neat.

Well, I don't really see how it's a blow to the idea that it's purely psychological. Well, unless someone was suggesting that pain was purely psychological...which it pretty clearly isn't. This actually seems to prove that thoughts can have physiological effects...

[Edited on Aug 25, 2005 8:32PM]

I think you and the scientist are on the same page...the article seems to say
that the act of telling someone that they are taking painkillers (the "thought")
leads to a physiological reaction (endorphin production).

This started me thinking...
An experiment I'd like to see is one in which the subject was injected
with saline, but was told that they were being injected with an agent that
would make them ill in a specific way; ie nausea, headache, etc. A sort
of reverse placebo effect. perhaps the body would actually manufacture damaging stuff to simulate what the subject thought should be happening to them. Of course it would suck for the control group who would actually be getting something that made them sick...

maybe it would go a long way towards understanding hypochondria . I don't think its out of the question to believe that people can actually make themselves ill if they can make themselves block pain.

I guess I just didn't like the wording used when they said it was a blow to the idea that the placebo effect is purely psychological, because in a way it still is. But at the same time I see the point made. Blah.

I like your second point, incidentally, go talk to the scientists who ran this test and ask them to try your idea too, in case none of them thought about it. That research would be pretty beneficial.

Funny aside, when I put a bandaid over a cut it stops hurting, or I stop noticing it hurt. I used to think I wa sbeing silly but it's a direct and imediate effect. I guess I am being silly, but what the hell, it works.

I wouldn't be surprised if that was the case with most people, whether they know it or not.

[Edited on Aug 26, 2005 3:40AM]

I agree that I don’t see how it is a “..blow to [the idea] that [placebo] is psychological...” I kinda’ thought that was the DEFINITION of placebo effect. That thought creates physiological changes. THAT concept has been well documented.

As for the experiment...even though there would not, technically, need to be a control group (as the effects of actual toxic elements is well documented through case study)...I agree that it would still be unethical. I have also heard the theory that if one can make oneself well, one can make oneself sick...although I’m not sure I buy into it. However, simply because I have worked as a medical advocate, this is a pet peeve of mine...I have to mention a few things about hypochondria (edifying the public, as it were.)

Hypochondria, or somaticism, is an illness very psychologically defined. To be diagnosed with “hypochondria” you must meet at least ONE symptom out of EACH OF 23 different categories...including things like a form of headache AND a form of gastrointestinal problem AND a sleep issue AND a depression issue...on and on. All legitimate illness have a somatic COMPONENT, meaning the anxiety/stress/psychology involved with the illness CAN make symptoms up to 20% WORSE...it does not account for the illness itself.

Point being; hypochondria, in the form of the “whiney person who is always sick with a slew of mysterious, unidentifiable illnesses” does not psychologically exist...except in the mind of medical doctors without appropriate psychological training...and television sitcoms. With the understanding that a person with a legitimate, but difficult to diagnose, illness visits an average of 28 DOCTORS before receiving a correct diagnosis...in MOST instances, the “hypochondriac” is generally a person with a legitimate, but as-of-yet unidentified illness. Many illnesses (MS, MD, FSHD, thyroid problem, adrenal problem, lupus, small tumor, arterial blockage, ETC.) can manifest themselves with a slew of largely varying symptoms...both amongst different people, and within the same person at the different times.

Summary...when your doctor says, “It’s all in your head”, unless he is a psychiatrist (not a psychologist), translate this to mean, “I have no idea what is wrong with you.”, kick him/her to the curb and move on to the next Doctor until you find out what is wrong.

Lecture over...test on Tuesday :-)



[Edited on Aug 27, 2005 2:13PM]

I think there may be a psychological event happening there too...but what makes the research difficult is (to use your example) when you put a band-aid over a cut, it is usually relatively tight, causing a restricted blood flow to the nerves, which will result in a reduced pain sensation to the area of the cut.

But how do we differentiate which component is having what effect.

The world may never know (crunch!)

I should imagine bandaid and other manufacturers rely on this for a fair proportion of their sales, how many plasters are used and not needed?

Also does this mean they will start to make medicine to directly stimulate endorfin release so that even if something doesn't work the patient would feel better, asprin with added endofin stimulator. Even as a more immediate pain relief.

Lastly is there a circumtuitous (is that a word?) way of linking that to S&M i.e. if a subject expects to recieve pain but is anticipating it feeling good will it actually hurt less?

Technically, pain IS purely psychological (by what I have always understood to be the definition of psychology...the functioning of the brain) which, thus, makes the statement about the blow to placebo effect being psychological an oxymoron.

No one feels pain in their arm. ALL pain is felt in the brainstem, which activates pain synapses when signals from your cut finger are received. Thus, when brainstem activity is reduced (through anesthesia, or narcotics, for example) pain stops. Narcotic pain killers have no effect on the cut finger, they effect the brainstem.

Conversely, phantom pain in an amputee exists because the brainstem still maintains a complete map of the body, even though the appendage may no longer exist. The map is maintained such that the brainstem can differentiate to your cerebellum and motor centers WHERE the pain is coming from. It does you no evolutionary good to know you are in pain, but not be able to identify it is coming from your foot (which just slipped into the campfire.) So, even though the arm (or whatever) may not physically exist, the map for it is still in the brainstem and has been triggered by an unknown event...causing the amputee to feel pain in their “hand”...even though they no longer have one.

Actually, since the pain center of the brainstem is located very near the pleasure center of the brainstem...some have speculated that individuals that enjoy pain, or pain during sex, do so because of "crosstalk" between the pain and pleasure centers.

Beat me, hurt me, make me write bad checks...

Hmmm...maybe.

Actually, that is the premise I am suspicious of. I remain skeptical that these psychological illness ARE actually psychological. Example, it was believed for decades that up to 75% of impotence cases in middle aged men was psychological...until research showed that as little as a 25% blood flow reduction to the penis due to perineal trauma can result in impotence. The study found that very small trauma to the arteries of the pelvis (even just from a lifetime of bicycling on an improperly fitting seat, for example) can lead to enough of a blood flow issue to cause impotence.

All of a sudden, 90% of impotence cases can be “cured” through a physical procedure.

Not to be argumentative, but I would need a list of illness said to be “psychological” in nature. I suspect many of them will be found, if they have not already been found to be, physiological in nature. Freud’s “hysteria” (hysterical blindness, hysterical paralysis) theories have been found to be almost entirely nonsense. I stick with the “it’s all in your head” diagnosis to mean...we can’t figure it out yet. :-)

Just on another side note...most patients who are eventually found to have a physiological problem are sent to a psychiatrist within the first three visits to specialists. I wonder how many people are living with pain, and or psyche meds, because they were unfortunate enough to be diagnosed with a “psychological illness”...when their problem is really an as-of-yet poorly-manifested physical problem?