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csandrinic's picture

Placebos

After reading Stacy’s post about pseudocyesis, I began to think about other examples of specific outputs that were created without the introduction of those inputs attributed to them. In my opinion, the use of placebos in experimental research is a perfect example of this phenomenon. Placebos are considered to be inert or ineffective treatments or formulations that are usually administered in drug test studies to a certain sample or people, while another sample receives the actual drug. However, it has been discovered that placebos are only inert or ineffective in the sense that they have no known cause and effect relationship with any of the pre-designated outcomes of the active and proven-efficacious medecine that might have otherwise been used. In fact, around one third of people taking placebos for complaints (including pain, headache and seasickness) are estimated to experience relief from symptoms. The effect on the individuals who are administered these placebos is called the placebo effect. This is triggered by the person's belief in the treatment and their expectation of feeling better, rather than the specific form the placebo takes.

  The placebo effect is particularly pertinent in this discussion of input and output, because it presents a challenge to the ‘spaghetti’ box model, which assumes that if you introduce stimulus A, you will end up with response A. In the case of placebos, the patient is being told that he or she is receiving stimulus A (a certain drug or treatment) when in fact he or she is being administered stimulus B (and ‘sugar pill’ or inert substance), which equates more or less to no input, since the substance is inactive. Rather than exhibiting response B (nothing happens) or producing no input at all, in many cases the patient will exhibit the same response to the placebo that those who are taking the actual effective substance exhibited (response A). In other words, it is possible for there to be an output without there having been any related input. This allows us to continue to dismiss the ‘spaghetti’ box model and validate the ‘autonomy’ boxes-within-boxes model. 

 What I appreciate most about the placebo effect is what it suggests about the power of the brain. Research has shown that the brain responds to an imagined scene in very much the same way as it responds to an actual visualized scene. Is it therefore possible for the brain to change its chemistry simply by believing that it is receiving a certain stimulus? Research would suggest yes. There is, however, something that I discovered that makes the whole input/output problem all the more complicated. Certain researchers believe that part of the reason why placebos actually work to cure patients’ symptoms is because of what is known as conditioning, a type of associative learning where the subject learns to associate a particular stimulus with a particular response. In other words, if a patient has been conditioned to think that as soon as he takes, say, Benadryl his headaches will go away, he has a higher chance of feeling a relief in symptoms after he takes what he is told is a Benadryl, even if it is not. Similarly, he will display undesirable reactions/ responses to the 'medication', such as drowsiness, etc. because he assumes that these are the side effects he should experience (this phenomenon is known as nocebo). What fascinates me the most about this theory is that it seems to incorporate both the ‘spaghetti’ and the ‘autonomy’ model. Could it be that the ‘autonomy’ model in this case becomes plausible only because the patient has been conditioned to think in terms of the ‘spaghetti’ model? Could it be that the brain’s belief that stimulus A will incite response A actually produces response A? I think it is necessary to look further into this issue, as well as to investigate why certain individuals will respond positively to a placebo pill while others will not.    

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