Any idea how placebos work so well, what they are, and if we're doing anything to take advantage of the effect?
> We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed.
from "The moral case for the clinical placebo"
http://www.nybooks.com/articles/archives/2011/jun/23/epidemi...
http://www.nybooks.com/articles/archives/2011/jul/14/illusio...
There is a feedback loop between abstract thoughts and effects on the body, so to make a proper distinction you want to ignore the feedback loop and look at where the inputs are.
A placebo's direct effect is not physical. The direct effect is that first thought that you are receiving treatment, before it even has a chance to affect your mood.
A kidney transplant's direct effect is mostly physical. It's filtering your blood at a rapid pace.
So technically mood has physical effects but by the time you reach that stage you've destroyed the meaning of the term "physical benefit" into meaning just "benefit". Feel free to suggest better terms, but please don't muddle the waters.
"No physical effect" means the same thing as "no effect", unless we are willing to discuss metaphysical effects.
The indirect effects are somehow the result of the user's expectation that there is a direct effect.
That is to say, "placebo effect" is not "the effect of the placebo object", obviously.
It's the emergent effect of the whole situation of someone being duped with a placebo.
Being duped with a placebo has direct, physical effects, while the placebo object has no effect.
See, that's the idea I'm not comfortable with. You are defining the term in a way which renders it basically meaningless, when there is an alternate definition that does have useful meaning.
There are some known ways to take advantage of similar effects--for instance, helping patients find ways to lower stress as a means of mitigating risk factors like high blood pressure.
I remember one time I needed eyedrops. They were only listed as homeopathic in tiny print and were adjacent to real eyedrops in the pharmacy, so it was a bit hard to read them with my allergies going.
And I've tried washing my eyes with water, but it's not as effective as real eyedrops. Moreover, these contained "aspis", allegedly some extract from bees, which I might be allergic to. One would hope that they'd diluted it enough, but it actually listed a fairly low dilution factor so I couldn't even be sure the damned things weren't harmful.
On a more serious note, medicine has a general problem dealing with the mind. The "placebo effect" is just one case where this manifests itself, but in case of drugs at least this effect can be scientifically measured.
In case of psychosomatic ilnesses (e.g. ilnesses which manifest with real symptoms, but the underlying cause is in the mind) it is much harder to quantify anything. How do you create a control group, if each person is so different? There is no way to "look inside the mind", no universal way to influence the mind.
Having gone through several ilnesses which (as I later discovered) were psychosomatic, I know the issue first-hand. Doctors tend to avoid even considering the mind's role, just as if we were simple machines, with the mind completely separate. On one hand this annoys me, on the other hand I understand them: a doctor is supposed to deal only with what is measurable and quantifiable. Cause and effect should both be measurable.
I've noticed that the number of articles about placebo effects, mind-caused ilnesses and psychosomatic problems in general seems to be increasing. I'm glad this is happening, as we definitely need more research done on these kinds of problems and we need to find ways to deal with them. From what I can see around me (now that I know about psychosomatic illnesses), many people suffer from them, and only deal with the symptoms.
Germany generally does a good job on evidence-based herbal medicine (like standardizing St. John's wort extract), but I worry that the line can easily be blurred between them and homeopathic products in the eyes of most consumers. You really have to look carefully - they're not clearly marked.
So honestly, you're probably quite right about it being a deliberate exploitation of the placebo effect. Because otherwise, there's no reason not to ban them.
I went home and looked it up: a homeopathic panacea with only a single "study". Not double blind, not even single blind -- they literally just gave the drug to some participants and the self-reported symptoms "improved".
I'm still not sure whether the GP was just trolling me.