Placebos without Deception: A Randomized Trial in IBS

[MBombardier]

Tex already talked about this in a post about Dr. Briffa's article on it, but I thought I'd post the PLoS ONE news release here:


http://www.plosone.org/article/info:doi ... ne.0015591

[tex]

You know, when you think about it, this is absurdity at it's finest. They are actually suggesting that doctors should say to their patients, "Here's a prescription for some sugar pills. There is no way on earth that they could possibly help you, but solid scientific research proves that they will probably help, anyway".

Makes you wonder about the value of scientific medical research, doesn't it.

Tex

[MBombardier]

As you know, I am reading Relaxation Revolution, the book that Polly recommended. I find its discussion of placebos to be fascinating. Part of the relaxation response that changes the expression of our genes, relieves pain, lowers blood pressure, etc., is called the placebo effect. There are many studies that are cited in the book where a sham surgery (for example, fake arthroscopic surgery to relieve osteoarthritis pain) had the same effect as the real surgery. In the book, people are asked to believe the results of these studies because believing the results of the studies that show placebo surgeries work the same as real surgeries will make the relaxation response work through the placebo effect to relieve pain.

The same placebo effect is supposed to work for lowering blood pressure, etc., etc. Very interesting stuff.

[tex]

I certainly don't doubt that the effect is real, since pain perception is solely a neurological effect. I would guess that it works best with people who are more adept at self-hypnosis, and similar techniques, but I could be wrong.

I find that deliberate, slow, controlled breathing, (using a "prescribed" technique), will usually significantly lower blood pressure, and it will do so in a relatively short amount of time. I've tried it many times in my doctor's office, while waiting for a BP check, and whenever I do that, my BP is significantly lower than it was when I checked it at home. (I have to check my BP in the morning and at night, before I take BP meds, to make sure that it isn't too low - if it's too low, I skip the pills. I'm not taking meds because of hypertension, I'm taking them to minimize stroke risk.) Anyway, by using controlled breathing for a few minutes, I can completely reverse the white coat syndrome effect.

Tex

[MBombardier]

Yes, that is what the MDs in this book recommend. They have a "protocol" that they detail, but they also say that the relaxation response is whatever works for you, even playing music or walking.

The placebo effect comes when (after you are relaxed and in a receptive mood, the self-hypnosis you speak of) you remember a time when you didn't have the pain, or the depression, or the inflammation that you are targeting. Or you can imagine yourself on a beach, in a meadow, etc., etc. Whatever works for you. They liken it in a way to getting rid of phantom pain in a limb that is missing. This is a very simplistic way of putting it, but...

The thing I appreciate about this book is that there is no psychological mumbo-jumbo. The MDs say several times that the relaxation response will not work if it does not engage your faith tradition. For me, as a Christian, this means that I focus on God and use a short prayer or a bit of Scripture. Sometimes I just focus on making sure I am relaxed and the process of slow, deep breaths. There is no emptying of oneself, but actually a narrowing of focus. Interesting stuff.