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 You are now reading PART 1 of The Placebo Effect


Link to PART 2 | What About The Homeopathic Interview? Case Taking Techniques 

 



Please see link to video on HWC where you can comment about your response to this short interview clip.

Alan G. Phillips recently asked me:

Has anyone ever done, or can somebody do, a "study" that compare the success rate of clinical homeopathy with allopathic studies looking at the success rate of actual placebos? If homeopathy can be shown to work at a rate significantly above known placebos, that should dispel the placebo theory pretty quickly.

I think if we start with the definitions we can begin to sort out some answers. It seems that there are leanings in the definition about the effects being positive or negative; about whether the people who feel better are delusional in their sensations or that they are really improved in their medical conditions. There is no connection between mind/body states in the medical definitions. 

So, it may be even more important to define and base reactions and results upon the definition of health, healthy mind, healthy body. 

Perhaps a chart could be constructed with the different definitions. 


MEDICINENET.COM DEFINES PLACEBO EFFECT

Placebo effect: Also called the placebo response. A remarkable phenomenon in which a placebo -- a fake treatment, an inactive substance like sugar, distilled water, or saline solution -- can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. Expectation to plays a potent role in the placebo effect. The more a person believes they are going to benefit from a treatment, the more likely it is that they will experience a benefit.

To separate out this power of positive thinking and some other variables from a drug's true medical benefits, companies seeking governmental approval of a new treatment often use placebo-controlled drug studies. If patients on the new drug fare significantly better than those taking placebo, the study helps support the conclusion that the medicine is effective.

The power of positive thinking is not a new subject. The Talmud, the ancient compendium of rabbinical thought, states that: "Where there is hope, there is life." And hope is positive expectation, by another name. The scientific study of the placebo effect is usually dated to the pioneering paper published in 1955 on "The Powerful Placebo" by the anesthesiologist Henry K. Beecher (1904-1976). Beecher concluded that, across the 26 studies he analyzed, an average of 32% of patients responded to placebo.

It has been shown that placebos have measurable physiological effects. They tend to speed up pulse rate, increase blood pressure, and improve reaction speeds, for example, when participants are told they have taken a stimulant. Placebos have the opposite physiological effects when participants are told they have taken a sleep-producing drug.

The placebo effect is part of the human potential to react positively to a healer. A patient's distress may be relieved by something for which there is no medical basis. A familiar example is Band-Aid put on a child. It can make the child feel better by its soothing effect, though there is no medical reason it should make the child feel better.

People who receive a placebo may also experience negative effects. They are like side effects with a medication and may include, for example, nausea, diarrhea and constipation. A negative placebo effect has been called the nocebo effect.


What Is the Placebo Effect?

By , About.com Guide
Updated February 01, 2010


About.com Health's Disease and Condition content is reviewed by the Medical Review Board


Definition: A placebo, as used in research, is an inactive substance or procedure used as a control in an experiment. The placebo effect is the measurable, observable, or felt improvement in health not attributable to an actual treatment.

When a treatment is based on a known inactive substance like a sugar pill, distilled water, or saline solution rather than having real medical value, a patient may still improve merely because their expectation to do so is so strong. To eliminate the effect of positive thinking on clinical trials, researchers often run double-blind, placebo-controlled studies.

Fast Facts About the Placebo Effect:

  • The word placebo literally means "I will please" in Latin.
  • The first known double-blind placebo-controlled trial was done in 1907.
  • The FDA doesn't require that a drug study include a placebo control group, however, the placebo-controlled trial has long been the standard.
  • The NIH is funding several studies related to the placebo effect.

Sources: Placebo Effect, Robert Todd Carroll, The Skeptic's Dictionary, Skepdic.com, The Mysterious Placebo Effect, by Carol Hart, American Chemical Society, Modern Drug Discovery, July/August 1999: The Healing Power of Placebos, by Tamar Nordenberg, FDA Consumer magazine January-February 2000

Also Known As: placebo, placebo response, power of suggestion
Common Misspellings: plasebo, placeboo, placebo affect

 
The autonomic system controls the respiratory, circulatory, digestive, urogenital systems, and the action of the glands and hormone production and consists of two divisions known as the sympathetic nervous system and the parasympathetic nervous system. 

placebo effect
The beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itselfThe American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

placebo effect
(Medicine) Med a positive therapeutic effect claimed by a patient after receiving a placebo believed by him to be an active drug See control group
Collins English Dictionary – Complete and Unabridged 6th Edition 2003. © William Collins Sons & Co. Ltd 1979, 1986 © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003

placebo effect - any effect that seems to be a consequence of administering a placebo; the change is usually beneficial and is assumed result from the person's faith in the treatment or preconceptions about what the experimental drug was supposed to do; pharmacologists were the first to talk about placebo effects but now the idea has been generalized to many situations having nothing to do with drugs
consequenceeffectresultupshotoutcomeeventissue - a phenomenon that follows and is caused by some previous phenomenon; "the magnetic effect was greater when the rod was lengthwise"; "his decision had depressing consequences for business"; "he acted very wise after the event"


THE FREE DICTIONARY ONLINE


Discussion Continues~> PART 2 | What About The Homeopathic Interview? Case Taking Techniques 

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Replies to This Discussion

The problem is not that they don't see what they cannot see, but they close their eyes to evidence they do not wish to see. A virus has become more impotant to them than a human being, who has lost identity. And this is because they do not understand the human being.
Hello Dr Singh ~ so wonderful to hear from you! This is true. People can put up an inner wall so they do not see what can be painfully clear outside of themselves. It is a protective mechanism for their own belief system, that it does not come crumbling down; or an intention wall or blinders because there are other factors such as greed. When people are being 'paid' to speak for a larger organization, it is very hard to let any other ideas filter in to their thought processes.

By the way, take a look at the second part of this discussion PART 2 where I have added a surprising conclusion by the medical establishment "The Depressing News About Antidepressants: Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse."
the use of placebos is erroneous in our studies..............because we use placebo as a second prescription...........if patient is better ........
now in placebo controlled trials double blind.....the phyisican is blissfully unaware...and if the patient is not improving then he changes the remedy but what is the next remedy the patient gets?? does he get placebo or the remedy.......???
also if the patient is on placebo and not getting better the doctor changes the remedy......(thinking the first prescription he made was the remedy....which might be the correct similimum but he changes it..........) so the chance of cure is really nullified.....
it is but sheer ignorance or stupidity to conduct our trials the way they conduct theirs.....
we should have our own model........
but the condition is such that.. that our education institutes are going from bad to worse.. no research institute.........
i had blogged earlier about grass roots..........
we need successful institutes and not individuals........
Hi, Dr Nikhil,
You see the strong need for homeopathy to have strong and successful institutes. But, alas, the condition of our educational institutes is pitiable. We don't have role models for our budding homeopaths. On the other hand, we have chaotic mushrooming of so many theories and approaches that a youngster is likely to feel lost. And that is very natural.

How can the desired change come about? Do you have a solution in mind? Or, do you see the need of a collaborative constructive thinking? Is this place not good enough to begin the enquiry? Can we find ways that make our work more fulfilling and productive? So that more and more new homeopaths discover and demonstrate the magic of homeopathy? The irrefutable proof of homeopathy being a vital healing modality!

I would also like to understand your concern about placebo.

Usually, you prescribe a placebo when either you are buying time to get some insight into the similimum or patient needs something like medicine to feel being cared for while being on the similimum.

In the first case you will administer the similimum as soon as you happen to discover one. In the other case you will repeat the similimum when there is stagnation or the symptoms start reappearing. If a new symptome picture appears you will reconsider your choice. Isn't so?

So, what is your concern here? Will you please say it afresh?

Manoj
when a new symptom picture appears ...you see the new symptom picture in relation to the first symptom picture ( herrings law of direction of cure)....
.and then decide to either wait and watch or represcribe or change
Manoj
Just a small point here to continue our exploration of certain subtle aspects:
" or patient needs something like medicine to feel being cared for while being on the similimum."

My question ( which of course does not lend itself to an immediate answer ) is where does psychology end and body memory begin? You forgive me if it is poorly stated but I'm sure you get the idea.

This is based on the fact which I have often observed: if there is a particular reaction following a remedy - say sleepiness, then for a while this reaction will be activated by administration of placebo.

I have explained this to myself as an actual memory in the body being reactivated, a sort of repetition of the healing experience. Of course this is just my hypothesis and surely not the whole story
When we tell the patient that the remedy is acting when you sleep after taking a remedy? Is this what you mean? The body has innate wisdom that during times of rest the rest of functions, such as digestion, is slowed down. Most of energy goes to healing. Also, body is maintained at different rate, while spirit returns to source.
No that is not what I mean. What I mean is that after taking the remedy there may be an immediate reaction, sometimes sleepiness, sometimes headache, sometimes dizzyness etc etc. If for some reason or other I feel that placebo dosing is indicated it often happens that the placebo dose will cause the same reaction as the verum, that is sleepiness, headache, dizzyness or whatever.

I did find when I was doing acupuncture many years back that it was quite common for patients to experience great sleepiness some hours after the treatment and that it was essential for them to listen to this and sleep because if they ignored it and pushed through the result was not at all good.

I have not found this same frequency with the remedies. It happens but not that common in my experience
Jonathan. I understood what you said about the remedy primary reaction response. And then to give a placebo, because the first dose is still acting, but patient needs an emotional and physical stimulus to support through this waiting/acting period.

You find that the neutral placebo can stimulate the same type of response as the actual verum remedy. We do not have an explanation for this? Or is it written in the organon?

Perhaps like Pavlov's Response, the body/mind ties the two actions together? If one, then the other. So, if I once drank grape soda and went to school. Got very sick and vomited. Then every time afterwards, I will get nauseous from grape soda. Even though there is nothing wrong with grape soda and it wasn't the cause of the illness. Until the day that I can drink the grape soda and not get a symptom response. This may not be the best example.

The concept is that if taking the remedy and the memory of the remedy which acted due to matching energy selection; then the next time the act of taking this neutral placebo re-stimulated the body/mind since it was already acting in response to the original dose.

My question is how to separate out the placebo effect from the homeopathic effect?

And -- some people may be more sensitive and susceptible to suggestion and placebo effects.
My question is how to separate out the placebo effect from the homeopathic effect?

Right. This is what I mean when I say that things are more complex than they appear.

This touches on the nature of mind - that is the energetic level at which thought operates or to put it another way, the level at which thought resonates

Anyway the short answer is I'm not sure its possible at our current level of sophistication, especially so as a significant factor in the placebo response has to do with the belief system of the prescriber. I will post some research around this later when I have time

Vithoulkas claims he has criteria which will appear in a yet to be published book. These criteria are unavailable to me so I have not been able to evaluate them.

Definitely some people ( just as are some plants, animals etc) are more sensitive to ambient vibrations than others.

However I do not believe this sensitivity makes them more suggestible. This is a major misunderstanding around suggestibility.
for example Milton Erickson ( an outstanding hypnotherapist) maintained that the more skeptical the subject, the easier it was to hypnotize them.
Anyway my view is that this is a whole other topic, quite separate from the placebo effect and as regards homeopathy is only really relevant in the area of verbal interaction between patient and practitioner.
YES And it where the similimum lies..........
@debby
Non-REM sleep may be an anabolic state marked by physiological processes of growth and rejuvenation of the organism's immune, nervous, muscular, and skeletal systems (with some exceptions).

this is normal and physiological ..

hence after the remedy improvement of sleep is essential part of the generals..

"When we tell the patient that the remedy is acting when you sleep after taking a remedy"
homeoopathically speaking it has been found thuja and nux vom act better when given in evening (boericke materia medica)and bed time but you can't generalise with all remedies

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