[sciborg2]

Here's Dr. Lissa Rankin's TEDx talk on the apparent ability of the mind to heal its sack o' meat.

Some of these cases are pretty far out....

[Royce]

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?

[Alia]

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.

[Madness]

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.

[Alia]

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/behold-the-spin-what-a-new-survey-of-of-placebo-prescribing-really-tells-us/
http://www.sciencebasedmedicine.org/the-placebo-narrative/

[sciborg2]

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. 

[Alia]

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.

[sciborg2]

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, 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.

[Callan S.]

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.

[Callan S.]

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, 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.

[Alia]

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.

[Madness]

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.

[Alia]

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.

[sciborg2]

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, 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.

[sciborg2]

@Alia:

Sorry, missed your earlier reply in the above to Madness. Yeah, I saw a PDF from USCD's Pharma Dept 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.