normallized as much as is possible. Both are told to avoid alcohol and smoking during the test (if possible). Both are told to avoid illegal drug use. In the best situations, the diets of both groups are normalized - made equal. The environments of both groups are made as identical as possible.

There is, of course, one other factor to consider: the subtle effect a person's attitude has when receiving a drug, whether that drug is real or not. Anxiety, if they fear drugs; hope, if they really want treatment, whatever. Mental states are physical states, and physical states have solid and comprehensible effects. To just administer drug vs. no drug adds in another variable - one group has an expectation, the other does not. Placebos normallize this variable by providing both the same level of expectation.

If there were a drug or chemical that could be quietly administered to a person's food without them knowing about it, then a test without placebo would work just fine. In at least one group of tests, of which I took part, the 'placebo' was, in fact, a flu shot - the drug was combined with a flu shot as well. What they were testing, I have no idea; I just know the effects were clear and obvious, and we were pretty pissed off about the test. (Military drug testing - like anyone needs three flu shots in one year!)

Anyway, to moochie and Open-mind - the problem is, you have no understanding of what the placebo effect is, so I suggest learning a bit about how science works.

[tsg]

Originally posted by zaayrdragon
There are countless other examples in our popular media; I wish I could remember, there was one example, in which, even after having it revealed that he was being helped by placebos, the person in question still demanded his fix.


I don't know if it's the one you were thinking of, but an episode of MASH had Hawkeye giving a placebo to Klinger to help him deal with the heat. Klinger was perfectly comfortable until Hawkeye told him it was a placebo, at which point Klinger immediately became very hot.

[Moochie]

Originally posted by zaayrdragon

Anyway, to moochie and Open-mind - the problem is, you have no understanding of what the placebo effect is, so I suggest learning a bit about how science works.


Oh come now, the term "placebo effect" has been in the public domain for a very long time, and is not "owned" by any person, group, or clique.

Regards,

[drkitten]

Originally posted by Moochie
Oh come now, the term "placebo effect" has been in the public domain for a very long time, and is not "owned" by any person, group, or clique.


True, but if you expect to have a discussion with experts, you should stick to the commonly understood and used definitions of words instead of some made-up private use.

[Neutiquam Erro]

Originally posted by Moochie
Oh come now, the term "placebo effect" has been in the public domain for a very long time, and is not "owned" by any person, group, or clique.

Regards,

And yet, in the context of a scientifically-rigorous medical trial, the term "placebo" has a very specific definition, which may, in fact, be slightly different from its vulgar, "public domain" usage.

Consider, for example, a frequent error in many "anti-evolution" arguments, which rely on a common vernacular that fails to adequately distinguish the terms "theory" and "conjecture." How should science proceed, if it cannot demand consistency in its terminology, within the context of its specific activities?

[Moochie]

Originally posted by Neutiquam Erro
And yet, in the context of a scientifically-rigorous medical trial, the term "placebo" has a very specific definition, which may, in fact, be slightly different from its vulgar, "public domain" usage.

Consider, for example, a frequent error in many "anti-evolution" arguments, which rely on a common vernacular that fails to adequately distinguish the terms "theory" and "conjecture." How should science proceed, if it cannot demand consistency in its terminology, within the context of its specific activities?

All very true, yet isn't it up to scientists to explain these fine points to the masses who aren't scientists, and who do use the 'vulgar, "public domain" usage'?

Regards,

[MoonDragn]

Coming from a Chinese background I have always seen acupuncture as science. The possibility that it could be a placebo effect never occured to me til I read all these articles attempting to prove it. The question is, who determins what constitutes a proof? What if all acupuncture does is send instructions to your brain for your body to correct a problem? How do we detect whether these instructions were actually sent? It could be a nerve impuse that gets triggered based on where the needle was inserted.

I read somewhere that in a clinical trial they accounted a higher recovery from treatment than a fake acupuncture treatment and that both the real and fake treatments showed an improvement over those who received no treatment at all.

[Neutiquam Erro]

Originally posted by Moochie
All very true, yet isn't it up to scientists to explain these fine points to the masses who aren't scientists, and who do use the 'vulgar, "public domain" usage'?

Regards,

I agree completely! But a scientist's placebo is still a placebo, regardless whether she's explained its purpose to the public adequately or effectively. The speed of light doesn't change just because I can't do the math, does it? ;)

edited for spelling

[dogguy]

Originally posted by Moochie
All very true, yet isn't it up to scientists to explain these fine points to the masses who aren't scientists, and who do use the 'vulgar, "public domain" usage'?

Regards,

I would say that it is up to each individual to ensure that they understand the meaning of the words that they use. I would also say that people in this very thread are attempting to do exactly as you suggest, only to meet with some reluctance on your part to give up your original "public domain" understanding. It is very difficult for scientists, or anyone else, to educate those who do not wish to be educated.

[drkitten]

Originally posted by MoonDragn
Coming from a Chinese background I have always seen acupuncture as science. The possibility that it could be a placebo effect never occured to me til I read all these articles attempting to prove it. The question is, who determins what constitutes a proof?

Whether it works or not.

The "gold standard" for medical research is the randomized, placebo-controlled, double-blind clinical trial. Unpacking this collection of buzzwords, this means that

participants are assigned randomly to treatment groups
each (participant in a) group receives either a placebo or the experimental practice under study
the patient does not know what group s/he is in
the attending physician does not know what group the patient is in


If, under this framework, the patients in the experimental group do better (heal faster, experience less pain, whatever) than the patients in the placebo group, we have evidence that the treatment under study is effective. Conversely, if there's no different, then we have evidence that the treatment is "no better than placebo."


What if all acupuncture does is send instructions to your brain for your body to correct a problem?

Then why doesn't it give any better results than just giving the patient a sugar pill?

How do we detect whether these instructions were actually sent? It could be a nerve impuse that gets triggered based on where the needle was inserted.

It could be -- but if there's no difference in the way patients respond to nerve impulses vs. the way they respond to sugar pills, then there's not much curative effect in the nerve impulses, yes?


I read somewhere that in a clinical trial they accounted a higher recovery from treatment than a fake acupuncture treatment and that both the real and fake treatments showed an improvement over those who received no treatment at all.

Assuming that this trial really exists (which is a big assumption, and one that I don't really believe) and was properly done (an even bigger assumption), then this illustrates the points nicely.

The placebo effect ("people get better if they think they are getting treatment") explains why people in the "fake acupuncture" group did better than the "go home and die" group. The actual effectiveness of acupuncture as a medical treatment is shown in the difference between the "real" and "fake" acupuncture groups.

In practice, it seems impossible to do a "double-blind" acupuncture study, because the doctor will know which patients he gave "real" treatment to and which he just jabbed randomly with needles. Unfortunately, this means that the doctor himself knows which patients he expects to get better, which can introduce bias into the results. GIven this problem, I would actually be more inclined to attribute the difference between "real" and "fake" acupuncture to doctor bias.

[Rolfe]

Originally posted by Moochie
All very true, yet isn't it up to scientists to explain these fine points to the masses who aren't scientists, and who do use the 'vulgar, "public domain" usage'?Moochie, read what dogguy said. Then read it again, slowly, till it sinks in.

"Placebo" means "I will please". It refers to a doctor giving a patient a content-free medicine just to keep them happy, and make them feel they are being cared for. Because patients tend to expect to be given a medicine. The rest is just psychology.

What did you think it meant, anyway?

So, doing better than placebo means doing better than a content-free medicine doled out in exactly the same circumstances, so that the psychological element is kept constant between the two groups (the group getting the real thing and the group getting the placebo). If a treatment can prove that it can do this, then that is taken as proof that if has a real physiological effect, and it's not just the psychological expectation that's producing the improvement.

What's so hard about this for you to understand?

Rolfe.

[Rolfe]

Originally posted by MoonDragn
Coming from a Chinese background I have always seen acupuncture as science. The possibility that it could be a placebo effect never occured to me til I read all these articles attempting to prove it. The question is, who determins what constitutes a proof? What if all acupuncture does is send instructions to your brain for your body to correct a problem?....The possibility that acupuncture is a placebo only just occurred to you? Hold that thought, you're getting somewhere....

The situation is very simple. Does acupuncture actually influence healing or recovery? If it does, that is the time to start working on the mode of action. If it doesn't, then "maybe it might work in such-and-such a way" is a bit premature, don't you think?

There are a few studies that claim to have shown effects above placebo for acupuncture, but they have all been severely flawed. It's not hard to understand - organising a true placebo acupuncture group, double-blinded, is almost impossible. There are many studies where the researchers have done their level best, and found nothing. On balance, the evidence is in favour of the placebo explanation. However, the few apparently positive studies will always be there for the enthusiasts to cherry-pick and showcase.

The difficulty is that of course acupuncture actually does do something. You feel a pinprick. Your body recognises a foreign object. Inflammatory reaction is initiated. These are all tiny effects, given the very fine needles used, but they are effects. So, you can measure changes in the body with acupuncture. However, get on to whether there's anything significantly different depending on where you stick the needle, and that's a different matter. And then there's whether sticking a pin in your big toe really can cure your liver disease (or whatever the claim is). That's the real biggie.

First show that acupuncture actually does have any beneficial medical effect. And show that there is more happening in the body than we'd expect with any old needle stuck in any old place. Until you've done that, speculations about nerve stimulation or endorphins or whatever are putting the cart some few light years in front of the horse.

(Hint - if you really could trigger a nerve impulse to send a signal to heal a disease, really, it's just faintly possible that real medical science might have noticed by now.)

Rolfe.

[MoonDragn]

Unfortunately theres alot of mumbo jumbo that goes into an acupuncture treatment about chi and natural flow of the body etc. Since Im not an acupuncturist I can't understand it.

However I know that the doctors claim that each person must be treated differently, so there goes the consistancy thing. You can't just read a chart and say, here is the right spot to poke you. Its like a chiropractic session, the doctor finds out whats wrong through some tests and then determines just where to adjust you. I know alot of acupuncturists also know about human physiology and are often times also practiced in western medicine.

Another thing is, these points are not fixed, they move around your body. There is a method for determining where they move to. But a fake accupuncture treatment might accidentally hit the right spot.

I do know the Chinese philosophy is to treat the entire body, not just the location. That kind of philosophy just doesn't fit into large clinical trials.

All in all, accupuncture is a bad example because its not like other holistic medicines. This one has been practiced for thousands of years with literally billions of satisfied customers. In the case of western medicine, not every treatment always work on everyone either.

[Moochie]

Originally posted by dogguy
I would say that it is up to each individual to ensure that they understand the meaning of the words that they use. I would also say that people in this very thread are attempting to do exactly as you suggest, only to meet with some reluctance on your part to give up your original "public domain" understanding. It is very difficult for scientists, or anyone else, to educate those who do not wish to be educated.

Oh those poor scientists, having to put up with inquisitive hoi polloi!

Yet some manage to do this quite well -- as shown by Richard Dawkins and Jerry Coyne in their lucid explanation of the difference between ID (creationism) and evolution published in The Guardian recently.

Regards,

[MoonDragn]

Originally posted by Moochie
Oh those poor scientists, having to put up with inquisitive hoi polloi!

Yet some manage to do this quite well -- as shown by Richard Dawkins and Jerry Coyne in their lucid explanation of the difference between ID (creationism) and evolution published in The Guardian recently.

Regards,

Frankly Im a little skeptical if psychology works at all, how can you pigeon hole human behavior into a few definate states when its is obvious that everyone is different from everyone else and they psychology differs as well?

Didn't freud say somewhere that he made the whole thing up?

[dogguy]

Originally posted by Moochie
Oh those poor scientists, having to put up with inquisitive hoi polloi!

This has some relevance to my comment? I think that most scientists would welcome "inquisitive hoi polloi" with open arms. For many, having the general public take an interest in their work would be a dream come true.

Yet some manage to do this quite well -- as shown by Richard Dawkins and Jerry Coyne in their lucid explanation of the difference between ID (creationism) and evolution published in The Guardian recently.

Regards,

Agreed. Many scientists, and others, can provide excellent explanations. Getting the general public to read and take an interest in the information is another matter entirely. You cannot (unfortunately?) force an education on anyone.

[Mojo]

Originally posted by Moochie
All very true, yet isn't it up to scientists to explain these fine points to the masses who aren't scientists, and who do use the 'vulgar, "public domain" usage'? Well, yes, but you have to do a little work yourself. It's no argument at all to just say "I don't understand," is it?

[Rolfe]

Originally posted by MoonDragn
Another thing is, these points are not fixed, they move around your body. There is a method for determining where they move to. But a fake accupuncture treatment might accidentally hit the right spot.

I do know the Chinese philosophy is to treat the entire body, not just the location. That kind of philosophy just doesn't fit into large clinical trials. This is just the usual double-speak excuse offered by homoeopaths and so on. In fact by every one of these quack "narrative" treatments. What's really going on is the there is a syspem of excuses which is formulated to cover anything at all that might happen following the treatment. So, everyone is different and there is a neat explanation for all the different things that can happen. The method can never fail! And since nothing can be predicted in advance (you know, because everybody is different), then it's quite difficult to prove it wrong.

There have been thousands and indeed millions of satisfied customers for every single quack nonsense method ever used in the history of mankind. So what?

And the "holistic" thing is just another trendy buzzword. Doesn't mean a thing. Alt-med treatments tend on the whole to be less interested in treating the whole patient than real medicine. But doesn't it sound good?

And after all these centuries of alleged successful Chinese practice of acupuncture (I say alleged, because if you look into the history of it all you might find it's somewhat less than claimed), and all the perfectly serious attention given to the method in the 1970s by medical researchers who thought that perhaps there might be something useful there, still nobody has ever managed to prove that an acupuncture needle in the hands of an acupuncturist does anything different from any old needle stuck in any old place.

Rolfe.

[steenkh]

Originally posted by MoonDragn
I do know the Chinese philosophy is to treat the entire body, not just the location. That kind of philosophy just doesn't fit into large clinical trials.

All in all, accupuncture is a bad example because its not like other holistic medicines. This one has been practiced for thousands of years with literally billions of satisfied customers. In the case of western medicine, not every treatment always work on everyone either.
I once read a history of Japan written by a Japanese, and in the description of the 1780'es he wrote that a "Dutch" school of young doctors appeared who were so impressed with the Dutch medical system where surgeons actually tried to find out what organs were doing what, and where medication was based on observation and tests. The Chinese medical system the Japanese had been using until then, simply did not have the same beneficial effect as the Dutch. The Dutch school only lasted a few decades before the Shogun clamped down on foreign influences and demanded a return to traditional medicine, but the ground was laid, and when Japan was opened up in the 1860'es, the doctors were prompt to adopt western medicine.

It is funny how "wise" some people can find an ineffective system just because it is old, whereas the Japanese who knew everything about the Chinese system, scrapped it as soon as they could! As for the billions of satisfied customer for the Chinese system, we notice that in China it is only popular for those things that western medicine cannot cope with anyway, and for which there is a wide margin for interpretation of effects. Since Chinese medicine is based on magic, it shares its efficiency with other quack magical healing systems like homoeopathy that also has "billions" of satisfied customers.

As for treating the "whole body", nobody knows what it means. It is just words. I know for certain that in homoeopathy that is also claimed to be a holistic healing system, homoeopaths freely give advice about medication after having read only a two-word description of a patient's problems.

And the theory that acupuncture points move around the body, but can be found by a skilled acupuncturist is definitely not what is generally practised. All accounts of acupuncture that I have listened to have described how the acupuncturist simply sticks the needles in without probing around for anything.

[MoonDragn]

Originally posted by steenkh
I once read a history of Japan written by a Japanese, and in the description of the 1780'es he wrote that a "Dutch" school of young doctors appeared who were so impressed with the Dutch medical system where surgeons actually tried to find out what organs were doing what, and where medication was based on observation and tests. The Chinese medical system the Japanese had been using until then, simply did not have the same beneficial effect as the Dutch. The Dutch school only lasted a few decades before the Shogun clamped down on foreign influences and demanded a return to traditional medicine, but the ground was laid, and when Japan was opened up in the 1860'es, the doctors were prompt to adopt western medicine.

It is funny how "wise" some people can find an ineffective system just because it is old, whereas the Japanese who knew everything about the Chinese system, scrapped it as soon as they could! As for the billions of satisfied customer for the Chinese system, we notice that in China it is only popular for those things that western medicine cannot cope with anyway, and for which there is a wide margin for interpretation of effects. Since Chinese medicine is based on magic, it shares its efficiency with other quack magical healing systems like homoeopathy that also has "billions" of satisfied customers.

As for treating the "whole body", nobody knows what it means. It is just words. I know for certain that in homoeopathy that is also claimed to be a holistic healing system, homoeopaths freely give advice about medication after having read only a two-word description of a patient's problems.

And the theory that acupuncture points move around the body, but can be found by a skilled acupuncturist is definitely not what is generally practised. All accounts of acupuncture that I have listened to have described how the acupuncturist simply sticks the needles in without probing around for anything.

Acupuncture is still practiced widely in japan as well. They didn't abandoned it, they simply adopted to western medicine because Acupuncture was only really effective as an alternative to treating pain and nerve related problems like carpal tunnel. I know plenty of people who's pain cannot be controled by western medicine but accupuncture can.

As I said I am not sure how it works, but I definately read somewhere that those points move. Accupuncture is really just a refined form of accupressure. The various pressure points around the body are all related to some nerve there. The most likely explaination for accupunture is that it somehow transmits a signal to the nerve near by to trigger an event in the body.

[steenkh]

Of all the woo practices, I regard acupuncture as the least woo. At least there is a clear physical action, and a number of possible explanations (but none involving "meridians").

Acupuncturists have also willingly cooperated in trials with the best possible controls (but real double-blind trials have so far not been possible) and they have not claimed that the embarassing results have been caused by too high controls. Fortunately for them the results have not been too embarassing.

My own position is that IF it works, it does not matter exactly where the needle is inserted, because that has been tested and proven to be of no consequence. But the needle CAN be placed wrongly: my wife once got a needle in a nerve, and apart from the immense pain, it also left half of the leg numb for almost a month!

I note that in the West there is myth that acupuncture is used instead of anaesthetics in China, but as far as I know, major operations have only seldom been practised with acupuncture, and never with results that outsiders would believe had been painless!

[John Jackson]

There was a very large study done in Germany.

See: http://www.guardian.co.uk/health/story/0,3605,1170061,00.html

However, I have been unable to find the actual results of the study.


ETA: I meant to ask, does anyone have a link to the concluded study?

[Open Mind]

Originally posted by zaayrdragon
This is what I see from folks like Open Mind, et. al... a complete misunderstanding of what a placebo is and why it works at all.



Yet you provide no evidence, make no specific comment upon my words other than to compare with something to do with Mr Ed, Dumbo and Star Trek? :) Are you sure you know exactly what the placebo effect is and exactly how it works?


Anyway, to moochie and Open-mind - the problem is, you have no understanding of what the placebo effect is, so I suggest learning a bit about how science works.

I don’t think I claimed to know how the placebo effect works other than say it is not just useless patient deception as many skeptics tend to imply , it is much more than that ….. what I posted was ......

Originally posted by Open Mind


(1) http://www.jneurosci.org/cgi/content/full/23/10/4315

(2) A. Steptoe, 'Placebo responses: An experimental study of psychophysiological processes in asthmatic volunteers,' British Journal of Clinical Psychology, 1986, 25, 173-183.

(3) 'Effects of suggestion and conditioning on the action of chemical agents in human subjects: The pharmacology of placebos/ Journal of Clinical Investigation, 1950, 29,100-109.

……………………………..

An interesting theory concerning placebo effect is based on ‘neuropeptides’

( C. B. Pert, M. R. Ruff, R. J. Weber, and M. Herkenham, 'Neuropeptides and their receptors: A psychosomatic network/ /. Immunol., 1985, 35(2), 820s-826s.)

Neuropeptides can trigger emotion .... but of more significance to understanding the placebo effect emotion can produce neuropeptides (mind/body bi-directional process) ....... neuropeptides are involved in a whole array of different bodily functions, from hormone regulation, to protein manufacture, to cellular repair upon injury, to memory storage, to pain management.

...... neuropeptides have receptors all over the body…… the whole body therefore is psychosomatically wired to emotion to some degree?

PET Scans have showed placebo triggered neuropeptides in the brain. (Science 2002, 295, 1737-1740)

Also of possible emerging interest is …… ‘Psychosocial Genomics’
http://www.ernestrossi.com/about_ps..._expression.htm

[Z]

All perfectly valid - and none of which supports the idea that we should be supporting quack medicine on account of 'the placebo effect'.

The placebo effect is not the desired treatment of choice; it is the psychosomatic response to perceived treatment, which can help in mostly insignificant ways with minor ailments (especially psychosomatic ones), but which is not, itself, good enough cause to pursue research on homeopathy, touch therapy, or any of the other quack treatments out there.


I never said I know exactly how it works... but it's clear you support quack medicine, to some degree. "Hmm .... .... who knows yet ...... perhaps old snake oil doesn’t work anymore because we no longer believe it can possibly work anymore?"

IN other words, you would choose to use the placebo effect to deceive people in the hopes that snake oil would still 'work' - when, in fact, it never worked at all?

We've seen the nature of your posts, OM - you skirt right along the edge of valid science, but then try to misuse it to support quack notions like psi and alt-med. Wasn't it your thread (correct me if I'm mistaken) that suggested that skeptics can never conduct valid psi research, because of their own disbelief in psi?

What you've stated - amid many smilies - is that the placebo effect is some sort of faith healing; that if people will just believe, then the placebo will work miracles. And that's just not what the placebo effect is all about. Tell me - honestly - can a placebo cure AIDS, or brain cancer, or hepatitis? But this is exactly what a few homeopaths have claimed, what a few acupuncturists have claimed, etc... and this is what the public will believe, if left unchecked.

And you have definitely not demonstrated an understanding of the placebo effect, and what it is really about - only a few studies that aren't a big surprise to anyone, that show that the brain/body states we call emotions somehow have biochemical reactions associated with them. NO SURPRISE - at least to anyone who recognizes that the entirety of mental activity is, in fact, nothing more than biochemical reactions. So a 'positive mental state' is obviously going to have desirable effects on healing - and a negative mental state will have negative effects on healing. I'm betting that if someone were to do a study and REVERSE the placebo procedure - TELL all the patients they were getting a placebo, but actually medicate half of them - that you'd see effectiveness of both groups drop dramatically, but the actual medicated side would not drop as much - but they'd sue your tuchus off, I guarantee it...

The point is - the 'placebo effect' is not a suitable explanation to cover for the quackery and nonsense peddled by the alt-med industry. The 'placebo effect' is not a cure-all magical practice that can be applied to make colored crystals take care of your arthritis or magnetic boots cure your weight problems. It's just a normalizing factor in research, and a way of dealing with hypochondriac patients in general. However it works - and it does work, to some degree - it doesn't work on specific complaints and specific ailments the way some people implies that it does. It doesn't induce miracle cures in religious patients, or amazing recoveries in the faithful, or anything like that. It's a small, mostly insignificant effect, for the most part; useful in helping patients heal (when they would have anyway on their own), but not particularly useful in treating ailments, injuries, diseases - especially genetic diseases - etc.

Really, the OP was kind of dumb to ask in the first place. The question itself is covered fairly well in the research you quoted - that there is a small biochemical effect associated with positive mental states - but what was being implied (I believe) is that the 'placebo effect' was a miracle cure (or the reason miracle cures REALLY WORK) of some sort. As such, the question was pretty silly.

"How do skeptics account for the hundreds of anecdotes that show that Penta water makes people feel better?" Same type of question - it's a false claim carefully wrapped in celophane, designed to look legitimate.

Dull.

[Open Mind]

Originally posted by zaayrdragon

The placebo effect is not the desired treatment of choice; it is the psychosomatic response to perceived treatment, which can help in mostly insignificant ways


At what point does an improvement become ‘insignificant’? For example even if we assume it is only making patients feel less depressed, does that truly make it ‘insignificant’?

75% of the effectiveness of antidepressants is replicated by a placebo, that still sounds large but is only about 2 points on the HAM-D scale. If these drugs truly have a powerful antidepressant effect, then it is being largely masked by a placebo effect.
Yes the drugs consistantly beat the placebo effect, however one study, researchers analyzed 345 antidepressant trials for depression with 36,000 men and women. The goal was to determine if a link existed between the use of SSRIs and suicide attempts. Out of a 140 suicide attempts, the suicide rate was twice as high in patients taking SSRIs, when compared to those taking placebo pills.
http://www.sciencedaily.com/releases/2005/02/050223141638.htm


with minor ailments (especially psychosomatic ones), but which is not, itself, good enough cause to pursue research on homeopathy, touch therapy, or any of the other quack treatments out there.

So would you recommend people just needing reassurance and reduced depression take an antidepressant instead, with a list of possible side effects never mentioned to those tested in original trials (that might reduce effectiveness in actual prescribed trials?) I supposed you could give them an unethical placebo but if it says placebo on the bottle it is no longer a placebo.

With regard to ‘touch therapy’ how do you know it has no beneficial effect? …..in 1995 rat pups deprived touch were found to have dramatic reduction in growth hormone http://www.nature.com/npp/journal/v28/n6/full/1300125a.html

Earlier studies on human emotional deprivation suggest similar too (e.g. G.Powell studies in 1967 and 1973) .

Also read the ‘effects of healing with intent on pepsin enzyme activity’ Journal of Scientific Exploration Volume 13, Number 2, 1 July 1999, pp. 139-148(10)


I never said I know exactly how it works... but it's clear you support quack medicine, to some degree. "Hmm .... .... who knows yet ...... perhaps old snake oil doesn’t work anymore because we no longer believe it can possibly work anymore?"

Easy to test, give people a placebo but tell them it is a inactive placebo, if the effect is less in comparison to another placebo told to be a wonderfully powerful new drug …. This would suggest my statement in principle is correct.


IN other words, you would choose to use the placebo effect to deceive people in the hopes that snake oil would still 'work' - when, in fact, it never worked at all?

How do you know it never worked at all, perhaps snake oil cannot work because skeptics have told people it cannot work ;)
I should really look into researching whether famous past drugs that got abandoned lost effectiveness over time with doubt or were always rather ineffective.


We've seen the nature of your posts, OM - you skirt right along the edge of valid science, but then try to misuse it to support quack notions like psi and alt-med.

Have you considered the possibility that the information you are reading on organized skeptic websites is somewhat biased? Being skeptical is fine but that should include being skeptical of organized skepticism! :) The skeptic paradigm has moved from ‘doubt’ to a defense of the conventional and predictable science against anything that falls outside the conventional that is hard to predict or understand …. And a placebo was conventionally supposed to be completely useless and inactive patient deception, rather than admit a placebo can have a beneficial effect. It seems skeptics, in a desire to shoot down anything alternative, prefer to dismiss weak effects altogether. It is always 'nothing but something else' ... yet this 'something else'
skeptic claim often lacks the necessity of 'the burden of proof is upon the claimant' ........ To cast doubt upon a claim is OK but to debunk with unproven explanation is dishonorable IMHO.


What you've stated - amid many smilies

:)

- is that the placebo effect is some sort of faith healing; that if people will just believe, then the placebo will work miracles. And that's just not what the placebo effect is all about. Tell me - honestly - can a placebo cure AIDS

Can conventional medicine cure AIDS? Are you claiming belief and emotion has no effect upon AIDS?

‘Accelerated course of human immunodeficiency virus infection in gay men who conceal their homosexual identity’ SW Cole, ME Kemeny, SE Taylor, BR Visscher and JL Fahey Psychosomatic Medicine, Vol 58, Issue 3 219-231 1995

or brain cancer

People do occassionally recover from cancer after conventional medicine as said it can do no more, of course a skeptic will offer another (unproven) explanation as to what really occured..... but are you claiming emotion and belief can never have an effect upon cancer?

‘Emotional expression in cancer onset and progression’ L. Gross Soc Sci Med. 1989;28(12):1239-48.

Effects of psychological treatment on survival of. patients with metastatic breast
cancer.[ Lancet 1989, 2, 888-891


or hepatitis?


I’m feeling too lazy too look :) But I know there are at least 3 trials showing a possible link between emotions, stress and immunity.

Perhaps skeptics just believe emotions can make us ill but never better?…. Just a one directional process? Several earlier posters in this topic said a placebo cannot cure to belittle the effect …. yet seldom does a drug actually cure, it is often an effective maintenance dose to counteract and slow down deterioration? Can emotions also slow down deterioration too, if stress impairs immunity?


But this is exactly what a few homeopaths have claimed, what a few acupuncturists have claimed, etc... and this is what the public will believe, if left unchecked.

I am not against skeptics challenging anything, I am against them belittling or entering denial of weak effects


And you have definitely not demonstrated an understanding of the placebo effect

I don't think anyone knows enough about the placebo effect, that most certainly includes me too.


and what it is really about - only a few studies that aren't a big surprise to anyone, that show that the brain/body states we call emotions somehow have biochemical reactions associated with them. NO SURPRISE - at least to anyone who recognizes that the entirety of mental activity is, in fact, nothing more than biochemical reactions. So a 'positive mental state' is obviously going to have desirable effects on healing - and a negative mental state will have negative effects on healing.


Well I agree ...... so would you are just advising people to think negatively over alternative treatments and positively over conventional ones? :) I do think many people try alternative therapies because the conventional one wasn’t satisfactory. ‘Sorry Mrs X, there is nothing more we can do for your cancer …… but don’t try anything else!’


I'm betting that if someone were to do a study and REVERSE the placebo procedure - TELL all the patients they were getting a placebo, but actually medicate half of them - that you'd see effectiveness of both groups drop dramatically, but the actual medicated side would not drop as much - but they'd sue your tuchus off, I guarantee it...


Well I wouldn't 'guarantee it' but I would expect the same and I would like too see more of these trials done.


The point is - the 'placebo effect' is not a suitable explanation to cover for the quackery and nonsense peddled by the alt-med industry. The 'placebo effect' is not a cure-all magical practice that can be applied to make colored crystals take care of your arthritis or magnetic boots cure your weight problems. It's just a normalizing factor in research, and a way of dealing with hypochondriac patients in general. However it works - and it does work, to some degree - it doesn't work on specific complaints and specific ailments the way some people implies that it does.


I agree that many alternative practitioners are possibly giving the wrong reason for the benefit.


It doesn't induce miracle cures in religious patients, or amazing recoveries in the faithful, or anything like that.

Actually to a lesser degree I see a general lack of miracle cures in conventional medicine too. Surgery has been a great success. Slowing health deterioration with drugs has been comparatively successful (not necessarily clearly proven better in long term over diet and exercise) but no doubt vital if serious acute conditions.

As to whether miracles cures exist, that is a paranormal debate. I’m not religious, I have no religious faith … but I think belief produces significant if generally weak effects in health (placebo) and also possibly in the paranormal. (claimed sheep and goat effects)


It's a small, mostly insignificant effect, for the most part; useful in helping patients heal (when they would have anyway on their own),

I would dispute that, if stress can worsen a disease or cause it … how can you be so sure they would have healed without the placebo like effect?


but not particularly useful in treating ailments, injuries, diseases - especially genetic diseases - etc.

Again conventional medicine isn’t that successful on genetic disease either.

I’m still not sure it is that clear cut, our physical height is determined by our genes but our environment modifies the expression of those genes. (e.g. rat pup study mentioned above).

[Z]

Originally posted by Open Mind
At what point does an improvement become ‘insignificant’? For example even if we assume it is only making patients feel less depressed, does that truly make it ‘insignificant’?


When that improvement is considerably less than improvement with conventional medical means, it is an 'insignificant improvement'.

75% of the effectiveness of antidepressants is replicated by a placebo, that still sounds large but is only about 2 points on the HAM-D scale. If these drugs truly have a powerful antidepressant effect, then it is being largely masked by a placebo effect.

I won't disagree on antidepressants, for two main reasons: 1) I personally doubt the effectiveness of the diagnosis and treatment of some patients, considering many don't need the drugs at all and some are actually harmed by the drugs. I've seen that myself. - and 2) I'm not knowledgable on the broad scope of psychological drug therapy, except to notice that some scientists consider many of those drugs nearly as quack-oriented as some of the alt-med treatments.

Yes the drugs consistantly beat the placebo effect, however one study, researchers analyzed 345 antidepressant trials for depression with 36,000 men and women. The goal was to determine if a link existed between the use of SSRIs and suicide attempts. Out of a 140 suicide attempts, the suicide rate was twice as high in patients taking SSRIs, when compared to those taking placebo pills.

See above. I don't doubt that one bit.

So would you recommend people just needing reassurance and reduced depression take an antidepressant instead, with a list of possible side effects never mentioned to those tested in original trials (that might reduce effectiveness in actual prescribed trials?) I supposed you could give them an unethical placebo but if it says placebo on the bottle it is no longer a placebo.

Of course not. See above.

With regard to ‘touch therapy’ how do you know it has no beneficial effect? …..in 1995 rat pups deprived touch were found to have dramatic reduction in growth hormone http://www.nature.com/npp/journal/v28/n6/full/1300125a.html

Earlier studies on human emotional deprivation suggest similar too (e.g. G.Powell studies in 1967 and 1973) .

Also read the ‘effects of healing with intent on pepsin enzyme activity’ Journal of Scientific Exploration Volume 13, Number 2, 1 July 1999, pp. 139-148(10)

I mispoke. There is a beneficial effect, with regards to growth and development, and emotional well-being; but people are getting 'touch therapy' for ailments that have nothing to do with these areas of medicine. It's fairly well known, I thought, that infant and toddler development is enhanced - even dependent upon - caring physical contact.

Easy to test, give people a placebo but tell them it is a inactive placebo, if the effect is less in comparison to another placebo told to be a wonderfully powerful new drug …. This would suggest my statement in principle is correct.

No, this would be comparing a nocebo to a placebo. The placebo - the pills claimed to be a new wonder drug - would have an improved effect, there can be no doubt. But the effect has nothing to do with the pills, rather than the presentation.

How do you know it never worked at all, perhaps snake oil cannot work because skeptics have told people it cannot work ;)

By 'skeptics' I presume you actually mean 'valid scientific research'? ;)

I should really look into researching whether famous past drugs that got abandoned lost effectiveness over time with doubt or were always rather ineffective.

That would be difficult, since famous past drugs generally had numerous anecdotal reports and very little valid scientific data to read through; in other words, by looking at case studies, these drugs should most often be demonstrably effective, up to the point someone realizes they don't work at all. Bias, and all that, you know.

Have you considered the possibility that the information you are reading on organized skeptic websites is somewhat biased? Being skeptical is fine but that should include being skeptical of organized skepticism!

Since this is the only 'organized skeptic website' I've ever been to, and since I base my information on real science and actual studies, then, no, I don't consider the information here to be an y more biased than on any other public web forum. Skepticism is a technique of basing judgements upon valid evidence; therefore, skeptical claimes are less biased than other claims.

The skeptic paradigm has moved from ‘doubt’ to a defense of the conventional and predictable science against anything that falls outside the conventional that is hard to predict or understand …

Total strawman - and completely wrong.

And a placebo was conventionally supposed to be completely useless and inactive patient deception, rather than admit a placebo can have a beneficial effect.

Also wrong. Placebos are conventionally supposed to be a psychological means of dealing with patients whose symptoms cannot be treated through available medicine, where those symptoms are not life-threatening or crippling. In science, placebos are conventially a means of removing one more variable - the psychosomatic variable - from drug testing.

It seems skeptics, in a desire to shoot down anything alternative, prefer to dismiss weak effects altogether.

No, skeptics, in a desire to shoot down quackery and fraud, prefer to dismiss lame theories about how some alt-med ]i]might[/i] work in favor of valid scientific research.

Can conventional medicine cure AIDS? Are you claiming belief and emotion has no effect upon AIDS?

Putting more words in my mouth. I never said conventional medicine can cure AIDS - but some alt-med practicioners are claiming they can, wrongly. Conventional medicine isn't claiming a cure, now, is it?

People do occassionally recover from cancer after conventional medicine as said it can do no more, of course a skeptic will offer another (unproven) explanation as to what really occured..... but are you claiming emotion and belief can never have an effect upon cancer?

Did I make that claim? I seem to have missed it. But some alt-meds are claiming total cure of cancer - are you claiming that alt-meds that play on one's emotions and beliefs are valid and consistent cures for cancer?

I’m feeling too lazy too look :) But I know there are at least 3 trials showing a possible link between emotions, stress and immunity.

Never said otherwise - but a placebo is not a 'cure'. It can have an effect, but not a preferential effect to treatment, and not a consistant and reliable effect.

Perhaps skeptics just believe emotions can make us ill but never better?…. Just a one directional process? Several earlier posters in this topic said a placebo cannot cure to belittle the effect …. yet seldom does a drug actually cure, it is often an effective maintenance dose to counteract and slow down deterioration? Can emotions also slow down deterioration too, if stress impairs immunity?

Hey, it's your strawman - burn it however you like.

I am not against skeptics challenging anything, I am against them belittling or entering denial of weak effects

And I'm not against weak effects. I am against people taking hard-earned money from gullible sick people on the slim chance that a placebo effect might help them.

I don't think anyone knows enough about the placebo effect, that most certainly includes me too.

A lot of people know a heck of a lot more about it than you or I do.

Well I agree ...... so would you are just advising people to think negatively over alternative treatments and positively over conventional ones? :) I do think many people try alternative therapies because the conventional one wasn’t satisfactory. ‘Sorry Mrs X, there is nothing more we can do for your cancer …… but don’t try anything else!’

Alternative treatments are fine - if they have valid mechanisms of effect. If they're just sugar pills or colored lights, I would tell people to reconsider these quack treatments, end of story. "Sorry Mrs. X, there is nothing more we can do for your cancer. If it makes you feel better, you might seek some form of faith healing. There is no valid mechanism of effect for most of them, but in rare cases, cancer such as yours might go into remission if you keep a positive outlook and stay away from harmful alt-med treatments." At least that's honest.

I agree that many alternative practitioners are possibly giving the wrong reason for the benefit.

As well as vastly over-estimating the benefit.

Actually to a lesser degree I see a general lack of miracle cures in conventional medicine too. Surgery has been a great success. Slowing health deterioration with drugs has been comparatively successful (not necessarily clearly proven better in long term over diet and exercise) but no doubt vital if serious acute conditions.

At least science isn't claiming 'miracle cures'. Too many alt-med practicioners are.

As to whether miracles cures exist, that is a paranormal debate. I’m not religious, I have no religious faith … but I think belief produces significant if generally weak effects in health (placebo) and also possibly in the paranormal. (claimed sheep and goat effects)

Your beliefs are obvious in this regards.

I would dispute that, if stress can worsen a disease or cause it … how can you be so sure they would have healed without the placebo like effect?

Because some people do. In the case of mild illnesses - for example, the common cold - it is guaranteed they will heal with or without the placebo effect.

Again conventional medicine isn’t that successful on genetic disease either.

More successful than homeopathy, touch medicine, or faith healing is.

I’m still not sure it is that clear cut, our physical height is determined by our genes but our environment modifies the expression of those genes. (e.g. rat pup study mentioned above).

I have no idea what you're trying to say there. Of coure environment plus genes equals whatever we are. What does that have to do with what we are discussing?

Consider, for a moment, someone who comes down with a case of lice. (This, BTW, is a true story - an anecdote, and therefore without value, but true nonetheless)

The person in question, being leery of toxins on his head or chemicals in his body, seeks the advice of his local holistic practicioner; the doctor rightly advises commercial products, a variety of treatments for the home, and of course, shaving the hair off. "Nah," the person says, "isn't there something else?"

So the alt-med doctor prescribes for him a homeopathic shampoo, whose label claims, "Guaranteed to kill lice in less than 24 hours!" The guy takes the stuff home, douses his head in it, and waits.

Three days later, he's back, asking for another alt-treatment, 'cuz that one ain't cutting it. And on and on it goes until, finally, exhausting all other treatments, the guy shaves his head (and his wife and childrens', because they're all infected now), and undergoes conventional treatment. At this point, he's spent approx. $150 on alt-med treatments, to no effect. Where's the placebo effect there? But this is exactly what happens, with many ailments, to many people. This is exactly why alt-med should be viewed with suspicion and concern.

If it's something minor, like a cold or a mild sore throat, then sure, a placebo might be just as effective a treatment. But conventional meds aren't claiming a 'cure' for a cold, and many sore throats can only be treated for pain and swelling, and nothing more. The alt-meds can do no better - and no worse. But once you start trusting alt-med to 'cure your cold', you start trusting alt-med for more vital treatments, and there are very few scrupulous holistic doctors out there willing to draw the line and let you know when a quack treatment isn't going to help you. (I happen to know one such doctor, but he's a pretty weird duck.)

Take it however you want, of course. If you want to risk your health or your life on treatments that only make you think you're feeling better, then go for it. I'll stick to treatments that have some manner of effect. Whatever treatment I'm offered - whatever meds have EVER been prescribed to me - I educate myself on the meds involved, their effect, side-effect, mechanisms of action, etc. until I'm satisfied and either take the medicine, or seek an alternative medicine, or toss it aside and let time take its course. Unfortunately, most people don't bother; they trust their healers to be honest and to have effective treatments; so they swallow the B.S. hook, line, and sinker.

[John Jackson]

Originally posted by Open Mind
And a placebo was conventionally supposed to be completely useless and inactive patient deception, rather than admit a placebo can have a beneficial effect. That’s another major misconception that people have.

The placebo effect does have a psychological benefit as the person often feels subjectively better after a treatment; even if the treatment was homeopathic water or non-existent “vibrational energy” from a crystal.

Skeptics do not deny the placebo effect; merely take account of it when assessing medical treatments. If a treatment is compared to a placebo control and performs no better than the placebo control, then the treatment is useless. It just means that any benefit the patient feels is due to the placebo effect.

The placebo effect is real, that’s why treatments need to be compared to a placebo control and not compared to doing nothing.

If the placebo effect gives a perceived benefit why not allow treatments that induce it?

1) The placebo effect is a perceived benefit. It does not cure illness or disease.

2) All treatments induce the placebo effect, so is it not better to use treatments that are efficacious i.e. placebo plus a real benefit?

Finally,

This is not a “them vs us” argument.

Whether one classes oneself as a skeptic or anything else is irrelevant. We all need to understand as much as we can about the placebo effect and take it into account wherever appropriate. It is a factor, if ignored, that can lead us to wrong conclusions.

When it comes to testing, the placebo effect is a menace, and it is undoubtedly the reason why so many bogus therapies have flourished and persisted: so many people misunderstand it.

[Moochie]

Originally posted by new drkitten
True, but if you expect to have a discussion with experts, you should stick to the commonly understood and used definitions of words instead of some made-up private use.

My mama always advised me to steer clear of "experts."

Regards,

[Z]

Originally posted by Moochie
My mama always advised me to steer clear of "experts."

Regards,

Thank you, Water Boy.

Most cult controllers do, btw.

[MoonDragn]

Let me get this straight... If conventional medicine cannot cure something... And something that induces a placebo effect CAN its not a valid cure?

What kind of logic is that? If something can cure someone, by whatever means, it is a valid treatment. I don't care if it takes a long time, I don't care if the effect seems insignificant. If it works, then it works. I don't care if you have to do a stupid funky chicken dance while patting your stomach twice chanting the american anthem backwards, if it causes the right effect then it works.

Why do most alternative med doctors say that each patient is different and should be treated different? Maybe they understand that it is a placebo type effect and by them working closely in convincing the patient that it works, it has the desired effect.

This is exactly like treating the mind of the patient instead of the body. What other field attempts to do this? Psychiatry. It sure is a valid accepted field of treatment in our modern society. If that is valid, so should all of these "quacky" treatments as some of you put it.

[Z]

Let me get this straight... If conventional medicine cannot cure something... And something that induces a placebo effect CAN its not a valid cure?

No, no, no... if conventional medicine cannot cure something, neither will a placebo; placebos NEVER cure anything.

However, if a regular medicine doesn't have a desired effect in treatment, it still will have THE EXACT SAME PLACEBO EFFECT that a placebo would have.

This is another glaring example of a complete misunderstanding of how the placebo effect works... or what it is.

Please, Moon, our species is supposed to be smarter than THAT. :D

[Rolfe]

This reminds me of a story told to me by a colleague.

Colleague was a vet in general practice, and he had a problem case of a dog with very bad skin. The owner was a bit tight, and he didn't want a lot of expensive diagnostic tests, and the case was a nightmare. Nothing the vet tried had any significant effect on the problem.

Then the owner seemed to lose patience, and announced that he was off to consult the local homoeopath. The vet was actually quite relieved - he just wanted rid of this patient. Then, a couple of months later, the owner brought the dog back to my colleague. At first he assumed that the owner had given up on the magic sugar pills, and wanted to give real medicine another go. But no. "I just had to bring him back to see you to let you see the miracle cure that the homoeopathy has achieved!"

The only snag was, according to my colleague, the dog's skin was, if anything, actually slightly worse than it had been last time he'd seen it.

So, it seemed as if the owner's belief that the homoeopathy would help had changed his perception of the situation so that he saw a cure when in fact there was none. But why? Why did the homoeopathy have that effect, while the real medicine didn't?

It's obvious, really. The vet hadn't been confident that anything he was using was going to solve the problem. And when the dog came back no better, he acknowledged that the dog was no better and no progress was being made. On the other hand (we assume) the homoeopath showed all the confidence in the world, and even when an unbiassed observer would have said that there was no change, he claimed that the dog was in fact better. The owner's desire for that to be true, plus his confidence in the authority of the homoeopath's pronouncements, convinced him.

All placebos aren't equal. A placebo delivered in a half-hearted manner after a curt five-minute consultation, followed by a realistic appraisal of the patient's objective condition, is going to do a lot less than an hour-long visit where the patient is encouraged to talk obsessively about himself and made to feel really individual and special, followed by a rosy assurance that he's really looking so much better he's practically cured, is likely to do a great deal more.

It's just a pity the latter involves lying to the patient, which most doctors are averse to doing.

In fact some homoepaths (and I think the "large study in Germany" is in this category) have capitalised on this. They choose a mild, vague, chronic and fluctuating condition - the sort of thing that can respond really well to skilled placebo administration. Also, it has to be something that there is a licensed medicine for, but the licensed medicine has to be something which actually isn't a great deal of use. Fortunately there are quite a few things like this!

Then they set up a comparative trial with homoeopathy. But instead of doing it right, treating the homoeopathic group and the control group exactly the same as regards length of consultation and so on, and just varying whether they are given their individualised remedy or a blank sugar pill, they compare the full-blown homoeopathic "therapeutic consultation" including sugar pill, with a quick five minutes through the GP's surgery and a quick impersonal prescription for the not-much-good licensed medicine.

Hey presto, homoeopathy does just as well as licensed medicine!! Might even do better, given the right patients.

This protocol is virtually assured to give positive results for homoeopathy, and great headlines. It's dishonest as hell, but that doesn't stop them.

Some people have said that the main problem for real medicine is to find out how to get the effect of a nice cup of tea and a chat with a sympathetic listener into their case management regime, so take advantage of this effect, while not lying to the patient that sugar pills are medicine.

Sure, for minor, chronic, self-limiting things this is a fair point. But a nice cup of tea and a chat never cured a cancer yet.

Rolfe.

[MoonDragn]

Originally posted by zaayrdragon
No, no, no... if conventional medicine cannot cure something, neither will a placebo; placebos NEVER cure anything.

However, if a regular medicine doesn't have a desired effect in treatment, it still will have THE EXACT SAME PLACEBO EFFECT that a placebo would have.

This is another glaring example of a complete misunderstanding of how the placebo effect works... or what it is.

Please, Moon, our species is supposed to be smarter than THAT. :D

********. There have been many cases where the placebo HAS cured something conventional medicine cannot cure. I think alot of skeptics are so anal on the semantics of something being said and miss the point entirely.

Lets not call it placebo, lets call it a doohicky. A doohicky effect, no matter how rediculous, if it works, then it works.

Happy now? If our specie is so smart, then why do we have so many skeptics?

[Open Mind]

At last I think I now understand the skeptic explanation of a placebo!!!!! Eureka!
Placebo = nuisance effect that is completely useless but can be of benefit and improve many medical conditions :confused: ;) :rolleyes:
Originally posted by John Jackson

If a treatment is compared to a placebo control and performs no better than the placebo control, then the treatment is useless. It just means that any benefit the patient feels is due to the placebo effect.


‘then the treatment is useless’ many trials indicate even if the treatment is no better than a placebo but both may have significant beneficial effects
Here is yet another I didn’t mention earlier ….a study found 30% of patients with mild to moderate elevated blood pressure who received a placebo, had their blood pressure lowered to below the set goal of a diastolic pressure of lower than 90 mm H
Archive of Internal Medicine 2000;160:1449-1454

If the placebo effect gives a perceived benefit why not allow treatments that induce it?
1) The placebo effect is a perceived benefit. It does not cure illness or disease.

Also the opinion of ……
Originally posted by zaayrdragon
No, no, no... if conventional medicine cannot cure something, neither will a placebo; placebos NEVER cure anything.

How do you guys know, emotions can never cure disease? When people do recover you are just assuming another explanation occurred, the famous skeptic claim ‘it is nothing but something else’ which for some reason never requires any burden of proof?
Also one could say most conventional drugs do ‘not cure illness or disease’ . If you have blood pressure, how often does a doc say ‘take a course of these pills fo