veryrarelystable:

spacetwinks:

spacetwinks:

the fact that placebos can work even when you know they’re placebos is so fucked up. what the hell is up with the brain

like some kind of fucked up wrinkled goblin that won’t unlock the chemical secrets if you just ask politely, you have to give it some kind of pill. you can tell it that the pill doesn’t do shit, but it doesn’t care, it just wants the pill

A few years ago I had the privilege of proof-reading a dissertation on drug addiction interventions which touched on the placebo effect (because it turns out successful addiction interventions share the basic elements of the placebo effect: a desire to get better, a change in one’s beliefs about one’s condition, and a positive relationship with a trusted authority figure).

How the placebo effect works, in terms of feedback between the brain and (presumably) the inflammatory system, is still unknown.  But the logic of why the placebo effect should happen is not that mysterious.  There are two basic principles.

One, pain is protective.  A lot of the conditions we take medicines for are in fact interim defence mechanisms.  Pain stops us doing things that damage our bodies.  Fever kills pathogens.  Vomiting gets rid of poisons.  Fainting cuts the work-load on the heart.

Two, healing takes resources.  Before the body commits to expending those resources fully it needs to be certain they’re not needed for something else, like fighting off a secondary bacterial infection.  And of course the circumstances in which we get sick in the first place are the same circumstances in which we might want to hold resources in reserve for dealing with further assaults on the body.

This means that our healing systems will stay in the interim condition until they get a signal of some kind to let them know that our circumstances have changed and full healing is a good investment now.  What part of our body processes that kind of complex information?  The brain, that’s what.

The information basically needs to take the form: “Something external has changed and we have confirmation that as a result we are going to recover from this condition.”  Apparently our healing systems can tell when we’re just making it up to jolly them along.

The logic is presumably the same in most species, but in humans, being language-users, that external change can take the form of someone whom we trust to know what they’re talking about saying “These pills will do the trick.  Drop into the pharmacy on your way home and hand them this bit of paper.”

Most likely the signal from the brain takes the form of some kind of hormone, triggered by a new emotional state.

The word for the subjective experience of that emotional state?  Hope.