New York Times: "What if the Placebo Effect Isn’t a Trick?"

[Andy]

The Chain of Office of the Dutch city of Leiden is a broad and colorful ceremonial necklace that, draped around the shoulders of Mayor Henri Lenferink, lends a magisterial air to official proceedings in this ancient university town. But whatever gravitas it provided Lenferink as he welcomed a group of researchers to his city, he was quick to undercut it. “I am just a humble historian,” he told the 300 members of the Society for Interdisciplinary Placebo Studies who had gathered in Leiden’s ornate municipal concert hall, “so I don’t know anything about your topic.” He was being a little disingenuous. He knew enough about the topic that these psychologists and neuroscientists and physicians and anthropologists and philosophers had come to his city to talk about — the placebo effect, the phenomenon whereby suffering people get better from treatments that have no discernible reason to work — to call it “fake medicine,” and to add that it probably works because “people like to be cheated.” He took a beat. “But in the end, I believe that honesty will prevail.”

Lenferink might not have been so glib had he attended the previous day’s meeting on the other side of town, at which two dozen of the leading lights of placebo science spent a preconference day agonizing over their reputation — as purveyors of sham medicine who prey on the desperate and, if they are lucky, fool people into feeling better — and strategizing about how to improve it. It’s an urgent subject for them, and only in part because, like all apostate professionals, they crave mainstream acceptance. More important, they are motivated by a conviction that the placebo is a powerful medical treatment that is ignored by doctors only at their patients’ expense.

https://www.nytimes.com/2018/11/07/magazine/placebo-effect-medicine.html

 

[Invisible Woman]

Loooonng article.

One point that jumped out at me - he says

Tell someone a normal milkshake is a diet beverage, and his gut will respond as if the drink were low fat.

Well, the diet industry in the UK is a testament to the fact that doesn't work.

 

[Jonathan Edwards]

Well, if I was a boozer I would invent an organisation called SIPS and go and have a few drinks in some ornate concert hall in Leiden. I would of course make sure the meeting was approved by the Ministry of Funny Talks and make sure I paid the bill in dummy bank notes.

I better read it - not sure if I will make the end.

 

[Jonathan Edwards]

I read it. Oh what drivel. Why do we live in an era when it is acceptable to write complete drivel as if it was high intellectual debate. Is it the price we pay for ease of communication - that the empty vessels' noise drowns out everything else completely?

And why are 'educated people' so ignorant of the basic issues of philosophy that 100 years ago were well understood in the institutions of learning. All this dross about mind and body and MRI scans - which even a policeman can see is nothing new (my boss always used to insult policemen in this way).

Civilisation is quietly sinking into the waves. A tiny island remains above water - called S4ME.

 

[obeat]

The words "mind and body "create a Pavlovian response in people where they stop using their own mind to critique what they are reading.

 

[Sean]

Placebo interventions for all clinical conditions.

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.

https://www.ncbi.nlm.nih.gov/pubmed/20091554

Until the placebo cult can properly rebut these findings, they got nothing, IMHO.

 

[rvallee]

Objective evidence for it or bust. It's not that hard.

It's fascinating and very entertaining. But you need actual objective evidence. Moving goalposts to claim that sometimes subjective evidence is fine should not be accepted. That's how we got exceptions like the psychosocial model, built up from laundering a small number of unblinded trials into some sort of evidence base.

It's madness to see science and technology advancing farther than ever before while ongoing a crisis of magical thinking that regresses and cheapens the whole.

It's great for mood. Mood is good. It's still not medicine. It's complementary and a whole other level on Maslow's pyramid. About on par with a warm, homely room. That's always nice and helps recovery, just not on its own.