Placebo Effect and Consciousness
Why would a placebo work? And what does it mean for the mind-body-behaviour relationship when drugs which interact directly and empirically with the body also cause similar effects?
This is where I got the question: https://www.youtube.com/watch?v=csAjZ1MwhPE
This is where I got the question: https://www.youtube.com/watch?v=csAjZ1MwhPE
Comments (25)
Why placebos 'work' along with actual pharmaceuticals is something of a mystery, especially when the number of people affected by a placebo is significant.
We don't have to be terribly concerned if 4% or 5% of a large experimental group who received a placebo experienced benefit. It's more a mystery when 10 or 15% of placebo recipients experience benefit.
"Mind over matter" is not much of an explanation. Perhaps belief in the drug mobilizes the immune system in some way. By chance, some people will get better for unknown reasons. Some people (a minority) have recovered from diseases that we would not have expected them to recover from. If we go back to the time before anti-biotics and anti-sepsis (1940 for antibiotics, 1870 for antisepsis) it's still true that some people benefitted from treatment that should not have worked.
Medicine was not very scientific prior to the 18th century. Still, some people recovered from the diseases, probably In spite of treatment, rather than because of treatment.
The placebo is an attempt to tell the subconscious brain to stop initiating a certain process. Clearly, influencing the subconscious brain is not easy. For example, if the person in question is convinced their condition will kill them, that message to the subconscious brain is potentially much more powerful than the placebo. In addition, there are probably factors beyond our knowledge.
What does it mean? It should make us aware of the immense power the brain has over the body, and the possibilities that lie open if we would be capable to control the brain on a more conscious level.
Quoting SophistiCat
The fact that the brain has such a large influence on the body lends credibility to the claim that the brain is master over the body. If we take the concepts of subconsciously influencing the brain, but instead make the influence conscious, we may state the mind becomes master over the brain, and thus over the body. And thus we arrive at the famous phrase "Mind over body". I think such ideas are relevant within the philosophy of mind. Don't you?
Are we talking about the same thing here? The placebo effect suggests that the mind has slightly more influence over the body than most of us had credited it with, although this extra influence manifests itself in rather obscure and capricious ways. "The brain is master of the body?" Please...
Everything the body does has it's origin in the brain. This is scientific fact and as far as I know not up for debate. Do spare me the condescending "Please..." at the end of your messages. I'll converse with you, but not if you cannot show a modicum of grace towards people you may not agree with.
Lawyers have a saying: "If you have the law on your side, pound the law. If you have the facts on your side, pound the facts. If you have neither on your side, pound the table."
The facts in question do not support your position, so you resort to pounding the table. You think it's graceful?
Dear writer, our lawsuit hasn't even started and yet you already accuse me of pounding the table. It would behoove you to take a look in the mirror.
You talk about my position and my facts, but I haven't done more than introduce my view on the matter. The only fact that has gotten attention in our brief and so far unpleasant encounter is the fact that the brain controls (and thus is master of) the body. You seem to disagree. We can discuss this.
I am curious what positions you think I have taken and what facts you think I have brought to bear to support these, because I'm trying to understand what has gotten you so riled up. I cannot imagine that a disagreement over the degree to which the brain influences the body (as per your first response) is what invited all this hostility.
What about when it's 80- 90%?
https://www.theguardian.com/science/2017/aug/20/when-surgery-is-just-a-stitch-up-placebo-effect
So we know that faith healing works, to an extent, and it is supposed to be the foundation of medicine that it works better than faith. But the supposition is faith, and disentangling that faith from 'real' medical benefits is only possible if you question that faith.
https://bmjopen.bmj.com/content/5/12/e009655
I'm reading some stuff from the net and I'm seeing ranges of 20-60%, depending on the test, and it's increasingly mystifying.
BTW, I am not a medical man, but does anyone else think that "Everything the body does has it's origin in the brain?" That is news to me.
I know which part of my body most of my actions originate from.
That is what clinical testing is supposed to tease out, no? Which is also how we know about the placebo effect in the first place.
For those who want to think that it's all about the brain, a purely physical phenomenon, consider that the mind might have a distinct effect on brain chemistry from beyond the domain of neuron activity, for example, https://brainworksneurotherapy.com/what-are-brainwaves, which states that, "Gamma is also above the frequency of neuronal firing, so how it is generated remains a mystery. It is speculated that gamma rhythms modulate perception and consciousness, and that a greater presence of gamma relates to expanded consciousness and spiritual emergence." However, it is impossible to think that it relates to the physical brain without a physical mechanism. So, perhaps, it's a matter of 'we'll eventually discover the connection'.
Personally, I like to think that both mind and brain participate in the phenomenon we call a mental state, somehow like how electric and magnetic capacities interact in metals. They are both distinct phenomena which can best be said to co-relate.
The placebo effect may also go beyond our mental states and have a far reaching physical effect, for example, it can boost immunity which can have a drastic impact on harmful microorganisms in our bodies, which I think is quite an improvement from the usual psychosomatic conditions like stress-related migrains.
Of course, I would expect that eliminative materialists would already have a response to something as obvious as that.
The mind's control over the brain is another matter, since many of the brain's functions happen unconsciously. Influencing these processes is a lot harder, because it requires the mind to become conscious of unconscious proceedings within the body. However, it is possible. Think for example of using breathing techniques to slow the heart rate, or meditation to influence thermoregulation.
And this brings us to the placebo. This is an example of the conscious mind influencing the unconscious part of the brain. The conscious action and thought from mind to brain: "I took a pill that will help me." and the unconscious signal from the brain to the body: "We are being helped so calm down/stop whatever you're doing." The reason the placebo-effect is so interesting is because it shows the mind's ability to influence unconscious processes in the body.
This gets us to the question I raised earlier: To what degree can the mind influence the body? Can mind become master over the brain and thus become master over the body? We have seen the mind can control conscious as well as unconscious processes, so can it control all of them? You seem skeptical, but personally I believe the influence of the mind, with practice, can become very significant. We can discuss that, but we should first make sure we understand each other to avoid a repetition of our earlier situation.
https://listverse.com/2013/02/16/10-crazy-facts-about-the-placebo-effect/ Check out number 8 on the list. How does the conscious mind impair itself without administration of actual alcohol?
By the brain releasing particular neurochemicals, I would guess.
quack, quack.
I agree that some kinds of surgery are frequently ineffective. Surgery for lower back pain, for instance, seems to be frequently ineffective at reducing lower-back pain (opinion based on medical journalism). Osteoarthritis (something I have) seems to be pretty variable on a day to day basis. Some days no pain, other days major pain. I have found that certain activities guarantee more pain, some activities seem to reduce pain. Living with a bone spur on a toe is probably a better strategy that surgery, unless the pain is unbearable.
I don't classify chronic neck pain with headache as psychosomatic, but short of cancer, I wouldn't volunteer for surgery or heavy-duty medicine to fix it. My guess is that chronic dissatisfaction with the details of life (chronic tension) is a major factor, not curable by medicine or surgery.
My suspicion is that many people have heightened expectations of what their aging bodies should be like: beautiful, flexible, strong, pain-free. If that is what one has, great. But a lot of bodies--especially aging bodies--are no longer so beautiful, flexible, strong, or pain-free. Many people think there are fixes for all of their legitimate complaints. Some problems are fixable--like cataracts. Definitely worth doing. Back, wrists, fingers, hips, knees, and/or ankles hurt from arthritis? Accommodate it rather than forcing a 70 year old body to perform like a 35 year old one.
I blame patients for some of the over-and-dubious treatment that is performed. A lot of people have unreasonable expectations for both life as we know it and for medicine/surgery.
Could be true.
And, "But the pendulum swings both ways — a fake-drunk subject could conceivably get a fake-hangover, Kirsch says, pointing to the "nocebo effect," where subjects taking a placebo experience negative side effects purely based on pessimistic expectation. In one extreme example, a participant in an anti-depressant trial attempted to commit suicide by overdosing on the pills he had been provided as part of his study." - https://psmag.com/social-justice/placebo-week-getting-drunk-beer-alcohol-expectations-92254 For the full explanation.
How cool is that? (Scientifically cool, not suicide cool.)
I sympathize with your general position, but you have overstated it. The brain controls some things and merely influences others. The immune system is not controlled by the brain, but the efficacy of placebos is suggestive of the brain having a degree of influence.
I recall reading about newer research that shows nerve connectivity between the organs responsible for immune function and the brain. They found more direct connections than previously believed anyway, if I recall correctly.
It's said to have implications for how we deal with stress. For instance, if we interpret a stressor more as a threat then our body (including our immune system) will prepare for injury, but if we interpret it more as a challenge then our body will prepare for performance. Clearly more of the stressors in our modern lives would be better treated as challenges than direct threats of bodily harm.
The human body cannot function without the liver either, but that doesn't mean that every process in the body is controlled and directed by the liver. But never mind, I don't think your point hinges on this position being 100% accurate.
Quoting Tzeentch
OK, so I asked what relevance the phenomenon of the placebo effect might have for the philosophy of mind, and you just presented us with an example where the placebo effect has implications for a theory of mind that you support. To summarize, the theory says that the mind controls or influences bodily processes. But there are actually two minds: conscious and unconscious, and each of them has its own domain of influence. It might seem that there is little if any crossover between the two, but the placebo effect shows that the conscious mind has at least some degree of influence over the unconscious mind. The idea is that the placebo effect occurs when the conscious mind influences the unconscious mind, which in turn influences some processes over which the conscious mind normally does not have a direct influence.
This is a good answer; I agree: within the parameters of your theory, the placebo effect is relevant and potentially significant. I'll just note that the theory of conscious vs. unconscious mind should not be taken as the received view among experts (I don't think there even is one such view), but rather sounds like a folk theory of mind. Also, the interpretation of how the placebo effect works (i.e. the conscious mind works through the unconscious mind) is not obvious even if the main premises of the theory are taken for granted. But, to repeat, if all of these premises are accepted, then your point is valid: the evidence of the placebo effect makes a difference.
Quoting Tzeentch
I am rather more skeptical of the whole conscious/unconscious mind theory, but I don't claim much expertise on this subject.