Wednesday, September 24, 2008

The Placebo Effect

A direct link to the above video is at

placebo :
1 a: a usually pharmacologically inert preparation prescribed more for the mental relief of the patient than for its actual effect on a disorder b: an inert or innocuous substance used especially in controlled experiments testing the efficacy of another substance (as a drug)
: something tending to soothe
- from the Mirriam-Webster Online Dictionary
In entries like Changing Your Genes and Changing Your Genes Part 2, we've talked about the surprising new scientific research that indicates people can change which genes are expressed purely through changes in lifestyle. The idea that each of us are dealt a certain genetic hand of cards at conception, then, which destines us to a particular future of good or poor health depending upon our genetic luck of the draw, is an old idea with much less weight than it used to have. In Crossing Your Arms to Change Your Trajectory, we talked about a different scientific study showing that something as simple as changing your physical stance will have an effect on the decisions you make and the paths you choose.

In my book, the chapter "How Much Control Do We Have" wrestled with a related set of ideas, and as we just discussed in my blog entry We're Already Dead (But That's Okay), even if we do have a surprising amount of control there are still a combination of factors that cause us to have one life or another from out of the bush-like branching structure of possible futures that extends out for each of us from our current "now". It's a balancing act, as we live out a life where each of us have free will, but are also affected by a certain amount of randomness and the actions that have come before.

There was an interesting article by Michael Brooks in the August 23rd issue of New Scientist Magazine about "The Power of the Placebo Effect", which discusses research being conducted by doctors Luana Colloca and Fabrizio Benedetti of the University of Turin in Italy. Here are some excerpts from that article:
...Benedetti and others are now claiming that the true nature of placebo is far more complex. The placebo effect, it turns out, can lead us on a merry dance. Drug trials, Benedetti says, are particularly problematic. "An ineffective drug can be better than a placebo in a standard trial," says Benedetti.

The opposite can also be true, as Ted Kaptchuk of Harvard Medical School in Boston points out. "Often, an active drug is not better than placebo in a standard trial, even when we can be confident that the active drug does work," he says.

Some researchers are so taken aback by the results of their studies that they are calling for the very term "placebo" to be scrapped. Others suggest the latest findings undermine the very foundations of evidence-based medicine. "Placebo is ruining the credibility of medicine," Benedetti says."The findings threaten the very credibility of modern medicine"

How did it come to this? After all, the foundation of evidence-based medicine, the clinical trial, is meant to rule out the placebo effect.

If you're testing a drug such as a new painkiller, it's supposed to work like this. First, you recruit the test subjects. Then you randomly assign each person to one of two groups to ensure both groups are alike. One group gets the painkiller, the other gets a dummy treatment. Then, you might think, all you have to do is compare the two groups.

It's not that simple, though, because this is where the placebo problem kicks in. If people getting an experimental painkiller expect it to work, it will work to some extent... If the control group know they're getting a dummy pill whereas the other group know they're getting the "real" drug, the experimental painkiller might appear to work better than the dummy when in fact the difference between the groups is entirely due to the placebo effect.

So it's crucial not to tell the subjects what they are getting. Those running the trial should not know either, so they cannot give anything away, creating the gold standard of clinical trials, the double-blind randomised controlled trial. This does not eliminate the placebo effect, but should make it equal in both groups. According to conventional wisdom, in a double-blind trial any "extra" effect in the group given the real drug must be entirely down to the drug's physical effect.
Later on in the article, it talks about a study involving a specific painkiller called a CCK-antagonist" that was known to be effective. The article continues:
...Now comes the mind-boggling part. When Benedetti gave the same drug to volunteers without telling them what he was doing, it had no effect. "If it were a real painkiller, we should expect no difference compared to the routine overt administration," he says. "What we found is that the covert CCK-antagonist was completely ineffective in relieving pain."

If you don't know you have been given the painkiller, it has no effect."
Please click on this link to read this whole article, there are many more surprises revealed. One of the most important things, the article tells us, in determining the effectiveness of a treatment is whether the patient has confidence in their treatment. Homeopathic remedies and other oft-ridiculed alternative medicines, then, take on a different light in the face of this evidence, as do the suppressed information that psychedelics or meditation may actually be helping people to live happier, healthier lives: and all of this points to the idea that we, as observers of a quantum wave function representing our possible future selves, may have much more control over our own well-being than we've been led to believe.

This is the current poll question, then, here at the tenth dimension blog, and it is based upon the New Scientist article we've been looking at today:
The placebo effect is real - people who think they are getting medicine are more likely to get better. This demonstrates that we have more control over our health than we realize.
Do you agree or disagree?

Clearly, the power of the placebo effect does not say modern medicine is bunk. What it does say, though, is that a doctor or caregiver who has the confidence and trust of their patients is going to be more successful in helping those people find their way to good health, and that's an inspiring scientifically proven fact.

Finally... for fun, here's one of the 26 songs attached to this project, and it's about the conundrum of how much control we have as we move one planck frame after another through the bush-like branching structure of possible futures. It's called "Making It Up As I Go". A direct link to this video is at

Enjoy the journey,

Rob Bryanton

Related Entries
Song 15 of 26 - What Was Done Today
David Jay Brown and Psychedelics
Crossed Wires in the Brain
Your Fifth-Dimensional Self
The Fifth Dimension Isn't Magic

Next: Why Do We Need More Than 3 Dimensions?

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