Yeah, that’s a good way of putting it. Maybe placebo is not the right word? My point is that if you give a person with depression a placebo, especially one with some kind of side-effect, then it can have a profound influence on their depression.
I guess my argument is, if you think of this as a treatment for depression-- then you have to deal with the fact that depression is difficult to study.
If you think of it as a treatment for gender-dysphoria, then obviously it works as claimed, and has a high satisfaction rate, and hopefully fewer suicides.
(I would also assume??? that all the people in this study are already in therapy and on anti-depressants, so presumably that placebo effect is accounted for, but I don’t know, it’s weird)
I think the proper effect to check is the Hawthorne Effect:
In the study under discussion, how much of an impact did the knowledge that the treatment group was getting their treatment sooner than normal have on the observed scores?
Huh? When my kids were little i gave them placebo when they were sick but didn’t have a fever. It always made them feel better. I was not comfortable giving them child decongestants, which even then had some warning signs. I was pretty sure the placebo wouldn’t hurt them.
(We cleaned out an old Tylenol bottle, and filled it with water, some corn syrup, and a couple drops of red food coloring. And labeled it “Placebo”.)
Um, what? The placebo effect has been hugely studied and is so real that in most scientific studies it’s considered necessary to control for it by administering a placebo to a portion of study participants and compare results to the ones who got the placebo.
There are literally thousands of studies out there supporting that it is real and powerful.
I only gave the article a quick scan, but I didn’t see anything to substantiate the assertion that the placebo effect is a myth? Just that it is confounded with all other non-treatment effects.
The main point of the article seems to have nothing to do with its title — namely, that medical research is too fixated on anything that gives a small benefit (of questionable statistical significance). Which is a good point, but has nothing to do with whether the placebo effect is a myth or not.
The article does not appear to be peer reviewed and seems to be more of a glorified opinion article (NTTAWWT). But the above quote strikes me that the author is arguing for a change in terms to describe the effect observed that is generally been called “the placebo effect”.
But regardless of what term is used to describe this particular observed result from a control group, it is still an important comparison to assess the efficacy of a particular treatment.
With all that said, I agree that the study under discussion recently did not have a placebo utilized. It suffers more from a lack of consideration for the aforementioned Hawthorne Effect.
I would further point out that the context of the article is in psychology/psychiatry; not general experimental studies. So I agree with your statement with regard to this discussion (i.e., there isn’t a “placebo effect” that should be considered); but not with the generalization of the statement to all contexts (which I think others are responding to).
I skimmed it and didn’t see it mention regression to the mean. And i searched for that phrase and couldn’t find it. So i cannot respond to your comment about that.
It reads to me more a work of philosophy than science. (I don’t mean there is anything wrong with that.) It seems to argue for emergence against reductionism, which i have a lot of sympathy for, and that the “placebo effect” is the western hegemony rejecting the healing that emerges from local social meaning, which i have less sympathy for.
I saw another article some time ago which said, basically: instead of treating the placebo effect as a nuisance in studies, why not understand why it happens and try to use it? I think that is some of the same idea, but in a way i find more convincing.
I think the idea was to understand the mechanisms by which the placebo effect works. In a way i suspect that article would deny as reductionist and therefore hopeless.
FWIW, there are links to additional articles related to the topic of this one within the above page. I think it would behoove us all to check some of them out as well to get a fuller picture of this particular issue.
ITA . . . all the more to take care when using a loaded term like “placebo” (note that this link contains the origin of Whiskey’s statement of “regression toward the mean”) when talking about studies on psychology and what treatment is actually given to the control group. My overall take on Whiskey’s article is that there are many studies that use “Eastern treatments” for the control group but call it a “placebo”. The author is acknowledging that the using Eastern treatments for the control group is appropriate, but not using the term “placebo” as the descriptor.
It basically says: the double blind study, and the scientist behind it, know more about the state of my own body than i do. I might think i feel better because taking this drug, but that subjective experience is not really legitimate or scientific.
I like that. In my mind, placebo treatments aren’t usually free. Often there is a con man (intentional or not) behind them. Or perhaps entire organizations that can use this power over the individual, as is the potential for religion based treatments.
The author would probably criticize that view as reflecting an attitude from the enlightenment that western style knowledge lifts people out of barbarism, which is never far away. So I am rejecting indigenous understandings of medicine, and that this is a kind of imperialism.
Rejecting this enlightenment based imperialism is, i suspect, behind the articles argument to use the phrase “healing effect” or “meaning effect” over “placebo.” It is not a trivial position about wording, and should be taken seriously, in my opinion.
Not as much Pedantry, that the concept of Placebo that we have gotten used to is not actually real. The idea of tricking people with a sugar pill and that somehow results in better results than the same treatment without the sugar pill.
I am now at work and not finding the exact article discussing threefold studies, that consistently show no significant difference between placebo and no placebo. I will see if i can find it tonight.
I take vitamin C when I have a cold because I believe in the placebo effect. I’m kinda serious. It feels good to “do something”, and vitamin C is pretty safe and feels like is is “doing something”.
I don’t have a problem with the word placebo, but I can see how people might. Either way, there’s a real effect, it’s not just “reversion to the mean”, and it’s documented by hundreds of studies.
