60 Minutes, Placebos, and an Impossible Study

Explosive! That’s how correspondent Lesley Stahl described it.¹ And a study on the implications it raises for all drug-based therapy would be impossible – or would it?

In her recent 60 Minutes report on Placebos, Stahl interviewed Irving Kirsch, Associate Director of the Placebo Studies Program at Harvard Medical School. The explosive news: that placebos (inactive pills, such as sugar pills) have virtually the same effect as antidepressant drugs for those who are mildly or moderately depressed. This certainly would seem to shatter the conventional view about antidepressant drugs. (She wisely also mentioned that patients taking such drugs should not drop their use cold turkey but consult their doctor).

Even if you didn’t see Stahl’s 02/19/2012 60 Minutes segment, you’ve probably heard of the placebo effect in which an inert pill has a therapeutic benefit because the patient expects it to. And maybe you’ve heard of the negative version of this – the nocebo effect, in which a patient experiences an expected harmful effect.

In both of these situations, the patient’s thought arms the inert pill with an effect, good or bad, indicating a mental component in the medicinal process. In Stahl’s report, she pressed Kirsh, “But people are getting better taking antidepressants. I know them. We all know them.” Kirsch responded, “People get better when they take the drug, but it’s not the chemical ingredients of the drugs that are making them better. It’s largely the placebo effect.”

This begs the question of what this might imply about drug-based therapy in general. Is a drug’s effectiveness the result of thought rather than chemistry?

If it is, here’s how this might work. A pharmaceutical company produces a drug and as a result of a clinical study decides that it has a therapeutic effect, adding a layer of placebo effect to the drug. The Federal Drug Administration approves the drug, adding another layer. Physicians then accept this determination and prescribe the drug, adding another layer of the placebo effect. The public is educated about the drug through the media and by physicians and they add another layer.

The chemist, the botanist, the druggist, the doctor, and the nurse equip the medicine with their faith, and the beliefs which are in the majority rule” is how Mary Baker Eddy, a pioneer in mental, spiritual healing back in the 1800’s, describes this in Science and Health with Key to the Scriptures (pg 155).

Now, if I wanted to do a clinical study to test this hypothesis, I would want to have each of these participants who create and use a drug to do so without adding a belief or expectation in a therapeutic benefit – without adding a layer of the placebo effect.

Of course, such a study would be impossible, wouldn’t it? A drug company is not going to invest the time and expense to develop and produce a drug they believe to have no chemical therapeutic benefit. The FDA would not approve such a drug, physicians would not prescribe it, and so on. You just couldn’t remove all layers of the placebo effect and then have our health care system utilize such a drug (not to mention the ethical issues involved).

But what if a study could be conducted that would address just one layer of the placebo effect? Hypothetically, if you could take a drug (an actual drug, not a placebo) and have physicians NOT add their layer of the placebo effect to the drug, what result would we expect to see? Wouldn’t we expect to see a decrease in the therapeutic effectiveness of the drug? And wouldn’t this decrease be a measure of the placebo effect layer added by physicians?

Consider this. In his book entitled, “Timeless Healing – The Power and Biology of Belief” (see page 30), Herbert Benson, M.D., a graduate of Harvard Medical School, shares what he learned from a 1979 study he and Dr. David P. McCallie Jr. made of therapies used to alleviate a condition called “angina pectoris” (chest pain). He explains that techniques used in years past that have since proved to be “misguided” nonetheless often worked even though there was “no physiologic reason” they should have.

He relates that when these therapies “were used and believed in, they were effective 70 to 90 percent of the time…” “Later, when physicians began to doubt whether these treatments worked, their effectiveness dropped to 30 to 40 percent.”

In this situation, the therapy lost over half of its effectiveness. Same therapy! What changed? Was this a result of the physicians’ layer of the placebo effect being removed as a more accurate assessment of the therapy surfaced over time? Was the higher rate of effectiveness early on the result of the physician’s layer of the placebo effect being included?

This all points to thought and the mental nature of the healing process. Stahl said her story involves “how the mind is so powerful over the body“¹. If this be the case, then how powerful would thought – influenced for the better by a single, all-good, infinite mind – an all-powerful, all-loving divine Mind – be to do the body good?

¹ http://www.cbsnews.com/8301-505269_162-57380096/inside-60-minutes-placebo-story/
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3 thoughts on “60 Minutes, Placebos, and an Impossible Study”

  1. Both the placebo and nocebo are names given to outcomes doctors don’t understand. They don’t know what caused them so they invent the “mind / body connection to explain it. You may be aware that no one knows what causes the “disorders” of the DSM, Diagnostic and Statistical Manual of Mental Illness of the American Psychiatric Association. They have been building that book since the late 1940’s but don’t know what causes any of it.

    There is a simple problem of human physiology discovered when it caused mental breaks for office workers in 1964. Engineers and designers solved that problem with the office cubicle by 1968. When it happened to my wife she heard voices and had depressive crying episodes about impossible situations she hallucinated. (See my Personal Experiences page.) I was stunned to learn something I had known most of my life is essentially unknown in mental health services.

    In nine years I found only one doctor who said he had seen the believed temporary psychotic-like episodes while in residency.

    If you have been following the news about LeRoy High School students who suddenly developed tics and Tourette’s behaviors, one of the students said her tics started when she saw another student with them in a store. That’s a startle matching behavior discovered as Jumping Frenchmen of Maine in 1880. It demonstrates hyper-suggestibility in Subliminal Distraction exposure cases. The Frenchmen wre lumber jacks confined in bunkhouses in cold Maine weather. Any concentating activity they engaged, sharpening tools for instance, would have detectable movement in peripheral from the other men in the crowded bunkhouse. (See Culture Bound Syndromes on my site.)

    Those who react to placebos are most likely chronic Subliminal Distraction exposure victims. They get better because of the suggestibility they have from SD exposure. With Nocebo the subject’s Subliminal Distraction exposure increases so their psychosomatic symptoms increase. The pill had nothing to do with the increase in symptoms.

    Subliminal Distraction happens when you create the situation so that your brain has a massive number of subliminal failed attempts to execute the vision startle reflex, defined as a subliminal distraction. This is explained in first semester psychology under subliminal sight and peripheral vision reflexes. Because you brain deals with the vision startle reflex subliminally SD exposure cannot be consciously experienced. That repeating subliminal appreciation of threat will begin to shape thought and reason.

    An incident in Ontario, Canada elementary schools last year shows the wide range of psychosomatic symptoms low levels of Subliminal Distraction exposure is capable of. Students had racing hearts, nausea, memory loss, headaches, dizziness, and trouble sleeping. Industrial Wi-Fi had been installed so laptop computers could be used anywhere in classrooms. Concentrating to read and understand the laptop view screen engages enough concentration for Subliminal Distraction exposure if there is detectable movement in peripheral vision. Pictures of that situation are linked at the top of my Home page.

    Visit my site then read the ‘Letters’ page for the unrealized history of the problem.

    Isn’t it more reasonable for there to be a simple explanation in human physiology rather than a mysterious unexplainable mind-body connection?

  2. There is no “objective testable evidence” that psychotropic drugs do anything. The testing method is to have two groups take the drug. After testing a code is opened to show which subjects were taking the active drug and which were taking the placebo.

    That is supposed to prevent examiners fudging the outcomes and is called a double blind test. Neither the test subjects nor the examiners can know which person got which pill during the period of the test. Sometimes active placebo’s are used that have an additive to cause similar harmless side effects to the test drug so subjects cannot determine by side effects which pill they take.

    But there is a flaw. The testing assumes only the drug and placebo are at work If there are one or more chronic Subliminal Distraction victims in either group their symptoms will remit or relapse in concert with changes in their SD exposure independent of the test pill.

    Either the drug or placebo will be credited or blamed with that change in symptoms.

  3. To LK Tucker: Thank you for your in-depth comments. Clearly there is room for further study and learning for all of us. I think, too, that it is important to remember and appreciate the great efforts made by so many to help those who are dealing with very difficult situations. –Bob

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