Why won’t the placebo effect work on laundry?

One of the things I’m really enjoying as a mom is the chance to slow down a bit and see the world through my baby’s eyes.  A world that is fascinating and complex and where nothing is taken for granted.  He hasn’t developed any heuristics or other forms of mental shortcutting yet.  When he eats, he doesn’t know that every piece of cucumber feels and tastes like a cucumber.  When he drops something, he doesn’t know it’s going to fall each and every time.  So he tastes and plays with each piece of cucumber.  And he drops them one by one and watches what happens.

How does this relate to laundry and placebos?

At some point in the future, he’s going to go through a stage of magical thinking.  And it’s going to be fascinating for me.  I’m going to hope he grows out of it…it can be nothing but a burden to think that your thoughts can influence outside actions since most of us can’t really control our thoughts very effectively.  We can control what we say and do, but we certainly have a hard time controlling our thoughts.  There may be some people out there that have committed to a lengthy meditation practice who might be able to have some control over their thoughts.  I am not one of them.  I settle for deciding which thoughts I’m going to let control me.

But how do we grow out of magical thinking?  I’m not a developmental psychologist but I guess it’s by making tons of observations.  Such as, “I wished and wished and wished for a pony for my birthday and I never got one,” or “I really want it to be sunny this weekend,” or, “I hate Mary, I want her to fall down and hurt herself,” or, “I want this teddy bear to come alive.”  Hehe…after my mom read me the Velveteen Rabbit I did think that last one really hard for a few days before I realized it wasn’t going to happen.

Thinking things, does not make them so.  Except when it does.

Stick  with me here and cut me some slack, cos the more I think about this, the more confused I get.

The placebo effect is real.  It’s variable depending on the condition and the therapeutic environment…but it’s real.  A number of people will get better just because they figure something is being done for them.  That something could be a sugar pill or it could be a sham procedure (like pretending to stick acupuncture needles in you).  Then there is the nocebo effect…which is when you get worse because you have negative expectations surrounding a clinical encounter.  I think the nocebo effect explains a lot of the craziness on mothering.com…and the placebo effect explains the remainder.

The placebo effect must come about because we move beyond magical thinking.  We learn that effects have causes and that these causes are external to us.  That’s why medicine makes me better.  I took a pill, now I’m better.  But when that pill is a placebo, I got better because I thought I would…or conversely, I got sicker because I thought I would.  I thought homeopathy would make me better…and it did.  My family doctor just wants to prescribe me a pill to get me to shut up and it didn’t work.

It doesn’t happen every time.  I’ve been told that the placebo effect occurs around 20-30% of the time (and no, I don’t have a reference).  That’s often enough to reinforce that the reason you got better (or worse) was the intervention.  And it’s enough to make “alternative” therapies a three billion dollar a year industry in Canada.  Note, this is pretty sloppy of me…I am quoting a newspaper article and who knows who they are quoting when they came up with that figure!  Nevertheless, I figure it’s a lot.

There are probably some natural remedies that work…it would be more astonishing if none of them did.  I’m not claiming that none of them work, I am going to claim that most haven’t been properly evaluated.

Check out this video on placebos….the best placebos come with lots of sparkles…:)

There is a lot of talk in medicine about whether we should use the placebo effect for therapeutic advantage.  For example, you could tell a patient that you have this great new drug, just approved, really a miracle…and prescribe, or give them samples of, a sugar pill.  Why not?  They have a 30% chance of getting better and, as long as the problem wasn’t something malignant (read: tending to get worse and end in death), very little harm, right?  Wrong.  Such a clinical encounter is based on a lie which completely undermines your credibility as a practitioner, the physician-patient relationship and is grossly unprofessional.

Humans are strange creatures.  The placebo and nocebo effects are fascinating.  We “give up” magical thinking, but the placebo and nocebo effects are, at their core, due to our thoughts and expectations.  My head swims from the paradox.  But I guess it isn’t really so much of a paradox…I suppose it makes some sort of sense that I could use my thoughts and expectations to frame my experiences while I can’t use them to alter someone else’s or the physical world.  Oh but I wish I could (insert evil laugh here)!

I wish I could put a load of laundry in and pretend to run it and 30% of it would come out clean!  I wish I could walk into the kitchen and open the fridge and 30% of the time there would be a yummy sandwich in there.  I wish I could walk into the bathroom and randomly sling some tubes around and 30% of the time emerge with clean teeth, perfect skin and a beautiful blow-out.  I wish I could do some kind of sham rocking/ singing/ nursing procedure during the day when my son is fussy and end up with him asleep 30% of the time…instead of the real rocking/ singing/ nursing/ rocking/ rocking/ nursing/ strolling procedure I engage in which, although it works more than 30% of the time, is really exhausting.

The list of things I wish the placebo effect applied to could go on and on.  How about you, dear readers?

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2 comments

  1. Michelle · · Reply

    I was just reminded of the line in Ron Burgundy about Sex Panther cologne.

    60% of the time, it works every time!

    My husband and I cared for his grandfather in our home for years. His dementia advanced over time but at the beginning we had to be cautious about how we informed him of his new medications- he always wanted to know what the side effects could be. Within a day of his taking a dose of anything new, he would manifest EVERY SINGLE SIDE EFFECT. He had untreated high blood pressure for 30+ years because he was convinced that every med made him sick, so he never treated the condition. The end result was small vessel disease, a form of vascular dementia. Thank god he eventually complained about his meds so much that we started crushing them. He didn’t notice when we started slipping him a Xanax every stinking night.

    1. It’s really difficult for some people to wrap therir heads around taking a pill for years and years to decrease their chance of developing a condition (like the complications of high blood pressure). Unless a medication immediately makes people feel better they don’t seem to like to take it! You’ve given an excellent (and tragic) example of the nocebo effect. He expected the meds to make him feel bad…and lo and behold they did.

      Looking after someone with dementia has got to be one of the hardest things in the world. I hope you find some respite and time to look after yourself too!

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