A Nation of Health FlakesPosted on 02/21/2011
When people aren't desperate for a cure for their disease, and still seek alternative medicines, as opposed to experimental surgeries, these people are actively defying both rationality and the body of knowledge that debunks alternative therapies.
The Placebo CulturePosted on 02/21/2011
When a mother kisses her child’s boo boo, messes her hand through his hair to distract him, and gives heart-felt assurances that the scrape will be all better in no time, she’s administering a placebo cure. If the scrape doesn’t get infected (good moms usually apply antibiotic ointment and a bandage in conjunction with the placebo), the boo boo will, in fact, heal. The mother’s kiss sells the hope, suggesting to the child that the pain is momentary and that faith in a mother’s love, care, and attention will speed natural healing.
The word, placebo, is Latin for “I shall please.” In therapeutic practice, a doctor may decide to provide a placebo therapy whose primary purpose is to please the patient. The therapy often consists of a sugar, or dummy, pill that contains inert ingredients that have no effect on human physiology. More important than the pill is the confident assertion or promise made by an expert physician authority that a cure is well nigh from taking the pill. This creates a hopeful expectation in the patient.
If the treatment pleases the patient and the patient’s progress pleases the physician, that’s a win-win, and the whatever-it-takes-minded physician doesn’t stress too much that the cure resulted from an inexplicable mind-body connection, or positive thinking, or the patient’s faith-driven release of the pain-numbing chemicals endorphin, dopamine, norepinephrine (natural opiates) or adrenaline hormones or a class of neurotransmitters called monoamines into the brain’s central reward pathways, or simply the body spontaneously healing itself as biology meant for it to do. Placebos are thought to act Pragmatism wins the day, the satisfied patient pays his medical bills without any dramatic resistance, and the doctor doesn’t have to contact his bill collection agency.
This same mind-body connection, this mental attitude that physically impacts the body, when paired with negative thinking, depression, and stress probably caused the patient’s symptoms to begin with. Placebo therapy is like fighting psychological fire with fire in some cases. Any improvement in the patient’s condition, in various proportions (which the physician doesn’t bother measuring), can be attributed to the effect of the placebo (the placebo effect), plus the time required for the body to heal itself naturally.
The emotional connection between a physician and patient can itself have a therapeutic influence. If the physician demonstrates high energy and enthusiasm for a new drug or a placebo to alleviate a patient’s pain, the patient will discount the degree of his pain following treatment simply not to let down his doctor’s high expectations for the drug in the patient’s recovery. The placebo effect is a response to the act of being treated, not the treatment itself. It is a result of the power of a physician’s suggestion and operant conditioning.
In experimental research, the placebo effect must be acknowledged and controlled for, as a confounding factor. The placebo effect in research is the degree of change in a test subject’s physiological condition (or the change in the subject’s reporting of that condition) based solely on the subject’s ability to psychologically cause the change in response to the conditions of the experiment; any remaining effect is assumed to be the result of the application of the treatment under study.
The Ancient Fraud of Acupuncture, & Other SillinessPosted on 02/21/2011
“Sham acupuncture using toothpicks instead of needles
may be as effective as the real thing at easing back pain,” one news story
heralds (“The Year in Health,” TIME, Vol. 174, No. 22, December 7, 2009,
p. 72). The “real thing,” acupuncture with needles, given a course of eight
weeks of treatment, is a sham, too. Any results from the insertion of needles in
make-believe points at body meridians that ancient Chinese practitioners and new
age frauds imagine release the flow of “qi” (energy) to balance yin and yang
(also imagined biological qualities) are actually caused by the placebo effect,
plus time. More rigorously controlled research into the efficacy of
acupuncture diminish any positive effects, and no study with a well-designed
sham acupuncture control group has shown any advantage for real acupuncture, all
benefits attributable to the placebo effect.
Practitioners who believe that the actual reported pain alleviation from acupuncture is a result of the needles’ micro traumas that cause irritation and the consequent stimulation of the body’s inflammation/immune mechanisms are also wrong. The theory that the body’s pain killers and reparation cells can flood an area, in response to light pin pricks, in sufficient quantities to alleviate the higher intensity pain under treatment is simply bogus. Acupuncture is also touted to cure smoking and indigestion, which the micro injury theory doesn’t fit.
It doesn’t matter if toothpicks pricked the points that the acupuncture charts indicate have some effect, but it does matter that the toothpick-poked subjects in a study had no idea they were being duped. Confidence in the treatment allowed them to believe that their bodies were releasing natural analgesics, and logic would dictate that they should feel better.
Of course, acupuncture is not real medicine, and
given eight weeks, most back pain from stress or torsion pulls will reside. A
trusting mind will trust massage, toothpicks thought to be acupuncture needles,
and acupuncture needles equally. Since pain, though real, is subjectively
reported, and since the injuries that cause such pain vary in the degree of
damage caused to back muscles and nerve connections, the control groups cannot
have been randomly assigned, which would explain any differential in reported
pain reduction.
In another news story, about “200 major league baseball players wear $23 titanium necklaces made by the Japanese company, Phiten….with many accepting the company’s claim that they improve circulation and reduce muscle stress. Said a company spokesman: ‘Everybody has electricity running through their bodies. This product stabilizes that flow of electricity if you’re stressed or tired.’ Said New York Mets pitcher Heath Bell (who has two necklaces): ‘If you think it works, it’s going to work. If you don’t think it works, it’s not going to work.’” (New York Times, 6-22-05).
Athletes are known for their intractable superstitions.
Despite discouraging results from early tests of the effectiveness of most alternative treatments, many people continue to accept anecdotal tales as evidence of treatment efficacy, further defending alternative medicine. If the placebo effect were real and lasting, and everyone could be taught how to effectively cure themselves, that would be the end of our health care insurance crisis. If people could get better by positive thoughts, alone, they would. They could cure trendy addictions, like sex addiction food addiction. They could prevent all manner of pre-medical conditions, cure at-risk teens, avoid potential problems, wish away predispositions to any condition, which don’t require medical attention and are simply bogus attempts to panic people into buying something—low-dose preventative prescriptions, child therapy, maintenance contracts on equipment and appliances, and tests to assure we won’t have genetic problems in the future, and donating to research for any of a variety of genetic timebombs that might be in our futures. We are all pre-death, pre-aging, pre-lonely, pre-saggy, but we can’t prevent it with positive thoughts alone.
A patient’s belief in a pill, potion, or a procedure’s effectiveness lasts only until the effectiveness diminishes and the patient’s very real disease asserts itself. Then, the patient tells herself that nothing can help. The negativity of hopelessness and despair, and the stress from the news of the ravaging return of a disease and the dismal failure of the initial treatment efforts returns and doubles. The underlying objective medical condition remains unchanged and the placebo relief was temporary.
More to come
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