Respectful Insolence

A couple of weeks ago, I made the observation that there seems to have been a–shall we say?–realignment in one of the central arguments that proponents of “complementary and alternative medicine” (CAM) and “integrative medicine” (IM) make. Back in the day (say, a few years ago), such CAM practitioners and apologists used to try very, very hard to argue that their modalities had actual efficacy, that they had actual, measurable effects that made them medicine rather than woo. Never mind that even back then they had been trying for at least a couple of decades to come up with preclinical and clinical evidence that various magical CAM modalities worked, without any appreciable success. Worse for them, it’s only gotten worse over the last few years. As I’ve documented here and elsewhere, the larger and better-designed the scientific study, the more likely it is that a CAM modality will show no efficacy detectably different than placebo effects. When we test a drug or medical device, finding no difference between the treatment arm and placebo arm leads us to conclude that the drug or device (or whatever intervention) does not work; i.e., does not have effects detectably different from nonspecific effects. When CAM practitioners find no difference between the treatment arm and placebo arm, they conclude that their treatment has promise. I love the double standard, don’t you?

In any case, as more and more evidence comes in failing to find CAM modalities to be any more efficacious than placebo, the inevitable conclusion is that most of CAM is placebo medicine. Given that placebo effects have not been shown to have any detectable effect on the actual pathophysiology of disease, that they are variable, unreliable, and generally weak, and that invoking them requires deceiving the patient, it is considered at best ethically dubious and at worst completely unethical to treat patients with placeboes. They are not particularly effective, and a practitioner must, in essence, lie to his or her patient. Paternalism, although by no means gone in medicine, is soooo 1950s; it’s slowly disappearing, and the disapproval of using placebo medicine is one part of that decline–except in CAM, apparently.

In any case, as I pointed out a couple of weeks ago, when faced with more and more evidence that the vast majority of CAM is placebo medicine, what do CAM pracitioners do? Do they do what a science-based practitioner would do, at least eventually, and give it up? Of course not! Instead, they double down and embrace the “placeboness” of their treatments by invoking the “powerful placebo” and claiming that they are “harnessing the power of placebo” to produce “powerful mind-body healing,” of course!

I thought I was done with this topic, at least for a while, but then I found a post in–where else?–that wretched hive of scum and quackery, The Huffington Post by someone named Robert Schiffman, who is apparently a journalist and wants to tell us How the Placebo Effect Proves That God Exists.


Now, I’ve seen some over-the-top CAM apologetics invoking the “power” of placebo to provide “mind-body” healing, but this was a new high (or low, depending upon your point of view). Schiffman first complains that people didn’t listen to him when he tried to argue in previous post that prayer and spirituality are correlated with better health. That in and of itself would be a topic for a post, given that I haven’t addressed that issue in a long, long, time, but for the moment I’m interested in his argument that the placebo effect somehow proves the existence of God. For the moment, it suffices to say that the evidence that prayer somehow results in greater health is does not mean what Schiffman thinks it means. In other words, it doesn’t show what Schiffman thinks it does; certainly it doesn’t show that prayer heals. Maybe I’ll elaborate next week if the mood takes me. Given that Schiffman argues in his previous article that the “jury is out” regarding whether intercessory prayer works, we know right away that he can’t be the greatest synthesizer of scientific

For now, here’s Schiffman’s, in which he concedes:

The research which correlates spiritual practices with health benefits does not ascribe these benefits to the intervention of a supernatural being. It does not prove that the God who people are praying to actually exists. It merely establishes that those who pray and meditate tend to be statistically healthier than those who don’t– end of story. And as for the placebo effect, you will get no argument from me there either. It is when people say “just a placebo effect” that my hackles rise.

But then he argues:

The placebo effect is arguably the most underrated discovery of modern medicine. Replace “just the placebo effect” with “the amazing placebo effect,” “the mind boggling placebo effect.” To my way of thinking, the very existence of this mysterious effect proves that God exists. That’s right, you can find evidence for the foundational truths taught by religion in virtually every double blind medical research study!

This clearly takes the promotion of placebo effects to an all new level, far beyond anything I’ve ever seen before. Placebo is evidence that God exists? Seriously?

Seriously.

First, however, Schiffman has to do some fancy footwork about just what he means by “God.” He’s quick to point out that what he means by “God” is not what a lot of “religious folks” mean when they refer to “God.” He also concedes that what he means by “God” might or might not be the “God you believe in” or “disbelieve in.” Schiffman doesn’t view God as some white-bearded dude in the sky or the “reclusive author of just one immemorial bestseller, the Hebrew Bible,” or the father of “just one son” (a.k.a. Jesus Christ). Instead, he does a bit of metaphorical hand waving, declaring God to be “so vast and all encompassing that we cannot limit it in the usual ways.” In other words, Schiffman is starting to sound more and more like a Deist, or maybe Deepak Chopra. The Chopra connection becomes even more obvious when he writes:

But I am not saying that you and I in our egocentric and separate selves are God. It is rather the other way around — when we drop the elaborate pretense and disguise of being these limited and conditioned entities, we discover that we are not separate or apart from anything. We are part and parcel of all that exists.

This sounds to me very much like Deepak Chopra’s “universal consciousness” woo, in which we are all somehow mystically connected by some sort of life force driven by Chopra’s misunderstanding of quantum physics and genetics. But, I wondered, what does any of this have to do with placebo effects and, even if any of this had anything to do with placebo effects, how does it “prove” that God exists? To Schiffman, it seems that it has something to do with mystics proclaiming themselves “one with God” or some such twaddle. As I read this, I was still trying to figure out just what the hell Schiffman was talking about and how any of this has anything to do with placebo effects. I bet you’re wondering, too.

So, I’ll end the suspense. Unfortunately, the payoff isn’t as interesting or brilliant as one might have hoped:

Which brings us back to the placebo effect. It is mysterious, right? We don’t know how it happens. A person was sick and they take a sugar pill and next thing you know — voila — they are healthy. To call this “the placebo effect” is to dress up our ignorance in words. What has actually happened is nothing short of a miracle. Science has got no explanation for it– something immaterial (a thought?) has impacted something material (our body) in a way which utterly defies logic.

Oh, no. I think I know where this is going. Unfortunately, where I think this is going and where it is going are pretty darned close:

And that is what prayer is all about. Prayer is based upon the conviction that the immaterial is more powerful than matter itself. Whether we call this immaterial force “God,” “the ground of our being,” “Spirit,” or “higher consciousness” doesn’t matter. The point is– there is an uncanny power (which all of us without exception have got access to) which performs miracles. The sick can be cured, the broken can feel whole again.

Yes, you read it right.

Let me get this straight. Because we don’t understand placebo effects and science has “no explanation” for them, placebo effects must be a miracle. And, apparently, because prayer is all about the conviction that the immaterial is more powerful than matter, it’s about miracles too. It so obviously follows that because we don’t well understand either prayer or placebo, they must be the same thing and the existence of placebo effects must be proof positive of the existence of God?

Or did I miss something here?

Of course, this is all Schiffman means to ask rhetorically, “Do we need any other proof for the existence of God?” My first retort was, “Well, yeah! Yeah we do! A hell of a lot of other proof!” My second thought was that Schiffman really doesn’t understand placebo effects. He seems to think they’re faith healing, given that he seems to think that a sick person taking a sugar pill will make a sick person healthy again (presumably only if you believe, given that expectancy effects are such an important part of placebo effects). They’re not. As I’ve explained time and time again, placebo effects are a name that encompasses a complex set of phenomenon that include observer effects, experimental bias in clinical trials, expectancy effects (wherein patients who expect to get better actually do feel better), the Hawthorne effect (in which the simple act of observation affects the outcome), and artifacts of the clinical trial process. Placebo effects are only commonly observed for subjective outcomes; they do not detectably affect the pathophysiology of disease. In other words, if Schiffman’s view of what placebo effects were correct, we would expect that placebos might shrink tumors, reverse atherosclerotic damage to coronary blood vessels, or even reverse diseases like multiple sclerosis. They do not.

Ironically enough, it’s not uncommon to see CAM apologists making similar arguments, only without the God angle. They’ll portray placebo as “powerful” or “near miraculous” mind-body healing, the difference being that instead of invoking a supernatural God they invoke a supernatural ability of the body to heal itself. Indeed, that’s just one reason why I tend to view CAM as far more religious–excuse me, spiritual–than it is scientific. If it weren’t, it wouldn’t be CAM. It would be medicine.

Comments

  1. #1 palindrom
    February 3, 2012

    As always, The Simpsons has the answer.

    In other news, The Onion’s desk calendar today reprints a news item headlined “Kid With Cancer Hopes to Realize Dream of Meeting Competent Oncologist”.

  2. #2 Andreas Johansson
    February 3, 2012

    Further evidence that creativity and insanity are closely related. Sensible people would never think up something like this.

  3. #3 MikeMa
    February 3, 2012

    If you were a corrupt, self-serving bastard interested in coin rather than cure, this is the perfect approach. If the woo fails, the fault is with the patient victim for not believing hard enough. If the patient survives, well woo did it all. Win-win for the wooist liar.

  4. #4 Kate Hopkins
    February 3, 2012

    I’m somewhat discouraged to see you lump all Complementary and Alternative Medicine in with a spiritual approach to healing, and the attempt to prove God’s existence. As someone with an analytical mind, I would expect your article to be more precise, and speak directly to the target of God and placebos, not vague generalizations about CAM.

    While I absolutely agree with you that a large portion of what is being promoted as CAM are weak and ineffective, there is plenty of peer-reviewed research, and even some clinical trials currently underway for some unique and less toxic treatments. The two that I find most promising are Curcumin, and Mushrooms (currently given alongside chemo in Japan). The initial findings are that they enhance the effect of chemotherapy, and are protective of the immune system.

    While the American Cancer Society does not come out and recommend these treatments, and I doubt any doctors will be prescribing them any time soon, ACS does indicate the status of research in animals and humans that show promise.

    Yes, there’s still research to be done. I don’t expect you to promote them on your blog. But please don’t lump less toxic complementary treatments in with using prayer – one does in fact have some encouraging data, the other is purely anecdotal.

  5. #5 nastylittlehorse
    February 3, 2012

    Kate – surely once the trials have shown an effect, these treatments cease to be CAM and become, simply, medicine?

  6. #6 Orac
    February 3, 2012

    @Kate

    You must be new here. Welcome. If you weren’t new here, I’d find it hard to see how you could make such a criticisms, because I’ve written many times before about how certain herbs and plants might be effective because they actually contain pharmacologically active ingredients (i.e., drugs). I’ve also written many times how I don’t consider the study of natural products to be “CAM” because in reality it’s nothing more than pharmacognosy (the branch of pharmacology concerned with the study of natural products), an old and important subdiscipline of pharmacology.

    In fact, the lumping of herbs with “CAM” is just another way that CAM co-opts what is in reality science-based medicine (pharmacognosy, diet, exercise, etc.) as a foot in the door for the magic (homeopathy, “energy healing,” acupuncture, etc.). In fact, I only use the term “CAM” (or “IM”) because there isn’t really another suitable term. I also reject the false dichotomy inherent in CAM, which is that there is something “alternative” in medicine. To me, there are three kinds of medicine: medicine proven through science to be effective and safe; medicine not yet proven or disproven to be effective and safe; and medicine proven not to be effective and safe. The vast majority of “CAM” falls into one of the two latter categories. Finally, I’ll quote my favorite cliche: There is no such thing as “alternative” medicine. What do you call “alternative” medicine that works? Medicine.

  7. #7 Old Rockin' Dave
    February 3, 2012

    @ Kate Hopkins, #4:
    Finding new medical uses for natural substances is an actual scientific discipline called pharmacognosy, a branch of pharmacology, and drug companies big and small spend a significant amount of money to find them.
    In oncology, Taxol and the vinca alkaloids were found this way. Warfarin was a serendipitous discovery from an investigation of why clover seemed to be killing cattle. The topical pain reliever capsaicin comes from chili peppers.
    The story of the vinca alkaloids is instructive – the locals were making periwinkle tea for upset digestion. Not until evidence-based science studied them were they found to have anti-cancer properties.
    There is nothing magical or alternative in finding remedies from plants.

  8. #8 MikeMa
    February 3, 2012

    @Kate,
    Research into natural healing agents is only a problem when the methods are not rigorous or, as with many of these CAM/woo charlatans, rely on a cult of personality rather than actual research to sell their weeds. Studying spices is great. Extrapolating that a spice which has had inconclusive or incomplete results is a Pharma conspiracy to keep a cure from people is bollocks, and common. Or if one spice shows promise, many spices become coattail miracle cures.

  9. #9 g724
    February 3, 2012

    I’ll have to disagree, just a little.

    First, about the execrable nature of woo: One of the things I find most highly objectionable about it, is that it hijacks the emotions of awe and reverence and presses them into the service of nonsense for the sake of greed.

    It’s healthy and not unrealistic to feel a sense of awe when contemplating NASA’s latest space telescope photos, or the latest findings of physics about fundamental particles, or in biology about genetics, etc. It’s a Darwinian advantage to feel a sense of reverence for natural ecosystems, endangered species, and new findings about organisms and the ecological relationships among them. It’s highly likely that the origin of these feelings occurred when early humans contemplated the natural world around them and sought to understand it.

    What needs to be fought tooth & nail, is the hijacking and cheapening of those core human emotions to serve the bank accounts of the promoters of fraud.

    Second, IMHO it’s perfectly ethical to prescribe placebos as long as one is up-front about it. Ask the patient if they’re interested in doing an experiment, tell them that placebos don’t contain any medicine, and that they make some people feel better. Then, with informed consent, prescribe a bag of cough drops, one every four hours. Or chicken broth twice a day. And ask the patient to call back in two days.

    But there’s one circumstance under which prescribing placebos without the patient’s knowledge, is arguably ethical: when patients with viral infections demand antibiotics. Antibiotic abuse in all of its forms, particularly on farm animals but also by humans, is the undisputed cause of the development of resistant bacteria, one of the most significant public health threats we face. Nobody has a right to be a public health hazard, whether by abusing antibiotics or by letting a bedbug colony in their apartment go untreated, or by letting their swimming pool become a giant mosquito-breeding pond. If a patient won’t take “no” for an answer and demands inappropriate antibiotics, give them Power Placebos for the sake of protecting public health, and tell them to stay home until they’re better.

    Lastly, about Deism. Seems to me that an outbreak of popular Deism would be a good thing. Unlike fundamentalism, it respects others’ rights, it doesn’t seek to impose theocracy, and it at least claims to respect science (and many are the Deists who do respect science, rigorously, plus or minus their belief in a vague supernatural entity). If Deism can displace fundamentalism as the religion of choice by politicians and the masses, I’ll rejoice.

    There’s no need to insist on taking the Deus out of the Machina, so long as He/She/It doesn’t interfere with the mechanism.

  10. #10 Denice Walter
    February 3, 2012

    @ Kate Hopkins:

    I survey alt med and have been hearing about these substances for years ( RI even had a commenter using PSK for stage 4 colon cancer) as I have heard about prayer’s efficacy ( Larry Dossey 1990s). I suspect that- like many alt med, natural health memes- they are advertising techniques that serve two purposes simultaneously- they cause you to doubt standard SBM and raise hope that alt med is on the brink of momentous discoveries: the paradigm is about to shift, leaving SBM upon the ash heap of history. Meditation, prayer and supplements will replace pharma autocracy.

    In the early 1990s, I heard a great deal about “breakthroughs” involving CoQ10 for heart disease- at the time my extremely aged father was being treated for several types of heart problems, for most of the time with a simple, inexpensive med ( diltiazem) that kept him going for a really long time. Well, he’s gone now for 10 years and CoQ10 still hasn’t panned out, has it now? I can show you a 1992 alt med tome ( “Healthy Healing”, L. Rector-Page) that speaks of mushrooms’, curcumin’s, and CoQ10’s promise. Gary Null lauds the miracles of curcumin, along with garlic and ginger ( sounds like a curry) being discovered *this very day* . It’s right around the corner. So’s my grand prize in the lottery.

  11. #11 Steelclaws
    February 3, 2012

    The use of natural products becomes woo only after the product in question has been tested, found not to work but the woosters still make false claims about its efficacy.

  12. #12 Dangerous Bacon
    February 3, 2012

    I didn’t find that Orac’s article “lump(ed) all Complementary and Alternative Medicine in with a spiritual approach to healing”.

    It is true that “spirituality” and CAM often go hand in hand. For example, proponents of herbalism frequently argue that herbal medicines are safe and effective and that whole herb preparations are far superior to isolated active components, based on the idea that God put herbs on earth to serve mankind. Somehow, the conception that pharmacologically active herbal compounds evolved to serve the plants never comes into the picture.

  13. #13 Karl Withakay
    February 3, 2012

    “Which brings us back to the placebo effect. It is mysterious, right? We don’t know how it happens. A person was sick and they take a sugar pill and next thing you know — voila — they are healthy”

    This is some of the most profound ignorance of placebo factors that I have ever seen. First, it’s not completely mysterious. Certain placebo factors are very well understood, like the various perceptual, cognitive, and reporting biases on the part of both subjects and observers. If a person does better in a vision test after taking a homeopathic remedy, it’s very likely because they felt more confident about what they could barely make out on the chart and gave their best answer rather than just assuming they are probably wrong and saying “I can’t make that last line out”, or it is probably because the examiner is accepting near hits like X for a K. (Note to Steven Novella and the SGU: You can sort of fake an eye exam.)

    Second, it’s not really a matter of a sick person taking a sugar pill and becoming healthy, at least not any faster than they otherwise would have without the sugar pill. Placebos don’t affect objective outcomes.

  14. #14 Chris
    February 3, 2012

    Ms. Hopkins:

    The two that I find most promising are Curcumin, and Mushrooms (currently given alongside chemo in Japan). The initial findings are that they enhance the effect of chemotherapy, and are protective of the immune system.

    Ms. Hopkins please become acquainted with David Kroll. Along with the blogs he mentions, he also posts articles on the ScienceBasedMedical blog, many on the study of botanical products in medicine.

  15. #15 Jojo
    February 3, 2012

    I get the feeling that Schiffman’s research was limited to a philosophy 101 text and a bag of some really strong weed.

  16. #16 David N. Brown
    February 3, 2012

    As a theology student with a background in the sciences, I’d be willing to accept Schiffman’s line of argument as legitimate. The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called the spiritual realm, and theological interpretations are perfectly acceptable for discussion. Unfortunately, Schiffman doesn’t really seem interested in discussion, but only a simplistic presentation of a foregone conclusion.

  17. #17 kruuth
    February 3, 2012

    Schiffman’s excuse is too easy. We may as well use the Simpsons “A wizard did it” response.

    Kate, nobody doubts the efficacy of certain herbs, plants, etc. in medicine. Aspirin, one of the most widely used drugs ever comes from among other things, willow bark. It is tested, documented, peer reviewed, etc. That’s the difference.

    Not to stray here, but I asked before and didn’t hear. Anything on the Doctor’s Data vs Barrett lawsuit?

  18. #18 Karl Withakay
    February 3, 2012

    David N. Brown,

    “The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called the spiritual realm, and theological interpretations are perfectly acceptable for discussion. ”

    It’s somewhat ironic that you make that statement in a simplistic presentation of a foregone conclusion. Are you interested in providing support for your assertion in order to facilitate discussion?

  19. #19 Andreas Johansson
    February 3, 2012

    Dangerous Bacon wrote:

    Somehow, the conception that pharmacologically active herbal compounds evolved to serve the plants never comes into the picture.

    Well, duh. You needn’t look further than the name to tell evilution could never produce something that’s good for people. If it did, it’d be called goodution.

  20. #20 David N. Brown
    February 3, 2012

    @16,
    I am NOT presenting a “conclusion”, I am suggesting terms for constructive interaction between theology and psychology and medical science. The most fundamental consideration is that we are clearly dealing with phenomena that are not purely physical in nature. Also, in more practical terms, we can clearly see that emotional support is an important aspect of physical health, which is where religious leaders and communities can and should be stepping in.

  21. #21 Chemmomo
    February 3, 2012

    I am underwhelmed by Richard Schiffman’s article. He clearly doesn’t understand placebo effects, and he assumes far too much about how others perceive god.

    I looked at his earlier article as well, and several of his references in it. Not surprising: none of them lead to actual research articles, just more affirming summaries.

    @David Brown #18

    in more practical terms, we can clearly see that emotional support is an important aspect of physical health, which is where religious leaders and communities can and should be stepping in.

    Although you did include communites (and I’m assuming you meant to include secular communities as well as religious ones), this idea makes me very uncomfortable. Who decides when someone ought to step in and for whom?

  22. #22 David N. Brown
    February 3, 2012

    @19
    I mean primarily “faith-based” communities, though I am certainly aware of more or less secular organizations that try to give the same kind of support traditionally provided by churches and equivalent houses of worship. My own position, in actively working on resources for churches and other religious organizations, is that churches, synagogues, mosques etc can and should collaborate when it comes to dealing with illness and disability in their own members.

  23. #23 JGC
    February 3, 2012

    The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called [human psychology]…

    FTFY

  24. #24 Todd W.
    February 3, 2012

    But why God? Why not the devil? Placebos trick people into thinking that their condition is improving, when, in reality, it is not. People take a placebo and think that their asthma is getting better, but the airways are still just as constricted and inflamed. Given the general personalities ascribed to God and demons, I’d say placebos, if they prove anything spiritual at all, are proof that the devil exists.

  25. #25 Chemmomo
    February 3, 2012

    @Todd

    But why God? Why not the devil?

    The devil doesn’t sell as well.

  26. #26 David N. Brown
    February 3, 2012

    @21:
    Agreed, for purposes of discussion,”spiritual” and “psychological” are substantially interchangeable.

    @22:
    You bring up an important issue. All religious systems speak of benign and malign spiritual beings or forces, though recent trends have seen the latter heavily glossed over, especially in the New Age/ neo-pagan circles where “CAM” is especially strong.

  27. #27 JGC
    February 3, 2012

    So let’s substitute teh word ‘psychological’ for ‘spiritual’ since you beleive the words as you’re using them are interchangable. Your argument becomes

    The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called the [psychological realm], and theological interpretations are perfectly acceptable for discussion.

    Can you explain why you believe theology would be of utility when seeking to understand a psychological phenomena?

  28. #28 Mephistopheles O'Brien
    February 3, 2012

    If placebos really worked as Schiffman describes (you’re sick, you take a substance that has no active ingredient and – voila – you are well!) then that certainly would be convincing evidence of something. Magic, perhaps. Or possibly amazing mental control over the body. Or maybe even God, if you believe that God is in the habit of performing miracles every time someone takes a sugar pill.

  29. #29 Mephistopheles O'Brien
    February 3, 2012

    And if you give an elephant a magic feather…

  30. #30 Andreas Schaefer
    February 3, 2012

    possibly one can argue that Mr. Schiffman is proof that God exists: Certainly stupidity can not be the result of evolution through survival of the fittest, but must be regarded as sign of ‘design’. <\smirk>

  31. #31 Karl Withakay
    February 3, 2012

    David N. Brown,

    You have stated

    “The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called the spiritual realm, and theological interpretations are perfectly acceptable for discussion. ”

    and

    “The most fundamental consideration is that we are clearly dealing with phenomena that are not purely physical in nature.”

    and yet have provided no support for these assertions.

    You are presenting conclusions at least as much as Schiffman is. You don’t really seem interested in a discussion of your assertions except other than the a priori assumption of their validity as a starting point for further discussion of placebos and theology.

    Also, you’d have to clarify what you mean by, “Also, in more practical terms, we can clearly see that emotional support is an important aspect of physical health” before I was ready to agree with that statement.

    Yes, emotional support is important in psychological health, and that can affect lifestyle and compliance with medical recommendations, etc, but If you’re stating that emotional health can directly influence the course of something like cancer, I don’t think that’s been established.

    “Agreed, for purposes of discussion,”spiritual” and “psychological” are substantially interchangeable.”

    For you, this may be the case, but I (and I suspect many others) disagree that they are so. Once you substitute “psychological” for “spiritual”, your case for invoking theological interpretations becomes even less supported.

  32. #32 lsm
    February 3, 2012

    Off topic, but thought this may be of interest: Marc Stephens is still threatening Ken at Popehat.

    http://www.popehat.com/2012/02/03/marc-stephens-threatens-me-some-more/

  33. #33 lilady
    February 3, 2012

    Well the only good thing to be said about this article is that it appears on the Ho-Po’s “Religion” page, not its “Science” page.

    It seems that this “devout” poet attempts to reconcile the placebo effect from a CAM/alt treatment or “medicine” with a miracle from (a generic) God. It would help if he had a clue about the utter uselessness of CAM/alt and the participant expectations/observer biases seen in placebo effect studies.

    As I stated in my post at the Ho-Po, “…your poetry may be inspiring, but your knowledge of science is not.”

  34. #34 David N. Brown
    February 3, 2012

    @29:
    Theology has many aspects. I would see it overlapping with psychology AND medical science specifically on issues of the interelationship of mind (or soul) and physical health, which is precisely what one is discussing with placebos. It also can’t be ignored that, for most of history, anything resembling mental healthcare would have been administered by religious authorities.

    On the specific question of whether psychological (spiritual) factors can be decisive in the course of a physical illness, I would consider that to be established beyond reasonable doubt, within limits. I would expect that to be particularly true of cancers, because recovery is mainly about the body’s ability to regulate itself rather than to fight an external pathogen.

  35. #35 rw23
    February 3, 2012

    @David N. Brown:

    As a theology student

    Sorry, but I didn’t read much further. I carry very little regard for theology, and am unlikely to do so until the existence of a theos can be demonstrated.

  36. #36 rw23
    February 3, 2012

    @David N. Brown #32:

    On the specific question of whether psychological (spiritual) factors can be decisive in the course of a physical illness, I would consider that to be established beyond reasonable doubt, within limits.

    Decisive? Really? That is your magic speaking.

    “Beyond…within limits?” Please…

    But can a positive attitude be beneficial in the management of a disease — yes, I would say so. However that positive attitude could come from any source meaningful to the sufferer, not necessarily (or only) the specific cultural one which you happen to espouse.

  37. #37 Composer99
    February 3, 2012

    IMO, Schiffman’s piece is a non sequitur: the conclusion (‘God’ or ‘something very close to God’ or similar equivocation) does not follow of necessity from the premise (placebo effects exist).

    The most significant missing premise is “here is conclusive evidence showing placeboes actually make ill people objectively better”; although I am sure there are others.

  38. #38 Karl Withakay
    February 3, 2012

    David N. Brown

    “Theology has many aspects”

    I really think you’re giving theology too much credit here, or you’re defining theology to be something other than it is commonly understood to be. Theology != psychology regardless of whether you assert that it is.

    “I would see it overlapping with psychology AND medical science specifically on issues of the interelationship [sic] of mind (or soul) and physical health, which is precisely what one is discussing with placebos.”

    I would suggest you spend some more time here reading up on the subject of placebos. Placebos are more related to the perception of physical health than they are with actual, objective physical health. Also, if you want to talk about the mind, do so, but please don’t imply or assert that the concept of mind is interchangeable with that of a soul, because you’ll find strong disagreement there as well. Check the writings of Dr. Novella in regards to the mind being an emergent property of brain function.

    “It also can’t be ignored that, for most of history, anything resembling mental healthcare would have been administered by religious authorities.”

    It also can’t be ignored that for most of human history anything resembling a scientific understanding of the universe or human behavior hasn’t existed. Additionally, It also can’t be ignored that for most of human history, the closest thing to mental health care that existed probably did more harm than benefit to the “patient”.

    “On the specific question of whether psychological (spiritual) factors can be decisive in the course of a physical illness, I would consider that to be established beyond reasonable doubt, within limits.”

    I’m not sure why you continue to equate psychological and spiritual (you continue on with your argument resting at least partially on a disputed premise as if that premise is accepted), but what you consider to be beyond reasonable doubt and what is actually beyond reasonable doubt may not be the same thing. Can you point to any support for your claim that psychological factors can be decisive in the course of a physical illness when controlling for all other factors such as lifestyle, health practices, and compliance with treatment programs, etc?

    “I would expect that to be particularly true of cancers, because recovery is mainly about the body’s ability to regulate itself rather than to fight an external pathogen.”

    On what do you base this assertion? (Specifically the assertion that your claim is particularly true of cancers because of the nature of cancer, not your over-simplification of cancer as being mainly about the body’s ability to regulate itself.)

  39. #39 David N. Brown
    February 3, 2012

    @26:
    “If placebos really worked as Schiffman describes… then that certainly would be convincing evidence of something. Magic, perhaps… Or maybe even God, if you believe that God is in the habit of performing miracles every time someone takes a sugar pill.”

    The religiously inclined could express the idea thusly: The act of taking the pill, plus the belief in the expected result, may draw the influence of God or some other external, extra-physical being, beings or force sufficient to produce the result. It’s the same kind of proposition that underlies typical magic practices, and I for one take it quite seriously.

  40. #40 claire
    February 3, 2012

    Seriously? I’m getting a brain tumor just reading this. Oh, look, there’s some sugar at the office coffee corner. Thank Jeebuz! I’ll make it after all.

  41. #41 David N. Brown
    February 3, 2012

    “please don’t imply or assert that the concept of mind is interchangeable with that of a soul, because you’ll find strong disagreement there as well. Check the writings of Dr. Novella in regards to the mind being an emergent property of brain function.”

    I consider this mostly a matter of interpretation, if not simply classification. Whether one speaks of the “mind”, or “soul”, or some combination of both, one is dealing with something beyond the strictly physical and three-dimensional. One of the more memorable expressions of the idea I have run across was from an openly atheistic psychologist writing in the 1950s: “The mind is not the brain… The mind is the brain in time.”

  42. #42 palindrom
    February 3, 2012

    David N. Brown @ 37 —

    This would be an easy thread to derail, but I’ve never quite understood why God is supposed to be “extra-physical”, except that this assumption provides a convenient hiding place for an entity for which there is no material evidence.

    Never did much care for this whole mind-body duality thing, which seems to me to have been a dreadful wrong turn in intellectual history.

  43. #43 Karl Withakay
    February 3, 2012

    I suppose I should know better by now than to include multiple points and requests for support in a single comment and especially not to make a side comment that’s mostly just an “oh by the way” and expect responses to more than one point, that point most likely being the side comment.

    “Whether one speaks of the “mind”, or “soul”, or some combination of both, one is dealing with something beyond the strictly physical and three-dimensional”

    My position is that the mind is strictly a result of physical, naturalistic, materialistic phenomenon, and there is no vitalistic/non-material soul. If you are disputing that, we have another point of disagreement.

    It is increasingly clear that what you consider merely a matter of interpretation or semantics is not as simple and clear cut as you think. The devil is often in the details, and I think the devil(s) in your details is/are key to your position(s), and thus too important to brush off so lightly.

  44. #44 David N. Brown
    February 3, 2012

    @40:
    The most fundamental grounds for presuming a supernatural God or some equivalent is that only such an agency could produce the observable space-time universe.

    As for mind-body duality, that’s something that could mean many different things, and I personally take a highly critical view of the whole line of discussion. I have been struck particularly by the fact that the (Judeo-Christian) Bible can’t be seen to envision an afterlife without some equivalent to the actual, physical body. One of the more strongly documented and logically coherent traditions is the intertestamental Jewish belief that God would simply recreate the body of every human.

  45. #45 Pareidolius
    February 3, 2012

    DNB, you don’t know squat about neurology, do you? Your mind is an artifact of your brain, there is no credible evidence to the contrary. The rest is wishful thinking when you say that you “take these things (magic) quite seriously.”

  46. #46 Beamup
    February 3, 2012

    The most fundamental grounds for presuming a supernatural God or some equivalent is that only such an agency could produce the observable space-time universe.

    Except that we are coming to understand that quantum mechanics can do so on its own, without need to invoke anything supernatural.

    You could ask where quantum mechanics comes from, but then I get to ask where “a supernatural God or some equivalent” comes from.

  47. #47 palindrom
    February 3, 2012

    DNB @42 — I don’t think the observable space-time universe requires an “agency” to produce it — it just is. Exactly why there is something rather than nothing is, in my mind, the only mystery. Teleology seems to me to be nothing but projection, and imagining that there is an intelligent God sitting like a puppeteer keeping the cosmos going strikes me as invoking a contraption that is entirely unneeded.

    There is no way to prove either of our positions, of course, which is why discussions of this kind are never, ever resolved. For that reason, I find religious speculation to be pointless and boring.

    Peace out.

  48. #48 Mephistopheles O'Brien
    February 3, 2012

    David N. Brown,

    The religiously inclined could express the idea thusly: The act of taking the pill, plus the belief in the expected result, may draw the influence of God or some other external, extra-physical being, beings or force sufficient to produce the result.

    Yes, I suppose one could. On the other hand, one could just as easily express the idea as something completely differently – which certainly would not prove or disprove God.
    Of course, this is somewhat moot in that the first part of my original statement (“If placebos really worked as Schiffman describes”) is demonstrably false.

    It’s the same kind of proposition that underlies typical magic practices, and I for one take it quite seriously.

    Just for argument’s sake, why do you take that kind of proposition seriously?

  49. #49 Narad
    February 3, 2012

    DNB, you don’t know squat about neurology, do you? Your mind is an artifact of your brain, there is no credible evidence to the contrary.

    There is no credible evidence that your brain is not an artifact of your mind, either.

  50. #50 tioedong
    February 3, 2012

    placebo effects, faith healing, Trancendental meditation, reiki, yoga, deep concentration, and getting deeply involved in doing something creative all are forms of hypnosis, aka “Deep concentration” that lets you block out a lot of distractions.

    All are “natural” and have nothing to do with God, although prayer that uses deep concentration on God can result in either deep spirituality resulting in good works or fake mystical delusions.

    I learned this 30 years ago when I studied medical hypnosis. Too bad modern “alternative” medicine is getting sucked into the delusions. I blame it an over reaction to cook book modern medicine that ignores the art of medicine and the old lessons of “laying on of the hands” and listening that we old docs knew how to do.

  51. #51 Mark M
    February 3, 2012

    Placebo response is not all in the mind. Placebo painkillers stop working if the patient is given the ‘antidote’ to the REAL painkiller. Fascinating stuff.

    By law, this Wired article should be at the top of every homeopathy web page:

    http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all

  52. #52 David N. Brown
    February 3, 2012

    @43:
    I believe you are responding to a position I have not defended and would not in fact agree with. I am not defending the idea that the mind can be considered to exist wholly seperate from the brain and body, and in fact I consider the idea overly simplistic at best. For the present purposes, I am not even concerned with debating ideas of the afterlife. The key consideration is that whatever may influence the mind (and whatever might be called the soul) may have significant effect on the body.

  53. #53 qetzal
    February 3, 2012

    @David N. Brown:

    I sincerely recommend that you learn to distinguish between things that you think are true, and things that are actually established to be true. (Insert usual disclaimers about absolute truth and certainty here.) Doing so will make you a much better student.

    For example, none of your claims below is actually established to be true. Each of them is either highly contentious or outright false.

    The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called the spiritual realm.

    The most fundamental consideration is that we are clearly dealing with phenomena that are not purely physical in nature.

    All religious systems speak of benign and malign spiritual beings or forces

    I would expect that to be particularly true of cancers, because recovery is mainly about the body’s ability to regulate itself rather than to fight an external pathogen.

    I consider this mostly a matter of interpretation, if not simply classification. Whether one speaks of the “mind”, or “soul”, or some combination of both, one is dealing with something beyond the strictly physical and three-dimensional.

    The most fundamental grounds for presuming a supernatural God or some equivalent is that only such an agency could produce the observable space-time universe.

  54. #54 Pareidolius
    February 3, 2012

    There is no credible evidence that your brain is not an artifact of your mind, either.

    How very postmodern in a Jane Roberts-y sort of way . . .

  55. #55 Karl Withakay
    February 3, 2012

    David N. Brown
    “The most fundamental grounds for presuming a supernatural God or some equivalent is that only such an agency could produce the observable space-time universe.”

    Try reading Lawrence Krauss’s “A Universe from Nothing: Why There Is Something Rather Than Nothing”.

    The most fundamental grounds for presuming a supernatural God or some equivalent is that you lack any other explanation that you find acceptable for the the observable space-time universe and so you fill in the gaps with a god.

    Over the history of science as we have learned more about the universe we live in, the role of and need for god has steadily diminished and retreated to the point of the cosmological uncaused first cause. It would be foolhardy to assume we have finally reached the threshold beyond which must lie god.

  56. #56 Dan
    February 3, 2012

    David Brown,

    Sorry, but a classic argument from ignorance for god’s existence probably won’t work here. Your basic claim seems to be that since we do NOT know why the universe is the way it is then that means we DO know why the universe is the way it is, and, conveniently, the answer is your personal definition of god. I believe, and even many religious thinkers agree, that the god of the gaps argument is very poor theology, and much, much worse ‘science.’ It has also failed time after time throughout history.

    You also seem to be just assuming that the mind is non-physical. The vast majority of philosophers of mind and neuroscientists vehemently disagree with your position. You can’t just buck all the experts and take it is a given that a nonphysical soul or mind exists. If the mind is the natural outcome of the physical brain than it it not at all surprising that changing brain states affect the rest of the body. It would be like saying that since the heart’s action affects other organs than that proves we have a soul. You are the one who has the onus to show that something nonphysical exists, and that it is somehow capable of changing physical states and violating the laws of causality.

  57. #57 Narad
    February 3, 2012
    There is no credible evidence that your brain is not an artifact of your mind, either.

    How very postmodern in a Jane Roberts-y sort of way . . .

    It’s nothing of the sort. An argument between monist idealism and monist materialism offers only stalemate.

  58. #58 qetzal
    February 3, 2012

    @David N. Brown:

    I sincerely recommend that you learn to distinguish between things that you think are true, and things that are actually established to be true. (Insert usual disclaimers about absolute truth and certainty here.) Doing so will make you a much better student.

    For example, none of your claims below is actually established to be true. Each of them is either highly contentious or outright false.

    The “placebo effect” and its converse, psychosomatic illness, easily fall into the domain of what can broadly be called the spiritual realm.

    The most fundamental consideration is that we are clearly dealing with phenomena that are not purely physical in nature.

    All religious systems speak of benign and malign spiritual beings or forces

    I would expect that to be particularly true of cancers, because recovery is mainly about the body’s ability to regulate itself rather than to fight an external pathogen.

    I consider this mostly a matter of interpretation, if not simply classification. Whether one speaks of the “mind”, or “soul”, or some combination of both, one is dealing with something beyond the strictly physical and three-dimensional.

    The most fundamental grounds for presuming a supernatural God or some equivalent is that only such an agency could produce the observable space-time universe.

  59. #59 Dan
    February 3, 2012

    Narad, are you seriously trying to claim that the mind creates the brain? Wow, now you are trying to impress us with a Deepak Chopra impression!

  60. #60 David N. Brown
    February 3, 2012

    @54:
    “Over the history of science as we have learned more about the universe we live in, the role of and need for god has steadily diminished and retreated to the point of the cosmological uncaused first cause.”

    The “uncaused first cause” is precisely the description that Christian theologians have ALWAYS given to God, so it’s a stretch to speak of a “retreat”. One may propose an alternative understanding of the nature of the “first cause”, but the paradox of an “uncaused cause” will remain. Failure to recognize that is what leaves us with atheists on one side who say “Who created God?” and theists on the other who say “What was before the Big Bang?”

  61. #61 Calli Arcale
    February 3, 2012

    Pareidolius:

    DNB, you don’t know squat about neurology, do you? Your mind is an artifact of your brain, there is no credible evidence to the contrary. The rest is wishful thinking when you say that you “take these things (magic) quite seriously.”

    As another theist around here, I just have a brief observation at this point. I agree with you that the mind is an artifact of the brain. This is what caused me, a year or so ago, to suddenly realize why “resurrection of the body” was important. I’d previously blown that part of the Apostles Creed off as wishful thinking; I figured we mere humans couldn’t possibly know what the hereafter was like, so why would we assume we’d somehow get our bodies back? Wouldn’t it just be our souls? But then I realized: you can’t have a mind without a brain, and the mind and brain are intimately linked. Brain tumors change personality; obviously the brain is a lot of what a person is. Ergo, if we do get resurrected as individual people, as ourselves, we must be resurrected with our bodies intact. (Presumably these would be *working* copies of our bodies, rather than the rather icky condition our real bodies would be in by this time.)

    Not that this is relevant to the original post: I just thought it was sort of interesting. How science can influence a person’s theology.

    The original post makes me think of the Hitchhiker’s Guide to the Galaxy, and in particular the entry it has about the Babel Fish, a creature which, if you stick it in your ear, will instantly enable you to understand every language.

    “It’s so mind-bogglingly improbable that a creature so useful could evolve purely by chance that some thinkers have chosen to see it as a final and clinching proof of the non-existence of God. The argument runs something like this:

    ‘I refuse to prove that I exist,’ says God, ‘for proof denies faith and without faith I am nothing.’
    ‘But,’ says Man, ‘the Babel Fish is a dead giveaway. It proves you exist and so therefore you don’t. Q.E.D.’
    ‘Oh dear, I hadn’t thought of that,’ says God, and promptly vanishes in a puff of logic.
    ‘That was easy!’ says Man, who goes on to prove that black is white and gets himself killed at the next zebra crossing.'”

  62. #62 JGC
    February 3, 2012

    The most fundamental grounds for presuming a supernatural God or some equivalent is that only such an agency could produce the observable space-time universe.

    How exactly has it been demonstrated that such an entity as a supernatural god is an absolute prerequisite for the observable space time universe to arise? That’s as extraordinary a claim as can be advanced, after all–one hopes you can provide a suitably extraordinary body of evidence to support it.

  63. #63 David N. Brown
    February 3, 2012

    @55,
    Again, this is a response to ideas I haven’t presented, and some of which I wouldn’t agree with. As I have indicated, it is my considered opinion as someone with formal education in Christian theology that the Bible does not (at least explicitly) represent the human mind/ soul as existing independent of a brain and body, even in the afterlife. For that reason among others, I feel no attachment to such an idea. And, as I have stated directly, the obvious problem with describing the “mind” as physical is that, strictly speaking, it is (at least) a TEMPORAL phenomenon. Given that understanding, people with differing ideas about God and the afterlife can have a constructive dialogue. Otherwise, one is just left arguing over terms and definitions.

  64. #64 Karl Withakay
    February 4, 2012

    “The “uncaused first cause” is precisely the description that Christian theologians have ALWAYS given to God, so it’s a stretch to speak of a “retreat””

    Nope. Typically, when one retreats, one retreats to a smaller area of territory one already holds while conceding most of the rest of the territory they previously held in addition to the territory retreated to, so there is no “stretch” involved at all. I stand by my statement.

  65. #65 dreamer
    February 4, 2012

    Off-topic comment:
    I saw Jon Stewart interview oncologist Dr. David Agus, author of “The End of Illness.” All we need to do to stop “cancering” yes, “to cancer” is a verb, Dr. Agus told Stewart, is .. take aspirin to end all illness … sigh …
    http://www.thedailyshow.com/watch/thu-february-2-2012/david-agus

    The first three pages on Yahoo search of this title brought up nothing but praise or neutral blurbs about the book, there were ZERO critical mentions. NPR calls it “nonfiction,” and apparently according to NPR, Dr. Agus is against taking all kind of vitamin supplements, yet he recommends Aspirin as a cure-all.

    Dr. Agus was mentioned here in comment nr. 11 to a 2008 post on Vitamin C and cancer:
    http://scienceblogs.com/insolence/2008/08/vitamin_c_and_cancer_revisited.php

    Oh well, maybe Aspirin to End All Illness is on-topic after all, as another Placebo to dream about.

  66. #66 dreamer
    February 4, 2012

    Off-topic comment:
    I saw Jon Stewart interview oncologist Dr. David Agus, author of “The End of Illness.” All we need to do to stop “cancering” yes, “to cancer” is a verb, Dr. Agus told Stewart, is .. take aspirin to end all illness … sigh …
    http://www.thedailyshow.com/watch/thu-february-2-2012/david-agus

    The first three pages on Yahoo search of this title brought up nothing but praise or neutral blurbs about the book, there were ZERO critical mentions. NPR calls it “nonfiction,” and apparently according to NPR, Dr. Agus is against taking all kind of vitamin supplements, yet he recommends Aspirin as a cure-all.

    Dr. Agus was mentioned here in comment nr. 11 to a 2008 post on Vitamin C and cancer:
    http://scienceblogs.com/insolence/2008/08/vitamin_c_and_cancer_revisited.php
    maybe Aspirin to End All Illness is on-topic after all, as another Placebo to dream about.
    Oh well,

  67. #67 dreamer
    February 4, 2012

    sorry about that, don’t know how it posted three times, I thought it was lost in cyberspace.

  68. #68 lilady
    February 4, 2012

    @ dreamer: You can find out about Dr. Agus by just “Googling” his name…Wikipedia has profiled him.

    Recently, I saw a small TV segment on ABC Nightline with host Bill Weir that featured Dr. Agus…the video is also available on the internet. He has been “making the rounds” of TV shows promoting his book.

    Dr. Agus has some good credentials and he has also, in partnership with a geneticist, opened a genetics lab testing service…sort of a do-it-yourself genetic profile of risk factors for Alzheimer disease, heart disease and cancers. He ran into some problems with California (lab licensing board) about proving that a physician was actually ordering these tests…which apparently has been resolved, now.

    “Cancering”?…to me it is a neolism…and IMO just a “catchy” word to promote his preventive health book. The doctor had a few short minutes to promote the book and he did so. But throwing some “catchy” words, phrases and statements and the discombobulation of his topics, left me confused. (Just my opinion of the video)

    His statement about curing infectious diseases starting in the 1920s and the generalization that people expert cures in the bottle of pills…is a bit “over the top”. Again, a short TV spot, is not the right forum to discuss the theme of his book i.e. prevention.

    I don’t believe there is anything in Dr. Agus background or any record of some iffy published research, that would indicate the book isn’t what he says it is…a guideline for healthy habits.

  69. #69 Narad
    February 4, 2012

    Narad, are you seriously trying to claim that the mind creates the brain? Wow, now you are trying to impress us with a Deepak Chopra impression!

    No, I am not. I am pointing out that is well-worn philosophical ground. Monist idealism does not imply “The Secret,” and declarations of victory based on ownership of ontology beg the question.

  70. #70 Narad
    February 4, 2012

    ^ “that is well-worn” -> “that this is well-worn”

  71. #71 Militant Agnostic
    February 4, 2012

    Todd W.

    But why God? Why not the devil?

    Don’t you know there ain’t no devil? There’s just God when he’s drunk.*

    *Tom Waits – Heart Attack and Vine

  72. #72 sophia8
    February 4, 2012

    You can read about Dr Agus’ book here.
    The synopsis goes a bit OTT on the “whole body” stuff, but I doubt that Mike Adams and other woosters will be rushing to endorse it:

    …How taking multivitamins and supplements could significantly increase our risk for cancer over time…..
    ….How three inexpensive medications—aspirin, statins, and an annual flu vaccine—can substantially change the course of our health for the better…..
    ….How taking shortcuts to health via blending fruits and vegetables, and sometimes even by purchasing what we think is “fresh,” could be shortchanging our health.

  73. #73 robert landbeck
    February 4, 2012

    What is so tragic about Robert Schiffman, not unlike other CAM/religious apologists, is that they reduce ‘God’ to such abject trivia, in this case a placebo! It certainly demonstrates just how tenuous is the hold existing faith offers. But if one is going to throw God into the health equation, there is new material circulating on the web that could have profound implications for both health and resolving the conflict between science and religion. If anyone wants to check it out, try http://www.energon.org.uk

  74. #74 sophia8
    February 4, 2012

    But if one is going to throw God into the health equation, there is new material circulating on the web that could have profound implications for both health and resolving the conflict between science and religion. If anyone wants to check it out, try:

    You have arrived at one of an increasing number of sites and links for downloading: The Final Freedoms. This, the first wholly new interpretation for 2000 years of the Gospel and moral teaching of Christ. It redefines Faith, the Word, Baptism, the Tinity, and especially the Resurrection. It questions all existing Christian tradition and focusing specifically on marriage, Love and human sexuality, overturnes all natural law ethics and theory……

    Oh look – another new religion that’s going to solve all of our problems and bring happiness to all, an end to war, a cure for cancer and an organic chicken in every pot! It must be, ooh, months since I’ve come across one of those.

  75. #75 Pareidolius
    February 4, 2012

    I suppose that going down the rabbit hole of philosophy, postmodernism and biblical scholarship is perfectly applicable to this post. But really, this is a science and medicine blog. All the high-minded, philosophical, mental masturbation of the ages will not change the fact that your mind is an artifact of your brain. Try cutting out some of your brain and see how much “you” is left. Spend some time with profoundly brain-damaged people or with loved ones with Alzheimers. Grow up already! Your fairy tales of eternal personality-wholeness may be comforting, but they’re demonstrably false. When your brain dies “you” will cease to exist unless you have some rock solid evidence to the contrary. And Landbeck, what in Zeus’ Lunchbox was all that energon crap about anyway? It’s like bibical timecube or something. Really. Go away.

  76. #76 Narad
    February 4, 2012

    there is new material circulating on the web

    That’s not exactly new, and the “circulation” of The Final Freedoms appears to be limited precisely to a single person spamming it around along with preteding to have just discovered this work by an “unknown author,” along with “reviews” that are strikingly similar in construction.

    I will grant that as far as such things go, the endeavor seems to be truly impressive in its ability to produce complete apathy.

  77. #77 Alan
    February 4, 2012

    To paraphrase Sagan – “We are not independent observers of the universe, we are the universe observing itself.”

    Problem is, we are only equipped to see a narrow band of reality and have evolved an innate bias that says what we see through that small window is all there is. It’s only very recently that we’ve opened new windows with new tools that vastly increase the observational power of our natural senses.

    Similarly when we observe ourselves under the influence of a placebo we have an innate bias (and some incredibly powerful brain chemicals) to ‘feel better’. But pain is an incredibly subjective thing which does not correlate well with the observations medical science sees through their new windows.

    …Or to paraphrase Sagan again; “Science is a tools that helps us distinguish between what is real, and what makes us feel good”.

  78. #78 Narad
    February 4, 2012

    All the high-minded, philosophical, mental masturbation of the ages will not change the fact that your mind is an artifact of your brain. Try cutting out some of your brain and see how much “you” is left.

    If one wants to have this argument, which has very few practical implications other than one’s ability to converse with people who assert having seemingly implausible experiences, that’s not an effective reply. (And Postmodernism most assuredly is not idealism, as it relies entirely on plural minds.) If one has constructed the world, which apparently by this construction is not subject to casual omnipotent whimsy, there is nothing surprising in its conformance to expectations, which are more or less holding the whole operation together in the first place.

    Indeed, the statement that “your mind is an artifact of your brain” is basically epiphenomenalism, which is to say, dualism, which contradicts monist materialism in the first place.

  79. #79 Andrew Ator
    February 4, 2012

    The God Part Of The Brain was published some time ago, and while I don’t recall any specific chapter mentioning the placebo effect, it sparked the notion in me that religious experiences and the placebo effect may take place in the same regions of the brain. Going with an evolutionary perspective, the author goes on to explain how such a brain region would benefit its user what with this whole “consciousness” thing springing about in our development, providing peace of mind to the newly confused. If anyone knows of any research along these lines or insight I’d much appreciate it.

  80. #80 g724
    February 4, 2012

    First, Tieodont @49; second, the psychology/theology thrash clarified; and third, Andrew Ator @ 78:

    Tieodont at #49, “placebo effects, faith healing, Trancendental meditation, reiki, yoga, deep concentration, and getting deeply involved in doing something creative all are forms of hypnosis, aka “Deep concentration” that lets you block out a lot of distractions.”

    No, no, no.

    It is accurate to say: medical hypnosis, meditation, certain types of yoga practices, deep concentration, certain types of creative activity, and certain types of religious activity, are all examples of the induction and use of trance states.

    Trance can be defined as a spectrum of altered states of consciousness that are produced without drugs, and that have in common substantially different patterns of attention compared to that which obtains in the baseline waking state of consciousness.

    Medical hypnosis is Western psychology’s traditional and established method of inducing and utilizing trance states for various purposes including psychotherapy and anaesthesia.

    There now, much better! And it doesn’t put us in an uncomfortable position when we discover that some “primitive” culture’s traditional practices, or something associated with religion, also turn out to have psychological benefits to individuals who hold those beliefs.

    Second, about brains, minds, and “souls:”

    Here we’re talking about “philosophy of mind” or “theory if mind,” of which there are basically four variants:

    One, mind/body dualism: minds inhabit bodies but are fundamentally different entities with distinct existence independent of the bodies they inhabit.

    Dualism was utterly falsified with the discovery of LSD and the EEG. LSD, because for the first time, medical science had a compound of which infinitesimal quantities (as little as 25 micrograms) produced profound changes in state of consciousness with little or no detectable change in other physical measures such as vital signs. The EEG, because for the first time, medical science had a means of measuring the correlations between subjective states and objective measurements, from which the first notable breakthrough was the documentation of REM sleep (emergent stage 1 sleep) as the physical correlate of the dream state.

    Two, spiritual monism: Mind is the primary and fundamental constituent of the universe; all things physical are epiphenomena of mind or soul.

    That’s an unfalsifiable proposition, so by definition it lies outside the realm of science and comes under the heading of comparative religion. Since the subject matter of this blog is not comparative religion, it needn’t be debated further here.

    Three, material monism: Mind is produced by or identical with the functioning of the brain.

    That’s the position held by a large majority of those in the medical sciences. There is ample evidence for at least a slightly more conservative version of it, that mind appears to be an emergent property of the functioning of the brain of a living organism. That is, one can be a material monist and still leave a door open for a soul and a hereafter, should one also happen to be religious.

    The evidence for at least the conservative version of material monism is overwhelming, and I needn’t detail it here. Psychopharmacology, neurophysiology, neurology, and psychiatry, have all contributed in various ways.

    Four, interactionism: Mind is an emergent property that arises from the interaction between information-bearing biological systems and information, where information is held to be a fundamental constituent of the universe in a manner analogous to matter and energy.

    This is basically an extension of material monism to include information theory, and while it’s still a minority position, it addresses the “hard problem” of the existence of consciousness in ways that pure material monism can’t quite. The leading theorist of interactionism at the moment is David Chalmers (Australian National University), whose published papers can be found online.

    (And here I should say, I’m with Chalmers on this; interactionism appears to have potential for greater explanatory capability than pure material monism, including generating new falsifiable hypotheses.)

    Thirdly, Ator @ 78:

    Here I’d suggest looking up the published works of Michael J. Persinger (Laurentian University, Ontario) in the journal _Perception and Motor Skills_. Having read all of his stuff during graduate studies, I’d summarize it in one sentence as follows:

    Abnormal activity in the right temporal lobe of the brain, in subjects who are predominantly right-handed, is found to be associated with “the feeling of deep personal meaning in relation to something larger than self.”

    The relationship is apparently two-way, in that these numinous feelings can be correlated with EEG measurements, and can also be induced through transcranial electromagnetic stimulation adjacent to the area in question, at a nominal frequency of 5 Hz.

    Conventionally these findings can be applied to religion, but they can also be applied to other instances such as patriotism (the “something larger than self” being one’s nation), devotion to various artists and athletes (e.g. music fans, sports fans), and presumably, tribalism (similar to patriotism but on a small scale).

    Based on my reading of Persinger in depth, I would disagree that the placebo effect is related to abnormal temporal lobe activity in and of itself. I would tend to consider the placebo effect to be primarily a matter of “suggestion,” which can be described as the ability to construct a belief, and hold it as-if true, and behave accordingly, where “behavior” for this purpose includes alterations of perception, attention, and emotion.

    The obvious problem here is to operationalize “suggestion” in a manner that is amenable to measurement. Here we end up needing tools for measuring brain activity at a level that is not presently accessible.

    However it would be interesting to try something like this, as a wild guess and a rough starting point:

    Take and compare a patient’s 24-channel EEG, at the time the placebo is prescribed, and at the times when the patient takes the placebo. Correlate EEG at both times, and rank-order from low to high similarity between both times: the rank-ordering of these correlations becomes Variable A.

    Next, rank-order degree of placebo response based purely on the patients’ subjective reports. That rank-ordering becomes Variable B.

    Hypothesis: there will be a significant positive correlation between Variables A and B.

    The deep structure of the hypothesis here, is that the ability of the patient to recall and enter the state of consciousness (not a “discrete” ASC per C.Tart, but something more subtle e.g. an emotion plus a thought process) s/he experienced during the doctor visit, at subsequent occasions while taking the placebo, would be a rough measure of the degree to which the patient “internalized” the suggestion that the placebo was an effective medicine. Further, the EEG correlates of that state would be sufficient to show up in a rank-ordering. And lastly, that the recall of and re-entry into that state, would correlate with subjective reports of the efficacy of the placebo.

    But one thing I doubt you’ll find for this, is any heightened or abnormal activity in the temporal lobe of the subdominant hemisphere.

    Now if I may say so, this, IMHO, is what you’re supposed to do with claims of and for various types of “anomalies.” Holding that something is “nonphysical” means locating it outside the entire known physical universe that is the domain of science, thereby putting the subject matter into the domain of comparative religion. On the other hand, black-boxing it as if it is already well known and deserving of no further inquiry (“placebo effect = suggestion”) or is merely illusion or delusion, is just as useless because it can rapidly devolve into obscurantism.

    What science does is attempt to find the mechanism (or the organism, if you prefer). So when you say “suggestion,” don’t stop asking questions there. Ask the next question: what is suggestion, how can we operationalize it, how can we measure its effects? And then propose an experiment! Even a thought-experiment that would be difficult in practice, such as taking 24-channel EEG while patients are being prescribed placebos, and when they’re taking placebos, can help to shed light on the question and help refine it toward an experiment that can be performed in a practical sense.

    Too often what I see the skeptical community do, is adopt a dismissive attitude toward things that may (maybe, might) overlap in some way with something uncomfortable or demonstrably false: but that’s “guilt by association” that has no place in science. Writing something off as “only whatever” or “merely whatever” or “nothing but whatever” doesn’t get us an answer to how it actually works.

    It’s a whole lot more interesting to try to find the mechanisms.

  81. #81 flip
    February 5, 2012

    @19 David N Brown

    Also, in more practical terms, we can clearly see that emotional support is an important aspect of physical health, which is where religious leaders and communities can and should be stepping in.

    Er, shouldn’t trained psychologists, psychiatrists, counsellors etc be stepping in? This is one of those things I don’t get: why is it when we need emotional counselling, the first port of call should be the spiritual adviser?

    Continued as I now see #21. … This is just silly. I’m not going to approach a secular community for emotional help. I’m going to approach a psychologist. It doesn’t matter if they have spiritual/theological beliefs or not, so long as their treatments are based in science and don’t effect their overall approach to my problem.

    This is where your “dialogue” between science and theology falls off the rails for me. If it was a true dialogue, you’d be saying that it doesn’t matter what a person believes when it comes to using SBM in treating an emotional issue. I personally don’t find it convincing to sit and listen to Bible stories as a way of solving my problems; but likewise I don’t see how a ‘secular’ viewpoint aids either. Once can argue over it if the context comes to a moral decision I suppose, but I can’t see how psychological should be the province of either ‘secular’ or ‘theological’. It should be the province of SBM.

    My own position, in actively working on resources for churches and other religious organizations, is that churches, synagogues, mosques etc can and should collaborate when it comes to dealing with illness and disability in their own members.

    I’d add a clause: that those groups should try to help where they can IF the person who needs help would like it. Again, it comes back to me thinking that I’d be more inclined to seek help from a person trained in SBM and not a person who is simply affiliated with a group I hang out with. (As an example, a family member of mine offers well-meaning but woo-based advice. It matters not that I find family emotionally comforting and supportive; their advice is still not science-based and therefore I shouldn’t listen to it)

    @25 David N Brown

    Agreed, for purposes of discussion,”spiritual” and “psychological” are substantially interchangeable.

    No they’re not. One refers to a somewhat mystical concept, the other refers to an area which is science-based. One is based on faith, the other on evidence.

    @33 David N Brown

    It also can’t be ignored that, for most of history, anything resembling mental healthcare would have been administered by religious authorities.

    If your basis for mental healthcare belonging to the realm of theology is antiquity, then I say: learn a bit more about history of mental healthcare. History says it *can’t* possibly be proof of anything but keeping theology out of mental healthcare.

  82. #82 David N. Brown
    February 6, 2012

    @82:
    There are a lot of complexities in this area, and you raise many of the right questions. My thoughts would be as follows:
    1. Instruction for religious leaders should include at least basic information on how to recognize signs of mental illness.
    2. Training for religious ministry, esp. a counseling role, can already include instruction in psychology. (While living on a seminary campus, I gave two interviews to other students who took a class on “diagnosis”.)
    3. The main responsibility of a house of worship in dealing with mental health issues is to see that an affected member is accomodated as well as possible in regular services, and NOT placed in a situation that might lead to harm to self or others.
    4. For a house of worship to provide mental health care (outside of the context of basic counselling) obviously poses many problems, including legal liability. As a rule, the best thing to do will be to refer an affected member to a qualified professional. If a house of worship does choose to provide such services, it would be best done on the same terms as a church-sponsored hospital: Staffed by fully qualified professionals; openly identifying its affiliations; and open to members of the general public.

  83. #83 flip
    February 6, 2012

    @83 David N Brown

    I agree with all of your points, but still don’t see why encouragement of dealing with mental health problems should be directed towards people with spiritual/religious affiliations. Far better to just skip that step and encourage people to seek psychology professionals in general, no? I mean if a religious person affiliated with an organisation spots something wrong, it’s obviously a good idea for them to make an initial approach as they see fit: but is not better to simply encourage people to approach a mental health professional first, and a priest (for example) second?

    This also leads me to one other point: it’s hard enough to seek professional help, even harder when you are aware that your particular faith sees suicide as “selfish” and something to be ashamed of. This is why I think it better to avoid the whole involvement of religious organisations altogether, because I worry about prayer, hope, stigma and false ideas replacing or temporarily under-emphasising proper understanding/treatment.

    In general I agree with you, in the finer details… well, I’m unconvinced.

  84. #84 Ender
    February 6, 2012

    Those are some very accurate posts Narad

    “Dualism was utterly falsified with the discovery of LSD and the EEG.”

    Nothing could be further from the truth g724. Neither of these discoveries address Qualia.

  85. #85 David N. Brown
    February 6, 2012

    @84:
    You raise the issue of suicide, and there is a history of very strong religious stigma against it, but to my knowledge that’s mainly come from the Catholic church. A problem which is probably much bigger is the interpretation of mental illness as “demon possession”, and resorting to traditional exorcism rituals. Personallly, I don’t oppose the general interpretation of malign, external influences possibly acting on the mentally ill, but I think the conventional idea of “possession” is an unduly crude conception of how such an influence might work.

    On the central question of the involvement of religion in responding to mental illness, I would say the practical reality is that many affected people are going to seek out the counsel of a religious leader ahead of anyone else. I don’t see this as necessarily good (or bad), but I think the best response is to help religious institutions (including those I might disagree with) deal with the situation when it comes up.

  86. #86 flip
    February 6, 2012

    @86 David

    Personallly, I don’t oppose the general interpretation of malign, external influences possibly acting on the mentally ill, but I think the conventional idea of “possession” is an unduly crude conception of how such an influence might work.

    There’s a fine line between saying that external influences can affect one’s abilities to be emotionally stable, and blaming the victim. It can be very very subtle which is why I prefer to leave religious groups out of giving guidance to those who actually need supportive, objective, psychological help.

    On the central question of the involvement of religion in responding to mental illness, I would say the practical reality is that many affected people are going to seek out the counsel of a religious leader ahead of anyone else.

    I’d like to see some stats on that. Particularly as many people simply don’t seek help at all. I’ll admit complete ignorance as to the likelihood/truth of your point, but from personal experience I consider it to be extremely unlikely. I’d say that within a religious community, it’s more likely that someone would seek help from a religious person/institution; however, I don’t see that as being proof that someone from a religious institution is going to be the first point of call for most people. It’s certainly no more practical than picking up the phone and dialling a helpline; finding a shrink in the Yellow Pages; or approaching a family doctor (and/or asking them for a referral).

    I’d also think it depends on one’s level of religiousness; one who attends church only for Christmas mass is less likely to seek out a priest for advice than one who attends on a weekly basis. Which returns to my point: why not just educate people to seek out psychology professionals?

    Like I said, I agree with you in general, but remain unconvinced in the finer points.

  87. #87 Laura
    February 7, 2012

    People apparently can get rid of warts by hypnosis or other kinds of suggestion, including placebo effect. I don’t think that has been convincingly debunked and there seems to be a lot of evidence that it can work.
    The particular kind of suggestion is immaterial, whether hypnosis or placebo effect or whatever. It’s like the paraphernalia used in a magic trick. The paraphernalia are a secondary consideration, the real question is what effects suggestion of any kind can have, what the mind can do “top-down” to the body.
    The mind seems certainly able to affect the body negatively – people die when they’re cursed, things like that. Perhaps positive effects are more difficult to achieve, but people do seem to be able to do something to their immune system to encourage warts to disappear.
    There has been lots of evolutionary pressure for suggestion to work, because humans have been attempting healing by suggestion for hundreds of thouands of years. Physical responses to suggestion would be selected for.
    If there comes to be evidence for better or worse ways to use suggestion, this could be incorporated in medical practice.
    For example, if it’s shown that people recover quicker from surgery if they hear their favorite music or prayers from their religion, this could be done. This could also be a good idea, even if such things only affect their perception of how well they are doing.
    If alt-med does the “soft” part of medicine better, adopting some of those techniques might be a good idea. Part of the reason that people turn to alt-med is because they find the alternative practitioners to be nicer. Whether or not this plays a part in “hard” outcomes like cancer survival, paying attention to why this is might help scientific medicine “sell” itself better.

  88. #88 David N. Brown
    February 8, 2012

    “The mind seems certainly able to affect the body negatively- people die when they’re cursed, things like that.”

    I consider such phenomena the most impressive possible evidence of an objective non-physical agency affecting human health. Rather disconcerting, really…

  89. #89 g724
    February 11, 2012

    Re. 85, Ender: (quotes me saying) “Dualism was utterly falsified with the discovery of LSD and the EEG.” (then says in rebuttal) “Nothing could be further from the truth g724. Neither of these discoveries address Qualia.”

    Chalmers addresses qualia without having to hop the fence into dualism, much less spiritual monism. If I understand him correctly (not something that can be taken for granted!:-), qualia are properties of information, and arise into awareness at the interface between information and biology. He’s building a framework where “the hard problem” can be addressed in scientific terms, which is in many ways a “new” project for philosophy in recent times.

    One can say that vision (eyesight) is the result of the interaction between photons and receptors, interpreted by the brain as patterns corresponding to objects in the environment. One can also say the emotion is the result of the interaction of neurochemicals with neurons; or as I put it in deliberately blunt language to bug woo-woos, “emotions *are* chemicals.” But these are “easy questions,” whereas the very existence of conscious minds in organisms is an issue with which the philosophy of mind in science has barely begun to come to terms.

    So if you have a better answer to the “where” of qualia, I’m all ears, as it were.

  90. #90 John Sonnenberg
    February 25, 2012

    Parts of Biology processes are very random, so believers will use them to see their God, and the free-thinker will be skeptical of any such claim. But, using them will never provide a clear proof to either side.
    I’ve developed a better proof. Use a microprocessor. The physics and manufacturing behind an Intel i7 is way more proof that there is not God playing with our universe.
    I’ve been a computer engineer for 30 years, and never have I ever heard another engineer or computer executive say they had a production problem due to demons or a devils invading a micro-processor. Computer chips always calculate 1+1=2. If there were a God twiddling with the physics of the universe, he sure must love the semi-conductor industry because computers have been adding 1+1 accurately for years. Sure there are “Bugs”, but these are due to design errors. Humand fix them. When a transistor is fabricated properly, it works amazingly well. The physics behind producing sub-micron transistor circuits that can perform billions of complex operations every second is incredibly complex. And every day, the semiconductor fabs of the world crank-out trillions of transistors that reliably do their job. If the physics of silicon atoms changed even slightly, the factories would quickly go silent. But this never happens. Intel can reliably put almost 2 billion transistors on a IC chip, and be certain the chips will work. Regardless of how their competitors pray to God that their transistor would work better than Intel’s, Intel transistors keep working.
    Read my full article here: http://wecreatedgod.com/where-god-is-found/
    Thanks, and never forget. We Created God.

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