The Second Apocalypse
Miscellaneous Chatter => Philosophy & Science => Topic started by: sciborg2 on February 18, 2014, 01:28:26 am
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Here's Dr. Lissa Rankin's TEDx talk on the apparent ability of the mind to heal its sack o' meat. (http://www.youtube.com/watch?v=LWQfe__fNbs&feature=youtu.be)
Some of these cases are pretty far out....
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Yeah I remember seeing a Danish documentary where this guy who were very depressed had agreed to participate in a medical experiment. He was to try out a new kind of medicine(Which was a fake pill) and was to take one pill a day. After a few weeks he had quarreled bigtime with his girlfriend, and in affect he swallowed 20 pills. He regretted this pretty fast, and managed to get himself to a hospital. When he got there he was sweating, had very high bloodpressure, dehydrated, and could not stand on his feet. One of the staff on this hospital recognized him(since the hospital was in on this experiment) and soon the man in charge of this experiment came and explained the whole thing to this poor guy, and his symptoms vanished almost right away.
Fascinating stuff. Body controls mind? vice versa? Maybe bodymind is one thing?
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One thing about placebos. What they influence is always subjective symptoms. So that people who get placebo painkillers report their pain is lesser on a pain scale - but pain perception is subjective all the way. We have a saying over here "If you want to get rid of headache, hit your thumb with a hammer" - newer, more immediate pain makes the older pain "disappear". However, placebo responses do not improve objective measures. There was this trial with asthmatics - the ones on placebo reported feeling better but tests like spirometry showed that in fact nothing improved. Which can be dangerous - you think you are better when in fact you are not.
About this Danish guy - all his symptoms are a typical stress response, too much adrenalin and cortisol in the blood stream. And stress responses can be very well triggered by thinking alone - when I was in primary school, I would get all sick before some tests, complete with high fever, sweating and vomiting. It took my mother some time before she realised what it was.
But yes, placebo responses are very important in some cases. We have no real medicine for common cold, for example. But if you have a cold and feeling miserable, a bowl of chicken broth and a little care can go a long way.
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I definitely don't think we know enough about the mechanism by which placebos function. It is arguable in some circumstances that a person's ability to mediate stress might determine the efficacy of certain drugs and that stress (which is inevitably tied to placebo responses, I think) itself can [make us] more susceptible to illness.
I may have more thoughts. I want to watch Sci's link first to stay topical.
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So I'll just add some reading about placebo response from the point of view of medical professionals, the first one is pretty recent:
http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-placebo-effects-again/ (http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-placebo-effects-again/)
http://www.sciencebasedmedicine.org/behold-the-spin-what-a-new-survey-of-of-placebo-prescribing-really-tells-us/ (http://www.sciencebasedmedicine.org/behold-the-spin-what-a-new-survey-of-of-placebo-prescribing-really-tells-us/)
http://www.sciencebasedmedicine.org/the-placebo-narrative/ (http://www.sciencebasedmedicine.org/the-placebo-narrative/)
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In the video Rankin says tumors were healed, children died, and people who thought they had been given Rogaine grew hair.
Now I don't think all this stuff is going to happen to everyone magically, but those are weird cases AFAICTell. ???
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I'm afraid I'm a sceptic here. I believe that mind can have a lot of powerful effects on the body, but they are mostly connected with hormones and neurotransmitters (last weekend, while walking down a street I had a serious case of "fight-or-flight", for no reason really, other than seeing three guys who just triggered this effect - and I suppose my pulse and blood pressure were pretty much elevated for some time afterwards). I simply do not believe in a tumour disappearing due to placebo effect - although there are some cases when tumours spontaneously regress. All the rest is logical fallacy, like mistaking correlation with causation.
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Don't worry about being a skeptic - I don't think anyone here thinks we're going to develop magical superpowers. But even grounding ourselves against extrapolating to extremes I think it's interesting the extent to which the mind can affect the body.
Take this case from the New Scientist (http://www.newscientist.com/article/mg18524911.600-13-things-that-do-not-make-sense.html#.UwOc4V5sjGw), which listed the Placebo Effect as one of science's unsolved mysteries:
Don't try this at home. Several times a day, for several days, you induce pain in someone. You control the pain with morphine until the final day of the experiment, when you replace the morphine with saline solution. Guess what? The saline takes the pain away.
This is the placebo effect: somehow, sometimes, a whole lot of nothing can be very powerful. Except it's not quite nothing. When Fabrizio Benedetti of the University of Turin in Italy carried out the above experiment, he added a final twist by adding naloxone, a drug that blocks the effects of morphine, to the saline. The shocking result? The pain-relieving power of saline solution disappeared.
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We have a saying over here "If you want to get rid of headache, hit your thumb with a hammer" - newer, more immediate pain makes the older pain "disappear".
I'd suspect headaches are largely thought processes that are looping over and over with no 'tie breaker' to end them. The pain of the thumb means the thought processes get closed since you have a here and now issue to deal with instead of the largely philosophical/non immediate concerns that caused the headache.
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Don't worry about being a skeptic - I don't think anyone here thinks we're going to develop magical superpowers. But even grounding ourselves against extrapolating to extremes I think it's interesting the extent to which the mind can affect the body.
Take this case from the New Scientist (http://www.newscientist.com/article/mg18524911.600-13-things-that-do-not-make-sense.html#.UwOc4V5sjGw), which listed the Placebo Effect as one of science's unsolved mysteries:
Don't try this at home. Several times a day, for several days, you induce pain in someone. You control the pain with morphine until the final day of the experiment, when you replace the morphine with saline solution. Guess what? The saline takes the pain away.
This is the placebo effect: somehow, sometimes, a whole lot of nothing can be very powerful. Except it's not quite nothing. When Fabrizio Benedetti of the University of Turin in Italy carried out the above experiment, he added a final twist by adding naloxone, a drug that blocks the effects of morphine, to the saline. The shocking result? The pain-relieving power of saline solution disappeared.
I less wonderous part of me ponders how much morphine just stays in the system when you cut off supply? You can be drunk (in the eyes of the law) well after you've stopped drinking, for example.
Maybe some mid level of freakyness - like the body actually stores the morphine and starts providing itself its own supply fromt the storage.
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I've searched Benedetti on Pubmed and read a bit more about his experiments. He seems to claim that placebo response, if pre-conditioned by first using opioids (that's a very important point here) is mediated via opioid receptors. Which means it is really no wonder that naloxone disrupted the placebo response. Benedetti also claims that if placebo response is pre-conditioned using non-opioid medication, it becomes mediated by non-opioid receptors. And if it is not pre-conditioned (so a patient gets saline solution at the very beginning and only hears it is a pain-killer), it uses other pathways altogether.
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Alia, I just wanted to note again how much I've enjoyed your perspectives so far. And that those papers look interesting.
Sci, the video linked by Rankin... I would have to read up on her literature more... but ugh.
I don't think she's talking about the placebo effect and I think the presentation of her talk is extremely dangerous. I think it is irresponsible to qualify all that content as "placebo effect." She basically suggested that all social psychology can be explained by "the placebo effect."
Also, and I wish I hadn't lent my Drugs & Behavior textbook to my Mom - the one time it's not sitting, collecting dust in a box when I actually want to use it - but there is a great quote about a 1/3 of all recoveries can be accounted by the "placebo effect," which essentially suggests that the individual responses by particular human systems are unexplainable as we average them, that we don't know how some individual recover.
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Well, one more thing we have to take into consideration is that many illnesses are self-limiting, which means that one would eventually get better without any intervention whatsoever (common cold and a lot of other viral illnesses are a good example here). But because we are humans and our minds are prone to search for patterns, we would probably attribute the recovery to the remedy that we were taking at the moment.
Take the common cold (which I'm suffering from at the moment). When I was younger and had a cold, I used to take vitamin C and eat a lot of garlic (these are two most popular home remedies over here). And naturally I got better, so I thought it worked. Having read more about it, I realised that common cold is self-limiting, so now I just try to take things easy for a couple of days and drink plenty of liquids (hydration is important if you have a fever). And my colds go away as quickly as before. Naturally, I lack the comfort measure that vitamin C used to provide, namely "I'm actively doing something to get better, instead of waiting for the illness to resolve on its own." But since I don't believe in it anymore, there's no sense in taking it, even as a placebo.
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I don't think she's talking about the placebo effect and I think the presentation of her talk is extremely dangerous. I think it is irresponsible to qualify all that content as "placebo effect." She basically suggested that all social psychology can be explained by "the placebo effect."
You're gonna have to fill me in on social psychology vs placebo effect.
I do think she goes overboard with how efficacious the effect could be, but I wasn't really considering her advice.
It was the initial cases that I thought were interesting. The Wright case, and the fake Rogaine growing hair for example. And on the nocebo side the three little girls.
eta:
More research on the effect (http://www.bbc.co.uk/news/health-26191713), this time in the case of Parkinson's.
"What we found is that in somebody with Parkinson's disease, a placebo can release as much dopamine as amphetamine or speed can in somebody with a healthy dopamine system. So it's a very dramatic response."
That dramatic response only appears to last for a short while - a placebo certainly isn't a miracle cure.
And even if it was, doctors could hardly start lying to their patients and replacing real drugs with placebo pills.
It's also unclear exactly how a placebo is able to spur the brain into producing more dopamine, given that Parkinson's is caused by an apparent inability of the brain to produce enough.
But what is certainly clear is that the dopamine isn't coming from the placebo pill itself: there's nothing in it. The dopamine is coming from our brains.
And that goes to the heart of how a placebo works. There's now a strong body of evidence that a dummy pill can activate the brain's natural ability to produce the chemicals that we need.
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@Alia:
Sorry, missed your earlier reply in the above to Madness. Yeah, I saw a PDF from USCD's Pharma Dept (http://pharmacology.ucsd.edu/graduate/courseinfo/placebarticle.pdf) dealing with an overview of the placebo effect including the opioid stuff.
Haven't had a chance to look at it, but at least there does seem to be some explanation for that particular case.
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+1 Alia, though I think the mechanisms you highlighted your post, like "feeling like you are doing something," might do some of the work the inert drugs or therapy claimed to do to influence immune function, resilience, etc, otherwise.
It's difficult to parse.
I don't think she's talking about the placebo effect and I think the presentation of her talk is extremely dangerous. I think it is irresponsible to qualify all that content as "placebo effect." She basically suggested that all social psychology can be explained by "the placebo effect."
You're gonna have to fill me in on social psychology vs placebo effect.
At one point, she starts going through a list of "placebo effects," which seem to just rake through social psychology and pick out definitions. For instance, she cites a couple bias and heuristics among them one that play out when a friend comforts you and reduces complex emotional interaction between friends, that might be one aspect of that results in higher than baseline "health" (as a super broad category) response, to the placebo effect.
There are real chemical reactions that take place as a result of particular social circumstances and they themselves can be broken down into more specific contextual reactions for that particular subset of social circumstances.
I do think she goes overboard with how efficacious the effect could be, but I wasn't really considering her advice.
This reminds me of another thing now that I'm feeling ranty. Seeing as she is familiar with the science herself in broad strokes, why not take 25-30 seconds to throw in a quick example. In some ways, when you genuinely compliment someone, it creates social reactions that might extend much farther than yourself.
While this might be general dividend for the rest of that day for those people projecting love, very few of them are going to take anything actionable away from that session.
It was the initial cases that I thought were interesting. The Wright case, and the fake Rogaine growing hair for example. And on the nocebo side the three little girls.
eta:
More research on the effect (http://www.bbc.co.uk/news/health-26191713), this time in the case of Parkinson's.
"What we found is that in somebody with Parkinson's disease, a placebo can release as much dopamine as amphetamine or speed can in somebody with a healthy dopamine system. So it's a very dramatic response."
That dramatic response only appears to last for a short while - a placebo certainly isn't a miracle cure.
And even if it was, doctors could hardly start lying to their patients and replacing real drugs with placebo pills.
It's also unclear exactly how a placebo is able to spur the brain into producing more dopamine, given that Parkinson's is caused by an apparent inability of the brain to produce enough.
But what is certainly clear is that the dopamine isn't coming from the placebo pill itself: there's nothing in it. The dopamine is coming from our brains.
And that goes to the heart of how a placebo works. There's now a strong body of evidence that a dummy pill can activate the brain's natural ability to produce the chemicals that we need.
I wish this had a link, it'll be interesting if they can isolate the mechanisms by which it occurs.
@Alia:
Sorry, missed your earlier reply in the above to Madness. Yeah, I saw a PDF from USCD's Pharma Dept (http://pharmacology.ucsd.edu/graduate/courseinfo/placebarticle.pdf) dealing with an overview of the placebo effect including the opioid stuff.
Haven't had a chance to look at it, but at least there does seem to be some explanation for that particular case.
Lol - see isn't that too drastic a disconnect from her presentation to the PDF? There must be a more effective way to express the latter without dragging it on or "needing a degree" to comprehend it (which I don't think is the case but something people use not to challenge themselves).
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I agree that social interaction has very real effects on our health and the way we deal with illness. There was this study that looked at people suffering from cancer and the effect of counselling, self-help groups and in general social interaction on their outcomes. What they found is - positive attitude and social interaction do improve outcomes, but not in the way "if you think positive, you will beat cancer" and all that stuff. Rather, it improves adherence to therapy regimens, like radiation and chemo, which in turn improves outcomes. Which makes sense. Cancer is terrible and surgery/chemo/radiation regimens can be even worse. But if you are positive, if you think "I can beat cancer" and have people around you that support you, it is more likely that you will tough it out, grit your teeth and go through all the nasty side effect and complete the therapy.
And then there are a lot of studies to show that married men have better health than singles. Which again is probably not that strange, at least they have someone to talk to - and also someone who cares that they eat proper dinners and not forget to take their medication, if they need one ;)
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I agree that social interaction has very real effects on our health and the way we deal with illness. There was this study that looked at people suffering from cancer and the effect of counselling, self-help groups and in general social interaction on their outcomes. What they found is - positive attitude and social interaction do improve outcomes, but not in the way "if you think positive, you will beat cancer" and all that stuff. Rather, it improves adherence to therapy regimens, like radiation and chemo, which in turn improves outcomes. Which makes sense. Cancer is terrible and surgery/chemo/radiation regimens can be even worse. But if you are positive, if you think "I can beat cancer" and have people around you that support you, it is more likely that you will tough it out, grit your teeth and go through all the nasty side effect and complete the therapy.
+1 - and I think Sci is probably discussing and presenting evidence in this thread hoping for idealized speculation, as if we could control for the type of variables like the bold - which I think enough people don't understand or try and act on.
It there remained unexplainable circumstances, then they might help us find... "placebo effects." But as we're all highlighting it's like shorthand for a number of affects and that doesn't seem to be how the video in the first post, and presentations like it, represent what we are talking about here.
And then there are a lot of studies to show that married men have better health than singles. Which again is probably not that strange, at least they have someone to talk to - and also someone who cares that they eat proper dinners and not forget to take their medication, if they need one ;)
Lol. +1. But being able to do those things in yourself is very important as well.
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Well, to be honest I just thought it was one of those weird things. (As a child I grew up on copious amounts of Ripley's literature ;D)
The Wright case (http://www.nytimes.com/1998/10/13/science/placebos-prove-so-powerful-even-experts-are-surprised-new-studies-explore-brain.html?pagewanted=all&src=pm) in particular caught my ear.
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Lol, sometimes I feel like this guy (http://www.collegehumor.com/video/6952792/why-engagement-rings-are-a-scam) is this forum ;).
Which I obviously enjoy tremendously.
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Lol, sometimes I feel like this guy (http://www.collegehumor.com/video/6952792/why-engagement-rings-are-a-scam) is this forum ;).
Which I obviously enjoy tremendously.
Heh, no worries, there might be people who read hear about this stuff and come to believe they psychically heal themselves. Good for them to be grounded.
I just think some cases that comes up are Ripley's material.
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Well, it's one thing to believe in the power of positive thinking etc., while at the same time undergoing conventional therapy, but if you skip the "conventional" part, it might end badly. For you and for people around you, if you try to do it with, let's say, bi-polar disorder.
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Well, it's one thing to believe in the power of positive thinking etc., while at the same time undergoing conventional therapy, but if you skip the "conventional" part, it might end badly.
I don't think we should discount the idea that "positive states" do have an actual, measurable, effects on our natural immune function and that "negative states" make us more susceptible to illness?
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I'm not saying that, Madness. It's been proven that negative emotional states, like stress, have negative influence on our health - we're not made to tolerate increased levels of cortisol for longer periods. So naturally, you should try to relax, unwind, think positive thoughts, talk to friends, meditate, do yoga, go for a walk in the park, whatever makes you feel less stressed and reduces cortisol levels at the same time.
What I'm saying is that if you suffer from something more serious than just feeling a bit down and weary, it's time to consider alternatives, like medication. Because telling a really depressed person to "think positive" may end very badly. In best case scenario, they will just tell you to shut up.
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I'm not saying that, Madness.
No, I know. I just like to be clear for myself and for those readers who don't partake and simply watch us all perform on the stage here ;).
+1 your last, by the way.
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Good Placebo Gone Bad (http://seedmagazine.com/content/print/good_placebos_gone_bad/)
Placebos are supposed to be inert controls, designed to prove a drug’s efficacy. Consequently, placebo composition is rarely documented in drug trials. Is this dangerous?
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Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why. (2009) (http://archive.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all)
Why are inert pills suddenly overwhelming promising new drugs and established medicines alike? The reasons are only just beginning to be understood. A network of independent researchers is doggedly uncovering the inner workings—and potential therapeutic applications—of the placebo effect. At the same time, drugmakers are realizing they need to fully understand the mechanisms behind it so they can design trials that differentiate more clearly between the beneficial effects of their products and the body's innate ability to heal itself. A special task force of the Foundation for the National Institutes of Health is seeking to stem the crisis by quietly undertaking one of the most ambitious data-sharing efforts in the history of the drug industry. After decades in the jungles of fringe science, the placebo effect has become the elephant in the boardroom.
The roots of the placebo problem can be traced to a lie told by an Army nurse during World War II as Allied forces stormed the beaches of southern Italy. The nurse was assisting an anesthetist named Henry Beecher, who was tending to US troops under heavy German bombardment. When the morphine supply ran low, the nurse assured a wounded soldier that he was getting a shot of potent painkiller, though her syringe contained only salt water. Amazingly, the bogus injection relieved the soldier's agony and prevented the onset of shock.
Returning to his post at Harvard after the war, Beecher became one of the nation's leading medical reformers. Inspired by the nurse's healing act of deception, he launched a crusade to promote a method of testing new medicines to find out whether they were truly effective. At the time, the process for vetting drugs was sloppy at best: Pharmaceutical companies would simply dose volunteers with an experimental agent until the side effects swamped the presumed benefits. Beecher proposed that if test subjects could be compared to a group that received a placebo, health officials would finally have an impartial way to determine whether a medicine was actually responsible for making a patient better.
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I'm not saying that, Madness. It's been proven that negative emotional states, like stress, have negative influence on our health - we're not made to tolerate increased levels of cortisol for longer periods. So naturally, you should try to relax, unwind, think positive thoughts, talk to friends, meditate, do yoga, go for a walk in the park, whatever makes you feel less stressed and reduces cortisol levels at the same time.
What I'm saying is that if you suffer from something more serious than just feeling a bit down and weary, it's time to consider alternatives, like medication. Because telling a really depressed person to "think positive" may end very badly. In best case scenario, they will just tell you to shut up.
I think the (limited) helpful affect of "positive thinking" on, for example, depression, is actually down to other feedback mechanisms. For example I saw an article wherein the researchers selectively paralyzed certain facial muscles in depressed patients with botulinin toxin such that they could no longer frown, furrow their brow, or make other facial expressions denoting poor mood.
Their depression improved
Their thoughts presumably weren't any different. They didn't suddenly turn into optimists. They just couldn't frown. A neurological fluke of evolution apparently means that via some pathway the data being sent to the brain from the muscles of the face is influencing the brain in the same way that data from the brain sent to the muscles of the face influences expression. The brain produces inputs and outputs that become inputs for itself again. It's a labyrinthine exchange of information between many different levels of organizational heterarchies and like most systems produced by blind evolution, it's an absolute illogical mess.
I'm reminded of the Cants of Compulsion in Bakker's work. It's impossible to discern the compulsions from your own will.
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Digging out an old topic, because there is an interesting article on placebo (although they prefer to call it "contextual effects"). http://www.sciencebasedmedicine.org/placebo-are-you-there/ (http://www.sciencebasedmedicine.org/placebo-are-you-there/)
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Digging out the topic again, this time because of a new study which shows that placebo effects seem to have increased over the years in clinical trials - but only in the USA: http://www.ncbi.nlm.nih.gov/pubmed/26307858 (http://www.ncbi.nlm.nih.gov/pubmed/26307858)
And a discussion of the study: https://www.sciencebasedmedicine.org/are-placebos-getting-stronger/ (https://www.sciencebasedmedicine.org/are-placebos-getting-stronger/)