Thoughts on placebo
I've spent a bunch of time thinking about placebos. At one point I gathered a lot of it into a single long and rambling LJ post almost a year ago (I've posted about it in my problog since then, but I don't want to directly link that blog to this LJ; it was about placebo only in the context of clinical acupuncture research, and thus less applicable here). So when a friend pointed me at this article on IBS and the high efficacy of known placebos I felt the need to think aloud yet again.
One thing is, that long and rambling LJ post was prompted by a class taught by the second guy quoted in the article, Ted Kaptchuk. I'm utterly unsurprised to find his name there - he's one of the leading authorities on placebo, as well as one of the first American acupuncturists. I also kinda knew that he'd been working with IBS recently, but had no idea what he was working on. I strongly suspect the study was his idea - it's his kind of clever (and the first guy was way too dubious of the notion to have thought to try it in the first place).
That dubiousness makes me giggle. The sheer misunderstanding of placebo it indicates! So many people think placebo is all about a mental state, specifically a state of ignorance. People who are treatable via placebo must be stupid and/or naive, believing in voodoo medicine, dancing to the piper's tune like a fool. What a terrible thought, that we could be preying on these weak-minded individuals with false medicine! This is how a doctor who watched a wounded soldier find real relief from suffering via a bag of saline labeled "morphine" decided that the proper use of this knowledge was to make sure no one was given a bag a saline labeled "morphine" ever again. How sad it is that we fear the stereotypes so strongly we would rather suffer, and watch others suffer, than suggest we, or they, might be susceptible to placebo. But now, now that we can see the placebo effect doesn't require conscious belief in the efficacy of the placebo, maybe we can start to leave such stereotyping behind. Maybe we can start to think about the benefits of placebo, rather than just treating it as damage within the human being to route around. Also, the panic I expressed in that previous post is greatly relieved - knowledge is no more the route to suffering than ignorance is the route to simple cures.
I have a lot of other thoughts, about what healing really is and what our roles as healthcare practitioners are in that process, but they're not fleshed out enough to throw into the wild.
One thing is, that long and rambling LJ post was prompted by a class taught by the second guy quoted in the article, Ted Kaptchuk. I'm utterly unsurprised to find his name there - he's one of the leading authorities on placebo, as well as one of the first American acupuncturists. I also kinda knew that he'd been working with IBS recently, but had no idea what he was working on. I strongly suspect the study was his idea - it's his kind of clever (and the first guy was way too dubious of the notion to have thought to try it in the first place).
That dubiousness makes me giggle. The sheer misunderstanding of placebo it indicates! So many people think placebo is all about a mental state, specifically a state of ignorance. People who are treatable via placebo must be stupid and/or naive, believing in voodoo medicine, dancing to the piper's tune like a fool. What a terrible thought, that we could be preying on these weak-minded individuals with false medicine! This is how a doctor who watched a wounded soldier find real relief from suffering via a bag of saline labeled "morphine" decided that the proper use of this knowledge was to make sure no one was given a bag a saline labeled "morphine" ever again. How sad it is that we fear the stereotypes so strongly we would rather suffer, and watch others suffer, than suggest we, or they, might be susceptible to placebo. But now, now that we can see the placebo effect doesn't require conscious belief in the efficacy of the placebo, maybe we can start to leave such stereotyping behind. Maybe we can start to think about the benefits of placebo, rather than just treating it as damage within the human being to route around. Also, the panic I expressed in that previous post is greatly relieved - knowledge is no more the route to suffering than ignorance is the route to simple cures.
I have a lot of other thoughts, about what healing really is and what our roles as healthcare practitioners are in that process, but they're not fleshed out enough to throw into the wild.