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Despite a recent dubious claim that placebos don't require deception (critiqued here), placebos appear to function on the basis that a subject believes X will have effect Y. Without knowing too much detail, we say that the subject's mind/body will assist or attempt to achieve Y upon the perception that X causes Y.

Can a person, without self-deception [1] and with knowledge of the placebo effect, induce a placebo response? Or can a person knowledgeable of the placebo effect induce the same "reactions" that a placebo can normally be used to induce?

Consider a silly example.

Persons A and B each have a headache. They are told that balancing a spoon on one's nose eliminates headaches with very high success rates by conducting electricity via the sinuses. Person A believes the claim. Person A balances a spoon on their nose, and their headache is eliminated.

Person B, having a background in medicine, doesn't believe it at all. Person B, to prove the point, balances the spoon on their nose and remains in pain.

At this point, is there any way for Person B to "simply decide" that this ritual, which he knows to be an attempt at a placebo, to start working?

Would there be a difference using a pill instead of something purely ritualistic?

[1] self-deception. [for the purpose of this question,] any mental activity in the general category of suspending one's "participation" in the full body knowledge they normally possess.

svidgen
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  • suggestion itself can cause a placebo effect. By suggestions I mean what the subject is expecting from the procedure. Even if not informed at all, due to cultural commonalities a western control subject will assume that he is given "something" that will make him feel better of whatever he might or might not have. – Wolphram jonny Mar 20 '14 at 04:06
  • @julianfernandez Can the subject, without self-deception, self-suggest? E.g., Can the subject simply decide, knowing that they're attempting to "invoke" a placebo effect, efficaciously say, "This chocolate chip cookie will make my cold go away?" – svidgen Mar 20 '14 at 04:30
  • I am not sure to understand what you are suggesting (I mean, if you think that rational thought is the main source of our behavior), but they way I see it is more like a reflex. Like many optical illusions, even if you know what is the trick, you still cannot stop perceiving them. To me the ideal control subject would be one that doesn't even know he is being part of an experiment (or, at least, one dumb enough to not have any expectations from it). – Wolphram jonny Mar 20 '14 at 05:21
  • @svidgen What, to you, is the difference between self-suggestion[ of a belief] and self-deception? – BenCole Mar 21 '14 at 18:40
  • @BenCole I've added a generalized definition of self-deception that can be applied to the question. But, I hadn't given much thought into what specific mental activity I was trying to denote. So, if there's a better, generic, psychological definition of self-deception that can be inserted, I suspect that would also be sufficient. Without putting too much thought into it, per the definition as I've stated it above, I think self-suggestion often overlaps self-deception. But, I could conceive self-suggestion being used to correct an "innate" belief, based on intellectual knowledge. – svidgen Mar 21 '14 at 19:08
  • And maybe that last bit isn't clear either: An example might be a longstanding, "innate" belief in unicorns. Not that the subject is born with the belief, but that they acquired it and internalized it. If the subject then researches unicorns and finds them to be mythical, there's probably no self-deception in convincing one's self repeatedly through self-"suggestion" that unicorns are not real, physical creatures. (Probably the worst example of all time. But, hopefully illustrates a distinction, if there is one!) – svidgen Mar 21 '14 at 19:13
  • I suspect that the key difference between the two is one of agency, intent, or awareness - with self-suggestion having much more self-awareness than self-deception (which, by definition, includes a lack of self-awareness). I...doubt that that distinction is helpful though, sorry. – BenCole Mar 21 '14 at 20:27
  • @svidgen while I suspect you are asking with the specific context of taking a placebo pill, as mentioned in what's answer you'll find that undergoing rituals is well-documented for producing altered states of consciousness (yoga, shamanic practices, religious rituals, etc). Or, for a more modern/relevant example, performing exercise for mood regulation. At some point, it's not self-suggestion or self-deception: it's a true belief that doing a certain thing will produce certain results (whether or not that thing is a self-induced 'placebo' effect, or a biochemical effect). a.k.a magic! – BenCole Mar 21 '14 at 20:37
  • @BenCole Your examples are relevant. Can a person, having discovered that ritual X does not produce effect Y (other than through "sheer expectation"/placebo effect), still produce effect Y through ritual X? – svidgen Mar 21 '14 at 20:51
  • ... or, would the person have to convince him/her-self that there must be some link between X and Y I'm just unaware of? As opposed to, I know there's no link between X and Y, but I'm going to perform X to cause Y anyway. – svidgen Mar 21 '14 at 20:53
  • @BenCole I've edited the question with a hypothetical scenario, along the line of ritual, that might help clarify the question. – svidgen Mar 21 '14 at 21:11
  • Excellent example! Unfortunately, now we're getting into more complex/fuzzy areas. In your example, person A attempts the ritual without expectation as to the result - whereas person B attempts the ritual with strong expectations as to the outcome. Could B, the same person B with the same prior knowledge, instead perform the ritual with the (to them, inaccurate) expectation of success? That is, can B suspend their disbelief for the length of the ritual? If possible (and I suspect this is personality-dependent), I see no reason why person B couldn't also create the same outcome. – BenCole Mar 21 '14 at 21:24
  • It's also worth adding that the suspension of disbelief is a gradient, not an on-off thing. We can be all levels of suspicious/disbelieving. So the suspension of disbelief may only be half of it - person B would also have to acknowledge the possibility of a result (even if they don't expect a result, they are to some degree [more would be better] open to its occurrence). Most of this seems to come down to expectations, personality, and the ability to say, "this doesn't fit my current model of the universe, but that's okay". – BenCole Mar 21 '14 at 21:27
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    @BenCole Interesting ... So, the answer seems to be yes; so long as Person B can "expect" the result, regardless of whether they believe that the ritual works in and of itself. (For my next question ... What the devil is expectation anyway!?) – svidgen Mar 21 '14 at 21:37
  • seems, yes, though most of this is speculation, haha. As for your next question, it's a good one, and one I can't answer. I'll definitely upvote it if you ask though! – BenCole Mar 21 '14 at 21:45

2 Answers2

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Not an answer, because I couldn't find any studies, but too long for a comment:

  1. Placebos aren't arbitrary. You are not given chocolate chips as a placebo treatment for a cold. The placebeo has the form of a "real" treatment for the illness or disorder, e.g. a pill without an agent.

    This means that in your experiment your subjects must treat themselves with what looks like a real treatment but isn't. It must look like it could work.

  2. Placebos are not administered without the knowledge of the sick person, e.g. while that person sleeps. Placebos are administered in what is effectively a ritual: you go visit an expert, the expert speaks some magic words (the latin names of your organs and illness), the expert gives you a magic potion (the sugar pill), and touches you and transfers some of his or her power to you. Well, of course he doesn't, but the similarity between religious and magic rituals and what a doctor does are striking and have been studied by ethnologists.

    This means that in your experiment your subjects must explicitly treat themselves and not just eat breakfast and decide after the fact that one of those chocolate chips was the placebo. They need to plan how, with what, and when they want to treat themselves, and then administer the treatment in the way it was designed.

If, in this way, you consider what a placebo actually is – a ritualised administration of a faux treatment – it becomes immediatly apparent that this treament contains several psychologically powerful elements that must certainly have some kind of effect.

  • Is this a reply to julian fernandez his comment? If so just write a short summary as a comment there, possibly several comments. This does not seem relevant to the OP at all. – Steven Jeuris Mar 21 '14 at 14:57
  • I'd give you all the upvotes if I could - this may not be directly relevant to the question being asked, but it's excellent accompanying information. It also opens up an interesting subject - the role of ritual in activating the placebo response (i.e. belief/perception), especially in 'primitive' societies/cultures. The OP might find the answer to his question researching that subject. – BenCole Mar 21 '14 at 18:43
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    @BenCole If you search on Google scholar, there are some texts dealing with modern medicine and its relation to magical rituals or shamanism. –  Mar 21 '14 at 19:22
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    @StevenJeuris It is more a hint on how to think about the question in the absence of research. –  Mar 21 '14 at 19:25
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It has been shown that even if you tell a patient this pill is placebo and it's not going to help you, there's still some positive effect. It's all about perception.

There was a really good TED talk with the topic "Is there scientific proof we can heal ourselves?" at TEDxAmericanRiviera presented by Lissa Rankin, MD.

Steven Jeuris
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Ariel
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    Welcome to cogsci.SE! This looks like a very useful answer, but the Stack Exchange community prefers that they be somewhat more self-contained. I.e., this would be even more useful if you could tell us a little bit about the content included in these links (e.g., in case they close down someday, or a reader can't play videos while at work, using the mobile SE app, or because Flash Player is a hassle to update in Firefox). Any chance we could trouble you to tell us a little more about what you've found? – Nick Stauner Mar 21 '14 at 17:45