> * Many mental health conditions, on the other hand, have unbelievably high placebo response rates over the duration of a short trial*
Probably how faith healing works.
Probably how faith healing works.
There's still so much to learn I recently heard that new fathers see a reduction in testosterone. How does having a baby chemically alter a man!? What's the stimulus and mechanism for that...
It’s fairly apparent how fathers amped up on testosterone could be worse for offspring survival than those who have a drop, so the evolutionary pressure is pretty clear, then the mechanism is readily explained by “they know that they have a child.”
How does adrenaline get released when you see a dangerous situation with merely your eyeballs?
How about the science behind how a baby's crying stimulates milk production.
These are only challenging you because you’re assuming cognition cannot affect hormones/chemical systems but we know otherwise.
Cognition is such a handwave IMO - what's the biochemistry behind that? What's the signalling mechanism by which our brain does that? Does that mean with the right external brain signals we can turn off T production?
The implication of cognition having control over the body, which you assert is so well known, is that if we can achieve more control over our cognition we can achieve biochemical control of our body. So the bene gesserit is less fiction than we like to think?
The notion of dualism is profoundly problematic in a bunch of ways, but the biggest problem with it is that it created generations of scientists who ended up believing that consciousness and body experience are completely separate, which is a little ludicrous when you think about it.
But it feels a lot more different because the two examples you used are very clear and direct stimulus-response pairings. See food, get hungry (and get ready to digest)
See mate, get aroused, genitals get ready.
But a hormonal response is weird because:
- you see a baby then your body makes you more nurturing
- testosterone has all kinds of health implications on a longer time frame, it affects decision making, strength, muscle growth etc etc
So the fact that the body has been preprogrammed to alter our mind when we see (our?) baby is kind of impressive. Would be interesting to know if it's all babies or just our own. Do male midwives or fathers of adopted children see the same T drop.
Not to mention that T is also such a sought after hormone that understanding (and controlling) this response could be quite helpful
Hormones are chemical messengers. They exist to relay messages between different organs and tissues. An organism is constantly sampling its environment and adjusting its internal state to optimize survival and reproduction. Within this framework, it is not at all surprising that cognition interacts with hormones; in fact, it would be kind of surprising to find a biochemical pathway that is entirely independent of cognition.
A good example is stress. For those of us in the first world, stress begins as something cognitive, but it is expressed hormonally as increased serum cortisol. All you have to do to change your hormone balance is start ruminating!
Another example is oxytocin. If another human touches you affectionately, you'll see a bump in serum oxytocin. But it depends on your judgment of how affectionate the contact is, which is cognitive.
Ultimately it's pretty easy to sit back and say - well it's just so. Sure we have a flight or fight and pathways towards adrenaline and cortisol. We also have pathways for oxytocin so we like to find a friend/mate. So obviously we'd also have pathways towards wanting to nurture our kids. That's evolution bro - I guess nature and science are pretty obvious and boring after all /s
The response to children is impressive to me because it appears to be highly specific in its stimulus and the ramifications are pretty large.
Our cortisol and adrenaline response is very generic. All kinds of things can trigger it. You can experience adrenaline by jumping out of a plane or gambling at a roulette table. Even in a showdown in poker or playing video games. So the same response has been conditioned towards all kinds of situations when originally it might have been predominantly towards enemies/predators
Likewise for oxytocin we can probably produce oxytocin from cuddling a pet so it's kind of generic in stimulus.
Meanwhile there's a whole slew of specific responses that men and women have towards babies that I personally find fascinating in their specificity. Maybe because I'm just ignorant but I'm excited for the future when we may be able to understand how a bunch of senses (visual, aural, olfactory) convert into specific neural signals which the body is preprogrammed (how?) to then produce a specific response (via what biochemical pathways) to induce a hormonal response. Which incidentally have pretty wide ranging physiological consequences in the case of testosterone.
At the time IIRC computer simulations would struggle to model like more 12 water molecules solvating something accurately.
So building up from that atomic level up to proteins into a full physiological system always seemed like magic to me and it's always felt like we didn't really know anything.
Coming back to the t response it would be interesting to know if anything else accidentally triggers it. Eg is it just babies that triggers the response? Only our baby? What about adopted babies or babies of family members? Can other cute things trigger it?
I have no clue how that mechanism migh operate, of course. I realize that makes this comment less persuasive, but so be it.
It's a silly example but what if you could combat age onset testosterone decline with brain exercises or by watching an hour of UFC everyday. I'd take that in a heartbeat over hormone therapy if it worked
Then, for conditions linked to our psyche, including pure psychological conditions but also things like pain, blood pressure, heart rate, nausea, and some others - the placebo effect is more real, but usually temporary. Some people who have been living in some amount of despair at their condition experience a positive surge of hope once treatment starts, and they can ignore the pain, or feel some push to get out of their depression, or calm their anxiety which was exacerbating, say, the high blood pressure etc. This effect almost always tapers off if the treatment is not doing anything more fundamental.
Coupled with the fact that we don't understand how psychological disorders work at the chemical level at all, especially in relation to the conscious mind and interventions on that (e.g. therapy, but also various religious practices), this means it's very hard to account for this without a double-blind RCT.
Just to note that on pain specifically, belief that one has been administered a drug can cause the body to synthesise painkillers. This has been most rigorously demonstrated by the fact that these painkilling effects are suppressed by naloxone (an opioid antagonist).
I'd love to read more on how this links to the powers of ritual and general routines. Specifically, if I'm not misremembering, it isn't just "belief that one has been administered a drug", but it has to be a drug that you have had before. Or that you have seen work on someone else. Just taking sugar pills does nothing. Taking sugar pills that you thought were the aspirin pills you took last time you were sick can cause the body to react.
Not always, you can see effects from open placebos, where you tell the participant that they're getting a placebo but placebos have been clinically proven to reduce pain.
It even seems to work when you warn participants in the consent docs that you may lie to them (authorised deception).
I agree that it's probably a broader effect than just sugar pills, it should probably be called expectancy effects.
Benedetti et al have done a load of work on recovering surgical patients that suggest that many, many drugs (including valium) mostly work based on these kinds of effects. Its a fascinating field (and what I did my PhD on).
Niacin was used as the placebo for Timothy Leary’s Good Friday experiment [1], where he randomly dosed catholic monks on psilocybin. Unlike a sugar pill, Niacin creates some facial flushing — so you do feel something. But it would be very clear eventually that you didn’t get the psilocybin. But that doesn’t negate the findings of the experiment.
But in many other conditions, you can't, because that kind of placebo effect is just noise. For example, you can't vary the effectiveness of placebo effects in antibiotics studies (though you may be able to reduce certain side effects like headache or nausea).
In short, yes! Mental outlook has a big effect on outcomes. It won’t cure you, but it will improve your physical outcomes.
This is the meta analysis they refer to: Rozanski A, Bavishi C, Kubzansky LD, Cohen R. Association of optimism with cardiovascular events and all-cause mortality: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(9):e1912200. doi:10.1001/jamanetworkopen.2019.12200
I also remember some similar stuff for back pain and surgeries. In that context people were seeking treatment when their back issues peaked, and the question was, when you take the cohort of people that had back surgery and the cohort of people that didn't, did the back surgery make a difference? Because some people healed naturally.
I don't know if this is true in that specific context, but to take a more pedestrian one, I've had lots of small cuts, burns and things like that during my life, and they all healed.
You can see the opposite effect with the less well known nocebos [1]. People can experience objectively measurable side effects (such as bloating) that are in no way associated with a treatment, but that a patient believes to be a side effect. It can even be fatal. The article references aboriginals who will 'curse' one another resulting in the victim rapidly dying, because he believes so strongly that he is going to die! A similar thing in contemporary medicine has been observed with those who receive a fatal prognosis of cancer with them ending up dying long before there is any way the cancer could have killed them.
Trusting your doctor is usually more along the lines of an educated guess due to the necessity to act without perfect information.
I had a placebo effect recently when switching ADHD medication to get around the shortages. For a couple months I thought there was a chance my new meds might actually be better, they definitely felt different (and still do). But six months in it’s clear to me that I’m struggling with productivity more than I was before I switched (though less than when I was off meds).
I’m just one guy, but I’d guess this is why doctors don’t just prescribe placebos all the time as actual therapies (well, that and they’d lose credibility which would then destroy any remaining placebo effect).
My M.D. father, family practice in the army, later a pathologist, would do what he had learned from other doctors: Put some dye in toothpaste, put it on the wart(s), bandage it, talk about what a miracle cure it was etc. He said it worked the few times he tried it.
https://link.springer.com/article/10.1007/s10068-011-0002-0
https://www.purdue.edu/newsroom/releases/2020/Q3/new-approac...
The pigments fungi produce are so essential to their survival, they can’t defend against pathogens when they are gene edited to stop producing them.
Toothpaste is also far from an inactive substance, there are definitely plausible mechanisms at play with the toothpaste and dye mix that could help suppress/resolve a wart. It would be worth a study, though I’m not sure what one would use to try and achieve a truly inert placebo for comparison without first figuring out what doesn’t work.
(I discovered this myself when I was a kid, any proper airtight cover is likely to get rid of it, YMMV)