Open Label Placebos: How Starting a Treatment Can Still Produce Pain Relief

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The discussion centers on the intriguing effects of placebo treatments, particularly how substituting a placebo for an initial treatment like opiates can still yield pain relief when patients are aware of the switch. This phenomenon highlights the power of expectation and the brain's ability to influence physiological responses. A related concept involves a technique where repeated visualization of a hand turning red after immersion in warm water can condition the brain to produce the same effect without the water, demonstrating neural connections formed through expectation. The conversation also touches on the measurable physiological responses to pain, noting that even the thought of pain can trigger sympathetic activation, evidenced by changes in skin conductance. This underscores the significant role of conscious and subconscious expectations in determining bodily reactions, emphasizing the complexity of studying placebo effects and the need for careful interpretation of findings in this area.
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Placebo doesn't need to be kept secret to have an effect on subjective symptoms
An interesting news article.

Part of it describes how starting a treatment (say, opiates for pain) and then substituting placebo afterward (with the patient knowing) can still produce a pain relieving effect. This aligns with an interesting thing I learned from a neuroscientist several years ago which I guess is a well known 'trick.' Goes something like this: Look at your hand and say "turn red" then place your hand in a bath of warm water for several minutes. Take your hand out and it will be red. Repeat about 28 times. Then do it again without the water and your hand will turn red. Apparently doing things like this in sequence connects neurons in a way that the intermediate step can be bypassed with the same result.

Unfortunately I don't remember the proper name of this type of thing. All I can find when I search is the other trick about putting someone else's hand in warm water (still amusing, but not very nice).
 
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Placebo is a tricky matter to study, especially since the expected effect has no lower limit: thus many other causes can compete for anything observable.
For example, in many cases simple personal interaction (!) can be a help. Or even a laugh.

Nonetheless it's kind of an interesting idea to study placebo-placebo ( o_O ).

The original source (Ted Kaptchuk) definitely does not looks like a crackpot, but that 'Vox' thing has very limited scientific value and this makes interpretations based on them really vulnerable. Be extremely careful.
 
brainpushups said:
This aligns with an interesting thing I learned from a neuroscientist several years ago which I guess is a well known 'trick.' Goes something like this: Look at your hand and say "turn red" then place your hand in a bath of warm water for several minutes. Take your hand out and it will be red. Repeat about 28 times. Then do it again without the water and your hand will turn red. Apparently doing things like this in sequence connects neurons in a way that the intermediate step can be bypassed with the same result.
Another robust result that I've seen myself and on myself many times is how not only pain, but the expectation or just "thinking of it", can induce the same symphatetic activation. It is easily measured by skin condutance response. Symphatetic activation of the sweat capillary channels in the skin are under direct symphatetic control and 1-4 seconds after a pain/shock or just "thinking about pain", it is robustly measurable in peripheral skin conductance as a transient and you can't miss it.

The test is, to pinch yourself, or someone else, note the reaction. The try it again and just THINK you should pinch yourself, but you stop and don¨t do it. You get a similar reaction as the real stimuli.

It shows clear how the body-brain connections and how conscious and subconscious expectations alone actually determines physiological reactions.

/Fredrik
 
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