
Mindfulness meditation trumps placebo in pain reduction - DrScump
http://www.sciencedaily.com/releases/2015/11/151110171600.htm
======
chvid
When I read about studies like these I always wonder how the placebo is done.

Here it is actually stated: "sham meditation" and petroleum jelly cream.

One of the problems with this is that the experimentors would know who got the
placebo and who did not.

I don't think it is far fetched than a subject would sense whether they were
being taught mindfulness mediation which the experimentor perceived as being
genuine or "sham meditation" which the experimentor knew to be false.

Whether a subject perceives she is undergoing an effective treatment obviously
will effect the placebo effect and probably also show on brain scans.

~~~
jhdevos
True - which is why they did the cream as well. At the very least, this study
tells us that the mindfulness meditation is a 'more effective' placebo than
the cream.

It's very hard do really do in a 'double blind' way - I would not be able to
think of something that is to all appearances equal to the real mindfulness
mediation, but actually only a fake. There's no substance to it.

Do you have any suggestions to do it better?

~~~
orblivion
> At the very least, this study tells us that the mindfulness meditation is a
> 'more effective' placebo than the cream.

Which leads one to consider - what is a placebo anyway? It's a mental state
one puts oneself in that improves physically measurable symptoms. That seems
indistinguishable to me from meditation. If you think about it, it's kind of
funny that skeptics like to dismiss impressive sounding treatments as being
placebos. A placebo is a pretty impressive phenomenon!

If one can reliably create a _reliable_ , powerful treatment that actually
works (fixes what you're targeting rather rather than symptoms, unless
symptoms are what you're targeting as in this case) by putting ones self into
a mental state, that sounds like a win, even if it does meet the definition of
a placebo.

~~~
contravariant
I always did wonder about that. Current research implies that placebos work as
long as you believe they will work, even if you know they are a placebo. But
then why would you need the placebo in the first place?

There seems to be no need to do anything really, if you can just stop thinking
you're feeling bad then you'll actually feel better.

In principle there's no need for any specific instructions on meditation
either, but it does seem to be related to meditation where you also aim to
stop thinking about certain things, so those instructions are likely to be
useful, even if they only turn out to be yet another placebo. After you gain
more confidence that you can do it, you should have less need for those
instructions though.

~~~
DanBC
> Current research implies that placebos work as long as you believe they will
> work, even if you know they are a placebo.

It depends on the research. There's some that don't find a strong placebo
response.

------
benevol
Pain reduction is just one benefit.

Another one is stress reduction, leading to a stronger immune system, less
asthma, improved digestion, etc.

The main point is probably that you rewire your brain:
[http://news.harvard.edu/gazette/story/2011/01/eight-weeks-
to...](http://news.harvard.edu/gazette/story/2011/01/eight-weeks-to-a-better-
brain/) which means doing it on a regular basis improves your hardware, not
just your software.

You will end up managing your emotions more efficiently, which is extremely
useful for people who need to stay away from d e p r e s s i o n and a n x i e
t y.

~~~
zuck9
Why did you space out those two words? To make it unsearchable? But why?

------
jpmattia
75 subjects divided into 4 groups, so about 19 people per group.

Suppose the study was studying the effect of coin tosses per group. The
standard deviation is sqrt(19)/19 or about 23%. And that is only one sigma.

So we might also conclude that those who flip heads are <insert effect here>
than those who flip tails. Is anyone really surprised that the reproducibility
study [1] found reproducibility comparable that of a coin toss (to about one
sigma)?

[1] [http://www.nature.com/news/over-half-of-psychology-
studies-f...](http://www.nature.com/news/over-half-of-psychology-studies-fail-
reproducibility-test-1.18248)

~~~
epistasis
The std. dev. of a binomial is sqrt(n p (1-p)). So for 19 coin flips that's
~2.2, or 11%, not 23%.

Plus your setup is not relevant to the setup that they performed (check figure
3).

I am not so surprised that many studies are not replicated, but I also am not
surprised when critical internet comments are weaker than the analysis they
criticize.

~~~
jpmattia
> _The std. dev. of a binomial is sqrt(n p (1-p)). So for 19 coin flips that
> 's ~2.2, or 11%, not 23%._

You are correct. The usual way in which std dev is applied is ± sigma accounts
for about 68% of the trials, which is 2 std deviations, and is what I had in
mind. So for 19 people flipping a coin, you'll have a range of about 23%
variation.

That factor of 2 does not change the message.

------
nns
"Mindfulness meditation reduced pain by activating brain regions
(orbitofrontal and anterior cingulate cortex) associated with the self-control
of pain while the placebo cream lowered pain by reducing brain activity in
pain-processing areas (secondary somatosensory cortex).

Another brain region, the thalamus, was deactivated during mindfulness
meditation, but was activated during all other conditions. This brain region
serves as a gateway that determines if sensory information is allowed to reach
higher brain centers. By deactivating this area, mindfulness meditation may
have caused signals about pain to simply fade away, Zeidan said."

------
jamesk_au
You can read the full paper here:

[http://jn.sfn.org/press/November-18-2015-Issue/zns0461501530...](http://jn.sfn.org/press/November-18-2015-Issue/zns04615015307.pdf)

Fascinating results.

------
plusquamperfekt
Placebo is just a derrogatory term for the fact that your mind influences your
body and your perception of what is real.

It is a perversion of capitalist societies to only accept a physical and
obvious influence as being able to change something.

The trick is - our mind is physical - at least physically manifested - and so
it should be evident for even mildly educated people that your mind can affect
your body.

So instead of disregarding placebo as some bullshit that is used to test
whether something actually works - why not invest some time and money into
perfecting the application of placebo effects?

Well, and here we are back to the mechanisms of capitalism - you couldn't sell
that very well ... that's the problem.

And if you think about it - perfecting the reliability and effect of placebo
"medication" would inevitably lead in a straight path to ... meditation.

------
hobo_mark
Ok so how do I try this out?

~~~
rikibro
You could try this, which is similar, but more serious and demanding (the 10
day course): [https://www.dhamma.org/](https://www.dhamma.org/)

If you have the time, it can be one of the most unique and life changing
experiences, in a good way, one can have.

~~~
vijayr
Silence, food etc are easy. But _ten_ hours of meditation everyday for 10 days
sounds scary. Could you talk more about your experience?

~~~
rtl49
I attended one of these ten day retreats in September. It was a worthwhile
experience, but it hasn't produced any great change in my day-to-day
experience.

That said, many people I met at the retreat reported feelings of great
personal significance. I'm completely open to the possibility that the fault
lies with me, but I wonder whether these reports were influenced by group
pressure, since there is something of a sense of community and to admit that
you "didn't feel anything" is to exclude yourself. After ten days of silence
and seclusion from the world (there's no technology, communication, reading,
etc.), you will want all the social interaction and acceptance you can get.

Also bear in mind that this is basically a self-selected group of people who
are searching for "something." Whatever "it" is, it doesn't come as a surprise
to me that people find it after ten days alone with their thoughts (which
still come to mind, however much you try to focus on bodily sensations).

As an aside, I was also turned off by some of the quasi-religious content of
the retreat. The website claims that this is a strictly evidence-based
practice, but you'll quickly realize this isn't the case when you hear Goenka
chanting in Pali or explaining the benefits of meditation as an effect of
releasing "sankhara."

After the retreat, I thought a fellow named Harmanjit Singh did an excellent
job evaluating Goenka's teachings here:
[http://harmanjit.blogspot.com/2007/07/critique-of-
vipassana-...](http://harmanjit.blogspot.com/2007/07/critique-of-vipassana-as-
taught-by-mr-s.html)

If I ever have another continuous twelve days to spare, I'd still be willing
to try another retreat with a more secular focus.

------
tokenadult
From the footer of the press release kindly submitted here:

"Story Source:

The above post is reprinted from materials provided by Wake Forest Baptist
Medical Center. _Note: Materials may be edited for content and length._ "

It helps the quality of discussion here on Hacker News, especially the quality
of discussion of medical topics, to prefer sources other than press releases
and press release recycling services like ScienceDaily for news on medical
topics. Most new medical study findings are never replicated and are
presumptively false.[1] Most study findings about placebo effects do not take
into account the complications of defining what a placebo is, really, in a
clinical trial context or what mechanisms might produce a placebo effect.[2]
The small-n study reported here relies on subject patient measures of a
subjective symptom, pain, and doesn't suggest any actual clinical effect on
patients that can be objectively measured (such as reduction of tissue
damage).

Press releases are a known part of the science hype cycle used to draw in more
funding for research labs.[3] Let's go behind the hype and see what
experienced science journalists and other scientists say about each lab's
press release before opening discussion here.

Anyway, Hacker News participants have been saying for years that it's a good
idea to look for better sources than Science Daily.[4] If Science Daily is the
only place of publication for a finding, I find it more useful to look for
another source before presuming the hyped finding represents a fact about the
world.

[1] "Why Most Published Research Findings Are False", John P. A. Ioannidis,
August 30, 2005

[http://journals.plos.org/plosmedicine/article?id=10.1371/jou...](http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124)

[2] "Are Placebos Getting Stronger?" Steven Novella, October 21, 2015

[https://www.sciencebasedmedicine.org/are-placebos-getting-
st...](https://www.sciencebasedmedicine.org/are-placebos-getting-stronger/)

"Placebo by Conditioning", Steven Novella, July 29, 2015

[https://www.sciencebasedmedicine.org/placebo-by-
conditioning...](https://www.sciencebasedmedicine.org/placebo-by-
conditioning/)

"Placebo, Are You There?" Harriet Hall February 24, 2015

[https://www.sciencebasedmedicine.org/placebo-are-you-
there/](https://www.sciencebasedmedicine.org/placebo-are-you-there/)

[3] "The Science News Cycle"

[http://www.phdcomics.com/comics/archive.php?comicid=1174](http://www.phdcomics.com/comics/archive.php?comicid=1174)

"Related by coincidence only? University and medical journal press releases
versus journal articles"

[http://www.sciencebasedmedicine.org/index.php/related-by-
coi...](http://www.sciencebasedmedicine.org/index.php/related-by-coincidence-
only-journal-press-releases-versus-journal-articles/)

"Anatomy of a Press Release"

[http://www.skepticblog.org/2012/06/21/anatomy-of-a-press-
rel...](http://www.skepticblog.org/2012/06/21/anatomy-of-a-press-release/)

[4] Comments about ScienceDaily:

[http://news.ycombinator.com/item?id=3992206](http://news.ycombinator.com/item?id=3992206)

"Blogspam.

"Original article (to which ScienceDaily has added precisely nothing):

[http://www.washington.edu/news/articles/abundance-of-rare-
dn...](http://www.washington.edu/news/articles/abundance-of-rare-dna-changes-
following-population-explosion-may-hold-common-disease-clues)

"Underlying paper in Science (paywalled):

[http://www.sciencemag.org/content/early/2012/05/16/science.1...](http://www.sciencemag.org/content/early/2012/05/16/science.1219240)

"Brief writeup from Nature discussing this paper and a couple of others on
similar topics:

[http://www.nature.com/news/humans-riddled-with-rare-
genetic-...](http://www.nature.com/news/humans-riddled-with-rare-genetic-
variants-1.10655)

[http://news.ycombinator.com/item?id=4108603](http://news.ycombinator.com/item?id=4108603)

"Everything I've ever seen on HN -- I don't know about Reddit -- from
ScienceDaily has been a cut-and-paste copy of something else available from
nearer the original source. In some cases ScienceDaily's copy is distinctly
worse than the original because it lacks relevant links, enlightening
pictures, etc.

" . . . . if you find something there and feel like sharing it, it's pretty
much always best to take ten seconds to find the original source and submit
that instead of ScienceDaily."

------
skbohra123
Ironical headline, to my knowledge, mediation is mindlessness state.

~~~
DiabloD3
Both "mindless" meditation and mindful meditation have their purpose. They are
not the same thing, and people who do not practice meditation do not
understand they are different.

I find both extremely important in maintaining my mental state during times of
stress. A half hour of meditation a day keeps the mental hospital away.

