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Objective Proof of the Nocebo Effect?

Discussion in 'Other psychosomatic news and research' started by DigitalDrifter, Nov 17, 2022.

  1. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

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    DokaGirl and Peter Trewhitt like this.
  2. rvallee

    rvallee Senior Member (Voting Rights)

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    Junk pseudoscience. As always.
     
  3. ToneAl

    ToneAl Senior Member (Voting Rights)

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    fMRI seems to be the fnd researchers main instrument where they can interpret the results any way they like
     
  4. CRG

    CRG Senior Member (Voting Rights)

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    One would need to go through the referenced studies to understand how strong/weak they are but I don't see any monstrous claims - essentially telling someone that something unpleasant is about to happen causes them to react in preparation for the unpleasantness - and in contrast telling someone they are about to get a pleasant chemical experience causes them to relax in what might otherwise be a tense situation.

    This all seems to be basic 'fight or flight' psychology (and its opposite) which is hardly controversial, the changes in approach proposed for how anaesthetists work seem either useful or anodyne and designed to make surgery a bit less horrible.
     
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  5. rvallee

    rvallee Senior Member (Voting Rights)

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    Rorschach patterns but it's for the doctors. Basically.
     
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  6. ToneAl

    ToneAl Senior Member (Voting Rights)

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    Reminds me of Watchmen the movie with Rorschach and his continuous changing Rorschach mask
     
  7. rvallee

    rvallee Senior Member (Voting Rights)

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    And meanwhile we're stuck with them but it's them who whine about being stuck with us even though we don't even want them around and they know it.

    Such an easy fix for this. But egos. Just freaking narcissistic egos. Also lots of legal liability but who's counting?
     
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  8. bobbler

    bobbler Senior Member (Voting Rights)

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    So far what I can see after all the nonsense paras about 'nocebo claims' is a tiny para about 'translating theory into practice'

    So basically, when someone is powerless on an operating table using less of terms like ‘tissue damage’, ‘surgical trauma’ and ‘injury’ where there are terms that are less dramatic to the layperson who also has ears is the extent of their suggestion. 'don't deliberately and unnecessarily mislead the patient by talking about them as an object on the table, remember they are a human'.

    Could it be that their brain scans they claim reflect the torture process of someone being put in a powerless position with a threat and then the relief of realising said person isn't a complete nutcase, because they are going to anesthetise you before they cut into you. Is that nocebo - or is it just an experiment only weirdos would do where they suggest they are going to do something that is unkind, shocking and almost certainly against ethics to someone trapped by them by power differences, and last minute say 'only kidding I'm not that cruel' words and claim it is some sort of medical pain relief, rather than the 'cruel joke' should never have been allowed in the first place?

    Now I've seen the ridiculousness of this area has some trying to 'reframe' the price-quality effect in marketing (which has a massive literature, very little of it about 'just expectations' but... experience and the functional model (ie not experiential) that people search for and then compare products that will meet their needs) into 'placebo' by claiming 'people actually think it tastes better if they paid more'.

    Isn't this just doing the same old nonsense - sound advice for medical staff being pretended to be linked to some nonsense 'nocebo', rather than errr if you don't know this already there should be questions about who they let into medical school and continue on the job because it is empathy and just basic decency that most learn at school isn't OK to not understand?

    To remember patients can be squaemish and are in a highly vulnerable situation with someone about to do things that are not nice for anyone on the receiving rather than giving end of it: insensitive, dramatic, ambiguous words that unnecessarily might suggest something 'might be wrong' or 'they won't control their pain' in laypersons is inappropriate.

    Surely most anaesthetists would know this already as they measure blood pressure and other things - and it ain't 'nocebo' it measures but the impact of bad behaviour or actual emergencies when it can't be helped.

    Hence surely this is a manifesto to try and replace a lack of empathy issue as some non-representative alternative theory of it being a problem of 'the patients mind', even tho theirs really only covers a tiny % of what their experiment actually did (if you call their threat and nocebo a 'treatment' together there's a lot more in that than what they've distilled it to). And I guess they find it more palatable to think they are 'tricking the nocebo patient' than 'changing their behaviour for basic decency' (but then it gets more warped in the next bit).

    They've measured and described none of these aspects that would have been present in the 'pain relief' situation. The ones like trust, safety, information.

    So the insertion, via very weak claims of the next para - which isn't supported by their discussion either is shocking as a new turf only introduced by claiming 'connection' by putting the phrases in the same sentence inferring they are connected as far as I can see ie in linguistic trickery only:

    I'm really starting to think that psychsomatics and their obsession with all they are obsessed with is actually a whole subject formed and read by that % of people who don't have it - empathy (but many probably ape it in certain ways to get by in society by copying others without understanding it) - and are making up a literature to try and understand the world as they do.

    That last creepy line about not respecting patients autonomy starting to become the sales pitch - also the tendency to not be able to associate actions and consequences in the same way due to this deficiency/type (do what you want to do then create reality to justify it - let's not have to deal with 'emotions'). Some of the recent pain management stuff including the girl with severe ME and bladder stones who was told to visualise and distract herself as it wasn't caused by anything smells of exactly this 'science'.

    This is rewriting medical staff's protocol and job description requirements to exclude the requirement for something they don't like doing as far as I can see. Under the guise of 'best for patient in the end, all that stuff I don't like dealing with is superfluous'.

    As many in that boat like to see/pretend empathy is just 'niceness, over-emotion and weakness' as they don't understand it is a skill and information set ie a useless 'feeling' rather than instinct and basically another sense just as important as the five senses and skill as basic and fundamental as being able to add or read that they just don't have and don't understand - and I guess can't ever.


    I think that is what all the real 'reframing' is actually about the more I read of these. Who needs 'holistic' being modelled out to them as something it isn't? Anyone with common sense can see what contributes to making ill persons situation and therefore outcome worse - only those who don't want to change and be nicer to them want to rewrite these basic rules of the world. People who when they upset others with inappropriate behaviour see it as 'an emotions issue in others'.

    Maybe some linguistic analyst or other subject area should compare any literature on empathy (abnormal psychology, criminology I guess) and non-empaths understanding of it with the psychosomatics' literature.
     
    Last edited: Nov 25, 2022
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