> The placebo effect can bring powerful relief
Can it? I don't believe there are any studies that actually show this.
Can it? I don't believe there are any studies that actually show this.
If you want too see how powerful this effect can become look no further than acupuncture. Or, for a nocebo result, people have actually died because they thought they had been cursed. Or, maybe less dramatic, people who are given an alcohol placebo still get drunk.
Not all, but some do, and we don't know why they specifically and why at all.
Source?
I have yet to hear about an objective malady that can be fixed via placebo/nocebo, like stage 4 cancer, type 1 diabetes, etc.
The original comment was about placebos bringing "powerful relief," which there is a great deal of scientific research to support. As far as I'm aware, there is no serious medical researcher advancing the hypothesis that stage 4 cancer or type 1 diabetes should or can be treated via placebos.
That being said like you say for something more severe the placebo alone isn't going to do much, but I would imagine if you gave people a placebo that they thought would improve their stage 4 cancer recovery you would probably see an effect.
Generally in medicine there's a distinction between acute conditions and chronic conditions.
Allopathic (western) medicine has proved highly effective at treating acute conditions, including trauma/injury, certain forms of cancer and infection.
However, chronic conditions are still one of the primary experiences of many humans relating to their health, and allopathic medicine has generally done quite poorly at addressing these conditions. Other styles of treatment, including placebo, have been shown to be effective in at least reducing the severity or incidence of the symptoms associated with chronic conditions.
The fact that you don't want to consider someone's 20 year battle with chronic back pain, or neuropathy, or any other chronic condition, to be "an objective malady" doesn't make you the arbiter of what's real and what isn't.
Objective means measurable, definable, quantifiable. It has nothing to do with real or not. The human body is so complex with so many possibilities, I find it uninteresting to speculate about unknowns, hence restricting my request to what I am interested in.
Dying is an objective condition observable by others, so it piqued my interest as to how it was determined someone died due to a nocebo.
I'm very glad to have seen an increasing number of health care professionals say things along the lines of "we have no idea what is causing their experience, and in fact, we think most it may be entirely psychogenic, but that doesn't change the fact that this is what they are actually experiencing, and that's as real for them as a puncture wound or an infection."
I don't think so. Placebo is used to blind participants to which study arm they are in. The placebo effect was then discovered after the fact.
The best way to blind, however, is no treatment, but no treatment only gives you the efficacy of the treatment, and not what you actually want to know, the efficacy of the 'active ingredient'.
See e.g. https://en.wikipedia.org/wiki/Placebo-controlled_study#Natur...
Here's the TL'DR: The placebo effect is maybe not quite as powerful as it is sometimes made out to be. And the reason is spontaneous remission or reversion to the mean.
1. Initially, researchers tested a treatment, and when the patients got healthier, it was assumed that it was the treatment.
2. Then researchers got smarter, and tested a treatment against a placebo (control), ideally double blind and randomised etc., and when the control group got better, it was assumed to be the placebo effect, and when the treatment group got even better, the difference was the treatment effect.
3. Then researchers got even smarter, and tested a treatment against a placebo (control) and against no treatment at all, and when the no-treatment group got better, it was assumed to be reversion to the mean or spontaneous remission; when the control group got even better, that difference was the placebo effect; and when the treatment group got even better, that difference was the treatment effect.
Going from 1. to 2., it was realised that many treatments are not quite as potent as hoped, and that the placebo effect is quite strong. However, going from 2. to 3., it was realised that the placebo effect is not quite as potent either, and that there is considerable spontaneous remission or reversion to the mean.
2007 paper that specifically cites Hróbjartsson et al., but claims that they overlooked certain specific effects:
https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-...
2019 review that also cites Hróbjartsson et al., but catches up on subsequent and broader placebo/nocebo research and concludes that both still seem efficaceous in the right contexts. https://www.frontiersin.org/articles/10.3389/fpsyt.2019.0036...
I'm not surprised at all you doubt the existence - it's a very common phenomenon that modern medicine/science struggles to explain (yet) and it's a very weird phenomenon. E.g. placebos still work when you know it's a placebo, it works for animals, it works so well that insurance will cover it etc.
Maybe Bad Science by Ben Goldacre is a good starting point as a book.
This is a meta study.
> to overturn decades of research and medical practice?
“Medical practice” has an atrocious record of being based in fact. There is, in fact, plenty of research on placebo, and the preponderance seems to suggest that it’s weak or non-existent.
> E.g. placebos still work when you know it's a placebo, it works for animals
This is consistent with, and in fact favors, the theory that it’s actually just mean reversion.
> Maybe Bad Science by Ben Goldacre is a good starting point as a book
I don’t think pop scientism books are a good place to start.