Neuroskeptic has a splendid post this week on the placebo effect. He ends it thusly:
The strongest meaning of the "placebo effect" is a direct effect of belief upon symptoms. You give someone a sugar pill or injection, and they immediately feel less pain, or whatever. But even this effect encompasses two kinds of things. It's one thing if the original symptoms have a "real" medical cause, like a broken leg. But it's another thing if the original symptoms are themselves partially or wholly driven by psychological factors, i.e. if they are "psychosomatic".
If a placebo treats a "psychosomatic" disease, then that's not because the placebo has some mysterious, mind-over-matter "placebo effect". All the mystery, rather, lies with the psychosomatic disease. But this is a crucial distinction.
People seem more willing to accept the mind-over-matter powers of "the placebo" than they are to accept the existence of psychosomatic illness. As if only doctors with sugar pills possess the power of suggestion. If a simple pill can convince someone that they are cured, surely the modern world in all its complexity could convince people that they're ill.
And that is the nub, or one of the nubs of what we see, isn't it? In an increasingly complex world, we have managed to convince people that shyness is an illness, that ordinary ups and downs requires medication, and on we go, adding illnesses that heretofore were seen as ordinary problems in living. And then, because we would rather believe in the power of pills than in the influence of mind, many of us become convinced that we need medication to control, though never ever cure us of these ills. If only those medications were mere sugar pills, things would not be so bad, but the placebos -- and most of these drugs perform only marginally better than placebo, if that well -- taken now too often have serious side effects.
And I continue to contemplate what it means that People seem more willing to accept the mind-over-matter powers of "the placebo" than they are to accept the existence of psychosomatic illness.