Exquisite theory - paradigmatic bases in the concept of placebo

[Guest guest]

Stephen Morrissey wrote:

 

>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?

 

I follow so far and I agree, that's plausible.

 

>If this is true, then placebo does not heal the root but only the

branch.

 

I don't understand that sentence. If placebo successfully treats

problems with a psychological root then doesn't it treat the root of the

problem?

 

>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?

 

I don't understand that sentence either. If a therapy doesn't address

the causative unconscious psychological issue (when there is one) then

it is NOT as good as a placebo which DOES address those issues. Have I

miscontrued your meaning?

 

Marian

 

 

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[Guest guest]

..

 

>...If this is true, then placebo does not heal the root but

only the

branch.

 

I don't understand that sentence. If placebo successfully treats

problems with a psychological root then doesn't it treat the

root of the

problem?

 

Marian, I can understand your confusion with that sentence. And this

may not clear it up but... It is my perception that the unconscious

mind controls physiology in many ways, which in some cases becomes

dysfunctional to the point of symptoms, including, as examples,

allergies, headache, ulcer, or chronic low back ache, etc. If one or

more of these symptomatic manifestations of unconscious

psychological/emotional issues (i.e. rage/fear) are alleviated by taking

a medicinal substance or placebo, has the substance/placebo actually

removed the underlying rage/fear that triggered the symptom or did it

just cause a re-direction of the physical/physiological manifestation of

the unconscious rage/fear toward a different symptomatic outlet? One

observation is that unconscious responses to common circumstances that

we all have programmed into our psyches cause the unconscious mind to

respond by altering our normal physiologically. In many cases our

unconscious finds it most convenient to mess with the weaker links in

our physiology. Or, it could be that the demonstrated changes in

microcirculation triggered by conscious and unconscious rage and fear

naturally trigger symptoms in locations that are the most susceptible.

Either way, the relief of symptoms in that location don't necessarily

change the underlying psychological/emotional state that initially

caused the symptom.

 

In terms of placebo, isn't its effect more pronounced in certain types

of conditions? It is just a theory, but I believe it plausible that

placebo is more effective in relieving symptoms that are more

susceptible to the changes triggered by unconscious

psychological/emotional states, even if relieving these conditions does

not require affecting the basic nature of the unconscious, only its

relationship to the symptom. Since unconscious states and their

sensitivity or susceptibility to triggering mechanisms are somewhat

different for all of us, some would be naturally more responsive to

placebo than others. Could that same sensitivity and susceptibility to

unconscious triggers cause or correlate with being more responsive to

herbs and acupuncture?

 

Regards,

Stephen

 

 

Chinese Herbal Medicine, a voluntary organization of licensed

healthcare practitioners, matriculated students and postgraduate

academics specializing in Chinese Herbal Medicine, provides a variety of

professional services, including board approved online continuing

education.

 

 

 

 

[Guest guest]

Ken - just to be clear - I'm not saying that you are a hypocrite - I am

simply saying that it is my feeling (which I think you have expressed as

yours also) that if we are going to undertake this enterprise it must be

thorough and complete.

 

At 02:16 PM 10/24/2003 +0000, you wrote:

>Marnae,

>

>I am a Baudelairean and embrace my

>own hypocrisy. As I said to Todd

>in reply to his post, I hope neither he

>nor anyone is waiting for me to

>produce a comprehensive review of

>every significant book on the subject.

 

Certainly not expecting it from you - although after your review of TK it

would be interesting to have your views expressed as well as others. As we

have discussed before, I don't think that this is a project that can be

undertaken by any one person. It requires a group of

interested/interesting people working to create as good a review of the

literature as they can. One person doing it gives one persons view - a

group view may be a bit more " vanilla " but in the end I believe will serve

the community more effectively and keep people from getting upset at one

individual - instead they can get upset at a whole group.

 

>I have spent many hours with Harriet

>and Efrem lately, including the more

>than 40 we spent together with Paul

>Unschuld talking about the implications

>of our own representations and misrepresentation

>about the subject.

>

>I also have not attempted to deconstruct my

>own work, preferring that someone who is

>a little less close to it proceed.

>

>Harriet and Efrem are mulling this whole

>topic over.

 

 

I look forward to hearing from them. Both on the subject of their book and

on others. Wish I could be part of the conversation.

 

>I said at the top of my post yesterday

>that I would defer to their own statements,

>at least to proceed in the direction of

>analysing and coming to better understand

>the ways in which they got it right and

>wrong with respect to this issue of

>historical accuracy and the casecade of

>implications that follow.

>

>I say I embrace my own hypocrisy because

>I recognize that although I am my own

>toughest critic, withot a doubt, I am

>probably not my own best critic.

 

None of us are - that's why we have editors!!

 

 

>Nor do I think that I could adequately

>report about Heaven and Earth at this

>time, having recently spent so much

>time trying to understand the authors'

>own statements, thoughts, and feelings

>about it. I have to say at the moment

>that I really don't have a complete

>understanding of their typology scheme.

 

 

Fair enough - but, if you had not spent that kind of time with them or did

not have a personal relationship with them (and this is a an almost

impossible thing to know) would you be so even-handed with them or willing

to let them speak for themselves before a critique has been offered or

would you be more able to offer a critique and then present it to them as a

fait accompli as you did with TK?

 

>And to the degree that their statements

>about it suggest it is an element of

>traditional Chinese medical thought

>I think they misrepresent it. I don't

>have a copy of their book with me

>and am not prepared to try and determine

>the degree of this.

 

Perhaps their statements do not do this, but it is definitely the way the

public reads it.

 

 

>I've talked about it with them, and

>as I say, I think they will address

>the matter themselves.

>

>I'm also quite interested in the differing

>opinions that have been stated about the

>impact and influence of H & E on the field

>and its public. You portray it as considerable,

>while Todd represents it as miniscule.

>

>Which is it?

>

>How do we find out?

 

 

Of course there is no clear way to find out. I represented its influence

as being quite great among the larger public - our patients and those who

know little about CM but want to find out a little bit. I agree w/ Todd

that within the field of CM it is not an often referenced book - although

it is certainly out there and I have many students who cite it when writing

their papers for their History of CM class.

 

 

>Are our own impressions adequate?

 

 

Never.

 

 

>In judging the degree of my hypocrisy,

>you should take into account my work

>as an editor and, I believe, admit into

>evidence the fact that I did in the very

>first issue of CAOM that I edited

>include what must be one of the most scathing

>critical reviews that Heaven and Earth

>ever received.

>

>Then I hypocritically invited Harriet

>and Efrem to respond and worked with

>them to assemble an effective response

>to Nigel on the subject.

 

Ah - herein lies the rub - yes you are an editor, but did you " work with "

Nigel to make his review effective or did you let it stand pretty much as

he represented it. Yes, as an editor you have certain obligations to your

writers, but is it really your job to lead them in such as way as to make

their response more " effective " . And would you have done this with other

authors with whom you do not have the same relationship if their book were

reviewed in a similar manner? Certainly publishing the review and the

response was and remains important - perhaps you would be willing to post

Harriet and Efrem's response on the site so that it can sit with Nigel's

original critique.

 

>I am now working overtime to arrange

>a week long get together with Nigel

>at Butler Creek, hosted by Harriet and

>Efrem, at which I hope to reach new

>heights of hypocrisy by getting everyone

>involved to criticize everything!

 

Sounds Great!!! Can I come? (or can I be a fly on the wall?)

 

>I am not trying to do this all by

>myself. I'm simply trying to provoke

>widespread interst in a developing

>process that can lead to truth and

>reconciliation in the field. And as

>I have made quite clear, I'm working

>with Harriet on this.

 

I'm glad to hear it - but again, shouldn't the network of who you work with

be larger? Or will it be the truth according to Harriet and Ken (just

kidding, but how do you decide who gets to take part in the fun discussions?)

 

>How long has this field harbored

>unspeakable thoughts and feelings

>between authors, sources, schools,

>etc. that trace back to basic

>issues of how the most fundamental

>ideas are stated and represented?

 

About 2200 years!

 

>Isn't it about time that we all

>admit to our own hypocrisy and

>get together for a little old

>fashioned California fun?

 

 

I'm game! Can I bring the kids?

 

As you are certainly aware Ken, your posts tend to provoke a great deal of

discussion, which I think is great. As a result, some of the response may

seem quite personally directed at you (and in some cases it may be). Let

me make it clear that I support this discussion. I think it is a very

important one that absolutely needs to occur - I hope it can occur in a

relatively civilized manner amongst relative adults but I am sure that

there will be some hard feelings on the part of all who take part. Please

keep the posts coming and let's get this out in the open.

 

Marnae

 

>

>Chinese Herbal Medicine, a voluntary organization of licensed healthcare

>practitioners, matriculated students and postgraduate academics

>specializing in Chinese Herbal Medicine, provides a variety of

>professional services, including board approved online continuing education.

>

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>

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