About placebo tools and evidenced based documentation

Info about ongoing work

Placebo is usual understood as a fast change in dysfunctions/illness/..  behaviors which are not possible to find/identify any biopsychosocial – cultural reasons for, e.g. in terms of knowledge based functions/mechanisms/processes/.. It requires a start position, which is complex dysfunctional state and a final position, where start position criteria is absence or substantially decrease. But – perhaps such processes can be regarded as a special case of biopsychosocial medicine healing process, which can be explored in the very light of fast changes, but which also can be slow to very slow.  Perhaps also including the expression “spontaneous recovery”, which is used also without really understanding such processes. As our knowledge about human extreme complex systems/functions/behaviors .. are still limited we need to “dare” to approach observe processes even if we at present do have quite limited knowledge platform/paradigm to rely on for a safe discovery journey! Remember, much important findings have been developed by mistake or impossible ideas!

NB  (First, if nocebo is similar kind of systems complex processes but with complete reversed direction is not discuss below but in separate text, while equal important and complex, then -> why discuss placebo at all, if we can regard placebo only as an extreme fast self-healing (or internalized healing) process emerging out of scientific control? I do think the (real) placebo concept (not the sugar pills destructive use of the word) is not only a not well understood intervention optional force but also a force motivating us to move on elaborating the towards real clinical practice use in its own right! Of course it is very much challenging our traditional reductionistic medicine paradigm. Suggested is here that we consider more our evolution and influences of precognitive (spatial, see more during discussions of evolution of human brain “resting” on our old, mammalian and reptilian brain) based processes. Suggesting such perspective will have a pronounced, dramatic effects on basic understanding of biological, medical relevant systems – in terms of medicine as art (or biopsychosocial – cultural behaviors) of healing.

By working on this challenge, we might approach a more comprehensive understanding of the complete “health creation setups”-options and especially its varying variations in expressions between and within individuals over situations and time (motivating relevant tools to be tailored out of prototypes in clinical settings). I will below focus on placebo in the light of the above discussion. That is, try to understand “placebo interventional dramatic and fast occurring effects” enabled by specific (probably) unique integration of mind body synergetic “teamwork”, which also can be explored as a toolbox for more “normal” clinical use.

A specific unique, challenge for development of a placebo application is that it must be
(a) an option for a placebo effect at start position in terms of a dysfunction to be normalize or substantially changed. We can expect a very complex dysfunction that usually is not possible to change as an observable placebo effect indicate, e.g. complex autoimmune dysfunction which a number of associated consequences, e.g. in autonomic nervous and metabolic systems.
(b) the working placebo curative process must be able to, in a short period of time, return to target problems to normal.

Perhaps this will be two of the most complex challenges to be understood, identified and find out to be clinically addressed. Here variations between and within individuals over time increase this complexity. Perhaps this two challenges cab be utilized in “slow motion”, perhaps even associated with synergy combination of present knowledge in ways we have not thought of, e.g. while the reductionistic medical paradigm prevent us from such innovative creative elaborations. (See above “Remember, much important findings have been developed by mistake or impossible ideas!”)

“Working text”
While working with reconceptualization of the placebo phenomena, e.g. include parts as an evolutionary medicinal perspective which not usually is done,
a (at least for me) new “treatment package idea” emerged for more than 10 years ago.

The idea was growing during the years and now I will put as much effort as possible (while time permit it). The idea was; it maybe possible to developed interventional tools as well as instruments for follow the process of progress of individuals´(supervised) activities and added treatments.

A first draft was presented here December 15th 2016 when I celebrate my dissertation December 15th 1986, 30 years ago.

Impossible mission?
Perhaps but in accordance with “I shall not commit the fashionable stupidity of regarding everything I cannot explain as a fraud.” – C. G. Jung, I think that the – non-well biological, psychological, social and cultural defined and understood and thereby of course not proper empirical investigated – placebo phenomena are the (probably) greatest challenge for humanistic and non-profit medicine ever has had.

Thereby it is even worth and important with a very small step toward – including encouraging for other to take this challenge – such an ambition!

Bo von Schéele

Something to elaborated?

” From http://web.as.uky.edu/statistics/users/rayens/A&S100_Resources/PlaceboStudy.pdf

Scientific American Mind –  February 25, 2009


Placebo Effect: A Cure in the Mind
Belief is powerful medicine, even if the treatment itself is a sham. New research shows placebos can also benefit patients who do not have faith in them
By Maj-Britt Niemi

A man whom his doctors referred to as “Mr. Wright” was dying from cancer of the lymph nodes. Orange-size tumors had invaded his neck, groin, chest and abdomen, and his doctors had exhausted all available treatments. Nevertheless, Mr. Wright was confident that a new anticancer drug called Krebiozen would cure him, according to a 1957 report by psychologist Bruno Klopfer of the University of California, Los Angeles, entitled “Psychological Variables in Human Cancer.”

Mr. Wright was bedridden and fighting for each breath when he received his first injection. But three days later he was cheerfully ambling around the unit, joking with the nurses. Mr. Wright’s tumors had shrunk by half, and after 10 more days of treatment he was discharged from the hospital. And yet the other patients in the hospital who had received Krebiozen showed no improvement.

Over the next two months, however, Mr. Wright became troubled by press reports questioning the efficacy of Krebiozen and suffered a relapse. His doctors decided to lie to him: an improved, doubly effective version of the drug was due to arrive the next day, they told him. Mr. Wright was ecstatic. The doctors then gave him an injection that contained not one molecule of the drug—and he improved even more than he had the last time. Soon he walked out of the hospital symptom-free. He remained healthy until two months later, when, after reading reports that exposed Krebiozen as worthless, he died within days.

As Mr. Wright’s experience illustrates, a patient’s expectations and beliefs can greatly affect the course of an illness. When psychological factors tied to an inactive substance such as Krebiozen lead to recovery, doctors call the improvement a placebo effect.

In recent decades reports have confirmed the efficacy of such sham treatments in nearly all areas of medicine. Placebos can help not only to alleviate illnesses with an obvious psychological component, such as pain, depression and anxiety, but also to lessen the symptoms of Parkinson’s disease and inflammatory disorders. Occasionally, as in Mr. Wright’s case, placebos have shrunk tumors.

The latest research has shown that the placebo effect does not always arise from a conscious belief in a drug. Alternatively, it may grow out of subconscious associations between recovery and the experience of being treated, from the pinch of a shot to a doctor’s white coat. Such subliminal conditioning can control bodily processes, including immune responses and the release of hormones. Meanwhile researchers have decoded some of the biology of placebo responses, demonstrating that they stem from active processes in the brain”.

My comments; When I first (1979) read the above case I – did realizing variations between and within individuals over places and time but at the same time as well as probably most “believes” behind the placebo effect (not just related to believe a certain pill was effective) was old brain, precognitive, spatial activities not easy to be brought into the “conscious light” – thought “can  this be no 1 goal for humanistic medicine to step by step approach understanding and thereby transform it into individual adjusted treatment package (toolbox) we may over time increase the biopsychosocial medicine efficacy based on a non-profit paradigm/platform with none or few side effects!