Wednesday, May 28, 2008

The Placebo Effect

How is it that a placebo effect exists?
In writing about What the Bleep Do We Know?, I got an e-mailed comment about the part of that movie that talks about the effect of the mind on water--there are a series of pictures of water molecules showing how each had been affected by being labeled in different ways (presumably through the action of the mind). What if we had a bottle of "confident" water? or "peaceful" water? What would happen if we drank that water?

Now I don't know how to evaluate the accuracy of the science of the shaping of the water molecules, but I do feel pretty darn confident that the placebo effect exists, and, though I haven't actually studied the placebo effect, that there is plenty of research out there to support the notion of the placebo effect.

How is it that it operates? One possible explanation that we might imagine would be to link the water molecules of What the Bleep with the placebo notion: in the process of taking the placebo, our believing mind alters the molecules in some way. Another possible explanation (and the one I imagine most people would favor over the What the Bleep explanation) would be that our mind acts directly on our body--by believing that changes will occur, we may create those chances purely through the power of the mind. To explain the placebo effect--an observable phenomenon--somehow requires physiological change through action of the mind, whether that causal path is direct or indirect. I have come up with two possible explanations, but I daresay more could be imagined--both variations on the two basic themes I laid out, or development of some other theme (e.g., supernatural entities?).

If the placebo effect exists, is it possible that it can be consciously exerted--for example by repeating "I am confident", one grows in confidence? That would seem to be the rankest version of pop psychology and using affirmations. But does the logic of the placebo suggest that possibility?
We might argue that the placebo effect can only be unconsciously activated, but that requires a Freudian view of the mind, and one wonders whether we really want to believe that there is some entity called the "unconscious" or whether Freud's theory, which characterizes the unconscious as a sort of independent agent, relies on human conceptualization and thus creates a division that is not accurate with respect to the placebo effect. (I daresay someone has studied whether the placebo effect is only unconscious or not; I haven't researched that.)

If we acknowledge that there is a possibility (not a certainty) that we can consciously invoke the placebo principle through such behaviors as repeated affirmations, at what level does the possibility become great enough to try such actions? And though I dismiss affirmations as pop psychology, there is no doubt that there are therapeutic with significant empirical research to support them that suggest that we can improve our moods through behavioral modifications (like affirmations).

For me, especially at those moments when things seem the most difficult, the level of possibility doesn't have to be very high. It seems to be worth the chance, because the cost of changing my behaviors to promote is so low. The effort doesn't contradict other efforts to change my situation, and costs nothing but a little effort.

Following this logic, then, it seems that to the extent that we can imagine a possibility, and we can imagine the steps to get there, we can then use our minds to help us move there by focusing on that goal ("I am confident!").

This post is a little of a hodge podge, because I was also thinking about the role of imagination in work as academics or philosophers: when faced with an observed phenomenon, we can use our imagination to generate different hypotheses about the causal factors of interest (as I did with the placebo effect).

We can also use our imagination to hypothesize connections of significance: if there is such a thing as the placebo effect: how can that be significant to the individual? What can be done with the placebo effect? Maybe you could institute a whole program based on it (which might be a health pogrom, not a health program)? Or maybe you would want to limit attempts to apply the placebo effect as treatment to only some cases (say ones with low risk, or ones that are not treatable by other means).

Our imaginations are keys to a whole realm of possibilities in academic work. Judicious use of imagination, along with careful qualification (e.g., the conscious placebo effect is possible, not certain) can lead to fruitful lines of discussion.

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