

Its all in the mind. Why Placebos work - senith
http://online.wsj.com/article/SB10001424052970204720204577128873886471982.html?mod=WSJ_hpp_MIDDLE_Video_Third

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glenra
Not a great article. It omits several relevant known mechanisms. The placebo
effect is NOT "all in the mind"; some of it is (and some of the data in the
article argues to that), but some of the placebo effect is "in the math" and
some is "in the pill" and some of it is "in the measurement".

IN THE MATH: For depression in particular, regression toward the mean is huge
- people tend to seek treatment when they are _unusually depressed_ and thus
tend to feel better at some random later time regardless of whether they get
any treatment at all. You can verify this by having two control groups, one of
which gets NO treatment rather than a fake treatment. Or assign different
groups to start treatment at different times after a variable delay.

IN THE PILL: There's really no such thing as an "inactive" pill. The pill is
made of _something_ , and that something - even if it's milk sugar - might by
chance actually do something useful to the condition you're testing. To rule
this out you also need a no-treatment control - simply calling something an
"inactive control" doesn't make it one.

IN THE MEASUREMENT: If you apply "a treatment" and ask people "is this better
now?" the polite ones will say "Yes, I feel a little better" just to be
polite, even if they don't. To tease this out you need objective rather than
subjective measurements of success.

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TomasSedovic
There's some serious spinning going on in that article.

The asthma study showed that (in that particular case) the placebo treatment
did not work at all. The patients reported feeling as good as with using the
real treatment, but it did nothing to alleviate the actual symptoms.

The last paragraph tries to claim that placebo (sham acupuncture) may be as
effective as the real treatment (real acupuncture). That's not what the study
shows. The result of the study is: the "real acupuncture" doesn't work either.

Placebo is the null hypothesis. It's something that all treatments show
regardless of their actual effect. It's the level that you have to beat before
you can say that your treatment has any benefits.

If something is no different than a placebo, that means that it has no effect
other than the placebo effect. Therefore, the original treatment does not
work. Period.

Placebo effect is a psychological hack. You get it regardless of the active
component in the treatments. It's about the feelings and expectations of the
recipient.

In sham medicine, all you get is the placebo effect. But when you get actual
treatment, you're benefiting _both_ from the placebo effect and from the
treatment itself.

I'm not saying that feeling good is not a desired outcome. It's just that if
you have real issues that won't be resolved by feeling better, placebo is of
no help.

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keiferski
Reminds me of a Buddhist monk quote:

"The greatest problems of humanity are psychological, not material."

\- Lama Yesh

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senith
Nice quote Keiferski! Yes, everything is driven by whats in between our ears.
That is driven by what is in our heart!

Similar wisdom from the Bible is Proverbs 4:24 "Above, all else, guard your
heart for it is the wellspring of life"

