Tuesday, September 15, 2009

Wherein I Throw Down With XWL

XWL over at Immodest Proposals commits the ultimate crime here.

That's right, folks, he disses the placebo. Here at the 'strom, it's a toss up as to whether we prefer placebos or snake oil, but both have an exalted position in our world.

I'll concede his basic point that vague diseases lend themselves to vague cures. But it's a mistake to regard placebos as meaning that the patient was never sick to begin with. A lot of people tend to think that psychosomatic illnesses aren't real, that they're "all in your head".

But of course, they are real. The symptoms match those of "real" diseases. It seems to me that a psychosomatic condition could have a perfectly ordinary biological origin, but be held in place by a state of mind. The placebo gives the mind an excuse to let go of the symptoms, basically.

There's a congruence of mind and body not to be overlooked. If you injured your leg and tended to favor it, it would get stiff. And you might, noticing that it was stiff, tend to keep favoring it, actually making it stiffer. If you were convinced, on the other hand, that it was all right and just needed a little exercise, not only would you tend not to favor it, your body would probably create conditions more inclined to relax it.

The real question is how many diseases could be positively influenced by a placebo. Sometimes, I suspect, all of them. A midwife I knew said that while labor hurt, a lot of that hurt was a combination of past pain and future pain. In other words, remembering the previous contraction and fearing the next one made the present contraction three-times as bad as it really was.

I often wonder how much we could do with a really good placebo. I've mentioned my friend who died of cancer (three years ago now) and as I sat with her as she lay dying, I contemplated a chicken sacrifice. Rattle shaking. Dancing in a mask. I would've done it if I thought I could've convincingly sold it. Or if I could've hooked up a couple of Tesla coils and Jacob's ladders, and pulled a mad scientist.

There are examples of just about every disease getting spontaneously better. Maybe that's what we should be looking at rather than running placebos down.

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