Exquisite theory - paradigmatic bases in the concept of placebo

[Guest guest]

wainwrightchurchill wrote:

 

>We have not defined what a placebo is . . .

 

I think it's important for anyone who talks about 'placebo' here to

define how they're using it. Here's a definition (however rambling and

unsophisticated it is):

 

It is about discovering, in a western biomedical experimental setting,

whether one 'thing' (i.e.: typically a substance, procedure, aspect of a

procedure . . . ) is an effective component in a treatment protocol. An

experiment would run two (or more) identical (actually, they're never

identical and this is part of the problem with the paradigm) protocols,

called 'arms.' Only one 'thing' (as defined above) can vary between the

two arms soasto learn whether the 'thing' is effective or not. The

'placebo' is a (thought to be) inert 'thing' that replaces the active

'thing' in the 'placebo' arm of the study. Of course there are many

variations on the placebo, but that's the basic idea. (sorry it's a bit

clumsy)

 

Sometimes 'placebo' is used to refer to that inert 'thing.' Other times

it's used to refer to any or all aspects of the protocol except the

active 'thing' being studied. That's a major difference! It's very

important how we mean this word. (Oy, Ken, help!)

 

I think to use the word outside its application in the experimental

paradigm is confusing, to say the least. It would be far more accurate,

and interesting, to attempt to specify what all makes up a healing

encounter and talk about all those factors specifically. For instance:

 

I've read about a (I believe, Harvard) study where they're comparing a

compassionate, warm (even obsequious?) practitioner with a cool,

all-business-type practitioner. Thinking about this type of study

emphasizes for me how important it is that there is a type of

'resonance' between practitioner and patient. Some people may trust the

cool practitioner more, others the warm (yin/yang) . . . The resonance

may take the form of a common religious faith, ethnic background, body

language, verbal language . . . . This resonance is a major factor in

the 'effective' healing encounter.

 

Marian

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[Guest guest]

>We have not defined what a placebo is . . .

 

Sometimes 'placebo' is used to refer to that inert 'thing.'

Other times

it's used to refer to any or all aspects of the protocol

except the

active 'thing' being studied

 

If the placebo effect is real then isn't it mechanism of action presumed

to be a consequence of actions in the unconscious mind, or some other

aspect of psychological influence on physiology and metabolism? If that

is the case, then any condition which can be altered by a placebo effect

could reasonably be considered a consequence of unconscious

psychological influences at its root, rather than independent metabolic

or physiological dysfunction. N'est pas? If this is true, then placebo

does not heal the root but only the branch. If this is the case, then

any therapy that does not address the causative unconscious

psychological issue(s) is only as good as placebo. Yes?

 

Stephen

 

 

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