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Comment by stu2b50 | Hacker News Reader

The placebo effect is strong, especially for things like alertness. There’s been studies purposefully showing that participants who think they’ve been given a mental stimulant perform better in cognitive tasks in a statistically significant way, for instance.

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Well, that's good enough for me. Why would I care if it is really a placebo or real, if it gets me the desired effects?

Because placebo works only until you realize you're being fed bullshit, while the real thing continues to work even as your beliefs change.

I was under the impression that placebos work even when you know they're placebos.

Are people who have been given the information that they're using a placebo trully convinced of that or do they just have a mental barrier preventing them from further acknowledging it and just resign to respond: "yeah, I know it's just a placebo"

Try it yourself. I take placebo for all sorts of small ailments and it's surprisingly effective.

But a true placebo effect is only _if_ the ailment _did not_ heal if you hadn't taken the placebo. Otherwise, you're just taking a nonactive ingredient, and your body is merely healing itself from the ailment.

A true test of placebo effect must be one where you'd have a group who does not use a placebo, and a group that does! But then how would you study it blind?

> A true test of placebo effect must be one where you'd have a group who does not use a placebo, and a group that does! But then how would you study it blind?

Maybe a better (and possible) test would be to give everyone the placebo, but divide participants into three groups. One would be told they're given a real treatment, the other would be told they're given a placebo for the real treatment, and the third would be told they're given a sugar pill for no specific reason other than to see what happens.

1+2 would then tell you about whether or not knowing if you're getting a real treatment or placebo matters; 2+3 would tell you how much knowing you have a problem to treat in the first place matters.

Huh? I thought the point of the thread was that placebo works even when you know it's a placebo.

The point of the wider thread is that placebo generally does not work. It only may create an illusion that it does - but that illusion alone does not cure the underlying problem (unless that problem is highly affected by your perception, at which point it's not really a placebo, but a proper treatment).

They may have heard of "placebo effect" (i.e. the popular take on it), and figured "hey, this means it might still do something; better not dwell on it too much".

Some work even after you've been told. You still get the psychological/physiological boost from them, even after you know it's just a "sugar pill".

what is really intriguing about this is that placebo is shown to have an effect even if the subject is told it's a placebo

https://www.nature.com/articles/s41598-023-29624-7

The real thing may not work if you think it is bullshit.

We do not live in the wizarding world. There is a limit to how much your perception can influence your own body, or physical processes around you. That applies in both directions - belief alone can't move a mountain, but it also can't stop the excavators already moving one.

Placebo / nocebo effects aren't magic.

I would argue that because your body is the one doing the perceiving, there is likely no limit to the ability of our perceptions influencing our bodies. Belief alone can't move a mountain, but is that not because the belief is not strong enough, rather than because beliefs don't physically have hands with which to hold the pickaxe?

But if a placebo works, it isn't bullshit.

Do placebos typically keep on working, night after night?

Yes, why wouldn't they?

Are you familiar with a study where merely changing something improved outcomes for a while? They made lights brighter and workers were more productive for a bit, then they dim them back down, workers are again productive but for a bit. First they though oh, let's just make lights brighter everywhere eh? but it turned out nah. Probably it's just workers feeling like you are doing something for their benefit, so once you stop it's back to the baseline.

It seems important to eliminate that possibility, because otherwise sleeping mask or not literally doesn't matter and it's just about doing something and the study is simplified to "caring about sleep improves sleep". Which can be totally true even if bollocks per western medicine tradition to date, but then the study should be about that and not about sleeping masks eh?

https://en.m.wikipedia.org/wiki/Hawthorne_effect

Disputed, especially how significant it is...

> Evaluation of the Hawthorne effect continues in the present day.[24][25][26][27] Despite the criticisms, however, the phenomenon is often taken into account when designing studies and their conclusions.[28]

Not by this study about masks I guess

Regression to the mean, which apparently (per Wikipedia article on placebo) is what really happened in those old studies that made people think "placebo effect" is a big deal.

as long as there is deep seated belief

Wouldn’t the way around this be to mislead participants about what is actually being measured, or to have some sham device be involved to throw participants off?

Deception in scientific studies is controversial but not universally forbidden. Here's a link diving into the issue for psychological/social science studies. I'm unsure how it impacts medicine research, but I imagine it's a similar attitude.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502434/

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