Hypnosis and the placebo effect
My mother in-law is getting a new car, and she very kindly offered to give us her old one. It’s 4 years newer than our second car, and was a much nicer car in the first place. The catch is that it’s a stick shift, and I haven’t driven one in approximately 11 years. Ok, everyone promises it will come back to me. I spent some time practicing in an empty parking lot, and then last week I started using it to drive to the metro station.
Overall, it’s gone pretty well. Yes, I’ve stalled out at stop lights a few times, but overall the drivers around me have been remarkably gracious about waiting for me to get the car moving again. After a week and a half, I’m doing a lot better, and am no longer terrified.
Or at least my conscious mind is no longer terrified. My body seems to have a different opinion. Every day last week, I needed to use the bathroom pretty much nonstop from when I woke up until I left for work, and by Friday, I felt sick pretty much all day. I was fine over the weekend (when I drove our automatic transmission minivan) and then my gut acted up again Monday morning. Not fun.
So, I spent some time on Monday googling, and wound up downloading two MP3s from this hypnosis site, one on stopping irritable bowel syndrome,* and one on overcoming fear of driving. Since the problem was clearly originating in the mind-body
link, it seemed logical that was a good place to start trying to fix
it. And telling myself that I was being ridiculous didn’t seem to be
helping. I’m pretty sure that hypnosis can’t hurt, and the downloads are cheap enough that it was worth a try. I listened to them on both Monday and Tuesday, and yesterday my gut was better and today was better yet.
I told T, and he said he was glad it was helping, even if it was the placebo effect. My response was "what exactly do you think is the difference between hypnosis and the placebo effect?" As far as I can tell, hypnosis is essentially a way of harnessing the power of mind over body that makes the placebo effect work. I suppose you could test whether hypnosis directed at a specific goal was more effective than just putting someone in a trance and not making specific suggestions, but that would only work if you were able to get people into enough of a trance that they didn’t know what you had said. (I personally have no idea what’s on either MP3 I listened to between the introductory section and the ending, but I’ve had that happen in meetings too.)
* The MP3 begins with a disclaimer that only a doctor can diagnose IBS and that you should seek medical treatment, etc. etc.
June 28th, 2007 at 1:47 am
The difference between the placebo effect and the ideas backing hypnosis, is that the placebo effect comes about with any irrelevant treatment that a person believes might help (i.e. anything that tricks them). If hypnosis helps only through the placebo effect, the only thing it’s offerred is a myth that was sophisticated enough to trick you. For example, if I’d sugested that if you just tap the car four times before you start it, and make sure you pump the gas twice at every stop light, you probably wouldn’t believe me. If you did, we might have a placebo effect going, since I’m pretty sure that that advice would do nothing to help (either your driving or your physical ailments or stress).
Hypnosis is more than a placebo effect if it provides a specific mechanism for modulating or enhancing the mind-body interface. My take on the current data on meditation (I’m not sure I have one on hypnosis, but if it worked, it would work through similar mechanisms) is that highly trained individuals might actually be able to control their body through volitional control of usually autonomic functions. But I don’t think casual stuff has much affect.
bj
(yes, we’re coming close to what actually is my scientific field)
June 28th, 2007 at 5:13 pm
that’s an interesting distinction, bj. i’ve run into the placebo argument fairly often, and my response is always: “does it matter?” for example, when using acupressure bracelets to prevent motion sickness, i’ve had sceptics suggest that the effectiveness is the result of the placebo effect. the bracelets cost a couple bucks per pair, what difference does it make to me if acupressure works or i just think it works? if i’m not barfing on airplanes or busses, i’m happy.
as far as hypnosis goes, i used hypnosis to quit smoking over 15 years ago. that would be a tough one to chalk up to placebo, but again, it’s just all about the power of the mind as elizabeth points out, right? i remember distinctly the hypnotist telling me that i didn’t smoke cigarettes anymore, that it was just something i used to do, but not anymore, and that was that.
it’s an interesting subject, for sure.
June 28th, 2007 at 11:43 pm
Three things: First, the placebo is usually a comparison. For example, a new drug might do no _better_ than a placebo at reducing blood pressure, or alleviating pain (pain is the big thing where placebo seems to actually play a role). Second, the reason why we care that it’s a placebo effect is when we make comparisons (are the accupressure bracelets better than eating 3 chocolate chips?). Third, a true placebo effect means that things have really improved. The problem with evaluating whether something like accupressure for sea sickness _works_ is that the severity and frequency of the ailment can vary independentaly of any intervention. Thus, people can be mislead into believing that there was an improvement because they happen to try the intervention on a day when the nausea just got better anyway.
bj
June 29th, 2007 at 8:48 am
I can see why doctors or scientists care whether something is placebo or real, but for those of us that are finding whatever it is working…we don’t care. I think that is the difference. For example, when I was pregnant with my first daughter, I was nauseous for the entire 40 weeks. The only thing that helped me was drinking OJ..which I usually hate. The Dr said the acid in OJ should only aggrevate my stomach, but somehow it worked for me. Do I know why? nope. Do I care? nope.
June 29th, 2007 at 11:32 am
bj, yes, the frequency & intensity of the ailment can vary, but when someone lives their entire life with something like motion sickness, the triggers/responses get to be pretty familiar. for example, flying across nevada in a small plane in august when it is 100degrees out & the turbulence is so bad one’s head is repeatedly bouncing off the ceiling, even with the seat belt on, well there’s no way that isn’t going to make me sick! that was the first time i tried acupressure bracelets & i was hooked. and i’ve never gotten motion sick while wearing them.
June 29th, 2007 at 11:42 am
bj, i wanted to add that your point is well taken about the improper use of the term “placebo effect”, outside clinical trials testing a specific remedy or product. i think it’s one of those phrases that has entered the venacular however, and taken on a meaning of its own amongst the lay population.