Hypnosis is a placebo?

Replies to This Discussion

Permalink Reply by Greg M on January 23, 2010 at 10:35pm

Well, If you're gonna introduce FACTS, now...

Kelley Woods said:

The major problem, IMHO, with naming hypnosis as a placebo is that placebo is not an effect, but a response. Placebo is, by definition, Latin for "I will please" and like its darker counterpart, nocebo ("I will harm") occurs as a response to an application of an inert substance or ritual and is generated by the subject's expectations and beliefs.

Taken in this context, the process (or ritual) of hypnosis can create conditions for the response of placebo, but is not placebo itself.

[Citation]

http://en.wikipedia.org/wiki/Nocebo

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Permalink Reply by Jan Krüger on January 24, 2010 at 1:49am

Greg M said:

Ya think we should include benign side effects in our trancework so the clients won't know they're just getting a placebo?

Bandler has argued that a placebo can actually be more effective when the client knows it's a placebo. He uses a nifty bit of reframing to get that effect; basically he reiterates the point that placebos are actually very effective and doctors frequently use them, then uses the standard dissociation between "conscious mind" and "unconscious mind" and makes the placebo into a trigger for unconscious changes. The outcome is basically that the placebo is seen as more powerful than actual medication.

Quite daring, of course... but it might have stunning effects if you can pull it off.

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Permalink Reply by Walt Potter on January 24, 2010 at 3:09am

I heard Bandler tell the same story, Dilts was not mentioned.

Ian Jay said:

Use extreme caution when reading, most probably anecdotal:

"Robert Dilts, an American NLP trainer and therapist, tells a story from the ’70s when he was a ‘researcher/gofor’ to Richard Bandler and John Grinder, the co-founders of NLP (Neuro Linguistic Programming). Dilts at the time was a student at UCSC Santa Cruz where Grinder was a professor.

Dilts was instructed by Bandler to gather data from drug trials that had used placebos and to determine an average efficacy for them. Dilts found that placebos were effective in about 30% of patients. (I can’t remember the exact % Dilts told us but it was in this sort of ball park)

Bandler then decided to market sugar pills with the brand name of ‘Placebo’. His plan was to be absolutely open about the content of the tablets and to explain that they contained nothing but sugar. The punch line was to be something like “Research has shown that ‘Placebos’ work, on average, with 30% of all medical problems”

According to Dilts the idea fell apart when the American Food and Drugs authorities refused to play ball. Evidently the Food & Drug wallahs needed to sign off ‘Placebos’ before they could be put on sale.

I’ve often wondered what would have happened had ‘Placebos’ hit the market. Maybe Badler would have become the first ‘Bill Gates’!"



Jan Krüger said:

Greg M said:

Ya think we should include benign side effects in our trancework so the clients won't know they're just getting a placebo?

Bandler has argued that a placebo can actually be more effective when the client knows it's a placebo. He uses a nifty bit of reframing to get that effect; basically he reiterates the point that placebos are actually very effective and doctors frequently use them, then uses the standard dissociation between "conscious mind" and "unconscious mind" and makes the placebo into a trigger for unconscious changes. The outcome is basically that the placebo is seen as more powerful than actual medication.

Quite daring, of course... but it might have stunning effects if you can pull it off.

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Permalink Reply by Jan Krüger on January 24, 2010 at 3:14am

Ian Jay said:

Use extreme caution when reading, most probably anecdotal:

I know that cute little story, and the only thing it has to do with what I said is that both mention Bandler and placebos. I was talking about not a story but an idea: using the concept of placebos as part of a suggestion in actual therapy (or changework in general).

edington said:

I have heard the expression 'hypnosis works by the placebo effect' and from my experience of being hypnotised this shows a complete lack of understanding of the difference between the conscious and unconscious mind.

Even if there was such a thing as a conscious and unconscious mind, I'd still say that expectancy is one of the main underlying principles of both placebos and (most) hypnosis. If you do not believe in the efficacy of a placebo, it won't work. If you actively doubt everything a hypnotist tells you, hypnosis won't work (unless perhaps the hypnotist utilizes the doubt or does some other nifty bit of reframing).

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Permalink Reply by Jonathan Chase on January 24, 2010 at 3:34am

To the general public and I have asked a lot of people - Placebo means false.

And for those few of you who earn a living selling hypnosis it's the general uneducated non hypnosis trained public that pay your wages and their view that is important.

Even Erickson said you should join them in their reality.

Placebo does Not prove belief. If in drugs trials the placebo has an equal or better result than the drug it disproves the drug because, presumably the people taking the actual drug have exactly the same belief as the placebo crowd. And because they did Not know they had the placebo it would be only reasonable to suspect that if they all had the same belief then they would all get them same effect.

Placebo is Not a metaphor, it's a word with a very specific general understanding.

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Permalink Reply by Jonathan Chase on January 24, 2010 at 6:56am

The meaning of the word placebo is in the dictionary.

There really is no such thing as a placebo 'effect' its just psychobabble.

The understanding of the word by the paying public is the Only relevant thing here.

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Permalink Reply by Michael Ellner on January 24, 2010 at 10:48am

Ian wrote:
From this we could deduce that any placebo effect/response will be absent if we tell the subject that they are getting a placebo. I suppose that makes sense, for what makes an inert pill 'active' is what the receiver is conditioned to expect.

Actually researchers found placebos continued to be effective even when people knew they were taking sugar pills:
lee crandall park, m.d. - Nonblind Placebo Trial - Page 1
http://www.leecrandallparkmd.net/researchpages/placebo1.html
The patients were told: "Mr. Doe, at the intake conference we discussed your problems and your condition, and it was decided to consider further the possibility and the need of treatment for you before we make a final recommendation next week. Meanwhile, we have a week between now and your next appointment, and we would like to do something to give you some relief from your symptoms. Many different kinds of tranquilizers and similar pills have been used for conditions such as yours, and many of them have helped. Many people with your kind of condition have also been helped by what are sometimes called "sugar pills," and we feel that a so-called sugar pill may help you, too. Do you know what a sugar pill is? A sugar pill is a pill with no medicine in it at all. I think this pill will help you as it has helped so many others. Are you willing to try this pill?"

14 out of 15 reported benefits!

Michael E.

Ian Jay said:

With this slight reframing of your argument, Jonathon, I think I now understand your point. I have read of clinical trials using placebos ' placebo versus placebo', where the subjects did show a remarkable and significant, and measurable improvement. However, some time later, when the patients were told that they had received a placebo - the improvement disappeared. I guess the 'expectation' that I spoke of earlier was no longer held?

From this we could deduce that any placebo effect/response will be absent if we tell the subject that they are getting a placebo. I suppose that makes sense, for what makes an inert pill 'active' is what the receiver is conditioned to expect.

Similar to telling the audience the mechanism of any magic trick before or after the event. This removes the awe and mystery that the magician wishes to create.

No smoke and mirrors, only pschobabble, as you say ;-)

Ian

Jonathan Chase said:

The meaning of the word placebo is in the dictionary.

There really is no such thing as a placebo 'effect' its just psychobabble.

The understanding of the word by the paying public is the Only relevant thing here.

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Permalink Reply by Michael Ellner on January 24, 2010 at 11:51am

Ian,

I agree, it's not a well designed study and it is quite small...

On the other hand, expensive sugar pills work better than cheap ones. FYI: Sugar pills and placebos are pretty much synonymous in the US --

I'm thinking we can empower, ehance and increase our client's outcomes by keeping the "Hierarchy of Placebo Effectiveness" in mind:

Snip:

Placebo surgery works better than placebo injections

Placebo injections work better than placebo pills

Sham acupuncture treatment works better than a placebo pill

Capsules work better than tablets

Big pills work better than small

The more doses a day, the better

The more expensive, the better

The color of the pill makes a difference

Telling the patient, “This will relieve your pain” works better than saying “This might help.”

Unsnip

http://www.psychologytoday.com/blog/side-effects/200906/placebos-do...

More:

http://www.reuters.com/article/idUSN0446808020080304



Ian Jay said:

Interesting Michael

But not exactly the effect that I was talking about ...
I said when the patients were told they had been taking a placebo (not sugar pill) ...
The perception of the word 'placebo' is the key, methinks?

The trial was small, the patients were all diagnosed with neurosis .. And perhaps they understood the term 'sugar pill' as some energy booster. (Sugar is not inert, of course, and not truly a placebo in this case)
A poor trial, imo.

But interesting

Ian

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Permalink Reply by Michael Miller on January 24, 2010 at 12:16pm

Well, it makes sense that pragmatic doctors, researchers and scientists would label hypnosis as a placebo because it is not a mechanistic form of healing. We don't open the patient up and remove something tangible. Therefore, what we do is outside of their beliefs about reality and the only way they can describe it which fits within their belief system is the placebo effect.

Once scientists are able to clearly map the brain ( in an inexpensive way ) and study the brain plasticity effect hypnosis has on the physical structure of the brain, then it will be recognized as the amazing therapy that it is.

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Permalink Reply by Henxy on January 25, 2010 at 12:26am

Spot on, Michael.

Whatever the precise meaning actually is, placebo has come to be understood as a 'non' treatment. The use of an inert or inactive substance (as compared with the intervention/drug being tested).

Which is why hypnosis isn't placebo: people will tell you ad nauseam of the altered brain waves as seen on EEG; thereby negating the inertia of HT.

The difficult part of healthcare professionals using placebos such as saline instead of an active opiate is that the relationship is built on trust. The patient expects WYSIWYG; and only in specialist pain clinics can 'we' get away with using saline instead of an opiate (even if the patient gets better relief from the saline). Medical ethics are an absolute minefield, which doesn't always end up with the patient's interests being best served (imagine the headline in the National Enquirer 'doctor uses saline instead of painkiller on cancer patient'...).

Michael Miller said:

Well, it makes sense that pragmatic doctors, researchers and scientists would label hypnosis as a placebo because it is not a mechanistic form of healing. We don't open the patient up and remove something tangible. Therefore, what we do is outside of their beliefs about reality and the only way they can describe it which fits within their belief system is the placebo effect.

Once scientists are able to clearly map the brain ( in an inexpensive way ) and study the brain plasticity effect hypnosis has on the physical structure of the brain, then it will be recognized as the amazing therapy that it is.

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Permalink Reply by Michael Ellner on January 25, 2010 at 3:49am

In my opinion our inner-doctors produce what is called the Placebo Effect/Response
One of the best kept secrets about healing is that all conventional, complementary and/or alternative healing systems simply tap into and in some cases bolster the persons own healing resources. Nobel laureate Albert Schweitzer, MD, summed it up quite neatly when he pointed out to his fellow physicians “Each patient carries his own Doctor inside him. We are at our best when we give the Doctor inside a chance to go to work”.

Allan Nelson said:

I always took hypnosis to be a highly effective mind tool to amplify a positive placebo within a client/self, for the most part... other aspects not entirely placebo but used in hypnotherapy, cognitive restructuring.
I think placebo-effect deserves to change from some peoples imaginations as something not significant to the realisation its one of the most potent forces of influence. Hypnosis/placebo is one of the greatest pioneers of utilising placebo phenomenon, heighting its profile in a positive light. My note here is intended for the general public's perception.

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Permalink Reply by Kelley Woods on January 25, 2010 at 7:04am

In every country in the world blue or purple placebo sleeping pills are more effective than red or yellow pills, save one. In Italy, for men only, blue pills are worse sleeping pill placebos because Italian men get AMPED when they think of the Azzuri.

Note to self: Buy blue wardrobe for trip to Italy!

http://www.wnyc.org/shows/radiolab/episodes/2007/05/18

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