WEBVTT - The Placebo Effect: Brain Over Pain 0:00:03.800 --> 0:00:06.680 Welcome to Stuff to Blow your Mind from how Stuff 0:00:06.680 --> 0:00:13.920 Works dot com. Hey, welcome to stuff to Blow your Mind. 0:00:13.960 --> 0:00:16.919 My name is Robert Lamb and I'm Julie Douglas. And 0:00:16.960 --> 0:00:19.880 you know, Julie, I used to, uh or I still 0:00:19.880 --> 0:00:22.680 take some of these, you know, sort of health help 0:00:22.720 --> 0:00:26.680 food store supplements for different things. You know, you know 0:00:26.760 --> 0:00:31.080 you've noticed my, my, my large tray of Monday through 0:00:31.200 --> 0:00:34.120 through Friday. And yet yes, your medicine chest sitting on 0:00:34.159 --> 0:00:37.720 your on your desk. I've I've scaled down in recent years, 0:00:37.880 --> 0:00:40.080 but but I still take a few things here and there, 0:00:40.200 --> 0:00:42.519 and and I tend to stick to the things I 0:00:42.520 --> 0:00:44.760 take because I feel like they're helping in some way 0:00:44.760 --> 0:00:47.159 shape or form, like either it you know, relaxes me 0:00:47.240 --> 0:00:49.880 when you know, when I'm needing a relaxation, or gives 0:00:49.920 --> 0:00:54.120 me a little a bit of increased concentration or or 0:00:54.320 --> 0:00:57.360 or energy or what have you. Whatever the the the 0:00:57.480 --> 0:01:00.040 desired result happens to be. But in the back of 0:01:00.120 --> 0:01:02.920 my mind there's always the idea of the Polcebo effect, 0:01:03.040 --> 0:01:06.520 and I'm always find myself thinking, now is this working 0:01:06.959 --> 0:01:08.800 or is this or am I just paying you know 0:01:08.920 --> 0:01:12.319 whatever for for you know, a fake little pill and 0:01:12.360 --> 0:01:14.080 it's and it's all in my mind. And then if 0:01:14.080 --> 0:01:16.440 it is all in my mind, should I stop or 0:01:16.480 --> 0:01:19.000 should I keep going to get that pulacebo effect, because 0:01:19.200 --> 0:01:22.480 at what point can you can you still get I mean, 0:01:22.880 --> 0:01:25.800 if you explain away the placebo, then you can't fool 0:01:25.840 --> 0:01:28.720 your brain, can't fool you into getting that effect, right, Yeah, 0:01:28.800 --> 0:01:30.880 I know, I know, And sometimes I may have had 0:01:30.920 --> 0:01:33.440 the same thoughts before because I use essential oil sometimes 0:01:34.120 --> 0:01:36.600 mainly because they smell nice, but of course they're supposed 0:01:36.600 --> 0:01:40.280 to be mood lifting or what is essential about essential oils? Well, 0:01:40.319 --> 0:01:44.119 I mean they're the distilled um oil of whatever that 0:01:44.560 --> 0:01:47.080 thing is, so um, you know, sort of like gelfling 0:01:47.760 --> 0:01:53.120 um oil or whatever from the dark crystal when they would, yes, 0:01:53.480 --> 0:01:56.760 sort of, except for it's more like lavender, okay, So 0:01:56.760 --> 0:02:00.720 it's like a lavender parent condensed oil. And in great 0:02:00.760 --> 0:02:03.040 Fruit that's a nice one too, and it it does 0:02:03.120 --> 0:02:05.320 have like a sort of nice uplifting center. But I 0:02:05.360 --> 0:02:07.640 have thought before, you know, am I just is this 0:02:07.720 --> 0:02:09.920 sort of quackery. But at the end of the day, 0:02:09.919 --> 0:02:11.720 I don't really care because it smells good, right, and 0:02:11.840 --> 0:02:14.760 like if that's if it's just all bs. But it 0:02:14.919 --> 0:02:17.800 just but you know, the the underlying thing here is 0:02:17.840 --> 0:02:20.560 that my house is going to smell nice? What harm 0:02:20.600 --> 0:02:23.000 is it doing? Right? Yeah? So I mean that's the 0:02:23.000 --> 0:02:26.200 whole thing about placebo, right, is we know a little 0:02:26.200 --> 0:02:29.480 bit about it. Right. It makes us feel better in 0:02:29.520 --> 0:02:31.880 a medical sense. You know you were talking about in 0:02:31.919 --> 0:02:35.760 aert pill that someone might take. Um, it's actually measurable, 0:02:35.840 --> 0:02:40.560 observable felt improvement in your health and in your behavior 0:02:40.760 --> 0:02:44.919 and um. And it has pretty wide reaching ramifications, as 0:02:44.919 --> 0:02:48.160 we're going to discuss in this in this podcast episode. 0:02:48.280 --> 0:02:51.280 Like it goes beyond just you know, me shopping for vitamins. 0:02:51.280 --> 0:02:53.400 Are you you know, getting the oil of a tree? 0:02:54.080 --> 0:02:57.720 So yeah, it turns out the placebo effect is driving 0:02:57.960 --> 0:03:04.079 big pharmaceutical companies crazy and like never before and that 0:03:04.400 --> 0:03:06.760 and the reason for that is because the placebo effects 0:03:06.760 --> 0:03:09.840 seems to be increasing in their clinical trials with new drugs. 0:03:10.600 --> 0:03:12.919 So they're sitting there saying what was going on here? 0:03:13.000 --> 0:03:14.520 Like we used to be able to pass you know, 0:03:14.639 --> 0:03:19.240 nineteen out of fifty drugs through clinical trials, but now 0:03:19.320 --> 0:03:22.600 and this is this is super crazy. Half half of 0:03:22.639 --> 0:03:25.960 the medicines that are coming out of clinical trials are 0:03:26.000 --> 0:03:31.080 being discounted because of the placebo effect. Basically, when you 0:03:31.080 --> 0:03:33.480 go to these clinical trials, the medication has to go 0:03:33.520 --> 0:03:36.360 up against the placebo and tests exactly. It's I mean, 0:03:36.440 --> 0:03:40.440 it sounds really straightforward that, Hey, for this medication to 0:03:40.440 --> 0:03:43.360 to work, it needs to work better than fake medication 0:03:44.840 --> 0:03:47.400 because you have control groups in these you'll have white 0:03:47.440 --> 0:03:49.440 Group A. Well, let's say you have a new a 0:03:49.480 --> 0:03:52.839 new drug that contains I don't know, um, I don't 0:03:52.880 --> 0:03:54.960 pecans in it or something I don't know that was 0:03:55.120 --> 0:03:57.640 just I don't imagine some imaginary drug that comes from 0:03:57.680 --> 0:04:00.720 some plant in South America or something that it's yeah, 0:04:00.760 --> 0:04:04.240 something that is expensive to obtain, something that's costly, something 0:04:04.240 --> 0:04:06.120 that they may A lot of research has gone into 0:04:06.480 --> 0:04:08.880 a lot of scientists have been hunched over labs, and 0:04:08.960 --> 0:04:11.080 lots of money has gone into developing this pill. So 0:04:11.160 --> 0:04:13.080 you've got that, and you give that to Group A 0:04:13.320 --> 0:04:16.520 to treat their I don't know, their hypertension, and then 0:04:16.560 --> 0:04:20.600 a group B gets this placebo, which is nothing. It's 0:04:20.720 --> 0:04:23.640 it's made, it's a it's just a pill. It's like 0:04:23.680 --> 0:04:27.080 basically like a sugar pill, and and it has no 0:04:27.600 --> 0:04:31.880 actual there's nothing inside that pill. That can actually help them, 0:04:32.839 --> 0:04:35.200 but they're giving it, and both groups think they're they're 0:04:35.200 --> 0:04:40.200 getting the price research possible new super drug to treat 0:04:40.200 --> 0:04:45.360 their hypertension. So you and again it sounds just overly simple, 0:04:45.440 --> 0:04:48.520 but you want group A who's taking the real drug 0:04:48.560 --> 0:04:51.800 to have better results than the group taking the sugar pill. 0:04:52.640 --> 0:04:55.640 But it's not always the case, and unless you discuss 0:04:55.720 --> 0:04:58.040 it's often a surprising amount of time it is not 0:04:58.080 --> 0:05:02.080 the case. And in fact, within a depressants in particular, 0:05:02.920 --> 0:05:06.760 they're finding astounding results, which is that seventy of the 0:05:06.839 --> 0:05:10.120 drugs that are using anidepressants are found to be effective, 0:05:10.480 --> 0:05:14.960 but also seventy five of the placebos are also giving 0:05:14.960 --> 0:05:18.480 people relief. So that all of a sudden that that 0:05:18.520 --> 0:05:23.080 puts the whole question about medication into a new light 0:05:23.400 --> 0:05:26.880 and the approach to actually even testing them or even 0:05:26.920 --> 0:05:32.480 assessing depression and other disorders. Um, it's actually really blown 0:05:32.520 --> 0:05:35.919 open the whole placebo effect in general and made Big 0:05:35.960 --> 0:05:39.200 Farm look at placebo in a new way because before 0:05:39.240 --> 0:05:40.719 it was sort of like we just have to get 0:05:40.720 --> 0:05:45.600 over the placebo effect. It's a problem. Yeah, and and 0:05:46.000 --> 0:05:50.040 there's this great Wired article it's called placebos are getting 0:05:50.040 --> 0:05:52.760 more effective. Drug makers are desperate to know why, and 0:05:52.800 --> 0:05:54.960 they actually call out the fact that that this may 0:05:55.000 --> 0:05:58.680 be an opportunity to actually look at the amazing ability 0:05:58.760 --> 0:06:00.840 of the body to heal its health. Yeah. This is 0:06:00.880 --> 0:06:07.159 the article by Wired Steve Silberman, Yeah, be Silberman, Yeah, yeah, So, 0:06:07.200 --> 0:06:11.000 I mean it's it's pretty fascinating to look at the issue. 0:06:11.200 --> 0:06:14.119 And um, I wanted just to give a little quick 0:06:14.160 --> 0:06:17.000 history of placebo though. Oh yeah, now we're only going 0:06:17.160 --> 0:06:20.640 we're going by Sieber's paper and going back to World 0:06:20.680 --> 0:06:23.920 War two, right, Yeah, World War two basically you have 0:06:25.200 --> 0:06:30.640 you know, in Italy, there's um, there's an enthusiologist I believe, Yeah, 0:06:30.920 --> 0:06:33.560 by the name of Henry Beecher, yea Henry Beecher. He's 0:06:33.600 --> 0:06:37.520 attending to U. S. Troops under heavy German bombardment. And uh, 0:06:37.760 --> 0:06:41.279 when you're treating catastrophic injuries, you need to have morphine 0:06:41.320 --> 0:06:43.719 on hand, right, So they're pumping full Yeah, they're pumping 0:06:43.800 --> 0:06:48.039 morphine into these guys to to deaden the pain while 0:06:48.040 --> 0:06:51.839 they work on him. And uh, they run out of morphine. Yeah, 0:06:51.920 --> 0:06:54.840 And a nurse, very savvy nurse that was working with 0:06:54.920 --> 0:06:59.840 Henry Beecher basically pretended that she with a wounded soldier 0:07:00.120 --> 0:07:02.760 was giving him an injection of morphine and said, I'm 0:07:02.760 --> 0:07:05.160 giving you a really potent pain killer. Don't worry, You'll 0:07:05.200 --> 0:07:08.560 be fine. It was in fact only saltwater. Um. But 0:07:08.800 --> 0:07:13.200 what Beacher observed is that the wounded soldier did not 0:07:13.280 --> 0:07:16.760 go into shock when he had his procedure done, and 0:07:16.800 --> 0:07:19.960 that the wounded soldiers seemed to feel relief. So he 0:07:20.040 --> 0:07:23.600 saw firsthand the effects of the placebo effect, and later 0:07:23.640 --> 0:07:25.560 on when he went back to Harvard after the war, 0:07:25.680 --> 0:07:28.760 he began to look at it more seriously, um, and 0:07:29.000 --> 0:07:32.840 was now investigating the placebo effect against current day medications 0:07:32.880 --> 0:07:35.160 of that time to see if they were really effective. 0:07:35.200 --> 0:07:38.480 It was an incredible new idea. Actually. Yeah, in the 0:07:39.400 --> 0:07:42.120 you put out a paper called the Powerful Placebo, publishing 0:07:42.120 --> 0:07:46.680 the Journal of American Medical Association, and uh, it undermined 0:07:46.680 --> 0:07:49.239 the results of more than a dozen trials by causing 0:07:49.720 --> 0:07:55.600 improvement that was mistakenly uh, you know, attributed to whatever 0:07:55.600 --> 0:07:59.400 the medicinal properties were. Yeah, yeah, so it was This 0:07:59.480 --> 0:08:04.720 was a a huge moment in modern drugs because because suddenly, 0:08:04.800 --> 0:08:08.240 here's the placebo messing up everything that you're you're trying 0:08:08.280 --> 0:08:10.840 to do, becoming this hurdle. And like you said, that's 0:08:10.880 --> 0:08:12.800 kind of the history of it. It It becomes this hurdle 0:08:13.240 --> 0:08:16.360 when uh, when perhaps they you know that you could 0:08:16.440 --> 0:08:18.320 argue they should be looking at it and saying, well, 0:08:18.400 --> 0:08:22.000 why why is the placebo working as opposed to why 0:08:22.160 --> 0:08:26.320 why are drugs not working better than the pacebo? Yeah, 0:08:26.360 --> 0:08:27.920 and with Beecher, I mean, he was just trying to 0:08:28.000 --> 0:08:30.520 keep quackery at bay, right, and he was basically just 0:08:30.560 --> 0:08:33.600 trying to apply this um. He wasn't necessarily thinking that 0:08:33.640 --> 0:08:35.520 this was going to be taken up by big farmer, 0:08:35.640 --> 0:08:38.560 nor could he have ever predicted how big this industry 0:08:38.600 --> 0:08:41.320 would become. And as you say, it would become this 0:08:41.360 --> 0:08:45.760 obstacle for them to to, you know, get over um. 0:08:45.960 --> 0:08:47.920 So there you go. That's the history of it, and 0:08:47.960 --> 0:08:50.120 that's why we have it and we know that it's effective. 0:08:51.040 --> 0:08:53.920 But that being said, it's been a long time since 0:08:54.240 --> 0:08:58.320 we've revisited the placebo effect, and particularly in the light 0:08:58.480 --> 0:09:00.720 of antidepressants and stuff and what's talk about a little 0:09:00.720 --> 0:09:04.040 bit about that later, and it still remains a fairly 0:09:04.120 --> 0:09:08.600 unknown quantity. I mean, it's scientists continue to try and 0:09:08.679 --> 0:09:11.080 understand it. But the will seebo effect is is in 0:09:11.120 --> 0:09:13.320 many ways still a mystery. Yeah, and we do know 0:09:13.400 --> 0:09:15.520 a little bit more. But I mean the question is, 0:09:15.600 --> 0:09:17.920 what in the world is really going on in your 0:09:17.920 --> 0:09:21.920 body when it starts to actually heal itself and give 0:09:21.960 --> 0:09:25.679 you albeit temporary really right, placebo effect has its limits. 0:09:25.679 --> 0:09:30.400 It's not going to cure tumor. But um, if you've say, 0:09:30.480 --> 0:09:35.840 like you have Parkinson's or um sexual dysfunction or um 0:09:35.840 --> 0:09:39.480 sorry for you, and you have maybe depression or something 0:09:39.480 --> 0:09:42.640 along those lines, we know that those sort of disorders 0:09:43.480 --> 0:09:48.240 really respond well to placebo effect. So um. And actually 0:09:48.280 --> 0:09:51.360 it was once thought that placebo effect was a result 0:09:51.400 --> 0:09:54.520 of our own level of gullibility or even like a 0:09:54.559 --> 0:09:59.360 psychological trait that was related to neurosis, weakness of character, 0:09:59.480 --> 0:10:01.679 kind of thing. Give him anything, they'll they'll give him 0:10:01.679 --> 0:10:04.680 a sugar pill. They'll think they're they're healed. But but 0:10:04.760 --> 0:10:06.800 it seems more than that now obviously, I mean, we 0:10:06.840 --> 0:10:09.560 can't go so far as to, you know, scientifically say 0:10:09.880 --> 0:10:12.760 what it's mind over matter, it's it's anything you believe 0:10:12.880 --> 0:10:17.080 becomes real, because I don't either that's not the case, 0:10:17.160 --> 0:10:19.840 or no belief is really strong enough to to to 0:10:20.080 --> 0:10:23.839 alter physical reality. But but but something's happening, but we 0:10:23.880 --> 0:10:25.880 see the belief system working in tandem with the body. 0:10:26.000 --> 0:10:30.320 So uh entered Dr Fabrizio Benedetti, UM, and he actually 0:10:30.360 --> 0:10:33.280 calls a placebo effect the placebo response because of its 0:10:33.280 --> 0:10:37.040 self healing, and he calls it endogenous health care system. 0:10:37.080 --> 0:10:40.880 After fifteen years of research, Benedetti has mapped a biochemical 0:10:40.960 --> 0:10:44.760 reactions of the placebo effect and he's found that Uh. 0:10:44.840 --> 0:10:47.160 And this is again from the Wired article quote, placebo 0:10:47.240 --> 0:10:51.520 activated opioids not only relieve pain, they also modulate heart 0:10:51.600 --> 0:10:55.840 rate and respiration. The neurotransmitter dopamine, when released by the 0:10:55.840 --> 0:11:00.520 placebo treatment, helps improve motor function in Parkinson's patients. Uh. 0:11:00.559 --> 0:11:03.640 So it's mechanisms like this that can elevate mood, sharpen 0:11:03.720 --> 0:11:07.920 cognitive ability, alleviate jutive disorders IBS is another one. But 0:11:08.360 --> 0:11:11.319 responsibile to this, by the way, relieve insomnia and limit 0:11:11.360 --> 0:11:15.000 the secretion of stress related hormones like insulin in the cortisol. 0:11:15.320 --> 0:11:19.520 So he's seeing this in action. UM. And again we're 0:11:19.520 --> 0:11:22.880 talking about the placebo effect working in tandem with the mind, 0:11:23.400 --> 0:11:26.199 and what this is bearing out is that the mind 0:11:26.360 --> 0:11:30.440 is trying to anticipate the future, right it's just it's saying, Okay, 0:11:30.559 --> 0:11:34.119 I'm going to take this pill. I've got this condition, 0:11:34.800 --> 0:11:38.480 and you know I already know that. Um, I already 0:11:38.520 --> 0:11:42.120 knew what to expect in terms of relief and even 0:11:42.160 --> 0:11:45.680 side effects, right, And so the mind is actually queuing 0:11:45.720 --> 0:11:49.760 itself up for this and releasing those opioids, which is 0:11:50.000 --> 0:11:54.120 amazing um. And actually one of the biggest self healing 0:11:54.160 --> 0:11:57.400 triggers is to witness someone else experiencing the benefits of 0:11:57.400 --> 0:12:00.880 a drug. So again, you you have this sort of 0:12:00.920 --> 0:12:04.720 conditioning response. Well, you're you're engaging in this kind of 0:12:04.720 --> 0:12:08.920 so the social activity of of the the doctor administering 0:12:09.200 --> 0:12:11.960 something that that heals you. Yeah. Absolutely. In fact, there 0:12:12.000 --> 0:12:15.760 was a researcher ted Capouch, and he recruited volunteer suffering 0:12:15.800 --> 0:12:19.120 from IBS irritable Boll syndrome, and they were put into 0:12:19.200 --> 0:12:23.560 three groups. One group just made uh an appointment for 0:12:23.679 --> 0:12:26.280 treatment and they found some relief just by the act 0:12:26.320 --> 0:12:30.640 of signing up for for treatment. The other group were 0:12:30.679 --> 0:12:34.040 given a placebo from a medical professional who did not 0:12:34.200 --> 0:12:37.160 engage with them at all. And then the third group 0:12:37.200 --> 0:12:41.960 were given the placebo, but the clinician actually engaged with 0:12:42.040 --> 0:12:45.200 that group quite a bit, talked to them about their suffering, 0:12:45.320 --> 0:12:49.360 talked about them, um, you know how they felt about it, 0:12:49.559 --> 0:12:53.360 and gave them some positive feedback. So again here we go. 0:12:53.800 --> 0:12:56.520 Like you mentioned, there's there's the social aspect to it. 0:12:56.679 --> 0:12:59.280 That group responded the best out of all three. So 0:12:59.360 --> 0:13:02.160 the bed the beds I manner of the physician is 0:13:02.160 --> 0:13:05.840 really important. Yeah, absolutely. Um. Steve Silverman also points out 0:13:05.880 --> 0:13:08.480 that the color of the pill even makes it different. 0:13:08.800 --> 0:13:12.760 This is this is like yellow pills make make the 0:13:12.760 --> 0:13:16.520 bet the most effective antidepressants. Red pills give you a kick, 0:13:16.640 --> 0:13:18.600 you know because it's red, like the blood of a 0:13:18.640 --> 0:13:23.560 bull or something. Right. Adrenaline. Yeah, green reduces anxiety, you know. 0:13:23.640 --> 0:13:27.840 Green is kind of calming. Um and uh and and 0:13:27.840 --> 0:13:30.000 and they say that even like branding, you know, becomes 0:13:30.040 --> 0:13:32.040 involved in it, like it's all in the packaging and 0:13:32.080 --> 0:13:34.560 the delivery. And I mean the color thing just makes 0:13:34.559 --> 0:13:37.160 me think, you know, it's just some like a sufficiently 0:13:39.080 --> 0:13:43.560 sufficiently believable physician could just walk into a sick ward 0:13:43.600 --> 0:13:46.360 with like a bag of starbursts and just start healing 0:13:46.360 --> 0:13:48.760 people left and right. Yeah, if you have the association 0:13:48.840 --> 0:13:51.360 that starbursts, we're going to make everything about like you know, 0:13:51.400 --> 0:13:54.160 if maybe Star Wars had spent one hundred million dollars 0:13:54.160 --> 0:13:57.480 on the campaign trying to link some sort of benefit 0:13:57.520 --> 0:14:00.920 between the consumption of the chewy stuff stuck in your 0:14:01.280 --> 0:14:04.640 teeth and your health. Um. One of the other things 0:14:04.640 --> 0:14:07.600 too that was interesting is that it's cultural. These perceptions 0:14:07.600 --> 0:14:10.719 are cultural. Oh yeah, like they're the Germans, right, well, 0:14:10.800 --> 0:14:13.600 not only the Germans, but the Italians because you're talking 0:14:13.640 --> 0:14:16.200 about the blue pills and the red pills and so 0:14:16.920 --> 0:14:18.959 of course the blue pills was to be soothing, right 0:14:19.080 --> 0:14:22.000 and the red pill again it's more of an aggressive thing. 0:14:22.240 --> 0:14:26.560 But in Italy the color of the national soccer team 0:14:26.720 --> 0:14:32.000 is blue, so that's perceived as aggressive. And yeah, so 0:14:32.080 --> 0:14:34.960 it comes down, you know, to that level. It's really interesting. 0:14:35.080 --> 0:14:37.240 That is fascinating, Like I wonder how that affects like 0:14:37.280 --> 0:14:40.360 even like international branding, you know, oh yeah, you know 0:14:40.400 --> 0:14:42.760 if you have you have branding for for something that's 0:14:42.960 --> 0:14:46.680 that you want the consumer to to think of it 0:14:46.720 --> 0:14:50.280 and relax terms or soothing terms, and then in Italy 0:14:50.320 --> 0:14:52.000 you have the angry blue and the you know, the 0:14:52.280 --> 0:14:55.840 victorious soccer team and get them all riled up. Yeah yeah, 0:14:55.840 --> 0:14:58.240 and you have to wonder how that extends like throughout 0:14:58.240 --> 0:15:00.680 their society, like you know, if they've if their apartments 0:15:00.720 --> 0:15:02.400 are all in blue, if that's not like, wow, that's 0:15:02.440 --> 0:15:07.040 like a really aggressive bachelor. But the Germans in particular. 0:15:07.440 --> 0:15:11.600 Anthro anthropologist Daniel Mormon um to the study and he 0:15:11.600 --> 0:15:15.000 found that Germans are high placebo reactors and trials of 0:15:15.080 --> 0:15:18.640 ulcer drugs, but low in trials of drugs for hypertension. 0:15:19.840 --> 0:15:25.040 Um because hypertension is an undertreated condition in Germany. So um. 0:15:25.720 --> 0:15:28.040 So again, it's about engaging in this in this uh, 0:15:28.720 --> 0:15:31.160 this social maze that comes with the treatment of an 0:15:31.280 --> 0:15:34.320 of an illness, being being aware of its treatment, seeing 0:15:34.720 --> 0:15:38.320 um success stories either in your life or in the media, 0:15:38.600 --> 0:15:40.480 like a lot of it. Like you know, when you 0:15:40.560 --> 0:15:43.280 think of like anxiety or depression medications, instantly we think 0:15:43.280 --> 0:15:46.440 of those commercials where or I guess it's also even 0:15:46.440 --> 0:15:48.320 for things like her pies and stuff. But it's like 0:15:48.320 --> 0:15:50.560 you know, some smiling person walking through a field and 0:15:50.560 --> 0:15:53.680 they're happy and they're they're running and birds are singing 0:15:54.360 --> 0:15:56.720 and it is just driving home. Take this and be 0:15:56.800 --> 0:15:59.600 happy and you will be able to go outdoors and frolic. 0:16:00.000 --> 0:16:01.840 That's usually the message. Oh and you'll you know, you'll 0:16:01.880 --> 0:16:04.360 be surrounded by a bunch of people who love you. Yeah, 0:16:04.400 --> 0:16:06.400 it's kind of the same as a Mentos commercial, except 0:16:06.400 --> 0:16:08.040 they have to add a lot of legal text at 0:16:08.040 --> 0:16:10.160 the end, like Mentos doesn't have to have that that 0:16:10.280 --> 0:16:13.040 half a strain of fight. Yeah, there's there's no talk 0:16:13.080 --> 0:16:16.160 of diarrhea and the Mentos commercial thanksfully. Um. But the 0:16:16.280 --> 0:16:19.360 German example that is really interesting that that makes me think, 0:16:19.440 --> 0:16:22.240 is it um again, is it sort of like this 0:16:22.560 --> 0:16:27.840 uh anticipation like they because it is underreported, Um, what 0:16:27.880 --> 0:16:30.880 was the hypertension is under reported? It's not as big 0:16:30.880 --> 0:16:34.120 of a deal maybe, and they're not as conditioned to 0:16:34.120 --> 0:16:36.640 to think as much of it as that perhaps, I 0:16:36.680 --> 0:16:38.280 think so, Yeah, like it's undertreated, like it's just not 0:16:38.320 --> 0:16:42.480 on people's minds as much, where whereas you know, something 0:16:42.520 --> 0:16:45.200 like like depression is very much on everybody's minds. Everybody, 0:16:45.280 --> 0:16:48.040 Like we just have this this uh almost like this 0:16:48.240 --> 0:16:51.560 cult of the quest for happiness that has been pressed 0:16:51.600 --> 0:16:54.640 upon us through uh mass media and through you know, 0:16:54.800 --> 0:16:59.040 everybody knows somebody who takes the takes something to improve 0:16:59.120 --> 0:17:02.120 their their daily life, whether it's uh, you know, prescote 0:17:02.120 --> 0:17:06.160 medication or just some sort of weird you know, herbal 0:17:06.200 --> 0:17:07.960 thing that they buy from the health food store. Yeah, 0:17:08.000 --> 0:17:10.240 that's true. And just just to put that in perspective 0:17:10.240 --> 0:17:13.720 with the statistic, let me see, in nine six there 0:17:13.760 --> 0:17:18.200 were thirteen million antidepressants doled out and that has since 0:17:18.280 --> 0:17:22.480 doubled to twenty six million by two thousand and seven. Yeah, So, 0:17:22.760 --> 0:17:25.120 I mean, and you know, we all know that that's 0:17:25.160 --> 0:17:29.000 something that everyone is apt to grapple with at some point. 0:17:29.200 --> 0:17:31.280 We have plenty of statistics that tell us that, you know, 0:17:31.400 --> 0:17:33.560 each of us is going to at some point feel 0:17:33.640 --> 0:17:37.120 maybe a cute depression. So it's not surprising that it's 0:17:37.160 --> 0:17:40.560 on our minds. Um. But again, you know, good getting 0:17:40.600 --> 0:17:42.760 back to the placebo effect and why it may be 0:17:42.880 --> 0:17:45.639 getting stronger, and going back to the commercials that you 0:17:45.680 --> 0:17:48.040 were talking about. That actually seems to be one of 0:17:48.080 --> 0:17:51.639 the culprits of why the placebo effect, why people in 0:17:51.640 --> 0:17:56.480 clinical trials are feeling this conditioning to to get better 0:17:56.560 --> 0:17:59.800 or actually self healing. Um. They think that the marketing 0:18:00.000 --> 0:18:02.720 has just been so great and so rampant that it's 0:18:02.800 --> 0:18:05.639 really conditioning people to already get in that mindset. We 0:18:06.640 --> 0:18:08.520 already have studies that say that when people make an 0:18:08.560 --> 0:18:12.080 appointment to even do this, they feel better. So that's 0:18:12.119 --> 0:18:16.639 that's one area of it. Uh. And then another aspect 0:18:16.840 --> 0:18:22.760 is that the way that they're classifying an illness or 0:18:22.920 --> 0:18:26.000 disorder this is sort of interesting. And talking about depression 0:18:26.119 --> 0:18:29.639 in particular, there's something called the Hamilton's Depression Rating Scale, 0:18:29.640 --> 0:18:32.000 and that was created fifty years ago and it's based 0:18:32.080 --> 0:18:36.199 on a study of major depressive disorder and patients in 0:18:36.280 --> 0:18:38.919 an asylum. Okay, so you can already tell that there 0:18:38.920 --> 0:18:42.680 are problems with this scale anyway, because fifty years ago, 0:18:43.040 --> 0:18:45.719 when we had a different idea of what depression was 0:18:46.359 --> 0:18:51.240 in an asylum a small sample group. Um, So there 0:18:51.280 --> 0:18:53.600 are people today they are saying, maybe we shouldn't take 0:18:53.640 --> 0:18:57.399 this scale and use it particularly for disorders that have 0:18:57.480 --> 0:19:02.200 to do with depression, and revisit this and and maybe 0:19:02.200 --> 0:19:04.680 we'll get a better idea of what the placebo effect 0:19:04.720 --> 0:19:08.640 is doing if we can redefine what depression is an 0:19:08.640 --> 0:19:10.760 interesting way of looking at it. Um. Now, there are 0:19:10.760 --> 0:19:19.480 a couple of other related This presentation is brought to 0:19:19.520 --> 0:19:27.080 you by Intel Sponsors of tomorrow topic sample Sebo that 0:19:27.080 --> 0:19:29.439 that are pretty fascinating. One that I ran across and 0:19:29.640 --> 0:19:32.440 imagine you did as well, it's the honest placebo, and 0:19:32.520 --> 0:19:34.399 I just that, well, this is kind of like what 0:19:34.440 --> 0:19:37.200 I was talking earlier. If I, you know, if I 0:19:37.200 --> 0:19:38.760 I have to say, you know, I have some sort 0:19:38.800 --> 0:19:41.640 of herbal thing back from the health, you know, and 0:19:42.000 --> 0:19:44.320 I don't know for certain that it's working, but I 0:19:44.320 --> 0:19:46.639 don't know that it's not working. But if I knew 0:19:46.680 --> 0:19:48.640 for a fact that it was just a sugar pill, 0:19:48.920 --> 0:19:51.760 would it still work on me? Well, this is called 0:19:51.800 --> 0:19:57.280 an honest placebo? Uh, this is a doctor's uh involved 0:19:57.320 --> 0:19:59.840 in this think that the placebos work because patients think 0:19:59.840 --> 0:20:01.639 they might be getting an active drug. But there's a 0:20:01.640 --> 0:20:04.080 no element of deception or I mean that's the the 0:20:04.119 --> 0:20:06.600 old version, you know. It's like there's the deception at 0:20:06.600 --> 0:20:08.520 work that I think this is gonna work. So it does, 0:20:08.560 --> 0:20:10.760 even it's a sugar pill. Right. But in two thousands, 0:20:10.760 --> 0:20:13.719 ten Harvard researchers found that even when volunteers with severe 0:20:13.720 --> 0:20:18.520 bowel disease know they're getting a placebo, had relief in 0:20:18.560 --> 0:20:23.800 the symptoms um which which is is is pretty amazing. Yeah. 0:20:23.840 --> 0:20:25.960 I know. Again, it's that whole idea of like, why 0:20:26.000 --> 0:20:28.640 aren't we studying what's going on with the body when 0:20:28.640 --> 0:20:30.840 it's trying to self heal. And then it brings up 0:20:30.840 --> 0:20:34.920 the question of do we must must we always have deception? Yeah? 0:20:35.080 --> 0:20:39.240 You know, is there is there any way too to 0:20:39.320 --> 0:20:43.199 have the placebo response without some sort of you know curtain, 0:20:43.800 --> 0:20:46.160 you know, behind our understanding of what's going on? Well, 0:20:46.600 --> 0:20:48.520 it seems like one way that it might. It's like, 0:20:48.560 --> 0:20:51.000 even in listening to this podcast, or even in researching 0:20:51.040 --> 0:20:54.160 this podcast, we get this idea that, oh, there's I mean, 0:20:54.520 --> 0:20:56.800 I hate to mystify it at all, but you kind 0:20:56.800 --> 0:20:59.600 of get this mystic idea of what is a placebo doing? 0:21:00.040 --> 0:21:01.919 Maybe you know, what is my mind doing when I 0:21:01.920 --> 0:21:05.199 take up placebo? And then it becomes this possible that 0:21:05.240 --> 0:21:09.120 you get this possible expectation in your mind that even 0:21:09.160 --> 0:21:12.000 if you take something that doesn't work, that it might work, 0:21:12.040 --> 0:21:14.879 you know, like like that becomes the new placebo, the 0:21:14.920 --> 0:21:17.680 new fiction for the placebo to work. Then. But see, 0:21:17.720 --> 0:21:19.760 that's why I think it's so fascinating, because I think that, 0:21:20.600 --> 0:21:23.120 you know, in an evolutionary sense, have we always had 0:21:23.160 --> 0:21:28.040 to construct some sort of fiction in order to pull through? 0:21:28.200 --> 0:21:29.560 Do you know what I'm saying is this is it 0:21:29.720 --> 0:21:33.400 something that's comes out of evolution. Well, interestingly you should 0:21:33.400 --> 0:21:36.240 ask that because there is a guy in the name 0:21:36.240 --> 0:21:41.320 of Matt Rossano who's professor of psychology at Southeastern Louisiana University, 0:21:41.840 --> 0:21:45.040 and he wrote a book called Supernatural Selection, How Religion Evolved, 0:21:45.080 --> 0:21:48.760 And this is basically his argument. All right, Um, First, 0:21:48.960 --> 0:21:52.520 he says that our ancestors developed complex social structures to 0:21:52.560 --> 0:21:55.720 cope with a harsh, unforgiving world. You know, it's there, 0:21:56.680 --> 0:22:00.639 giant mammals everywhere eating everything I have worked really hard discrete, buy, 0:22:00.680 --> 0:22:02.560 and then I'm going to die when I'm really young, 0:22:02.720 --> 0:22:05.439 probably eaten by a large mammal. Uh. It's it's a 0:22:05.520 --> 0:22:08.159 rough world. So you know, you end up with this, 0:22:08.240 --> 0:22:11.919 This social structure emerges, um and uh. And you end 0:22:12.000 --> 0:22:14.639 up with the hierarchy in the group and uh. And 0:22:14.680 --> 0:22:18.120 there's some probably some sense of peace or some structure 0:22:18.200 --> 0:22:20.480 that makes you feel better about the world. Right, But 0:22:20.600 --> 0:22:22.280