Tuesday, December 28, 2010

Placebos Work Even if You Know They're Fake: But How?

Time Magazine

Physicians have long believed that some form of deception is essential to the placebo effect:  after all, if you tell people that you're giving them a fake drug, why would they respond by getting better? But new research suggests that it may one day be possible to use placebos in everyday medicine without misleading patients into thinking they might get active treatment.The study, which was published in the journal PloS One, included 80 patients suffering from irritable bowel syndrome (IBS), a condition that causes abdominal pain, bloating and frequent bouts of either constipation, diarrhea or cycling between the two. There is no specific treatment other than managing symptoms, which can range from mild to severe.

Participants — who were mainly on the severe end of the spectrum — were randomized to receive either a placebo or no treatment. Those given the placebo were told that they would be taking “placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.”

They were instructed that taking the medication at the times and doses prescribed was “critical.” In essence, the researchers revealed that they were using placebos — but, unlike the approach used in typical trials, they told patients that the pills work. The no-treatment group simply interacted with the medical staff in appointments of the same length as those given the placebo. All patients stayed on medication schedules or diets they were already following — no changes were allowed during treatment. [...]


  1. I have an entire theory of halakhah based on the notion that it's direct experience that shapes a person. Halakhah can be phrased in terms of man's quest for refinement, or wholeness, or closeness to the Creator -- in any of which, the role of halakhah is transformative. The idea is that the bug which is too small to be seen, or a microscopic maggot egg, even if you intellectually know they are there, do not impact you on the level of personal transformation. Similarly, a piece of meat that may or may not be kosher impacts you as an unknown, and therefore can take on states other than kosher vs treif, such as "probably kosher" (rov). I relate to the meat in terms of its uncertainty, and that's what shapes me. And I discuss the other rules of doubt resolution. As well as why we make birkhas hachamah on the wrong date -- because our guts aren't mathematicians, and intellectually knowing the date is wrong does't rob the berakhah of its value.

    This study appears to justify my underlying assumption. Knowing intellectually it's a placebo doesn't change how we respond to the experience of taking it. Placebo effect works on a deeper level than conscious thought.


  2. Have you written about this theory anywhere else? It sounds interesting.

  3. Science is approaching Torah. One of the central themes of Torah is that action is more important than belief. (Naseh v'nishma - do first, understand second) Here, this is confirmed as the action of taking a placebo is more important than the belief that the placebo works.

    We are living in amazing times.

  4. SB, if you're asking about my theory of halakhah, I blogged a series on it. See the "Halakhah and Phenomenology" category of my blog, Aspaqlaria.

    There are 4 posts:

    The Very Small, Tastes and Birkhas haChamah (microscopic mites, maggot eggs, nosein ta'am, and birkhas hachamah)

    The Actually Perceived (on qavu'ah and chazaqah demei'iqarah)

    The Unperceived (on safeiq and rov)

    Chazaqah (more on chazaqah, and shedding light on a couple of counter-intuitive cases of how these rules interact)



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