Beware the Nocebo Effect
nytimes.com
nytimes.com
This is just as likely to be true for the "nocebo" effect as for the placebo effect. Dizziness, for example, is a very common symptom for people to experience for myriad benign reasons. Orthostatic hypotension (head rush) is a common cause of dizziness, and it is affected by a lot of minor factors like hydration, vasodilation, how long you've been sedentary, how fast you stand up, etc. This may happen to you three times in a week, and you'd never pay it any mind. But if a doctor told you that a medicine you were taking might cause dizziness, you would notice it.
So to this extent, a placebo (or nocebo) effect can be accounted for with absolutely no "mind over matter" style physiological change whatsoever. It is plausible that some specific placebo effects like reduction/increase of pain response, anxiety, and mood could actually be real psychological effects involving suggestion. But if you hear of a placebo doing something and you think "how could a belief in a placebo possibly have that kind of effect", it's very likely that you are at least partly seeing mere measurement error.
Using "measurement error" as an argument is kind of insulting to the testers as most of them have got to have a grasp of statistics and other factors in order to publish results that aren't going to get them laughed at by the scientific community.
How do you explain placebo effects in double blind tests?
>Over any period of time, a person will have a great many variations in mood, pain, etc.
>When [...] a subject or researcher has been primed to expect [an effect], the subject or researcher is more likely to notice that effect.
>to this extent, a placebo (or nocebo) effect can be accounted for [by these measurement errors.]
>It is plausible that some specific placebo effects like reduction/increase of pain response, anxiety, and mood could actually be real psychological effects[.]
It's not a yes or no answer. Part of what we call "placebo effect" is certainly the result of priming and confirmation bias, but for some specific subjective phenomena (like mood), it is plausible that the effect is real.
>Using "measurement error" as an argument is kind of insulting to the testers as most of them have got to have a grasp of statistics and other factors in order to publish results that aren't going to get them laughed at by the scientific community.
>How do you explain placebo effects in double blind tests?
Being aware of cognitive biases doesn't immunize you to them. There isn't even very good evidence that being aware of cognitive biases reduces your susceptibility to them. There is no shame in that, and any scientist who is insulted by the suggestion that s/he is susceptible to biases should go back to Science School. What being aware of biases does allow you to do is design experiments that compensate for those biases.
And that's the whole reason that we have double blind tests. We know that since humans have to administer and participate in experiments, a lot of biasing factors are going to come into play. So we have come up with designs like that which allow us to measure the extent to which the effects we appear to see are due to biases (or the power of suggestion), and how much the effects can be attributed to an actual effect of the drug.
The actual effect of the placebo is usually at most a small portion of all the factors that are measured by it. Of course this depends heavily on the experiment in question and some drugs (like psychological ones) have a higher placebo effect than others.
A lot of people seem to have the idea that the placebo effect is very big for medication outside of experiments - but most of the time it's very small to non-existing.
I don't think that anything has been demonstrated regarding allergies, but I wouldn't rule out a therapeutic effect in this case. The absence of evidence is not an evidence of absence.
I went from not being able to eat anything with wheat or soy lecithin to having no problem with it:)
Two reasons: 1) bias is a sufficient explanation, 2) the prior probability for biases effecting experiments is huge, while the prior for beliefs having a strong effect on physiology (with the exception of highly subjective phenomena like pain and mood) is comparatively quite low.
>so surely in these trials the placebo effect is legitimate
It would superficially seem so, but the key point to remember is that cognitive biases are not something we consciously apply. They are instinctive heuristics that worked really well at helping us survive in the ancestral environment (long before the concept of empirical tests), and even when we know about them, we can't turn them off. Cognitive biases work a lot like optical illusions. You've probably seen the checker shadow illusion[1]. You can understand how the illusion works, and know full well that the two squares are the same color, and you can even watch an animation that proves it to you[2], but when you look at the final image, square A will always look darker than square B. Knowing about the illusion doesn't fix it.
So even placebo controlled studies do not allow us to be unbiased in our perception. What they do is allow us to measure the effects of our biases, so that we can compensate for those effects in our calculations.
[1] http://upload.wikimedia.org/wikipedia/commons/6/60/Grey_squa...
[2] http://upload.wikimedia.org/wikipedia/commons/9/93/Optical_i...
After wasting a lot of money on ergonomic setups and doctors I read Aaron Iba's post on how he cured his RSI [1]. One of my takeaways from subsequent reading and research was that the nocebo effect played a huge role in how I associated computer usage and programming with pain. When you expect an autonomic symptom, you are much more likely to experience it.
Since treating myself with this in mind, along with other techniques such as those outlined by Aaron, it's been a couple months since I've been in pain from using a computer.
http://aaroniba.net/articles/tmp/how-i-cured-my-rsi-pain.htm...
I would really like to get one of those swords that heal on one side and maim on the other. Think of the possibilities!
Think, for instance, of those times when you've heard a friend or co-worker cough several times over a few minutes and you ask if they are alright, and they have no idea what you are talking about because they were not aware that they had coughed.
When you tell someone the pill they just took might have a side effect of making them cough, they are going to notice those random coughs that they normally ignore, and attribute them to the pill.
After all, a guy isn't going to just blurt out erectile problems if he is led to believe by the expert through the error of omission that erectile problems aren't a side effect. Its just too embarrassing.
If the belief that (s)he would die was almost enough to actually kill him/her, would it be possible for someone to end their own life with just their thoughts alone?
That man can spend nearly two hours sitting nearly naked immersed (except for his head) in an ice bath, without his core temperature dropping to dangerous levels and without suffering frostbite. He has also done such insane things as run a marathon in a desert without water.
Here's the pubmed link to a paper by some researchers who studied Hof to see what the hell was going on: http://www.ncbi.nlm.nih.gov/pubmed/22685240
It certainly seems plausible to me that there are probably many more things that we currently think are not consciously controllable this way that will turn out to be. It would not at all be surprising if one or more of those turn out to be things that you could use to kill yourself.
If one gave sugar pills to 100 dreadfully depressed patients at their lowest point and claimed it would make their heart stop beating within a few hours. Would any of the patients actually die from believing it? And if an autopsy confirmed the dead patients died from heart failure would the death be ruled a murder, assisted suicide, or suicide?
So my guess would be the subject in question took a bunch of pills, freaked out and went to the ER, and then had a panic attack because they thought they were going to die.
But to answer your question, I think that if you can, by panicking, alter your blood pressure (up or down) enough to kill yourself, that just means you had some pretty messed up cardiovascular issues. You wouldn't call that "killing yourself by thought alone"; you'd call it "dying of cardiovascular disease".
(I have an interesting vasovagal response -- I can draw my own blood just fine, and a nurse can draw my blood if I don't watch; but I've fainted from watching a nurse draw my blood.)