Contemplative Observatory

Placebo Effect

‘The notion that the mind is passive, whatever its ontological status may be, has been thoroughly discredited by science. One of the clearest indications of this is the euphemism of the so-called “placebo effect.” I call this a euphemism because a placebo refers to a substance or treatment with no known effect on the condition being studied. Therefore, the effects that are observed, evidently caused by such mental processes as expectation, desire, hope, belief, and trust, are nominally attributed to something that is specifically designed ‘not’ to affect the condition being studied. The “nocebo effect” refers to the opposite: people expect they will experience something painful or afflictive, and that’s just what they get. In this case, their thoughts, emotions, and beliefs cause physical effects, but how these mind-body causal interactions occur is far from clear.

‘The size of the placebo effect varies from study to study and depends on the condition under investigation, but 35 percent is a frequently cited figure, while in some cases it is far higher. In 1998, Irving Kirsch, who has done provocative work in this area, stirred up a lot of controversy with his paper “Listening to Prozac But Hearing a Placebo: A Meta-Analysis of Antidepressant Medication.” More recent research reveals not only that 50 to 75 percent of the efficacy ofantidepressant medication is due to the placebo effect but also that “effective”placebo treatment induces changes in brain function that are distinct from thoseassociated with antidepressant medication. An even more mysterious propositionthat is almost certainly true is that sometimes placebos catalyze novel kinds ofsomatic experiences, rather than simply replications of previous symptoms. Insome documented cases, mental effects (let’s finally call them what they are)actually override the effects of physiologically active drugs.’ In cases where the mind catalyzes unprecedented effects in the body, the nature of the mind-body interaction is especially mysterious. How is it that an individual with no knowledge of brain mechanisms or physiology can mentally cause changes in the body corresponding to an uninformed belief or expectation?

Neuroscientists commonly believe that information is stored in higher orders oforganization of neuronal networks. Maybe so. But how, exactly? In the case ofinformation stored in a computer, Searle points out, “The information in thecomputer is in the eye of the beholder, it is not intrinsic to the computationalsystem…. The electrical state transitions of a computer are symbol manipulations only relative to the attachment of a symbolic interpretation by some designer, programmer or user.” If the brain is accurately portrayed as a biological computer, where is the outside “eye of the beholder,” and what is the nature of the designer, programmer, or user? An alternative hypothesis is that information is actually stored in the mind, which acts as a substrate for certain neural events, rather than the other way around….’Wherever information is stored, the undisputed prevalence of placebo effects incontrovertibly refutes the hypothesis that in the relationship between the mind and brain, the mind is a passive partner. Instances of the placebo effect are far from unique in this regard. Other studies show that mental training modifies neural networks, coordinates regional brain oscillations, and modifies neurosecretory functions.

The recent work of Antoine Lutz, Richard Davidson, and their colleagues hasreceived a good deal of public attention. All such research show that the idol of the brain has been toppled by empirical evidence….’

–B. Alan Wallace, from’Contemplative Science: Where Buddhism and Neuroscience Converge’

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