Transcript The Power of Belief Complementary Therapies, Placebos and

The Power of Belief
Complementary Therapies,
Placebos and Healing
Gus Cairns
www.guscairns.com
Preparatory work
• Think of three adjectives that describe
the kind of person you would like to be.
• e.g.: If you are depressed think ‘happy’
or ‘fortunate’ or ‘loved’ or ‘gorgeous’
• If you are stressed, think ‘patient’ or
‘calm’ or ‘organised’
• If you are sick, think ‘healthy’ or ‘strong’
or ‘energetic’
Healing
Orthodox
medicine
‘Complementary’ - or
standard of care?
 One daily aspirin: cut the risk of heart attack by 28 %
 400-800 IUs of vitamin E cut the risk of all heart attacks
by 47%: non-fatal ones by 77%
 Electro-acupuncture induced surgical anaesthesia in
99.6 per cent of women having Caesareans
 6 out of 6 patients with NRTI-induced lactic acidosis
(mortality normally 50%) recovered when given
intravenous B1, B2, niacin and l-carnitine
 3g of l-carnitine for two months: triglycerides down
from 5 times normal to normal in 54% of patients on PIs
Just feel better, or
are better?
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20 HIV+ and 9 HIV- gay men
Daily massage for a month
Massage subjects had lowered cortisol
CTLs (CD8 cells) and natural killer cells up/
CD4 (T-helper) cells did not improve
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Indian study: homoeopathy vs placebo for HIV
PGL group: stat. significant difference in CD4 counts
Placebo group: non-significant results.
Asymptomatic HIV infection, differences not significant
“Two things are certain about
pills that treat depression:
Antidepressants like Prozac,
Paxil and Zoloft work. And so
do sugar pills.”
Washington Post, Tuesday, May 7, 2002
“A trial last month that compared the herbal remedy St.
John's wort against the anti-depressant Zoloft. St. John's
wort fully cured 24 percent of the depressed people who
received it, and Zoloft cured 25 percent.
but the placebo fully cured 32 percent…What's more, the
placebos, caused profound changes in the same areas of the
brain affected by the medicines. One researcher has ruefully
concluded that a higher percentage of depressed patients
get better on placebos today than 20 years ago.”
“Placebo response not
all in the mind”
•51 patients with major depression. 8-week
study.
•52 % receiving antidepressants responded
•38% receiving placebos responded
• Immediate decrease of prefrontal lobe activity in
patients given antidepressants
•Gradual increase in prefrontal lobe activity in
patients given placebo
“Placebo response not
all in the mind” contd.
• “They were virtually indistinguishable. At eight
weeks you couldn't tell them apart in terms of
mood ratings.
• What happened at eight weeks plus a day was a
bit different. Some of the placebo responders,
when told they were on a placebo, had a
deterioration of their mood. In fact, most of
them did. Within a month, most of the placebo
responders had enough depressive symptoms
that they actually ended up on medications.
Once people realised they were not taking real
drugs, the placebo effect stopped.”
• Leuchter AF, Cook IA, Witte EA, et al.: Changes in brain
function of depressed subjects during treatment with
placebo. Am J Psychiatry 2002, 159:122-129.
Placebo surgery?
“Surgery has been slow to take up the challenge of British
epidemiologist Archie Cochrane: to prevent the introduction of
new therapeutic procedures until randomised trials have
shown them to be more effective than existing treatments...
The fact that surgical trials cannot be double blind or placebo
controlled is often seen as a major methodological problem.”
(BMJ, 1995, 311:1243-1244 (11 November)
“Patients with osteoarthritis of the knee who underwent placebo
arthroscopic surgery were just as likely to report pain relief as
those who received the real procedure, according to a Department
of Veterans Affairs and Baylor College of Medicine study published
in the July 11, 2002 New England Journal of Medicine.”
Not ‘all in the mind’
– but by the mind
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The changes reported in people's brains under the placebo effect
are profound. But there's a Catch-22. You can't tell yourself, 'I know, I'll
just kid myself it's working'. It's like deciding not to think of a skating
hippo. The placebo effect is about something much more profound than
self-deception. Luckily the strangeness of the human brain comes to the
rescue - from studies of hypnosis.
So, to repeat what I’ve been saying, the effects of complementary
therapy are NOT ‘all in the mind’. They are extremely physical.
They may be physical because you take substances or had procedures
done that have real effects.
They may be physical because you are being touched, handled, listened
to, counselled, or are relaxing – activities that all promote the
parasympathetic response
But they may also have a real physical efffect because the 70% of your
brain that is unconscious is saying to the conscious half: YOU ARE WELL.
Many complementary medicines work by drawing out of you your own
ability to heal yourself.
The ‘hidden observer’
“During the hypnotic state one part of the brain
reports low levels of pain, while another reports
a high level. After coming out of hypnosis the
subjects report that they did feel pain - but
under hypnosis a ‘hidden observer’ in a
dissociated part of their brain told then they
were unable to perceive it.”
Michael Shermer, The Borderlands of Science, Oxford 2001
The sceptical comp
therapy user - how to
set up your own
placebo effect
• Intensive consultation
• Trust between patient and
practitioner
• Medicine as process, not as cure
• The will to succeed
• Ritual and discipline
Products, procedures,
practices
Products
Procedures
Practices
Systems
Herbal remedies
Homoeopathy
Active movement
TCM
Vitamins, minerals
Reflexology
therapies eg Yoga,
Ayurveda
and supplements
Acupuncture, etc
Tai Chi, exercise
African medicine
Bach flower
Massage, Shiatsu
Meditation
Naturopathy
remedies
etc
Qi Gong
Aromatherapy oils
Passive movement
Autogenic training
Special diets and
therapies
Dance therapy
food
Hypnotherapy
Spiritual practice
Crystal healing
Osteopathy
Psychotherapy
Spiritual healing
Native American
Kinesiology and
and Shamanistic
other diagnostic
practice
techniques
Colour therapy
Counselling
Homeopathy
• Principle of ‘like cures like’
• Almost infinitely diluted active
substance
• The weaker it is, the stronger it is
• ‘Memory of water’ theory
• Intensive consultation:
psychotherapeutic effect
Massage, shiatsu etc
• Permission to be touched by a
stranger
• Real effects on redistributing toxins
like lactic acid out of muscles
• Parasympathetic relaxation effect
• Psychological effect: reversion to
infancy
Reflex Kinesiology
• Reflexes ‘tested’ against
questions
• Impossible to ‘cheat’
• Harnessing the unconscious and
getting under the radar of
denial
Movement therapies
• Exercise is good for you
• Emphasis on combining movement
with calm: parasympathetic rather
than sympathetic strength
• Connection with spiritual values,
other cultures
Practical demo:
autogenic
training