Posts Tagged ‘placebos’

Conclusions for Suggestible You

March 29, 2017

There have been a dozen posts on Erik Vance’s “Suggestible You:  The Curious Science of your Brain’s Ability to Deceive, Transform, and Heal” because there is so much interesting material that is relevant to a healthy memory.  Nevertheless, these posts just scratch the surface.  Readers are encouraged to read the original book.

The power of our minds is enormous.  Our brains are an extremely valuable gift.  We need to use them to best advantage and to help them grow.  It is hoped that these dozen or so “Suggestible You” posts have accomplished  that.

Not much has been written about meditation, not because meditation was not covered in the book.  It was covered, but HM thought that the importance of meditation had been covered fairly well in other healthy memory blog posts.  And there will be many more posts on mindfulness and meditation in the future.

Suggestibility can have an enormous effect on many medical conditions, but not all of them.  Although Parkinson’s responds well to placebos, Alzheimer’s does not.  This makes sense, because suggestibility  involves the brain and Alzheimer’s destroys the brain.  The healthy memory blog has many posts on how to build a cognitive reserve.  There are many people who died with the defining amyloid plaques and neurofibrillary tangles of Alzheimer’s, have never shown any of the cognitive or behavioral symptoms.  It is said that a cognitive reserve precluded the cognitive and behavioral symptoms.

Anxiety responds to placebos, as does depression.  The pharmaceutical companies are spending a fortune trying to beat placebo effects.   But obsessive-compulsive disorders traditionally do not respond well to placebos.  Although the pain and nausea of cancer can be eased with placebos, tumors cannot.  Vance writes that the spontaneous regression—the sudden retreat of a tumor for no obvious reason is more common than you might think, but is not a product of suggestion (at least not that we know of).

And don’t forget to be suggestible to yourself.  When sad, remember that you can cheer yourself up, and that it is your mind and the chemicals in your body that affect your mood.  And you do have an ability to control your emotions due to your own suggestibility.  Meditation and mindfulness can also help here.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

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Rules from Suggestible You

March 28, 2017

The author Erik Vance closes with several rules that HM feels obliged to pass along to you.

Rule #1:  Don’t endanger yourself.   Some alternative health remedies are physically dangerous.  For example, Mercury is a poison, incorrect chiropractic treatment can seriously damage your spine, and a careless hypnotist can implant terrifying memories that a may not be yours.  HM adds that you need to be aware not only of hypnotists, but also of misguided psychotherapists who can also implant false memories.

Rule #2:  Don’t Go Broke.  Be suspicious of expensive placebos.   Although more expensive placebos might work somewhat better than cheaper ones, there is a limit.  People have gone broke on treatments and approaches that do not work.  HM adds that they key component of all of these treatments is your mind, and you mind costs nothing aside from the time and cognitive effort.

Rule #3:  Don’t send any creature to extinction.  HM would be surprised if this warning was relevant to any HM readers.  But avoid any treatments that endanger animals.

Rule #4:  Know yourself.  Stay within your limits and use your common sense.

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Suggestible You 11

March 27, 2017

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive, Transform and Heal.  This is the eleventh post on this book. This post deals with depression.

Vance describes depression as like being chemically sedated into someone you don’t recognize.  He writes that given the choice, he might prefer excruciating chronic pain to depression, then goes on to note many people suffer from both.  He notes that about 7%  of Americans will experience clinical depression this year, losing the United States more than $200 billion.

It is clear that placebos are effective against depression.  Remember that to be declared effective the drug is compared against a placebo.  But when antidepressant drug tests are examined about 75% to 80% of their efficacy can be attributed to placebo effects.  Moreover, there was no real difference between high and low doses, which is odd.  Differences are expected with truly effective drugs.

Moreover, over the past few decals, scientists have noticed a distinct uptick in the power of the placebo effect on pain and depression trials.  Some experts even say that if Prozac had to compete against the placebo effect today, it would not have been cleared by the FDA.  Once a drug clears the Phase III, placebo-controlled trial, it is certified regardless of how it performs in later experiments.

For drug manufacturers trying to get new drugs approved, this is a problem.  But it should not be a problem for depression sufferers.  Remember the reason of including placebos in these tests is that placebo effects are real.  Placebos are much less expensive than the drugs, and carry no side effects.  HM wonders, as long as they are 75% to 80% effective, why take the drug.  Physicians should also be asking the same question.  Now it is clear why drug companies continue to try to develop new anti-depressants.  But after some many decades of research, with all the antidepressants already approved, and with placebos being largely effective without any adverse effect why bother.? At some point the difficulty in exceeding the effect of the placebo might prove so expensive that drug companies might abandon the effort.

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Suggestible You 10

March 26, 2017

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal.     This is the tenth post on this book.  This post describe the role of  placebos in addiction.

Approximately 1 in 10 Americans is addicted to some kind of drug—mostly alcohol, although opioid addiction is gaining quickly.  Traditionally addiction has been viewed as a moral failing or a lack of willpower.  Today we understand addiction is mostly physiological, specifically around dopamine.  This is not surprising since this neurotransmitter deals with the anticipation and enjoyment of rewards.  Vance note that this includes sugar, sex, money, a high score on Grand Theft, as well as drugs.

Unfortunately, drug use doesn’t just change the way you feel for a couple of hours: it can also change the brain itself.  When the nervous system is presented with an abundance of pleasurable chemical stimulation through drug use, the nervous system gets overwhelmed and shuts down its production of dopamine to bring itself back into equilibrium.  This creates a bad feedback loop in which the person finds himself short on dopamine whenever he’s not using the drug.   Food no longer tastes as good, and sex can lose its thrill.  Taking the drug that caused this problem is the only way to get back to something close to normal.

Addiction literally changes the way the brain works.  Not only do addicts have less dopamine from drug overuse, but also their  dopamine receptors are affected (either changing their numbers or changing how well they transmit messages).  Regular drug uses twists memories so both the drug and the circumstances surrounding the drug use.  Addiction causes the brain’s impulse control centers to shut down, which greatly increases the chances of relapse.  If cocaine addicts are shown an image of blow for as little as 33 milliseconds, which is too fast to register in consciousness, they will have immediate cravings.

Vance sees addiction as sort of a perversion of all the brain circuits and processes  in his book.  Consequently he thinks that suggestion and expectation may hold the answers to overcoming it.  Naloxone, the drug that first helped expose the chemical nature of placebos and blocks placebo responses altogether, wasn’t invented for placebo research.  It serves a crucial role in medicine as an emergency treatment for drug overdoses.  It’s also pretty effective at blocking the effects of heroin or oxycodone.
A closely related drug, naltrexone, is one of the most effective treatments for alcohol abuse.

People get tipsy when a nonalcoholic beer is substituted for an alcoholic beer.  This also works the other way.  A study at Minot State University doctored root beer to give it the same alcohol level as regular beer.The researchers offered the doctored drink to a group of unsuspecting volunteers, while another group received regular beer.  Not surprisingly, both groups got tipsy after a few drinks. What is interesting is that those who drank beer actually absorbed more alcohol into their blood than those who thought they were drinking soda but were in fact consuming just as much alcohol.

It is clear that work on treatment is still a work in progress, but progress is being made.

Some two million Americans are addicted to prescription opioid drugs and about 19,000 died from overdoses in 2014.  This is about twice the number who died from heroin overdoses, and three times the number who died from cocaine.  One theory of pain is that after an injury, the pain never leaves, it just gets gradually covered up by the body’s internal medicine.  A team led by Bradley Taylor gave naloxone to patients who had recovered from an injury and for many of them the pain came right back as if pain had been hiding under the surface for this whole time.  These patients displayed some of the hallmarks of opioid withdrawal.  During the process of recovering from pain, we actually become dependent on our own opioids.   Taylor thinks that this may be the key to understanding not only addiction, but also the switch from short-term to chronic pain.

Given this understanding, NIH researcher Luana Colloca, whom we have encountered previously, is studying the role placebos my play.  She mixed a few placebo pills into a group of pain patients’ medication.  Each week they have five or six pain pills and one or two placebos.  As the week progressed, she upped the placebos and topped the opioids until the artificial was administered only about half the time.  The results of the project are not reported, but the idea is clear.  The patient is trained to expect pain relief when taking a pill.  Gradually she takes the pill away and lets the patient’s own expectation cover the pain relief.  The patient uses her expectations to switch from an external drug to an internal one.

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal.     This is the tenth post on this book.  This post describe the role of  placebos in addiction.

Approximately 1 in 10 Americans is addicted to some kind of drug—mostly alcohol, although opioid addiction is gaining quickly.  Traditionally addiction has been viewed as a moral failing or a lack of willpower.  Today we understand addiction is mostly physiological, specifically around dopamine.  This is not surprising since this neurotransmitter deals with the anticipation and enjoyment of rewards.  Vance note that this includes sugar, sex, money, a high score on Grand Theft, as well as drugs.

Unfortunately, drug use doesn’t just change the way you feel for a couple of hours: it can also change the brain itself.  When the nervous system is presented with an abundance of pleasurable chemical stimulation through drug use, the nervous system gets overwhelmed and shuts down its production of dopamine to bring itself back into equilibrium.  This creates a bad feedback loop in which the person finds himself short on dopamine whenever he’s not using the drug.   Food no longer tastes as good, and sex can lose its thrill.  Taking the drug that caused this problem is the only way to get back to something close to normal.

Addiction literally changes the way the brain works.  Not only do addicts have less dopamine from drug overuse, but also their  dopamine receptors are affected (either changing their numbers or changing how well they transmit messages).  Regular drug uses twists memories so both the drug and the circumstances surrounding the drug use.  Addiction causes the brain’s impulse control centers to shut down, which greatly increases the chances of relapse.  If cocaine addicts are shown an image of blow for as little as 33 milliseconds, which is too fast to register in consciousness, they will have immediate cravings.

Vance sees addiction as sort of a perversion of all the brain circuits and processes  in his book.  Consequently he thinks that suggestion and expectation may hold the answers to overcoming it.  Naloxone, the drug that first helped expose the chemical nature of placebos and blocks placebo responses altogether, wasn’t invented for placebo research.  It serves a crucial role in medicine as an emergency treatment for drug overdoses.  It’s also pretty effective at blocking the effects of heroin or oxycodone.
A closely related drug, naltrexone, is one of the most effective treatments for alcohol abuse.

People get tipsy when a nonalcoholic beer is substituted for an alcoholic beer.  This also works the other way.  A study at Minot State University doctored root beer to give it the same alcohol level as regular beer.The researchers offered the doctored drink to a group of unsuspecting volunteers, while another group received regular beer.  Not surprisingly, both groups got tipsy after a few drinks. What is interesting is that those who drank beer actually absorbed more alcohol into their blood than those who thought they were drinking soda but were in fact consuming just as much alcohol.

It is clear that work on treatment is still a work in progress, but progress is being made.

Some two million Americans are addicted to prescription opioid drugs and about 19,000 died from overdoses in 2014.  This is about twice the number who died from heroin overdoses, and three times the number who died from cocaine.  One theory of pain is that after an injury, the pain never leaves, it just gets gradually covered up by the body’s internal medicine.  A team led by Bradley Taylor gave naloxone to patients who had recovered from an injury and for many of them the pain came right back as if pain had been hiding under the surface for this whole time.  These patients displayed some of the hallmarks of opioid withdrawal.  During the process of recovering from pain, we actually become dependent on our own opioids.   Taylor thinks that this may be the key to understanding not only addiction, but also the switch from short-term to chronic pain.

Given this understanding, NIH researcher Luana Colloca, whom we have encountered previously, is studying the role placebos my play.  She mixed a few placebo pills into a group of pain patients’ medication.  Each week they have five or six pain pills and one or two placebos.  As the week progressed, she upped the placebos and topped the opioids until the artificial was administered only about half the time.  The results of the project are not reported, but the idea is clear.  The patient is trained to expect pain relief when taking a pill.  Gradually she takes the pill away and lets the patient’s own expectation cover the pain relief.  The patient uses her expectations to switch from an external drug to an internal one.

Suggestible You 9

March 25, 2017

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive”, Transform, and Heal.  This post is about the placebo response and related phenomena.   This is the ninth post on this book.

This post is on what might be called “marketing placebos.”  You can market yourself to yourself through what you think about yourself and via self talk.  “I  have a chance, I think I should apply for the job, position, …”  “versus “I have no chance for the job, position, …, so I’m not going to apply.”  A much larger example might be, “life is not worth living” versus, “Such an opportunity life presents, think of all the things I can learn, all the things I can do, the nice friends I can have.”  In fact, just forcing ourselves to smile can make us feel better.

Marketing placebos are like pain placebos in that they require healthy input from the reasoning prefrontal parts of the brain.  Most companies achieve this in one of two ways.  One way is by creating, cultivating, and enhancing a particular brand.  The other is via the price tag.  If a company tells you it has a new line of brain-enhancing drinks, and you believe it, you’ll likely find that, your cognitive performance actually improves after drinking it.  And if they tell you it’s an especially expensive brand, your performance will likely go up even more.  This same principle applies to branding.  Vance notes that studies suggest that athletes perform better when they drink favored water out of a Gatorade bottle.  And students’ test scores rise when they use a pen labeled “MIT.”

The researchers who did these studies correlated the subjects’ level of suggestibility to how they thought about the nature of intelligence and learning.  Those who thought of intelligence as more or less fixed were more suggestible to brands than those who saw intelligence as fluid.  So readers of the healthy memory blog should not be as suggestible to brands  as people who do not read this blog.  This is because growth mindsets are repeatedly advocated in this blog.  If this point is not obvious, enter “growth mindsets” or “Carol Dweck” into the healthy memory blog search block.

Fad diets can be regarded as an example of marketing placebos.  Key to the success of these diets, is a good story that makes the diet compelling.  The placebo effect likely plays a large part in the initial success of the diet.  And in the long term, few of them work.  Lost weight usually finds a way to return.

Vance argues that this same expectation applies to most of the “toxins” we read about.   He writes, “Evil free radicals and toxins are just stories.  We buy them or we don’t.”  And remember the role that social inputs play in amplifying placebo effects.

These effects extend to athletics.runners who thought they were getting blood doping shaved 1.2% of their times.  Another study demonstrated that weight lifters improved their performance by 12% to 16% when they were taken caffeine (a known, albeit legal performance enhancer), but were actually only taking placebos.

Suggestible You 8

March 24, 2017

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal.  This post is about the placebo response and related phenomena.   This is the eighth post on this book.

“Satan Worshippers, Aliens, and Other Memories of Things That Never Happened” is the title of Chapter 6.  It begins with the following quote from Josh Billings, “There are lots of people who mistake their imagination for their memory.”  This post will explain why this is so, and that a misunderstanding of memory and how memory works led to much misery between and among families and to the false imprisonment of innocent people.

As healthy memory blog readers should know, we do not have direct contact or knowledge with the physical world.  See the healthy memory blog posts “Understanding Beliefs,” “Revising Beliefs,” and “More on Revising Beliefs.”  We construct mental models based on the data coming from our senses.  As we experience more and learn more we develop new models, revise old models, and form connections among related or associated models.

Too many people think that our eyes and ears act like video cameras and tape recorders, that we see and hear what is and that these recordings are permanent and accurate.  Consequently, in the courts a great deal of belief is put on eyewitness testimony, when data indicate that eyewitness testimony is flawed and prone to error.

In reality, our eyes and ears are taking light and sound and turning them into electrical signals in the brain.  The brain then constructs a version of what is being perceived and what makes sense.  Expectations from prior models play an important role in this process.  Our brains have to make assumptions and take shortcuts and sometimes makes mistakes.  Optical illusions, blind spots, and hallucinations are all examples of how our brains misinterpret what is being perceived—sometime to very confusing and dangerous ends.

Similarly, memories are not like flash drives.  Memory is an integrated constructive process that is constantly refining itself, rebuilding, restructuring, and finding shortcuts.  And sometimes, our memories play tricks on us,  Memory processes can be divided into three stages.  First the information has to be encoded.  Then there is the process of consolidation during storage.  The third phase is retrieval, which is the recall of the memory.  Changes occur throughout this process and some changes can be erroneous.

The failure to understand how memory works and its malleability that can lead produce errors resulted in teachers and caretakers being falsely accused of sexually abusing children, and of Satanic rituals.  As near as can be understood, the people who conducted these investigations honestly believed that these children were being sexually abused.  But their beliefs poisoned their investigations.  They asked leading questions and repeatedly questioned these children to the point of exhaustion.  Unfortunately, the courts and juries, who were equally ignorant of how memory works, sent innocent people to jail.  This problem continued for much longer than it should have, and it took way too many years for these erroneous convictions to be overturned.

There were also too many cases of clinical psychologists and psychiatrists, many with Freudian conceptions of sex and repressed memories, inadvertently place memories of sexual abuse in the patients’ and clients’ minds.  Innocent parents were accused by their own children of sexual abuse.  These nightmares outdid the fiction of  Franz Kafka.   Imagine the pain that this caused within families. HM thinks that most of theses errors have been corrected, but he still fears that there are still therapists who should be avoided.  Be vary careful when choosing a therapist, and keep a watchful eye out doing the therapy.

Elizabeth Loftus is the leading psychologist who conducted research in this area, and who spent countless frustrating hours testifying in court.

Enter “false memory” into the healthy memory search block to find more posts on this topic.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Suggestible You 7

March 23, 2017

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal.  This post is about the placebo response and related phenomena.   This is the seventh post on this book.

This post is about hypnosis.  During the late 50s and early 60s researchers at Stanford and Harvard came up with 12-step scales to quantify how suggestible to hypnosis someone is.  Their research led these researchers to conclude that hypnotic susceptibility is a fixed trait.  Susceptibility to hypnosis doesn’t change much  from late adolescence until death.  The most spectacular  forms of hypnosis  work only on the most hypnotizable 10% or so of the population.  Another 10% do not respond to hypnosis at all, and 80% fall somewhere in between.

A Canadian psychologist Pierre Rainville successfully hypnotized one group not to feel any pain from hot water poured on their hands and another group to believe that they could feel pain but that it would not bother them.  Their brains were scanned with positron emission tomography (PET) and found two very different neural reactions to pain.  This suggested that the sensation of pain and the emotions associated with it have separate triggers as well a how crucial emotion is to our experience of pain.  There is also neurological evidence that there are two different pathways for pain.  One dealing with the response to the pain itself, and the second to the interpretation of the pain.  It is this latter response that characterized chronic pain.  See the previous healthy memory blog posts “Pain and the Second Dart,”  “To Treat Chronic Pain, Look to the Brain Not Body,” and “Controlling Pain in Our Minds.”

Rainville’s work indicates that hypnosis often involves parts of the brain associated with attention, emotion regulation, and pain.  People seem  to be wired differently for hypnosis, and that this doesn’t change much over the course of our lives.  Research has also shown that the capacity to be hypnotized is not tied to intelligence or willpower.

Some tend to think of hypnosis as being another placebo.  The consensus  is that they are not related.  Hypnotic susceptibility remains relatively stable throughout one’s life, whereas placebo responsiveness can change from day to day.  And the drug naloxone, which is effective at blocking placebo responses doesn’t block hypnosis.  So although they are not the same, they both tap into a deep force in the brain:  expectation.

Psychologist Marcel Kinsbourne says, “There is a wave of bottom-up information coming up from the external world, up into your brain.  There is a wave of information coming from the cortex that consists of your evaluations, your beliefs, your expectations.  Consciousness is these two waves hitting each other.  It’s a collision.  And this is where hypnosis and placebos do their work.”

Suggestible You 2

March 18, 2017

“Suggestible You” is the title of a book by Erik Vance.  The subtitle is “The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal.  This book is about the placebo response and related phenomena.   This is the second post on this book.

Vance participated in an experiment in Luana Colloca’s laboratory on the campus of the National Institutes of Health.  Dr. Colloca attached a variety of devices to Vance including two on his left hand.  One device delivered the shock, the other, on his middle finger.  She said that this device will tap into the A-B fibers in his hand that will occasionally interrupt the shocks, nearly cutting the pain altogether.  As he explained it, the difference between the weak shock and the powerful shock would be that one has a crossing guard and the other does not.  He was told that he would know which one was coming via a screen that will turn green when the A-B fibers are blocking the pain and red when they are not.

Vance said that the small shock feels like a pinprick or a pinch, but the bigger shock doesn’t feel like a bigger pinprick. He said that it’s more like a dull squeeze wrapped in fire, localized in his hand but seemingly all over his body as well.  Colloca slowly increased the strength of the shock, working Vance up a scale of 1 to 10 (10 being the worst tolerable pain), testing his pain threshold.  He agreed to a shock level of 6, although he said that this was very uncomfortable.  He went through two rounds of 12 shocks each.

On the third round he noticed that the green (weak) shock) had gotten slightly worse—maybe from a 1 to a 2.   He thinks there might be a problem with the shock blocker.  They ran through 11 more trials and the torture session was over.  When Colloca returned she told him his pain threshold was smack in the middle of the bell curve for pain, which is 100 hertz of electricity.  She remarked that pain thresholds vary tremendously among individuals.

Then Colloca pointed to a sheet of paper showing Vance’s third round and dropped a surprise telling him, “In Block 3 we used green and red both at 100 hertz.  You felt the green as less painful, compared to the red, when actually you received the same, and that is the placebo effect.”  There never was any magic pain-lessening wire.

The question regarding why the placebo effect works was addressed by a team in Scotland in 1975.  We do have a form of homemade opioids called endorphins.  These endorphins play a number of tiles in our brain, such as regulating circadian rhythms,  appetite and body temperature.  They are the primary chemicals that make sex feel so good.  Two neurologists, Jon Levine and Howard Fields conducted a simple experiment with people in pain after dental surgery.

The plan was to give a group of patients who had recently had a dental procedure either a placebo or naloxone.  Naloxone blocks the endorphins.  They told all of the patients that they were receiving a painkiller.  As expected, many of those  who got the placebo felt less pain, whereas the naloxone group felt miserable, as their own natural opioid (endorphin) generator was being blocked.  When naloxone was given to the genuine placebo group, they also felt miserable.  So this study does show that pain placebos work because the brain self-medicates with the opioid like drug endorphins.

Some Additional Notes on Cure

February 29, 2016

That is the outstanding book by Jo Marchant, “Cure:  A Journey Into the Science of Mind Over Body.”  There is much in this book that I am not covering.  Meditation and the relaxation response have received extensive coverage in previous posts.  Irritable bowel syndrome (IBS) has received perhaps more attention in previous posts than is deserved.  The importance of he Vagus nerve and Vagal Tone was discussed in the healthy memory blog post “The Importance of the Vagus Nerve in Relieving Stress.”

Marchant devotes a chapter to Rethinking Pain.  Another chapter on the importance of talking and caring.  A chapter on thoughts that kill.  A chapter on the importance of friends. And a chapter on the role of religious beliefs.

In her concluding chapter, she writes how she was hoping to end the book.  She was hoping to write that a new paradigm had been opened in medicine and that the mind would have a significant role in health and healing.  She concluded, however, that such a conclusion was not justified.  One problem still to be overcome is that too many physicians are held captive by their Cartesian mindsets.  By that I mean that the body and the mind are separate entities that do not interact.  Marchant’s book provides ample proof that such is not the case.  Over time as physicians die, retire, and increasing information keeps coming in regarding the importance of the mind in health and healing.

However, a more serious problem is economic.  The money is in drugs.  The drug companies benefit financially, and physicians are offered treatments that are quick involving minimal personal time.   I am continually amazed when I hear or see advertisements for most drugs.  Fortunately, the law requires drug companies to list possible side effects.  My amazement comes from thinking that people would still take these drugs given the possible side effects.  In the end the result in the United States is that we are an overmedicated society with health statistics approximating those of a third world country.

My guess is that the possible revolution will turn into an evolution.  In the meantime, seek out physicians who take the mind into account in their treatments.  And if there is no treatment, ask for a placebo or purchase one on your own.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Pavlov’s Power

February 26, 2016

Pavlov’s Power is the third chapter in Jo Marchant’s “Cure:  A Journey Into the Science of Mind Over Body.”  Remember Pavlov the Russian physiologist who discovered classical conditioning?  Pavlov is the one who discovered that by pairing a stimulus, a bell for example, with the presentation of food caused the dog to salivate when the stimulus alone, called the conditioned stimulus, was presented.  Classical conditioning is one of the fundamental paradigms in psychology.  The question is, does this procedure have any practical uses.  The subtitle of this chapter, How to Train Your Immune System, provides the answer.

Attention deficit hyperactivity disorder (ADHD) describe children who are inattentive, hyperactive, and impulsive.  They are constantly  talking and fidgeting.  unable to wait for their turn, and are unable to focus in school.  Medication helps them to control their symptoms, but still causes problems from irritable outbursts when the drug wears off  to weight loss and stunted growth.  A researcher name Sandler wondered whether a placebo might help these children to manage their symptoms on a lower dose of the drug.  He hoped that the honest delivery of placebos as part of a regime that would harness the power of both expectation and conditioning.   He employed seventy ADHD patients aged six to twelve in a two month trial.  These children were split randomly into three groups.  One group underwent a conditioning regime in which they received their normal medication, but also swallowed a distinctive green and white capsule along with their drug.  For the second month they received half their usual drug along with the placebo capsule.  There were two control groups, neither of which received any conditioning.  One group received their full dose of medication for the first month and a half dose for the second month.  The second control group received the full dose of medication for two months.

Sandler published his results in 2010.  The symptoms of the half-dose control group got significantly worse in the second month of the trial.  However, the conditioned group remained stable, doing just as well as the full dose patients.  There were even hints that the children in this group did even better, suffering fewer side effects than those on the full dose of the drug.

Bob Ader, a psychologist at the University of Rochester was doing research on taste aversion.  He gave a group of rats several doses of water sweetened with saccharin.  Normallt this would be a treat but he paired the water with injections that made the animals feel sick.  Later when the rats are given sweetened water on its own, they associated the sugary case with feeling ill (classical conditioning) and refused to drink it.  Adler then forced-fed them using an eyedropper to see how long it would take to learn to forget the negative association.  Rather than forgetting the negative association they died, one by one.

The drug that was used to make the rats feel sick was cytoxan.  In addition to causing the feeling of sickness, it also suppresses the immune system.  So conditioning reaches far behind normal responses, it can also affect the immune system.  This is a rather dramatic conclusion to draw, and it was not accepted at first.  David Felten, a neuroscientist working at the University of Indiana used a powerful microscope to look at the body tissues from dissected mice.  When Felten followed the different branches of the autonomic nervous he found nerves running right into the hear of immune organs such as the spleen and thymus.

Many scientists found Felten’s results difficult to accept.  However, one who did not was Dr. Jonas Salk, the creator of the Salk vaccine.  Salk wrote, “This research area could turn out to be one of the truly great areas of biology in medicine.  You’ll meet some opposition.  Continue to swim upstream.”

Felten did and stated a collaboration with Ader and his colleague Cohen and moved them to the University of Rochester.  These three are now broadly credited with founding a field of research known as psychoneuroimmunology.  This group went on of discover a complex web of connections.  They found receptors for neurotransmitters—messenger molecules produced by the brain— on the surface of immune cells, as well as new neurotransmitters that could talk to those cells.  The lines of communications went in both directions.  Psychological factors can trigger the release of neurotransmitters that influence immune responses, while chemicals released by the immune system can influence the brain.  For example drowsiness, fever and depressive symptomjtr that confine us to bed when we are well.

So Pavlovian conditioning can go way beyond making dogs drool!

Cure: A Journey Into the Science of Mind Over Body

February 23, 2016

The title of this blog post is identical to the title of an outstanding book by Jo Marchant.  The phrase, “it’s just a placebo effect,” has been one of my pet peeves for a long time as I find the placebo effect to be one of the most important facts of medicine.  Any medical trial needs to be run against a placebo treatment as the placebo treatment will result in a measurable effect, and the desire is to measure the effect of the treatment above and beyond the placebo effect.  However, what I find ironic is that this genuine effect is not routinely administered.  Absent some treatment, why not give the patient a placebo as there will be a benefit for at least some of the patients?  The reason that the physician would provide is that the placebo effect is not a real treatment so it would be dishonest to deceive the patient even though the patient might benefit from the deception.  Research has shown that patients still benefit from placebos even when they know that they are indeed placebos.  I find it ironic that physicians routinely treat viruses with antibiotics even though they know that the antibiotic is ineffective against viruses.  This practice has weakened the effectiveness of antibiotics,  Why not administer a placebo shot instead?  Any effect the antibiotic might have would be a placebo effect, so why not simply administer an injection of a placebo?

The truth is that too many physicians are infected with the bias that medicine is physical and that placebos are mental.  They refuse to appreciate the effect that the mind has over the body.  Marchant’s book goes a long way to documenting these effects.  The failure to correct this bias will result in unnecessary deaths, pain, and suffering.

At the outset, Marchant makes two important points about  the limitations of the placebo effect.  The first is that any effects caused by beliefs in a treatment are limited to the natural tools that the body has available  Note, however, that the body might not use some of the natural tools absent a placebo effect.

The second point is that effects mediated by expectations tend to be limited to symptoms—things that we are consciously aware of,such as pain, itching, rashes or diarrhea, as well as cognitive function, sleep and the effects of drugs such as caffeine and alcohol.  Placebo effects also seem to be particularly strong for psychiatric disorders such as depression, anxiety, and addiction.

However, these limitations are not as constricting as they might seem as placebo effects can affect the immune system, which is the disease fighting system of the body.  This is a new field of research, one that has been encouraged by the father of the Salk vaccine, Jonas Salk, called psychoneuroimmunology.  The potential of this new field of research is unknown.

So, who knows what placebos hold for the future, but today in many cases painkillers and antidepressants may not work much better than a placebo.  Moreover there are risks of addiction and side effects with these drugs.  The top ten grossing drugs in the United States help only between 1 in 25 and 1 in 4 of the people who take them,.  Statins might benefit as few as 1 in 50.

A study published in the British Medical Journal concluded that drugs are responsible for more than half a million deaths in the Western world each year with minimal benefit.

I would also call your attention to the healthy memory blog post, “Most Published Research Findings are False.”  So most physicians are working in the dark with research, most of which is wrong.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

How Placebos Could Change Research and Practice

March 29, 2015

The title was on the cover of the April 2015 Monitor on Psychology of the American Psychological Association.  Inside the issue was an article by Stacy Lu, “Great expectations:  New research is leading to an understanding of how placebos work—findings that may lead to more effective treatments and better drug research.  Our understanding and attitudes towards placebos is advancing.

In one study neuroscience researcher Shaffer and his colleagues asked participants to apply a “powerful analgesic” on their hands and arms.  Then the researchers administered small bursts of heat where the cream had been applied.  The cream was actually petroleum jelly, but participants reported that the s-called powerful cream protected them from feeling as much of a burn  as a control cream.  Even after the researchers showed them that the active cream was just petroleum jelly, it made little difference.  The participants still reported less pain from the heat when they were re-tested versus the control cream (The Journal of Pain, 2015).

Today scientists are studying  placebos as a psychobiological  phenomenon and the placebo response as a potentially important part of the success of many medical treatments.  Psychological assessments, brain scans, and genotyping are used  to understand better how placebo responses work and to identify who may be most likely to respond to them.  Placebos are similar to cognitive therapies in that they tap into people’s beliefs that there’s hope and that they will get better.

A meta-analysis of 25 neuroimaging studies of pain and placebos conducted by Wager and Atlas of the National Center for Complementary and Integrative Health (NCCIH) found that people who took placebos and expected have reduced pain had less activity in brain regions associated with pain processing, including the dorsal anterior cingulate, thamalus, and insula (Handbook of Experimental Pharmacology, 2014).

Research suggests that placebos have the greater effect in neural systems involved with processing reward seeking, motivation, and emotion.  Placebos seem to work especially well in patients with depression, Parkinson’s disease, and pain.  All three conditions involve the neurotransmitter dopamine.  These are also areas where people can consciously monitor their own treatment results.

In a study of patients with Parkinson’s disease Wager and colleagues found that simply expecting medication altered brain activity in the striatum and ventromedial prefrontal cortex in brain areas associated with reward learning in ways similar to actual dopaminergic medication (Nature Neuroscience, 2014).

In another study of people with migraines, placebos elicited a response without any verbal cue to effectiveness,   Slavenka Kam-Hansen and colleagues openly labeled placebo pills for some patients who reported as much pain relief as those who also got a placebo but had been told that they’d received real medication. (Science Translational Medicine, 2014).

Genetics research has found that participants with a specific genotype related to having more dopamine in the prefrontal cortex reported having a larger effect from a placebo  treatment  than participants with a genotype that produces less dopamine in the prefrontal cortex (PLOS ONE, 2012).

Children seem to respond especially well to placebos.  In one study their placebo response was 5.6 that of adults (The Journal of Pain, 2014).

Patients are interested and enthusiastic about placebo  treatments.  They are pleased to discover that they can contribute to their own healing.