The most baffling organ in the human body/Daniel Sabinasz, Wikimedia Commons

The inexplicable powers of believing

Sometimes your problems are largely in your head, according to the latest peer-reviewed research published by JAMA Psychiatry. 

The shamans, witch doctors, faith healers, medicine men, wizards and priests who spent tens of thousands of years trying to drive the demons out of people should now probably get some credit for figuring this out ages ago.

Then again, they largely arrived at their conclusions by default. For most of human history and prehistory, what little power existed to “cure” the sick and injured came from investing “patients” in the power of the then-unknown “placebo response.”

The species has come a long way since.

So far, that some want to overlook or dismiss the now well-documented and yet unexplained brain-body connections that can help people heal themselves along with the evolutionary history of a mammal whose physiology was shaped by physical labor and constant movement.

The shamans and witch doctors are dismissed as charlatans and con artists, and largely rightly so though they were onto something. And the “doctors” of modern times are held up as lifesavers, which they regularly are, though they are also far from perfect.

As Louis Dwyer-Hemmings of University College London observes in a history of tonsillectomies, said operations were common up until the 1980s when “public and professional discourse condemned (them) as a ‘dangerous fad’.”

Growing up in Minnesota in the 1960s, almost everyone I knew had their tonsils removed and every time I had a sore throat doctors wanted to remove mine, but my mother – Nurse Donna – thought the procedure most often nonsense. She turned out to be right.

By the end of the 1970s, Dywer-Hemmings wrote, the United Kingdom Medical Research Council, which had spent years studying the procedure, found “most tonsillectomies unnecessary. Almost all the accepted criteria for operation had been demonstrated to be problematic.”

Medical doctors, it would seem, or at least the majority of them, have an inherent bias toward medical treatments as the solution to all problems in part because this is how they make money.

Not even the pandemic of the unfit and unhealthy that has killed more than 1.2 million Americans to date and is killing more as you read this has been enough to move the majority of them to hammer home to their patients the reality that “exercise is medicine.”

You can run your body regularly like your snowmachine, your truck, your lawnmower or whatever other internal combustion powered machinery of your choice, or you can let it sit in the yard until the fuel gels in the carburetor or injectors and the motor ceases to function.

The latest news from the scientists – those learned people who Americans were being lectured to “listen to” only a short year or two back – isn’t about the human motor, however. It’s about the mind, the “computer chip” that controls the body to follow on with the analogy of the motorized equipment of today.

Pill sans medicine

Researchers in Germany found that in some cases people with psychiatric problems can get as much help from placebos (ie. sugar pills) as from drugs. This was especially the case for those suffering from depression who the researchers reported showed a placebo effect size of 1.40 when treated with placebos.

Effect size is a statistical measure of how well something is working. An effect size of 0.5 is considered medium, and an effect size of 0.8 is considered large. There is no extra large, but if there were the effect size of placebos on depression and as well as anxiety, which scored a 1.23, would be considered extra large.

Effects were not so large for schizophrenia (0.59) or obsessive-compulsive disorder (0.65, but they were in the medium-to-large range.

“A better understanding of placebo responses may improve treatments, especially in psychiatric disorders where confidence, conditioning, and belief play a significant role,” the researchers concluded.

If you haven’t read much or anything about this study elsewhere, that’s understandable.

The Un-united States of America has become a country where the problems we all face as individuals are not our problems anymore; they are problems caused by someone else.

Thus there is no point in telling people that they might be able to fix some of their problems with self-care. Blaming others is so much easier and now normalized.

On the left, the social warriors blame everything on the “privileged.” On the right, the freedom warriors blame anever-growing class of victims granted special treatment due to the lobbying of the left.

Bob Dylan wrote a song about the politics of all this in 1964. He titled it “Only a Pawn in Their Game”:

A South politician preaches to the poor white man
“You got more than the blacks, don’t complain
You’re better than them, you been born with white skin, ” they explain
And the Negro’s name
Is used, it is plain
For the politician’s gain
As he rises to fame
And the poor white remains
On the caboose of the train
But it ain’t him to blame
He’s only a pawn in their game 

Since then, thankfully, the South has changed. The days of “Whites Only” restrooms and businesses have been relegated to the dark bin of history, and though economic segregation remains in places, many Southern communities are now among the most diverse in the nation, even if the various diversity ranking systems sometimes miss this.

But while the South has changed significantly, the politicians’ game has shifted only slightly in that the poor black man, along with those of “color” and some women, have now joined the poor white man on the caboose of the train.

On the left, it’s all about the white man’s privilege while on the right it’s now about migrants streaming across the border to “steal” American jobs. Never mind that some of the people already in America don’t want to work if they can find a way to avoid it.

Suffice it to say that the “ask not what you can do for your country” of the late President John F. Kennedy now seem as distant as those “Whites Only” signs in the South. There are more folks than ever demanding to know what “my country can do for me.”

Suck it up

Placebo response or no placebo response this is no longer an America where anyone wants to be told “stop whining and get over it,” or “go take a long walk and you’ll feel better,” though when it comes to depression – the country’s leading mental illness – there is ample evidence supporting the idea that this simple advice helps.

“Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments,” a major, peer-reviewed meta-analysis published The BMJ in January concluded. ‘Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression.”

Americans, unfortunately, are more likely to get behind the wheel of a motor vehicle and go for a drive which too often heightens stress and anxiety which can in turn compound depression or lead to “road rage.”

Sadly, too, many Americans think of exercise as work and thus avoid it, and they are enabled by a healthcare industry built around the idea of a pill, shot or procedure to fix anything. See former Covid-19 czar Anthony Fauci’s claims that Covid-19 vaccinations would end the pandemic and stop the disease-causing SARS-CoV-2 virus from constantly mutating. 

That has not happened, and there are some scientists now arguing that the vaccines could be making the problem of mutants worse not better.

Writing in the Nature journal “Communications Medicine” in June of last year, evolutionary biologists Igor M. Rouzine and Ganna Rozhnova argued that “vaccination adds the immunity of vaccinated individuals to the natural immunity of recovered individuals, thus potentially favoring immune escape mutations even more. Using an equestrian analogy, vaccination spurs the Red Queen into a full gallop. Thus, the cost of the short-term decrease in the number of infections is the spread of new epitope mutations in the future.”

The Red Queen tracks back to Alice in Wonderland in Lewis Carroll’s “Through the Looking Glass.” The Red Queen is the character that must keep running to stay still. The Red Queen Theory holds that organisms must be in a constant state of mutation to avoid extinction, which is sort of a dream scenario for the pharmaceutical industry which must then be constantly coming up with new drugs to battle the mutants.

All of this has helped to create a massive, 21st century, health care industry.

On the basis of revenue, hospitals are now ranked just behind the nation’s banks as moneymakers. And after hospitals come, in order, “drug, cosmetic and toiletry wholesaling,” “health and medical insurance,” and “pharmaceuticals wholesaling.”

“New car dealers” are sixth despite having the advantage of producing their products in a nation that has for decades been designed around motor vehicles. It is still possible to survive in the U.S. without a car or truck, but in many places it isn’t easy.

After two years of going car-free in New Brunswick, New Jersey, Nolan Gray raved about the benefits on the Strong Towns website before confessing that “living car-free flatly wouldn’t be possible, or would be much more difficult, without ridesharing. There are some trips where you will just need a car: the monthly big trip to the grocery, the occasional visit to the friend way outside your neighborhood, and so on.”

The business of motor vehicles in this country is now a big business because the industry has Americans hooked on cars and trucks. But the automotive industry can’t begin to compete with a healthcare industry that has people hooked on legal drugs and medical procedures and pushes Americans new “remedies” every day.

Just turn on your TV and count the ads pushing drugs. According to the data tracking website Statista, the pharmaceutical industry in 2020 “spent $4.58 billion on advertising on national TV in the United States….ad spending of the pharma industry accounted for 75 percent of the total (TV) ad spend.”

So don’t expect the mainstream electronic media to pick up on a study suggesting some drugs aren’t nearly as effective as we’d like to think or that non-pharmaceutical solutions might sometimes be as good or better.

Imagine the financial losses to pharmaceutical companies if people could somehow be taught to harness the placebo response to manage their depression or kill their pain – pain being what led to the first serious discussion of this mind-body connection.

T.C. Graves is credited as coining the term in 1920, but it was Henry Beecher, a World War II medic, who boldly underlined its power in the 1940s. When morphine ran out, he injected wounded soldiers with simple saline, but let them believe it was the powerful painkiller.

“He was shocked to find that 40 percent of the wounded soldiers who received saline (and believing it was morphine) reported that pain was reduced or eliminated altogether,” Taiki Matsuura would observe in his dissertation for a doctorate from the City University of New York (CUNY) more than seven decades later.

Matsuura was at the time involved in a study to determine if altering drug trials by deviating from the standard 50-50 ratio of experimental drugs to placebos affected the placebo response. The results of his experiments indicated that it did.

If study participants had a reason to believe that they had a better chance of getting the experimental drug rather than the placebo, the placebo response went up.

His study, Matsurra wrote, suggested “that when placebo treatments are used to determine efficacy of target treatments, an unbalanced (randomization ration) RR could
impact the (placebo response) PR. Typically, an unbalanced RR suggests that there are more active treatments than placebo (treatments).

“This means that subjects who become aware of a higher likelihood of receiving an active treatment may demonstrate a greater placebo response. This could lead to insignificant findings in unbalanced trials – because placebo response will be greater – and as such promising treatments may not appear to do any better than placebo treatments. This is a legitimate concern even with balanced RR but the risk may be far greater with unbalanced RR.”

The placebo effect popped up recently during the pandemic when some doctors began prescribing ivermectin, an anti-parasitic drug, to treat Covid-19. The results of an early trial of the drug, published in 2021 by The Lancet, a respected medical publication, concluded that “there was…a marked reduction of self-reported anosmia/hyposmia (the loss of smell), a reduction of cough and a tendency to lower viral loads.”

But a larger study published by JAMA (formerly the Journal of the American Medical Association) in 2023, concluded that ivermectin was worthless for treating Covid-19 because it did no better than placebos, which also led to a certain percentage of people feeling better.

The placebo effect should probably get credit for helping fuel the early belief that ivermectin was a potentially effective drug because the placebo effect was clearly in play.

A peer-reviewed study published in the journal Psychiatry and Clinical Neurosciences in September of last year noted that 33 different, randomized controlled trials of various treatments for Covid-19 found that patients “treated with standard of care (SoC) plus placebo had lower odds of all-cause mortality than those who received SoC alone.”

The authors of the study concluded the “placebo effect”  could be skewing evaluation of the “the efficacy of treatment strategies for COVID-19.”

The “nocebo effect” – the evil twin of the placebo effect – also emerged in evaluations of both vaccines and what is now called “long Covid.”

Nocebo effects were blamed for “most COVID vaccine side effects,” a conclusion that was widely accepted by the medical community. Not so widely accepted, however, was another study that suggested many cases of what has come to be called “long Covid” could be linked to the nocebo effect.

And then there was the peer-reviewed study titled “Experiencing COVID-19 symptoms without the disease: The role of nocebo in reporting of symptoms.” The authors of that study found that there were a fair number of people who believe they were suffering from Covid-19 even though they were not infected with the SARS-CoV-2 virus.

“Believing to be infected with Covid-19, along with anxiety, can enhance the severity of COVID-like symptoms. Thus, the nocebo effect was due to both cognitive and emotional factors and was higher in females,” the study reported.

Some things, it seems, can sometimes be all in your head.