The Placebo Effect – Part 1

Panel Discussion

Posted September 7th, 2014

Chelsea Shields Strayer joins Glenn, Matt, and Scott for a discusion on The Placebo Effect.

Part 1 covers Chelsea’s time as a cultural anthropologist in Ghana, why she got involved in Africa, and how her field work among the Ashanti changed the way she views her Mormon culture. We also discuss cultural relativism — when is it OK to judge a culture’s vices and become an advocate for change? And we begin to discuss the Placebo Effect based on the faith healers Chelsea studied in Africa — how an inert medication or treatment can actually cause measurable physical change in a person’s body.

  • Older Thinker

    You know how some old people drool? Well, I figured out why that is. That is our brains draining out of our heads. I enjoyed this podcast, and felt challenged by all of the ideas and concepts, but I didn’t understand like I could have in my younger days.

    Having said that, I very much enjoyed thinking about how we all make judgements based on our own cultural traditions and expectations. The best way to overcome that is with education. So, thanks for bringing Chelsea on to discuss this. It has helped take me out of my very egocentric world view. I look forward to Part 2.

  • jeanbodie

    I felt like you guys were steam rollering Chelsea sometimes, but she held her own very well and I loved it when she turned the tables on you and asked how many of you were circumcised. I happen to agree with most of what she was saying. I was surprised to discover that there is a Mormon who I actually agree with. I have had quite a bit to do with African culture and what she was saying I really stand behind. Africa is not a country, it’s a continent with huge variations in cultures.

    While I hate the fact that in some of those countries women are circumcised, as Chelsea said that ranges from milder than what baby boys routinely have here, to actually removing a woman’s clitoris. They have been doing this for years and years, but THEY are the ones who must decide if it is wrong or right – not the world police. We can stand beside them as the women rise up, and they are believe me.

    They are realizing that they have been getting placebos and they now want equality and the real thing. We can watch a butterfly emerge from its cocoon but we may not help or it will not become strong enough to fly.

    This is how we have responded to the needs in our own culture. At one time heteros would not stand with or support a gay person, but we started to as they stood up for themselves. Little by little they won us over. We were not with them at the Harvey Milk time, but now so many of us are.

    We can’t force the ‘Brethren’ to change their misogynistic stand but we can support the women as they step up and challenge.
    I love Chelsea and I don’t even know her; glad you found her and cannot wait for the next episode.

  • Scott Evans

    I enjoyed this discussion. I’ve had many debates with people with worldviews like Chelsea’s. I absolutely agree with her on the power of the placebo. The power of belief. Yes, witchcraft is a powerful force. Not because it actually has access to supernatural means, but because the participant believes it does.

    My challenge to her, and to others like her is to evaluate what actions are led to from those beliefs. If, in her example, removing the millipede lead to the girl returning to her family, then that is a good result. However, wouldn’t it be the same…or even BETTER result if the parents didn’t think she was a witch in the first place…thus didn’t need to have the millipede removed..nor confess to a non-existent crime…nor be beaten.

    So, yes, the belief had a moderately positive result. But much more negative than just not believing in witchcraft at all. False beliefs…even if they have powerful outcomes does not make them valuable. Simply interesting.

    • Glenn

      Sure, Scott. But your “what if” ideal scenario isn’t based on reality. How are you going to get that girl’s parents (and everyone else in their community) to change their “false beliefs” to allign with what you would consider to be real value? You’re smoking a pipe dream, brother. But by all means, debate on.

      • Scott Evans

        It’s the reality for feeling “western guilt” for not beginning the exposure to rationality over hysteria.

        • Heather_ME

          That’s definitely a quandary I found myself exasperated with while listening. How does one promote the idea of rationality without being a cultural imperialist?

          • Glenn

            Heather, is “rationality” free of cultural bias?

          • Heather_ME

            Probably not entirely. However, instead of saying it’s all turtles all the way down, why don’t we work the best we can with what we got? Is any human system perfect? No. But! Aren’t there, as Sam Harris puts it, peaks and valleys in the landscape of human well-being?

          • ff42

            What is culture? Like someone said “what do you call alternative medicine that works?…. medicine” I’ll expand to “what do you call that part of culture that is true?… Science!”. There is not black science, nor white math, nor Asian biology, nor Indian Physics. That leaves culture as either artsy or the false (non-science) stuff. I have no problem with squashing or denouncing any ‘culture’ that promotes child abuse.

      • ff42

        One at a time. Child abuse repeats generation after generation until one (insider or not) is brave enough to break it.

  • chris

    At one point Chelsea was talking about doctors commonly prescribing placebos, and I wanted to point out that doctors actually know when it is and isn’t okay to give placebos in place of real medicine. That’s part of the reason you go to the doctor, so they can recommend medication if needed. The danger is in people partaking in placebos as if they are real medicine and thereby ignoring science-based medicine. It happens all the time. I think the guys were right about that — people buy into fads and myths and marketing and they put their trust in “alternative” forms of healthcare, which includes a lot of placebos, and actual treatments as well, many of which are not appropriate in the way they are used. For example, herbs are not homeopathy; they are not diluted. Herbs are plants, and contain chemicals. There is no regulation on these herbs, and no specific indications or contraindications, so anyone could take them and not realize that they are essentially taking drugs. This has sometimes caused complications due to drug interactions with medication the individual was prescribed.

    Yes, the placebo effect is powerful, but it’s not a cure for anything. It’s important to think about when the placebo effect is appropriate and when it’s not.

  • Randy_Snyder

    Chelsea’s assertion that people typically only turn to alternative medicine once actual medicine has failed them is naive and paints that industry in the most ridiculously positive light. People turn to alternative medicine because they think it will work. It’s a 50+ billion dollar a year industry because people think it’s real and preferable to medicine. Anyone that wants to hear a thorough counter argument to Chelsea’s claims go to the podcast Point of Inquiry (August 18th episode: Paul Offit, MD, Do You Believe in Magic?)

    • Glenn

      Randy – I listened to the Point of Inquiry episode you suggested. It’s very good. Especially in supporting Matt’s question to Chelsea about net harm in alternative medicine (although, in our discussion we never got into the issues about unsafe, unregulated, mislabeled alternative products that Dr. Offit does on PoI), but I totally disagree with you that this is a counter argument to Chelsea’s claims.

      In fact, listen again to the question the host asks Dr. Offit at 33:14 “one of the themes in your book is that people turn to alternative medicine because they aren’t getting what they want or they need in mainstream medicine. What should mainstream medicine being doing to bring those people back into the fold.” (Chelsea said that almost word for word in our discussion).

      And in response, Dr. Offit says that he’s not sure it is fixable, and gives a personal example of having a very impersonal experience with his surgeon for microfracture knee surgery –where the surgeon spent very little time with him,just wrote him a prescription for pain medicine, and then he was gone – wheras with a lot of alternative healing techniques, homeopaths thrives on spending much more time with patients and even giving them medicine that has been proven to be ineffective, they are able to take advantage of the placebo response – “that if you believe it is going to work, there is something to be said for that.” He suggests that doctors change their approach to spend more time and get them believing in medicine that actually has active demonstrable benefits – “anticipatory guidance” he calls it. How does this contradict Chelsea’s claims?

      I think you are confusing Chelsea’s enthusiasm for the Placebo Effect with a promotion of alternative medicine. A closer listen to what she is saying shows
      that is not the case — she is not promoting Alternative Medicine — only explaining why it can, in some cases, be more effective. But she certainly does not deserve to be called naïve. Not the way we should treat guests who we bring on to the podcast. Pretty sloppy work, Dr. Snyder.

    • Levi P

      Did the other infants leave you out of this one because they thought tings would have gotten too heated? As I was listening I was thinking you would have been perfect to be involved to provide counter points/arguments. What’s up with that?

      • Randy_Snyder

        I wasn’t deliberately left off. I was unavailable the night of the recording. But it might have been a good thing as I was yelling at my iPhone a few times. But to be fair, I thought it was an interesting conversation and I think Matt, Glenn and Scott did a great job pushing back at times.

  • Harris

    Chelsea, can you recommend a reading list for further study?

    • css

      Yes! I would recommend starting here: http://programinplacebostudies.org/media/

      My advisor is the director of The Program in Placebo Studies at Harvard and Beth Israel and they have done a good job taking jargon filled very pharmacologically specific research and making it applicable to the average person. This website will also direct you to popular writing, radio interviews and TV spots about the placebo. I think this is great starter stuff.

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  • Witch Doctor

    Help Free the “Witches” of GhanaHumanist Service Corps Now Accepting Applicationshttp://thehumanist.com/news/international/help-free-the-witches-of-ghana

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