Placebo, Intention (Yi) and medicine

[Guest guest]

Hi All, & Al,

 

Al Stone wrote:

> Phil, You're in ...a great position to validate TCM without needing

> a placebo group. This is really great information because

> presumably your animal clientele is not involved with any

> expectation of relief and so there is no placebo involved. I am

> curious however if you believe that the animals you treat are

> sensitive to the intent of the vet. In other words, do they like

> to have you putting needles into them because you're a comfort or

> do they pretty much just put up with it because you and all the

> other two-legged animals seem to think that this pricking thing is

> important.

 

Al, I cannot answer your question about possible animal

expectations, or whether they sense the healer's intent. I believe

that animals are far more intelligent and intuitive than most people

think. I also believe (and there are many stories that seem to

confirm) that animals can be telepathic. However, many vet

colleagues may disagree with that also.

 

Al has raised the query about PLACEBO. What does this really

mean? IMO, this is a crucial question that has far-reaching

implications for the design of valid experiments in several holistic /

integrative modalities. More importantly, it is a crucial question that

EVERY PRACTITIONER, whether working with people and animals

should explore in depth.

 

" Placebo " (from the Latin verb " placo, placere (or placare), placavi,

placatum... " means I will (want to) please (placate, appease, ease,

pleasure, satisfy, reassure).

 

The Middle English word " please " comes from the Old French word

" plaisir " , as in the pleasures of love ...

 

http://dict.die.net/placebo/ and

http://www.wordreference.com/definition/placebo

http://dictionary.reference.com/search?q=placebo

say:

(Placebo: noun): an innocuous or inert medication; given as a

pacifier or to the control group in experiments on the efficacy of a

drug;

 

A prescription intended to humor or satisfy;

 

A substance containing no medication and prescribed or given to

reinforce a patient's expectation to get well;

 

An inactive substance or preparation used as a control in an

experiment or test to determine the effectiveness of a medicinal

drug;

 

Something of no intrinsic remedial value that is used to appease or

reassure another.

 

I, and many others, believe that the current, impersonal and

superficial " medical definition " of placebo (as above), has lost its

most essential meaning, a meaning of the utmost importance to all

true healers.

 

Why do I say that? Because placebo has other meanings that are

directly related to the WILL or DESIRE to PLEASE / HELP. One is

(in Roman Catholic ritual): The first word of the first antiphon of the

service (vespers) for the dead.

 

This concept of " placebo " goes to its essence, a crucial concept

that rarely is discussed amongst professionals. It infers

INVOCATION, calling on G-d, or other " Supernatural beings " to

listen and act as per the INTENT / wish / prayer expressed in the

invocation. We will see the crucial relevance of INVOCATION in the

placebo response later.

 

IMO, from the dawn of civilisation, true healers KNEW instinctively,

and by experience of failures, that their personal knowledge was

inadequate to solve all the " medical problems " that they confronted.

 

The desire / instinct to help the injured / weak is not just a human

phenomenon. There are examples amongst animals, especially in

mother-offspring relationships. Animals try to protect their young;

some attempt to help injured members of the group. Elephants

have been seen trying to assist a recumbent herd-mate to regain

its feet, etc. And elephants (and dogs) can die of grief when a

beloved comrade or owner dies. See

http://www.geocities.com/Heartland/Oaks/3538/elephants.html

 

Dolphins have saved drowning people, and protected people from

shark-attack, etc. http://tinyurl.com/5jpjq

 

IMO, these are examples of the instinct / intention to help / please

/ heal (placebo) from the animal kingdom.

 

However, on its own, focused INTENTION / desire to heal (Yi) is not

enough to induce maximal placebo effect in therapy, even if it

contains the genuine, mystical desire to be part of G-d's Mercy and

Compassion for the sick and injured.

 

Two additional ingredients are needed:

 

(a) CONFIDENCE (by the healer, and, if possible by the subject) in

the method being used,

and

(b) the SUBJECT'S instinctive awareness that the healer is doing

his/her best AND has confidence in the OUTCOME.

 

Lack of confidence by the healer in the clinical outcome transmits

easily (if only by body-language) to the subject. Unconscious

frowns, slight shakes of the head, not making eye-contact when

asked will it be OK, etc, signal " bad vibes " to the [human] subject.

IMO, the best results are hard to attain in subjects that have " given

up " mentally.

 

Sadly, many members of our white-coated, stethoscope-draped,

hassled and over-worked medical colleagues seem to have

forgotten that essential meaning of placebo.

 

Saying to a cancer patient: " We'll cut out the tumour / organ, put

you on local radiotherapy and follow up with several rounds of

chemotherapy " already says to the subject: " We know / suspect

that your cancer is already metastatic. Get your affairs in order

soon! "

 

What effect does does that have on a worried or nervous Mrs.

Murphy, or Mr. Smith?

 

IMO, going through the motions of prescribing a drug (or other

remedy, or an unmedicted lactose tablet, or a " dummy needle " ), in

which the THERAPIST has no belief / confidence, is NOT a full

placebo, whether it be done for research or other reasons.

 

In most cultures, medicine originally was the preserve of the Healer-

Priest, Shaman, Witch-Doctor and Wise One. In Biblical times,

prayer was an integral part of healing. Christ, and other great

religious leaders, were said to be healers, even to the extent of

raising the dead. In the early Christan church, healing was part of

priesthood: " Go, heal the sick " .

 

But we live in changed times. We are better educated (?) and more

technically-oriented. Instead of being a G-d-inspired calling

(vocation) to ease the suffering of humanity, medicine is becoming

a very expensive high-tech business, far removed from its original

roots in priesthood and mysticism - wanting to be G-d's Hands

to ease suffering in this world.

 

Whether we treat humans or animals, while trying to heal, some of

us have an occasional mind-blowing mystical sense of wonder and

absoluts conviction of the Unity of Everything. I have had 2-3 of

those stunning moments in circa 40 years of working as a health

professional. Although I cannot describe them adequately to you,

or the profound impact that they had on my " world-view " , I wish that

that state of mind could be a normal, everyday part of my life. BUt

it is not; it is a rare experience, a tantalising glimpse into the world

of the Divine.

 

In that sense of wonder and worship of the Divine, when one

focuses on, or CONSCIOUSLY INVOKES the full idea of " placebo "

[i WILL please (help, assist, heal) in the Name of G-d, AND with G-

d's help], and especially if one can transmit the sense of G-d's

unconditional love to the subject, incredible outcomes are possible.

In that situation, I/you heal nothing but merely transmit healing

from G-d, the Great Healer.

 

Al, and colleagues, please do not get me wrong. I am not having a

" nervous breakdown " , nor am I claiming anything extraordinary for

myself. I am nothing but a spirit housed in an ageing body. I am

really no different from any of you; we are fallible beings with limited

knowledge and many failings. Few if any of us will attain sainthood

/ Buddhahood in this life. We must get on with our daily work / play

/ family business, etc, keep the Bank Manager off our backs, guide

the kids, be neighbourly, etc. We do our best with the resources at

our disposal.

 

Many on this List may not believe in spirit, G-d, or other " irrational,

superstitious and esoteric " concepts. Some of you hold fast to the

fallacy that science will explain everything in time, and that AP &

TCM should be trying to copy and apply the principles of EBM. I

used to think that way, but no more.

 

IMO, at best, science may explain physical (and maybe

pschological) mechanisms and interactions, and predict outcomes

to specific inputs. But, IMO, science will not, and cannot, put

meaning on life, console the longing of many people for basic

human rights and dignity, justice, happiness etc. The latter areas

are best handled by philosophy, theology, parapsychology, the

arts, etc.

 

IMO, we are too late to try to play catch-up with EBM, especially

by THEIR rules. We have not unlimited billions of dollars at our

disposal to set up extensive research trials on thousands of

different projects, and the multinationals and hospital industries are

unlikely to provide funding for such projects.

 

Yes, I would like to see far more high-quality research done on

TCM, but integrative medicine must develop ITS OWN standards of

critical appraisal that take its unique interactions of spirit-mind-

soma, its unique interplay between healer and subject, and its

unique attempt to prescribe for the INDIVIDUAL (not a standardised

" one formula for all subjects-in-the-group " ) into account.

 

[There is a place for " standardised formulas " in some areas of

research (such as artemisinin in malaria, PC06 in vomiting; BL67 in

breech presentation, etc). However, in complex cases, AP points

(or herbal/homeopathic formulas) need to be chosen for each

individual, and these selections may need to be changed at

subsequent visits from the same individuals.

 

IMO, we need a much more comprehensive examination of the

definition of PLACEBO, and its applications in research and clinical

practice. Sorry for the long post, but you can all blame Al for

triggering these thoughts! Thanks, Al!

 

For further insights into Yi (INTENTION), see: " MEDICINE IS

SIGNIFICATION " - MOVING TOWARDS HEALING POWER IN

THE CHINESE MEDICAL TRADITION by Volker Scheid Ph.D. and

Dan Bensky D.O., reprinted by permission of the European Journal

of Oriental Medicine:

http://www.siom.com/resources/texts/articles/v-scheid/yizhe.html

 

If you have not read that article, you are in for a surprise, because

it stresses the importance of the therapist's Yi/Intention in all

therapy.

 

See also http://vetlab.co.uk/voodoo/thoresen.html

 

It is an insulting comment by Voodoo Society [a group similar to

Quackbusters] on Are Thoresen's ideas. That Society is to be

thanked for putting Are's ideas on WWW, because many more

people will read them and interpret their importance differently to

what the Voodoo Society might like!

 

Are's main message in that article is: " As veterinarians, when we

treat animals, we must pay much more attention to our own Yí,

and to the psyche of our patients. "

 

See also: http://www.chinese-medicine.co.uk/articles/philos.htm

 

I'm off to the bunker now, for I can sense incoming missiles

triggered by some of you by the suggestion that Spirit, prayer, or

the paranormal has any practical role in modern medicine,

including modern AP and herbalism!

 

Great Qi and Yi to you all,

Phil

 

PS: Some vets disagree with my relegation of stimulators to a

dusty shelf. Some routinely use electro-AP; lasers, ultrasound,

Dermojet, point-injection, homeo-AP, etc. That is to be expected

because each practitioner (like Old Blue Eyes) is an individual, and

would like to think: " I did it MY way ... " . And some of them use

high-tech stimulators because their CLIENTS expect that, or are

impressed by the price-tag on the gizmo.

[Guest guest]

 

I'm off to the bunker now, for I can sense incoming missiles

triggered by some of you by the suggestion that Spirit, prayer, or

the paranormal has any practical role in modern medicine,

including modern AP and herbalism!

 

(Tom) No missiles here. Would like to take this opportunity to thank you for

sending us all that research and all those links. A lot of work, I'm sure.

Thank you for that. Highly appreciated. I have found some of it to be very

useful.

 

On placebo: we indeed need a thorough review of the so-called placebo effect

Whilst it is important to make sure that we know what we are doing, it's

also important to at least acknowledge the possibility of several mechanisms

of placebo effects. I can't think of any machine or test that would be able

to filter that kind of information out, but we still have our own minds and

hearts that can tell us a thing or two about these mechanisms. Especially if

we indeed practice some sort of meditation.

 

Some might argue that this kind of thing is not scientific, but who knows? It

might be one of the more developed forms of science. At least that's a

possibility, and a hypothesis we should not rule out.

 

 

[Guest guest]

On Dec 12, 2004, at 6:10 PM, wrote:

 

> I'm off to the bunker now, for I can sense incoming missiles

> triggered by some of you by the suggestion that Spirit, prayer, or

> the paranormal has any practical role in modern medicine,

> including modern AP and herbalism!

 

Uh-oh, I see that the " nocebo " response is kicking in. : )

 

Thanks for all that great information and links.

 

I agree that the placebo response is something that is in need of far

greater scrutiny by the scientific community as well as clinicians in

general. There is something there far beyond the usual " its all in

your head " type write-off.

 

-al.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

Hey Phil, that was a great post. My few experiences

have led me to have a very positive view on the

placebo effect and of our responsibility to use it to

the maximum with everyt treatment.

Thanks for your effort in writing all of that down!

Hugo

 

 

 

 

 

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[Guest guest]

Mr. Rogers,

 

I love placebo. I use it every chance I get.

 

I like to think of placebo as " nonspecific effects. "

 

Placebo as a golden standard for clinical research has been a fad

from the beginning, and I am amazed that many believe that we can

somehow roll up everything unmeasured into a ball of sugar and

thereby account for all the missing pieces. That said, I think

evidence from controlled research is extremely useful and important,

and separating specific from nonspecific effects is of course the

goal, even if we know we can never observe, describe, or quantify all

the active variables. I'll save further comments on research

protocols and the profound subject of placebo for a more appropriate

discussion, in which I would stand to learn a great deal.

 

As far as the animal placebo question, I find it practical when

patients ask about Chinese medicine and placebo, to let them know

that " it works on babies and animals, too. " This highly reduced view

of the topic seems to answer the main concern, which is that the

beneficial effects be purely psychological suggestion and nothing

more. (Incidentally, I have noted that psychological suggestion can

be highly paradoxical. Many are convinced against something but

secretly want to be persuaded (like many on this list), and I believe

outcomes are often enhanced as a result of disbelief.)

 

Last, I would like to add that if anyone's looking, I have a great

connection for some really effective placebo, cheap! It should be

released soon--it just has to be tested in a double-blind trial...

 

Warmly,

 

Jonah Hershowitz