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The Power of Belief Complementary Therapies, Placebos and Healing. Gus Cairns. Preparatory work. Think of three adjectives that describe the kind of person you would like to be. e.g.: If you are depressed think ‘happy’ or ‘fortunate’ or ‘loved’ or ‘gorgeous’

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preparatory work
Preparatory work
  • Think of three adjectives that describe the kind of person you would like to be.
  • e.g.: If you are depressed think ‘happy’ or ‘fortunate’ or ‘loved’ or ‘gorgeous’
  • If you are stressed, think ‘patient’ or ‘calm’ or ‘organised’
  • If you are sick, think ‘healthy’ or ‘strong’ or ‘energetic’

Orthodox medicine

complementary or standard of care
‘Complementary’ - or standard of care?
  • One daily aspirin: cut the risk of heart attack by 28 %
  • 400-800 IUs of vitamin E cut the risk of all heart attacks by 47%: non-fatal ones by 77%
  • Electro-acupuncture induced surgical anaesthesia in 99.6 per cent of women having Caesareans
  • 6 out of 6 patients with NRTI-induced lactic acidosis (mortality normally 50%) recovered when given intravenous B1, B2, niacin and l-carnitine
  • 3g of l-carnitine for two months: triglycerides down from 5 times normal to normal in 54% of patients on PIs
just feel better or are better
Just feel better, or are better?
  • 20 HIV+ and 9 HIV- gay men
  • Daily massage for a month
  • Massage subjects had lowered cortisol
  • CTLs (CD8 cells) and natural killer cells up/
  • CD4 (T-helper) cells did not improve
  • Indian study: homoeopathy vs placebo for HIV
  • PGL group: stat. significant difference in CD4 counts
  • Placebo group: non-significant results.
  • Asymptomatic HIV infection, differences not significant

“Two things are certain about pills that treat depression: Antidepressants like Prozac, Paxil and Zoloft work. And so do sugar pills.”Washington Post, Tuesday, May 7, 2002

“A trial last month that compared the herbal remedy St. John's wort against the anti-depressant Zoloft. St. John's wort fully cured 24 percent of the depressed people who received it, and Zoloft cured 25 percent.

but the placebo fully cured 32 percent…What's more, the placebos, caused profound changes in the same areas of the brain affected by the medicines. One researcher has ruefully concluded that a higher percentage of depressed patients get better on placebos today than 20 years ago.”

placebo response not all in the mind

“Placebo response not all in the mind”

51 patients with major depression. 8-week study.

52 % receiving antidepressants responded

38% receiving placebos responded

Immediate decrease of prefrontal lobe activity in patients given antidepressants

Gradual increase in prefrontal lobe activity in patients given placebo

placebo response not all in the mind contd
“Placebo response not all in the mind” contd.
  • “They were virtually indistinguishable. At eight weeks you couldn't tell them apart in terms of mood ratings.
  • What happened at eight weeks plus a day was a bit different. Some of the placebo responders, when told they were on a placebo, had a deterioration of their mood. In fact, most of them did. Within a month, most of the placebo responders had enough depressive symptoms that they actually ended up on medications. Once people realised they were not taking real drugs, the placebo effect stopped.”
  • Leuchter AF, Cook IA, Witte EA, et al.: Changes in brain function of depressed subjects during treatment with placebo. Am J Psychiatry 2002, 159:122-129.
placebo surgery
Placebo surgery?

“Surgery has been slow to take up the challenge of British epidemiologistArchie Cochrane: to prevent the introduction of new therapeuticprocedures until randomised trials have shown them to be moreeffective than existing treatments... The fact that surgical trials cannot be double blind or placebocontrolled is often seen as a major methodological problem.” (BMJ, 1995, 311:1243-1244 (11 November)

“Patients with osteoarthritis of the knee who underwent placebo arthroscopic surgery were just as likely to report pain relief as those who received the real procedure, according to a Department of Veterans Affairs and Baylor College of Medicine study published in the July 11, 2002 New England Journal of Medicine.”

not all in the mind but by the mind
Not ‘all in the mind’ – but by the mind
  • The changes reported in people's brains under the placebo effect are profound. But there's a Catch-22. You can't tell yourself, 'I know, I'll just kid myself it's working'. It's like deciding not to think of a skating hippo. The placebo effect is about something much more profound than self-deception. Luckily the strangeness of the human brain comes to the rescue - from studies of hypnosis.
  • So, to repeat what I’ve been saying, the effects of complementary therapy are NOT ‘all in the mind’. They are extremely physical.
  • They may be physical because you take substances or had procedures done that have real effects.
  • They may be physical because you are being touched, handled, listened to, counselled, or are relaxing – activities that all promote the parasympathetic response
  • But they may also have a real physical efffect because the 70% of your brain that is unconscious is saying to the conscious half: YOU ARE WELL.
  • Many complementary medicines work by drawing out of you your own ability to heal yourself.
the hidden observer
The ‘hidden observer’

“During the hypnotic state one part of the brain reports low levels of pain, while another reports a high level. After coming out of hypnosis the subjects report that they did feel pain - but under hypnosis a ‘hidden observer’ in a dissociated part of their brain told then they were unable to perceive it.”

Michael Shermer, The Borderlands of Science, Oxford 2001

the sceptical comp therapy user how to set up your own placebo effect
The sceptical comp therapy user - how to set up your own placebo effect
  • Intensive consultation
  • Trust between patient and practitioner
  • Medicine as process, not as cure
  • The will to succeed
  • Ritual and discipline
  • Principle of ‘like cures like’
  • Almost infinitely diluted active substance
  • The weaker it is, the stronger it is
  • ‘Memory of water’ theory
  • Intensive consultation: psychotherapeutic effect
massage shiatsu etc
Massage, shiatsu etc
  • Permission to be touched by a stranger
  • Real effects on redistributing toxins like lactic acid out of muscles
  • Parasympathetic relaxation effect
  • Psychological effect: reversion to infancy
reflex kinesiology
Reflex Kinesiology
  • Reflexes ‘tested’ against questions
  • Impossible to ‘cheat’
  • Harnessing the unconscious and getting under the radar of denial
movement therapies
Movement therapies
  • Exercise is good for you
  • Emphasis on combining movement with calm: parasympathetic rather than sympathetic strength
  • Connection with spiritual values, other cultures