Placebo Reality

Studies into the impact of playing video game – especially violent ones – are contradictory about whether the games are good or bad.

Like everything else, it really is down to the player – how much time spent gaming vs other activities.

When you immerse yourself in an experience of a different reality, whether it’s 6 hours of a video game or watching marathons of tv shows or movies with their sequels, your brain is in an alternate reality.

You’re aware that you are on the couch and that you are you watching or playing something – but your brain is responding to whatever stimulation you give it.

This is why action or horror movies can literally get you to the edge of your seat. This is why there was a national mourning when favorite tv shows – MASH and Cheers in particular – go off the air.

We like those realities and we respond emotionally because on some level in our brain, it’s real.

Suspension of disbelief is what allows us to accept the world the movie or game because it has clear rules that are consistent and thus we stay in the story.

But it’s not like anyone thinks that the movie or video game is real, it’s just that we accept that the experience of the entertainment is very real. Okay, yes, when I saw Rodger Rabbit in the theatre, I did get so enthralled that when the house lights came up, for just a moment, I was confused that there were no toons in the audience. But, hey that movie has amazing special effects.

I suspect this is why there’s a placebo effect in medicine. Not so funnily enough, there was an excellent episode of MASH that explored the placebo.

The MASH was out of pain killers and they had a full ward of wounded soldiers. They put sugar in capsules and dispensed them with a warning that it was a very power pain killer. The soldiers all accepted that claim and experienced a reduction in pain or they fell asleep.

Now, yes, that’s a tv show – a placebo reality explaining the placebo effect – but what it demonstrates is that with the proper preparation of the scene – in shows and real life – you can convince people of pretty much whatever you want.

Homeopathy is Homeobunk

The idea of homeopathy is to take something and to dilute it in water several times – usually 30 – and administer a few drops as medicine.

The underlying idea is that the water retains the characteristics of the dissolved substance and the more dilute, the more powerful it is.

What’s curious to me, is that generally, the people who embrace homeopathy maintain the opinion that drug companies are just out to make money and not help people.

But, if this was the case, wouldn’t the drug companies be willing to sell us free city water?

In homeopathy, there’s no research & development, no government regulators, no expensive clinical trials. You give a person a dilute solution and if whatever ails them goes away, it worked and if it didn’t, then you have another water treatment to try out.

What drug companies do, is isolate the medicinal chemicals in the various natural sources and replicate them. There is no chemical difference between the replicated chemicals and the ones sourced from natural sources. They remove any chemicals that are inert or harmful; so the medicine is only the active ingredients with inactive ingredients such as a base, colour and binding agent.

So who is really making the largest profits?

  1. Homeopaths who are selling you water with very low overhead
  2. Drug Companies with R&D, clinical trials, government regulators, marketing and a lot of overhead?

If homeopathy really worked, we wouldn’t need there to be drug companies – we’ve had water around a lot longer than drug companies have been around.

Aside: the idea that natural is only those things occurring in nature and not what humans can create or manufacture is strange to me, since, everything we work with comes from nature – including the raw materials used to replicate the chemicals and compounds used to make medicine.

To me, the first problem with the idea underlying homeopathy – that water can take on the characteristics of something else and retain those characteristics through a procession of dilutions.

Water is everywhere – as water, ice and vapour. Water touches everything and goes everywhere. There would be no need to put anything in water and dilute it – all water has already pretty much touched everything.

That’s assuming that water can take on the molecular structure of the substance dissolved in it in the first place. Which is another issue – homeopathy was invented prior to knowledge of molecular structure, so this sciencey sounding explanation of how it works is a dubious later addition.

Water is a very peculiar, common but not really understood substance. Molecularly, it can take on many shapes and cluster sizes in the liquid state. But, even if exposure to a foxglove leaf did allow the water in contact with it to take on the structure of a digitalis molecule – surely the process of diluting it 30 times would make those clusters come into contact with other water molecule clusters and they would all be altered by the movement of the dilution process and be influenced by the molecule cluster shapes of the other water being added.

Indeed, if homeopathy’s “less is more potent” can be believed, instead of swallowing pills, we should be able to lick them for a more effective treatment.

Clinical trials that test for Placebo effect offer an explanation for why homeopathy sometimes seems to work.

A person who knows that they are being given a treatment – whether it’s being given a medication or only having doctors and nurses come in and tell them they are giving them medicine – feel less anxiety, pain and other subjective symptoms.

If a person is given medicine without knowing it and without being seen by medical staff (ie a machine metering out the medicine through an IV drip), do not experience a decrease in the subjective symptoms.

Symptoms that are objectively measurable – such as broken bones or tumors – are not impacted by the placebo effect at all.

It also appears from these trials that the expectation of being given treatment is enough for the brain to release chemicals that reduce pain or block the pain perception. The placebo effect can also work when the person is aware of the placebo.

Aside:  For years, I have asked any lab tech drawing blood to say “now” at the same time that they insert the needle. (not “now” then poke, but now simultaneously with the poke). What the now signals to me, is to exhale very deeply. The concentrating on the breathing is enough to distract from the needle prick.

Another aspect that I find very curious – you can sue a doctor for malpractice – they carry insurance for that very purpose.

But homeopaths don’t. Homeopaths don’t make mistakes, they have just failed to find the right dilution for you, so really, it’s down to the patient for failure, not the homeopath.

If homeopathic and other so called complimentary treatments actually worked on their own – they would be treatments – not complimentary treatments.

To a degree, I support buyer beware. But it’s no longer the people willing to pay for complimentary treatments that are paying.

Many medical insurance plans and employer benefit plans include covering these “complimentary” treatments. Health care is expensive, so diverting money on unproven and often untestable “treatments” wastes public as well as private money.

In personal cost terms, people will often delay actual medical treatments in favour of trying various unproven treatment courses – sometimes to the point of dying owing to delayed diagnosis.

Even if a person proceeds with medical and a complimentary treatment – if that treatment includes herbal preparations – these can often interact with medicines and make it less or more effective. These interactions can be unpredictable and are often not admitted to the attending doctor. That carries a whole other risk set.

There is an easy way to determine what is medicine and what is quackery.

Medical diagnosis and treatment is a process developed over decades, with many people contributing to the knowledge and advances. There’s peer review, replication, clinical trials,  regulations and practice standards.

Treatments that are basically invented by one person, the mechanism or process is not able to be explained, aren’t effective in clinical trials and aren’t regulated in any way – and regulation isn’t a hoop for companies to jump through, they are a consumer protection standard – these are not medical treatments.

These are treatments to extract your money, make you subjectively feel like something is being done so you subjectively feel better and little else.

Placebos – fake treatment, real effect

The idea that the mind can be tricked with proper staging and a sugar pill is well known if not entirely understood.

The Placebo effect works for subjective assessments of illness – how much pain, tiredness and other symptoms that typically vary from person to person.

The Placebo effect does not work for illnesses or conditions that can be measured – the mind cannot trick the body that a sugar pill will shrink a tumor, mend a broken bone or any other symptom that can be measured.

Drug trials have to try to eliminate the placebo effect with blind studies – one group gets the medicine, one group gets a placebo and one control group gets nothing. For a drug to be approved, it must have results that are better than the placebo group.

While we don’t fully understand how the placebo effect works or really, why it works; I can’t help but wonder if it also works in reverse.

How many times have you phoned someone to get out of some event or work,  claiming vague ailments and within a short time span, begin to experience the very symptoms?

It is just guilt?

Or, did you have to psyche yourself for the phone call and by so doing, triggered a scenario that your brain has accepted as real and so perceives it as real? Maybe even manifests as real….

Placebo is not about actually feeling more or less of anything, but rather, what the person’s perception of what they are feeling is.

People who are left in a hospital room and have doctors and nurses coming in to check on them, tend to report less pain and discomfort because they perceive that they are being cared for.

People who are left in a hospital room and being delivered medicine through an IV but don’t have doctors or nurses coming in to check, do not report changes in their pain levels despite being the group actually on medication.

How we perceive a subjective condition like pain or pleasure appears to depend in large part to the context and scene setting. Sort of like the way that little children who fall down, don’t cry until an adult or other child freaks out.

So, in some aspect, how you set your mind to perceive and understand stimulus, events, interactions, appears to go a long way to shaping those events and interactions.