Comment by Apes | Hacker News Reader

Comment by Apes | Hacker News Reader

Please be careful with this article. It is not remotely skeptical, and seems to be highly biased in the favor of Dr. Sarno's book. Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag.

There is not a large amount of unbiased information about Dr Sarno's methods that I could find quickly, but from what is available TMS appears to be a form of alternative medicine that has no basis in science, and instead relies on pseudoscience and the placebo effect.

Rather than the pain relief being due to TMS, there is probably a more likely cause behind the result. Perhaps stretching exercises or pain medicine was involved. Or perhaps even just the placebo effect itself.

Please read this article for more information. It even contains a brief mention of Dr. Sarno.

http://www.sciencebasedmedicine.org/why-do-people-turn-to-al...

Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag.

Trying something to check whether it works is orthogonal to being skeptical about it. In fact, it's the heart of science.

Making very specific predictions via a hypothesis and gathering specific, and plentiful, data that test your predictions is the heart of science. Anecdotes (on which all alternative medicine is based on) do not make good science and "trying something to check whether it works" with a sample size of one is the worst way to do medicine.

Actually, the scientific method is the heart of science, and the method is to check a hypothesis.

When the goal is to fix yourself, the only relevant sample size is yourself. And when the problem may be psychological, then placebo effect may fix it, because you believe you've fixed it.

Hello Sillysaurus,

You're making a dangerous connection here. Alternative medicine such as TMS helping reduce pain through the placebo effect does not suggest that the alternative medicine is effective. It just proves that the placebo effect is real.

Alternative medicine may help in instances where the placebo effect is all that is needed. Unfortunately, there is risk that people may use alternative medicine as a replacement for real medicine and cause themselves unnecessary harm.

I'm trying to picture what harm can be caused by telling one's pain to go, other than delaying traditional treatment.

A delay in pursuing an effective treatment can be extremely significant. For example, if one simply tries to will away a broken bone, it can set incorrectly and cause permanent damage.

I did write "other than delaying traditional treatment".

It's not hard to learn how to deal with the minor pain of a cavity long enough for it to become a major even potentially life threatening issue. Dittio for thigs like a minor acke that's the sign of an early cancer ect. Overall pain is generally a really important issue and solid pain for over a week without obvious cause is a major warning sign that should not be ignored.

PS: Only after a reigorious investigation should someone look into developing coping skills.

Unfortunately, there is risk that people may use alternative medicine as a replacement for real medicine and cause themselves unnecessary harm.

Of course. That's how Steve Jobs died.

The scientific method requires someone to check their hypothesis. If they ignore data, then they're not doing science.

You're saying "placebo effect" like it's a bad thing. Many doctors agree placebo is a powerful drug, and a component of every type of pill administered to a conscious person. Even a consultation with a doctor can have a positive, even if unmeasurable placebo effect on a patient's health. If this method is about effective application of placebo and it works, at least for some people, what harm can be in it?

The negativity that you are sensing is not against the placebo effect, but against treatments that claim legitimacy and use anecdotes that are easily explained by the placebo effect as evidence of their effectiveness.

A placebo is by definition something that has no effect at all. Any improvement in the state of someone taking a placebo must be attributed instead to something other than the placebo. However, patients will attribute their improvement to the placebo. This is the placebo effect.

No doctor would literally say that a placebo is a "powerful drug", since it is by definition completely inert. However, they may say so in a figurative manner to mean that patients will claim effectiveness of ineffective treatments due to the placebo effect.

Treatments that rely on the placebo effect have two major negative aspects. First they may prevent people from seeking a truly effective means of treatment. Second, they take money for providing a treatment that has no actual value.

What is "actual value" and how does it relate to subjective use-value? If people value the placebo effect, why is that bad? And if they value the effect, what is wrong with valuing the source of it? (The distinction between placebo and placebo effect stinks of Cartesian duality). Do you see meditation or talk therapy as placebos? Are we obligated to deny people self improvement that isn't a result of ingesting a chemical?

Alcoholics Anonymous has the same effectiveness as cold turkey and a few other sobriety methods (about 10% success). Are you suggesting that alcoholics should never attempt the AA program? Some solutions work for individual cases and are worth being explored on a personal basis.

Placebos are great for things you can do nothing about. If you caught the common cold and a placebo makes you feel better then great. But if you have Repetitive Strain Injury (emphasis on repetitive and injury) and your cure is placebo then you're setting yourself up for something nasty.

I'll quote the article:

> I can type as much as I want, in whatever unergonomic position I want, on any keyboard, without any pain. The amazing thing about this recovery is that the changes I implemented were entirely psychological.

Sounds great, but I'd rather recommend to not buy the book and invest in a good chair with a comfortable desk instead. Also, breaks, stretching and yadda yadda.

So the guy who wrote the article took an open minded approach tried numerous methods until he found something that worked (including all the things you seem to suggest).

Your recommendation not to buy the book is based on what evidence exactly?

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