Showing posts with label placebo. Show all posts
Showing posts with label placebo. Show all posts

Sunday, April 14, 2013

Placebo: Cracking the Code


This is an older documentary (2002), and there is a lot of new information on placebo power, for example, the effect seems to be getting stronger. Here are a few more recent studies for those who are interested: A Comprehensive Review of the Placebo Effect: Recent Advances and Current Thought (2008), Neurobiological Mechanisms of the Placebo Effect (2005), and The Placebo Effect: Advances from Different Methodological Approaches (2011).

Placebo: Cracking the Code


Featuring members of the the Harvard Placebo Study Group, “Placebo: Cracking the Code” examines the power of belief in alleviating pain, curing disease, and the healing of injuries.

The placebo effect is a pervasive, albeit misunderstood, phenomenon in medicine. In the UK, over 60% of doctors surveyed said they had prescribed placebos in regular clinical practice.

In a recent Time Magazine article, 96% of US physicians surveyed stated that they believe that placebo treatments have real therapeutic effects.

Fascinating documentary about the science and psychology of placebos, centered on a gathering of the Harvard Placebo Study Group at a remote cottage in Ireland, featuring Nicholas Humphrey, Anne Harrington, Dan Moerman, Howard Fields, Fabrizio Benedetti. Directed by Jemima Harrison.

Watch the full documentary now - 53 min

Thursday, April 11, 2013

Glenn Wilson: Mind Over Matter (Psychosomatics)


From FORA.tv (originally - I retrieved the full lecture from the Gresham College website), this lecture by Glenn Wilson looks at the placebo effect, and it's role in "charlatan" cures and treatments, and it goes much deeper - into the realm of psychosomatics, an emerging field that examines the intersection of social, psychological, and behavioral factors in health. Wilson is the author of Born Gay: The Psychobiology of Sex Orientation, CQ: Learn the Secret of Lasting Love, and Psychology for Performing Artists.



Glenn Wilson: Mind Over Matter

Charlatan "cures" and "alternative" treatments are widespread and popular. Despite lacking any credible rationale, people often seem to benefit from them. The power of suggestion and "placebos" is impressive. What accounts for miracle cures and phenomena like stigmata? Are certain personality types prone to particular illness? How does stress affect our immune system? Psychosomatics is a fascinating branch of psychology with many issues yet to be settled. This is a part of Glenn Wilson's series of lectures as Visiting Professor of Psychology, 2012/13. For more information on this lecture, please visit its page on the Gresham College website.

As well as being one of Britain's best-known psychologists, Glenn Wilson is the Visiting Gresham Professor of Psychology. He has appeared on numerous television and radio programs and has published more than 150 scientific articles and 33 books.

He is an expert on individual differences; social and political attitudes; sexual behavior, deviation and dysfunction; and psychology applied to the performing arts. Not one to shy away from contention, his most recent books include: Born Gay: The Psychobiology of Sex OrientationCQ: Learn the Secret of Lasting Love, and Psychology for Performing Artists. He has lectured widely abroad, having been a guest of the Italian Cultural Association, and a visiting professor at California State University, Los Angeles, San Francisco State University, Stanford University, the University of Nevada, Reno and Sierra Nevada College.

Apart from being a professional psychologist, Dr. Wilson trained as an opera singer at the Guildhall School of Music and Drama in London and still undertakes professional engagements as an actor, singer, and director.

Extra lecture materials

Transcript for "Mind over Matter"
PowerPoint Presentation for "Mind over Matter"

This is a part of Glenn Wilson's series of lectures as Visiting Professor of Psychology, 2012/13. The other lectures are as follows:

Friday, April 20, 2012

io9 - 10 of the Most Surprising Findings from Psychological Studies

A fun list from io9 on psychological studies that might be surprising to a lot of people. I know all of these studies, so I'd be curious to hear which ones are surprising to you?

10 of the Most Surprising Findings from Psychological Studies


Saturday, January 07, 2012

NPR Science Friday - One Scholar's Take On The Power of The Placebo


The other day I posted an article from Edge by Nicholas Humphrey that looked at the placebo effect as a jumping off point for a brain-based "health management system." So it was interesting, in light of that, to listen to this NPR Science Friday discussion about the placebo effect.
January 6, 2012
 
A placebo can take the form of a sugar pill or even a fake surgery. It's often used to test the effectiveness of a trial drug. Ted Kaptchuk, director of Harvard University's Program in Placebo Studies and the Therapeutic Encounter, discusses potential applications for the healing power of placebos.

IRA FLATOW, HOST: This is SCIENCE FRIDAY. I'm Ira Flatow. It's a story we've heard before: A doctor prescribes a fake pill to a patient after other medications have failed. The patient begins to feel better after taking what she thinks is a real drug, but is only a placebo.

The story is not fictitious. It's rooted in real data. One study estimates 50 percent of U.S. physicians who believe in the benefits of placebos and the placebo effect secretly give dummy pills to unsuspecting patients. The ethical, questionable practice led researchers at Harvard University to explore whether the power of placebos can be harnessed honestly, and what they found was the placebos work even when patients are in on the secret that it is a sham secret. They know that they're taking a placebo, and it still works.

Ted Kaptchuk is an associate professor of medicine at Harvard Med School, director of the Program in Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center in Boston. The program was created last summer and is wholly dedicated to the study of placebos. He joins us from Cambridge, Mass. Welcome to SCIENCE FRIDAY.

TED KAPTCHUK: Ira, thanks for inviting me.

FLATOW: How do you define a placebo?

KAPTCHUK: Well, a placebo is a sugar pill or inert substance that's used to hide the genuine treatment in a clinical trial. A placebo effect is the effect of a sugar pill. The problem with that common definition is that it's an oxymoron: An inert pill can't have an effect. So what our team says is that the placebo is also hiding a very important phenomena: the clinical encounter. We think the placebo effect is the - a surrogate marker, or a way of measuring the effect of just caring for a person, the act of caring for a person.

We think that it's - the placebo is about the words, the gestures, eye contact, warmth, empathy, compassion that a physician exchanges with a patient, a doctor-patient relationship. We think the placebo is about medical symbols, white coats, diplomas, prescription pads.

We think the placebo is about medical rituals, the ritual procedures in medicine: waiting, talking, disrobing, being examined and being treated by pills or surgery. Ultimately, we think the placebo is about the power of the imagination, trust and hope in the medical encounter.

FLATOW: Can you quantify any of this, then?

KAPTCHUK: Well, that's what my work is, and that's what our program at the Beth Israel Deaconess and Harvard Medical School is trying to do, is that this is usually considered the art of medicine. It's the in background. People are mostly concerned about drugs, procedures and surgery, and our job is to quantify what's been hidden in the background and move it to the foreground, to make the human aspects of health care more prominent and optimalize them once we understand what they can do and how they work.

FLATOW: Because we hear that the placebo effect works about 30 percent of the time, correct?

KAPTCHUK: No, that's more of a medical myth. Sometimes sugar pills will not shrink a tumor, will not lower cholesterols, don't lower hypertension. Placebo effects work in some conditions much better than others. Placebo treatments will work in things like pain, insomnia, depression, anxiety, functional bowel disorders, functional urinary disorders. So that 30 percent is really a myth that was created a long time ago.

FLATOW: And you've discovered - let me see if this is correct - that even when the patients know they're taking a placebo, it still works?

KAPTCHUK: Well, discovery is a big word. We - what we did was we randomized patients with irritable bowel syndrome, half of whom went - we gave them placebos. We told them it was placebos. The bottle said they were placebos. We told them that the study was about placebos. This is an inert pill they were taking. And half of them we randomized to no-treatment control wait-list to make sure that if they changed and got better, it wasn't the normal, natural waxing and waning of diseases or spontaneous remission.

And we found, after three weeks, that people who were taking placebos did much better than those in the comparison group. Our study was small. It needs to be replicated. It's more proof of principle. But it certainly changes the conventional wisdom, which was if you know you're taking a placebo, you're not going to get better.

And what we - I think many other teams have to replicate this and other diseases, and we hope that that will happen down the line.

FLATOW: But you're saying, if I heard you correctly, just to go back on your original statement, is that the placebo basically masks, or it's really the encounter with the doctor and all the trappings of the office and being taken care of that - the action that is actually helping the patient and making the patient feel better.

KAPTCHUK: I think that's what I meant to say. I'm glad you said it that way. Yeah, a sugar pill doesn't do anything. What does something is the context of healing. It's the ritual of healing. It's being in a healing relationship. And that's what we study.

But the placebo pill is a wonderful tool, or a saline injection is a wonderful tool to isolate what is usually in the background, take it away from the medications and procedures that medicine does, and actually study just the act of caring. That's, I think, what we're measuring when we study placebo effects.

FLATOW: And how did you get involved in this, in Harvard opening up this center?

KAPTCHUK: I was originally hired at the Beth Israel Deaconess Medical Center and Harvard Medical School in 1990 to help do research in Asian medicine. And when I got there - my original training was in Asia - they talked about we have to find out whether this intervention, be it acupuncture, herbs or other kinds of alternative therapies, is more than placebo.

And I would ask: So what does it mean that it's more than placebo? And they say: Well, it's more than placebo. And I have a background in civil rights when I was a young person. And I said, boy, they're treating this placebo effect like it's really some kind of disgusting phenomena. And what is it exactly? So I would ask, and I realized there wasn't a lot known. And I thought this would be a better way of doing my career.

Luckily, at that time, the NIH created a National Center for Complimentary and Alternate Medicine, which has a deep interest in investigating the placebo effect. And I've been able to receive funding for many, many experiments, which hopefully have contributed to understanding this phenomenon better.
Read the whole transcript.

Thursday, September 22, 2011

Brain Science Podcast - Neurobiology of Placebos with Fabrizio Benedetti (BSP 77)

Strangely, the placebo effect has been getting stronger over the last couple of decades. But it's not some kind of magic or voodoo, a mere power of belief kind of thing - rather, Dr. Fabrizio Benedetti is the world's leading scientist in the neurobiology of the placebo effect. There are distinct neurochemical mechanisms behind the placebo effects (yes, plural, according to Dr. Benedetti).

There is a full transcript of the conversation available (see below).

And a BIG THANK YOU to Dr. Campbell for continuing to have these excellent and informative conversations and making them available for free to brain geeks like me. This is episode #77 - so there are 76 more episodes that you will thoroughly enjoy.

Neurobiology of Placebos with Fabrizio Benedetti (BSP 77)


 

Fabrizio Benedetti, MD (click photo for podcast)Dr. Fabrizio Benedetti is one of the world's leading researchers of the neurobiology of placebos. In a recent interview (BSP 77) he explained to me that he believes that "today we are in a very good position to describe, from a biological and from an evolutionary approach, the doctor-patient relationship, and the placebo effect, itself."

To appreciate Dr. Benedetti's work one must first realize that his approach differs from that of the typical clinical trial. As he observed, "To the clinical trialist, a placebo effect means any improvement which may take place after placebo administration.  To the neurobiologist, a placebo response, or placebo effect means only something active in the brain happening after placebo administration: learning, anxiety reduction, activation of reward mechanisms."

In contrast, he explains "The real placebo response, the real placebo effect is a psychobiological phenomenon.  It is something active happening in the brain after placebo administration: like learning, like anxiety reduction, and such like." Brain Science Podcast 77 provides an introduction to this complex, but fascinating topic.

Episode Transcript (Free PDF
Subscribe to the Brain Science Podcast: itunes-badge-30 zunelogo-70 feed-icon32x32 mail-sticker-tiny 

References 

  • Benedetti F, Mayberg HS, Wager TD, Stohler CS, Jon-Kar Zubieta J (2005) Neurobiological Mechanisms of the Placebo Effect. The Journal of Neuroscience, 25,10390-10402. (Full article)
  • Benedetti F (2009) Placebo Effects: Understanding the mechanisms in health and disease. Oxford University Press.
  • Benedetti F (2011) The Patient's Brain: The neuroscience behind the doctor-patient relationship. Oxford University Press.
  • Levine JD, Gordon NC and Fields, HL (1978) The mechanisms of placebo analgesia. Lancet, 2, 654-7. (Abstract)
  • Levine JD, Gordon NC and Fields, HL (1978) “The mechanisms of placebo analgesia.” Lancet, 2, 654-7. (Abstract). See also a follow-up paper: Levine JD, Gordon NC, Bornstein JC, and H L Fields HL (1979) “Role of pain in placebo analgesia.” Proc Natl Acad Sci 76(7): 3528–3531. (full text)
  • Volkow, ND, Wang JG, Ma Y, Fowler JS, Zhu W, Maynard L et al. (2003) Expectation enhances the regional brain metabolic and the reinforcing effects of stimulants in cocaine abusers. Journal of Neuroscience, 23, 11261–8. (Full text)
  • de la Fuente-Fernández R, et al. (2001) Expectation and Dopamine Release: Mechanism of the Placebo Effect in Parkinson's Disease. Science 293, 1164. (Abstract)
  • Benedetti F, Colloca L, Torre E et al. (2004) Placebo-responsive Parkinson patients show decreased activity in single neurons of the subthalamic nucleus. Nature Neuroscience, 7, 587-88. (Abstract)
  • Herrnstein RJ, (1962) Placebo Effect in the Rat. Science 138, 677-678.
  • Linde K, Witt CM, Streng A et al. (2007) The impact of patient expectation in four randomized control trials of acupuncture in patients with chronic pain. Pain, 128, 264-71. (Abstract)
  • See Episode Transcript for additional references.
 

Announcements

Corrections

  •  32:48 only NON-members are eligible to get a free audiobook download from our sponsor at http://audiblepodcast.com/brainscience.
  • Dr. Benedetti’s first book is called Placebo Effects, not Placebo “responses”.
  • Special Thanks to Lori Wolfson for finding this mistakes and correcting them in the episode transcript.
Episode Transcript (Free PDF)

Thursday, January 20, 2011

Dr. Ben Goldacre Talks About the Placebo Effect *NSFW*

Video thumbnail

Funny . . . science-based humor. The NSFW is based on language.
The Guardian newspaper's Bad Science columnist Dr. Ben Goldacre does a stand-up routine about medicine, the placebo effect, and the mysteries of the human body at Nerdstock.