[HN Gopher] All Placebos are not created equal (2021)
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       All Placebos are not created equal (2021)
        
       Author : sebg
       Score  : 50 points
       Date   : 2025-03-21 11:28 UTC (2 days ago)
        
 (HTM) web link (www.samstack.io)
 (TXT) w3m dump (www.samstack.io)
        
       | BugsJustFindMe wrote:
       | Something I never see discussed (though if you have resources on
       | the subject, please share them with me) are the very real and
       | important difference between believing and wanting to believe and
       | feeling better _about_ something without the something itself
       | being better.
       | 
       | When I feel like my symptoms have improved, that is factually
       | distinct from my symptoms having improved. Ok, so far so obvious.
       | But it is also factually distinct from me _really_ feeling like
       | my symptoms have improved. It may very well be that I 'm just not
       | sure and that I subconsciously lean toward giving the benefit of
       | the doubt as a tie-breaker for my own uncertainty. And then I can
       | feel better _about_ that without the underlying symptom
       | improving, and that is definitely factually distinct from the
       | symptom improving.
       | 
       | The impact would obviously be age-related, since age equals
       | exposure to factors like social influence, introspective
       | knowledge of the limits of self evaluation, and so on.
       | 
       | And it is _not the same thing_ as a placebo effect improving the
       | symptom itself. I can be experiencing the exact same amount of
       | pain but wishy-washy on the evaluation, but people report on the
       | placebo effect as though it means I experience less pain. But
       | maybe I 'm just less frustrated by the pain, or less inclined to
       | admit the pain to myself or to others, or less inclined to trust
       | myself. Maybe believing feels good, so I want to do it.
        
         | overu589 wrote:
         | Also discounting that the mind and body themselves are self
         | regulating technology. For instance I have the conscious
         | ability to push pain off into the distance and be unaffected by
         | it, for others they can "take their mind off it" in various
         | ways. Reminds me of Lawrence of Arabia, "the trick is to not
         | care."
         | 
         | There is more, much more, regarding our humanity and the mind
         | body link which science does not have qualitative ways of
         | exploring.
        
           | jonhohle wrote:
           | I find this very true of minor burns (e.g. touching a hot or
           | dish). I can tell myself it doesn't hurt and mostly it
           | doesn't from that point forward. I can't do that for any
           | other type of pain, though.
        
         | iinnPP wrote:
         | I don't want to expose the actual placebo or condition but have
         | been self-studying this for ~7 years now. It's not within
         | societal knowledge as of today.
         | 
         | The placebo is mentally administered, has a 100% success rate
         | at provably halting the condition for a indeterminate amount of
         | time. It also works in reverse, and is quite dangerous when
         | used this way.
         | 
         | It's one of my LLM tests to have the LLM come to the conclusion
         | based on available data on the condition (as it was my only
         | source). Today, no LLM has passed the test.
         | 
         | I hope this helps.
        
           | phtrivier wrote:
           | No, it does not help.
           | 
           | Feel free to submit detailed results to peer review. 100%
           | success rates have been too rare, these days.
        
             | iinnPP wrote:
             | You're welcome to be upset at the lack of peer review or
             | details. However, I will point out that the post includes
             | that this is deliberate. I also pointed out that the
             | knowledge can be dangerous, which is why it wasn't
             | expounded on.
             | 
             | There's some questions in the person's post that I was
             | providing some reflection on. The truth of my comment, or
             | any peer reviewed study for that matter, is up to the
             | reader.
             | 
             | It's funny because the idea of a mental placebo requires
             | the user to place their trust in the very same.
             | 
             | Have a good day.
        
           | theoreticalmal wrote:
           | What condition?
        
           | BugsJustFindMe wrote:
           | It doesn't help because without any details at all from which
           | to form an empathic bond between us there's no path for us to
           | navigate from "obviously fabricated anecdote" to "believable
           | anecdote".
           | 
           | It's also obnoxious for you to play obfuscatory gatekeeper
           | with grown ass adults, and it makes your word less valuable
           | not more.
           | 
           | > _It also works in reverse, and is quite dangerous when used
           | this way._
           | 
           | We're adults. We get to make our own mistakes if we want to.
           | Thank you for the warning, but please provide the information
           | so we can decide what to do with it for ourselves instead of
           | patronizing your audience. Otherwise it really does make you
           | sound like a crank, unfortunate as that may be.
        
             | iinnPP wrote:
             | The intent was to indicate that part of your problem might
             | lie in what you believe and how that impacts the effect of
             | any placebo.
             | 
             | I have no desire or need to prove anything on the internet.
             | I provided enough information for a motivated person to
             | determine what was said and apply it themselves.
        
         | 11235813213455 wrote:
         | The human body is extremely complex, drugs have always side-
         | effects. Placebo effect is quite efficient for simple symptoms
         | and has no side-effect, so it's in our interest to "want to
         | believe"
        
         | jt2190 wrote:
         | > But maybe I'm just less frustrated by the pain, or less
         | inclined to admit the pain to myself or to others, or less
         | inclined to trust myself. Maybe believing feels good, so I want
         | to do it.
         | 
         | That wouldn't be the placebo effect then, it would be more of a
         | psychological phenomenon in the realm of how your mental
         | outlook can influence how you experience pain. That is also
         | heavily studied.
         | 
         | Edit: This video is good intro to the placebo effect:
         | "Harnessing the power of placebos" Alia Crumb, 2017 (video)
         | https://youtu.be/WcQnSW1wpGA?si=A2tzqvd45BLiMADW
         | 
         | Edit 2: I think what you're describing is generally called
         | "pain tolerance".
        
           | BugsJustFindMe wrote:
           | > _That wouldn't be the placebo effect then_
           | 
           | This is my point! I would argue that a lot, if not most or
           | even all, of what gets called a placebo effect is clearly
           | confounded by these obviously-not-placebo-effect-as-defined
           | effects without any distinction, and to me that casts the
           | field into myopic disrepute.
           | 
           | > _I think what you're describing is generally called "pain
           | tolerance"._
           | 
           | No, I think that's yet another different thing.
        
         | thelaxiankey wrote:
         | I think my favorite point to this effect is that there's plenty
         | of medical literature (in the Lancet, and others) suggesting
         | hypnosis is as effective as certain drugs for killing pain in
         | certain contexts. And hypnosis is nothing more than talking
         | someone, in a very directed way. There's caveats of course, but
         | that's true of all drugs... Not to mention all this stuff on
         | gut microbiota, and even the truly 'woo-woo' stuff like
         | acupuncture. Personally, I don't think it's crazy at all to
         | imagine that sticking a needle near the right neuron can cause
         | some kind of occasionally helpful physiological response... in
         | fact, it would be almost more surprising to me if this wasn't
         | possible. Modern medicine works wonders for infectious diseases
         | & physical issues, but I'm not entirely convinced we have a
         | handle on the more subtle stuff.
         | 
         | I've been a lot more attentive to this kind of stuff lately due
         | to some chronic health stuff that came up in the family. I
         | think there's probably some framework in modern medicine that
         | makes it less prone to adopting these kinds of methods. Maybe
         | it's just historical baggage, who knows...
        
           | XorNot wrote:
           | The problem with acupuncture is that the relative
           | effectiveness compared to placebos has gotten worse and worse
           | as better placebos have been developed for trials.
           | 
           | I.e. you mentioned "sticking a needle next to the right
           | nerve" - that's a valid research question...and it was
           | studied. Turns out sticking needles where an acupuncture
           | specialist thinks they should go, versus just randomly has
           | the same reported effect in trials.
        
       | linasj wrote:
       | There are so many misconceptions in this article.
       | 
       | Placebo effect is not getting stronger over time. We are getting
       | better at controlling for all other factors: regression to the
       | mean, self reporting related biases, the effect that people
       | change their behaviour when they are being observed, etc.
       | 
       | Placebo effect is not "mind over matter" it just all the peoples
       | behaviours, biases and life that is happening while they are
       | getting treatment.
        
       | danilor wrote:
       | Would anybody more knowledgeable in the topic help me understand
       | the results of the first graph? Paper is here: https://sci-
       | hub.se/https://psycnet.apa.org/doi/10.1037/hea00... (I haven't
       | finished reading it) Seems the authors claim it's statistically
       | significant, but does it matter if it's clinically significant?
       | 1mm difference seems pretty small, and they conclude that it
       | suggests that it 'can harnessed to improve treatment outcomes'.
       | I'd have understood if the conclusion were that effects exist at
       | all, but not if the claim is that it's useful for something else.
        
       | tasty_freeze wrote:
       | This comment contributes nothing, but I find the title jarring.
       | To make it more obvious, "All doctors are not men" vs "Not all
       | doctors are men".
        
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