May 28, 2024 • 39 mins
A man attempted suicide by overdosing on a drug he was given in a clinical trial. He was rushed to a hospital in bad shape…shaking, breathing rapidly with a dangerously low pulse, and blood pressure that had bottomed out. He was eventually stabilized, but not by anything the staff at the hospital did. The treatment and cure? He was informed that the overdose he had taken was a placebo. He had downed 29 capsules that were effectively sugar pills and the cause of his medical emergency… was all in his mind…Really, no really!
Jason and Peter were fascinated by the seemingly lethal effects of an inert substance. And while they had heard about the placebo effect, they were amazed that it could be this powerful. To find out more, they sought out the world’s foremost expert and researcher on the subject. Dr. Luana Colloca is a distinguished professor at the University of Maryland and the Director of the Placebo Beyond Opinions Center.
As an NIH-funded, internationally recognized expert, Dr. Colloca and her team research human pain modulation in patients suffering from chronic pain hoping to deepen understanding of placebo and nocebo effects.
IN THIS EPISODE:
- The reason for the placebo’s creation in 1799.
- Why the placebo effect is more powerful than you think.
- The lesser-known nocebo effect and how it works.
- How do placebos mimic active treatments?
- Is it ethical to prescribe placebos without informing patients?
- Why patients who KNEW they were getting placebos improved!
- The placebo effect on positive vs negative-minded people.
- Acupuncture, reiki, other alternative treatments - placebos?
- Jason’s trick for alleviating pain using the power of his mind.
- A placebo to replace erectile dysfunction medications?
- Pondering non-medical uses for placebos - placebo vacations?
- Google-:heim: Placebo “isn’t” but “is.” Here are other things we think “are” that “aren’t.”
FOLLOW LUANA:
Placebo Beyond Opinions (PBO) Center
Instagram: @CollocaLab
Facebook: @LuanaColloca
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
Now Really.
Speaker 2 (00:06):
Really Real Hello, and welcome to Really Know Really, with
Jason Alexander and Peter Tilden, who note that subscribing to
our show has improved the health of our subscribers, or
at least it seems that way, because as much as
we'd love you to subscribe, it might just be a
case of the placebo effect.
Speaker 1 (00:25):
A recent YouTube video shows.
Speaker 2 (00:27):
College freshmen acting obviously intoxicated after drinking what they were
told were several beers, but the beers were completely non alcoholic,
hence the placebo effect, which refers to a fake treatment
of ailments by administering sugar pills in place of an
actual medication that is nonetheless successful. So how does it
work and how can it be so powerful and defective?
(00:49):
To answer that and other questions, we sought out the
world's foremost expert on placebos, doctor Luana Coloca, And what
we found out is a prescription for a fascinating episode
or a viable substitute anyway.
Speaker 1 (01:02):
And now here are two guys who are almost as
good as the real thing, Jason and Peter.
Speaker 3 (01:08):
There is a product that Jerry Seinfeld does a great
routine about that actually is a good pick me up
for me, is the five hour energy shot works? I
find it works. As Jerry said, why five hours five
hours of energy? You need an hour, two hours, four hours,
(01:29):
six or eight hours? Who needs five hours? They probably
did research that said, oh people, people will like the title.
Speaker 4 (01:38):
Five five hours, five.
Speaker 5 (01:40):
Hours, seven hour energy drinking. I don't have, Yeah, I
don't doing anything that long.
Speaker 4 (01:43):
Six hours hard to say.
Speaker 3 (01:45):
Two hours, you know, one hour, two hours you barely
get through late. I'm just thinking if they told me
it was a five hour energy shot, and I drank
it and it was grape juice, but I go.
Speaker 6 (02:00):
Well, and that discussed. Today's episode is about the power
of nothing right placebo effect, which basically started. I should
mention that it's being recognized as powerful enough that the
American Medical Association considers it ethical to use placebos to
enhance healing on their own. I was trying to find
something to denote how powerful this can be. So a
(02:23):
twenty six year old man was taken to an emergency
room after arguing with his girlfriend. He attempted suicide by
swallowing twenty nine capsules of an experimental drug that he
obtained from a clinical trial that he was testing on antidepressants.
When he arrived at the hospital, he was sluggish, shaking, sweating,
had rapid breathing. His blood pressure was extremely low eighty
over forty, and his pulse was one ten doctors who
(02:46):
are finally successful at raising his blood pressure. Over the
course of four hours, they injected him with six leaders
of saline solution. His blood pressure increased to one hundred
and over sixty two, which is at the lower end
of the normal range, but his pulse remained high. On six.
What finally cured the patient wasn't anything the hospital emergency
room staffed it. Instead, a doctor from the clinical trial
(03:07):
arrived at the hospital. He told the patient that those
antidepressant tolls weren't antidepressants because he had been randomized into
the control arm of the trial, he had overdosed on placebos.
Within fifteen minutes, the patient's blood pressure stabilized at one
twenty six over eighty and his heart rate dropped to
a perfectly normal eighty beats per minute, which shows you
the power of thinking you've taken something that he can
(03:31):
actually physically manifest itself. An overdose of placebo. The guy
thought he was going to die, and it actually took
yeah pretty pretty amazing.
Speaker 3 (03:40):
So that's that's a power that cut in all directions,
Like if I if I want to tell myself that
the chocolate cake I ate was really just a placebo,
will I not Will my insulin level not spike? Will
my beltline not expand?
Speaker 6 (04:03):
But the placebo effect, And they're also said there's a
no cebo effect, which is the opposite, which is about
believing that something's bad for you.
Speaker 3 (04:11):
Well, I have a question for our guess because I
was once in a desperate situation given a drug that
was the only thing that solved it. But I want
to know if it could have been solved with because
it is a pain management thing, and that is an
area that pusedly. Placebos have had a great deal of efficacy.
Speaker 6 (04:28):
And by the way, seventeen ninety nine is the beginning
when a British physician named John Hagar set out the
test this quack remedy. It was expensive metal rods named
perkinstractors that purported to draw disease in the body, and
he pitted the metal rods against wooden rods that looked
the same. Four or five patients with rheumatism reported that
(04:50):
the pain improved.
Speaker 3 (04:51):
Well, that is supposedly the science behind natural healers or
shamanistic healers, and a.
Speaker 4 (04:58):
Lot of it is.
Speaker 3 (04:59):
You know, there was one one thing I read in
the research you sent me that said, left alone nothing,
you don't do anything.
Speaker 4 (05:07):
Three out of five times people just get better.
Speaker 3 (05:09):
Nature takes nature. So if you if you say, oh, oh,
I'm making.
Speaker 4 (05:14):
You better, I'm making gaha making you better.
Speaker 3 (05:19):
Along with natural feeling, the mind goes, oh, I do
you know what?
Speaker 4 (05:23):
I feel a little better?
Speaker 3 (05:24):
And that that that is you know, I say what
acupuncture may be or acupressure or reiki or shaman is.
Speaker 6 (05:32):
The minerals that you take forever. But man, I say something,
I feel a little better. Whatever you did, what I
just did to you, I feel a lot of that.
Speaker 3 (05:39):
That's the ancient practice of BS.
Speaker 6 (05:45):
But it is fascinating how the mind, the mind actually
can heal itself.
Speaker 3 (05:51):
So we went out and found a placebo expert.
Speaker 5 (05:56):
Yeah, why wouldn't we do that?
Speaker 6 (05:57):
Why wouldn't we Why wouldn't we could stop in this?
Speaker 4 (06:00):
Why would they agree come on our show?
Speaker 5 (06:02):
Hey, we have said every episode I.
Speaker 4 (06:04):
Know we have with us today.
Speaker 3 (06:06):
Doctor Lewana Coloca is an empowered distinguished professor at the
University of Maryland and the director of the Placebo Beyond
Opinions Center, which I need to find out more about.
It's at NIH funded, internationally recognized expert. Doctor Klocha and
her team research human pain modulation in patients suffering from
(06:26):
chronic pain, hoping to deepen understanding of placebo and no
Cibo effects, which is what we've been talking about. She
has an MD, a PhD in neuroscience, a master's degree
in neuron Oh my god, she's done postdoctoral training at
the Brain Imaging Center in Stockholm, Sweden. And it is
a pleasure to welcome you, to really know, really, doctor
Lewana Kaloka.
Speaker 4 (06:46):
Nice to see you, Thank you very much.
Speaker 6 (06:50):
So I wanted to just alert you the fact that
I just told a story that I thought was one
of the better examples of the guy who overdosed when
placebo went to the hospital and because he took all
the antidepressants and his blood pressure, everything responded as if
he had overdosed until the doctor said you were in
the placebo group, and then within fifteen minutes to adjust it.
And that kind of is the most dumb down way,
(07:11):
easiest way to show the power of the brain that
the brain believes something, it can actually create physiological response
to something that's not happening, which is insane.
Speaker 7 (07:22):
The brain is very powerful and still one of the
organs will know less. So we truly excited to use
plusy boats as a tool to understand how the brain
can influence body responses.
Speaker 3 (07:36):
Was there a particular bit of research or an event
that because you really this is like part of your
full time work in research, was there something that just
made you go, oh, I just want to know more
about this placebo thing.
Speaker 7 (07:50):
Actually there is. I was a fresh PhD student and
I had to finish my medical degree since a few
months and I started starting plasive effects with Parkinson patients
receiving a very complex surgical procedure that we call diffibent stimulation.
(08:10):
I was very skeptical. I even told my.
Speaker 8 (08:14):
Mentor I wanted to do science that really matters, and
I didn't feel like Placibo is exactly that in those
science until I was in the interpretative room and we
started recording neurons from a patient with only local ants teacher,
(08:35):
so it was collaborating with pass and so on, and
then we gave a Placibo that was subercutaneous injection of
the fake doose of dopamine.
Speaker 7 (08:46):
Actually it was just a selling solution, and we started
recording and the spike of the neurons decreased as if
we had given the active treatment. They add apomorphine, which
is shocking.
Speaker 5 (09:04):
It was shocking.
Speaker 6 (09:05):
So you're saying instead of dopamine, you gave it fake dopamine.
Speaker 5 (09:09):
Exactly.
Speaker 7 (09:10):
The patients heard better, they said, oh, I feel better,
might remor disappear. A neurologist enter into the room to
assess the rigidity and was also decreased. The most important
for me as neurophysiologist, I was on the left side
before the equipment. See the spike of the neurons, and
(09:32):
the spike become flower and as if we had given
the active treatment.
Speaker 4 (09:39):
So it wasn't just the patient's experience.
Speaker 3 (09:43):
You could actually see that the body was responding neurologically
as if it had received.
Speaker 5 (09:49):
The real thing.
Speaker 7 (09:50):
I love that you say that, because as a NEUROSCIENTI
I want something changing in the brain for me as
much as as physician opinion of a patient. The release
of I want something true, you know, so objective, and
that objective sign was the reduction of the spike and
(10:13):
the neuronal activity as if the patient had receive an
active treatment. So for me, when we go wine all
the results, the clinical evidence and the objective evidence, but
me pujective evidence it's real.
Speaker 3 (10:29):
So you mentioned something in that example that I that
I want to ask about. Years ago, I started getting
kidney stones and the first time I got one, I
was I was on a set and I was being
treated with vicodin. I it wasn't working, and eventually I
was rushed to the hospital. Now, I have never in
(10:51):
my life prior to this moment, had morphine.
Speaker 4 (10:54):
But vicodin wasn't helping. Nothing was helping this pain.
Speaker 3 (10:57):
All of a sudden, they gave me morphine and instantaneously
my pain disappeared. My question to you is if they
had just told me I was getting morphine, would I
have had the pain reduction? Even though I don't know
what morphine feels like.
Speaker 7 (11:16):
Some patients respond very well even if they never had
the experience. Some other patients may not. But the Blasibo
research started with beech Air that was an anesthesiologist working
with saltiers in Sicily during the Second World WARLD and
it odd soldiers this is morphine your pain will be released,
(11:41):
and the observe that some patients were able to manage
their pain, do not feel pain, whether some patients do
not do that, and that is one of the main
line of research in my lab currently. We are interested
to know where this lucky one and those people a
little bit less if.
Speaker 6 (12:00):
People, yeah, well you also did you did the thing
that was fascinating to me where I know you did
the pain experiment where you would show a red light
when you when you hit people with a certain voltage,
and a green light when it was low. And after
a while you started messing with it and doing the
high voltage but showing them green, and they didn't feel
the pain that they had registered that they felt when
it was a red light. So the mind was told
(12:22):
to associate low with green and it adjusted.
Speaker 7 (12:26):
We observe the fifty five percentage of people responding to that.
It's a huge number. We don't even get this proportion
of responder when we run a try and or pharmacological
treatment of paint. Five is a very large proportion and
it may explain why many trials for pain, chronic acute
(12:50):
pain pain because the placebo response is so relevant. That's
somehow creating what we would call it sell effects. It
masks the effects of the active treatment.
Speaker 6 (13:04):
If the results are so good, do doctors ethically can
they prescribe a placebo.
Speaker 7 (13:10):
We call this open labeled placibo, telling patients we give
you placypo And over the last you know, five seven years,
several labs have published that even placibo and telling patients
they're taking placibo improve different kind of pain disorders, no
back pain as their tritis, irritable bowel syndrome related the pain.
(13:38):
And we felt too bad to let them go without anything.
So what do we start doing was telling a patient, look,
that is how you respond in this cant while we
were running this brain imaging experiment, and we offer you
the possibility to continue to benefit in another way. The
(14:03):
only way we have to give you placimbol. And you
understand this are placibo that you will bring home and
you will take for forty five days. So we start
doing that. The results are amazing. Their clinical pain decrease
when they receive open label placibo, and they understood, they
(14:28):
verbalized get it. They still respond that's that is not
one day, you know.
Speaker 6 (14:36):
So you're sending a home with forty five days of
sugar pills and their pain is still gone, even though
I know that it's sugar pills. Is it is it?
Is there a guess? Is it the attention they're getting?
Is it the treatment that they're getting.
Speaker 7 (14:49):
We have several control groups and still they receive the
attention because we were monitoring people without we call no
LP without any placibo. So the people that is the
more were, you know, monitoring daily the information and the
interaction with my team, they didn't improve. So there must
(15:11):
be something in the action of choosing to take up
placbo that trigger probably again this endogenous mechanism more healing.
Speaker 3 (15:26):
After Could has anyone tried or do you do you
speculate that this could work the other way? So, for instance,
if you have a patient who is now addicted to
an opioid, is there has anyone tried a placebo opioid
to sort of get them off opioids where their mind
(15:49):
is thinking, well, I'm still getting this thing, but in
fact they are not.
Speaker 1 (15:53):
This is.
Speaker 3 (16:04):
Has anyone tried a placebo opioid to sort of get
them off opioids where their mind is thinking, well, I'm
still getting listening, but in fact they are not.
Speaker 7 (16:17):
This is brilliant and it should be the next line
of research to try to use placebo to taper the
opioids or help those people. So today we don't have
any trial begin done with open label placibo, and it
is still an open question. And the challenge has been
(16:39):
and the offer this podcast will help to be contacted
from many patients who use opioids to manage their pain.
The challenge is to enroll patients who use oois and
that has been the you know, difficulties so far, but
(17:00):
we do want to do that. We do to enroll
patients to work with us because this is literally an alliance,
a partnership where we want to see how the brain
can play a or in helping managing given situations that
are very difficult.
Speaker 6 (17:17):
Does this have to do also, because again there's a
novel effect, which is if you're negative and you believe
it's not going to work. Does this have to do
with a level of I mean there are different levels
of positiveness in people and dourness and sadness and depression
that other people are more apt because they're more positive,
they're more hopeful.
Speaker 4 (17:37):
Yes.
Speaker 7 (17:38):
Absolutely, What do we consistently see is that those people
who tended to be distress fearful tend to have lower
expectations of benefit, and often they also have lower plasive effects.
But what is interesting is that place ebo somehow, or
(18:02):
even in people without any of we see people that.
Speaker 8 (18:06):
We ask you know, how much do you wish to improve?
As well?
Speaker 7 (18:10):
Letter everything? I have zero, there is nothing that can
help me. Well, when we do this rhet the green
exposure to reduction of pain, we can observe plasive effects
even in hopeless people, people who don't believe, people who
don't have anymore desire a drive to.
Speaker 6 (18:32):
Improve our people are doctors right now writing prescriptions for
policles for people.
Speaker 7 (18:39):
No, I don't think so not yet, So I.
Speaker 3 (18:42):
Can't go to the CBS yet.
Speaker 5 (18:45):
I'm generic.
Speaker 7 (18:49):
Some of my colleagues hope that that will be the
next step that at least in the States, we're not there.
You can't prescribe about as.
Speaker 3 (19:01):
There is something that I have done for years that
I discovered I could do and it has been very
helpful to me.
Speaker 4 (19:09):
So I don't get migraines.
Speaker 3 (19:10):
But you know, like anybody, I get a headache now
and then if I take a pain reliever it's great.
It knocks my headache out, but there are times when
I don't have it nearby. So I have been able
to mentally change the sensation of pain to a sensation
of pressure. And when it's pressure it it doesn't. I
(19:31):
just say to myself, Okay, where does it hurt. Okay,
it hurts right there. So don't think of it as
like this throbbing, radiating thing that's irritating your nerves. Think
of it as literally someone is pushing from the inside,
like a massage from the inside. It's just pushing on
that spot and what you're feeling is the tenderness of
the spot.
Speaker 4 (19:50):
And by doing that.
Speaker 3 (19:52):
Emotionally, I don't go oh something, you know, it's like
when you Sometimes it can actually take the headache away.
What it can certainly do is keep me at a
place where I'm very comfortable until I can get to
a place where I can lie down on a massage
ball or get to a pain reliever.
Speaker 7 (20:11):
The experience is shed is so important because in chronic
pain patient or those who have even acute pain, this
scene can be amplified by the level of attention with pain.
So when you describe the lack of ability to have
the drug. You know, the logos of control. You want
(20:31):
to be in control, so you say, okay, in one hour,
I will be home. I can lie down and I
feel better. And many times we take up and kill
immediately because we want Somehow, this feeling of pen reduction
and the response also can occur quite fast, even before
(20:53):
you know we metabolized to that medication. Feeling that how
the placebo component is power fully. You know, many time
we experience an lgsmmediately after taking appeal. That is a
ready deplasible component. Also, it is interesting that we panic
when we don't have access to a bankiller. Unfortunately, for
(21:16):
many patients this sort of ability to tackle the inner
mechanism of descending modulation of a pain become a very
unusual or difficult because they never tried or they never
were told of, and so the action of them is
(21:39):
taking appill immediately and then if the first doesn't work,
taking two or three or four and then escalating to
the next more powerful pain medication that mechanism can create.
You know, this sort of need of escalating and multitaire
(22:00):
be and so on. That is why I still believe
that even treatments that may work by virtual of placbo
mechans so important as long as they empower a patient
to be able to harness what I love to call informacy.
Speaker 5 (22:18):
We all have that.
Speaker 3 (22:21):
Has anyone this is good? This is my last question,
because you're gonna all judge me. I don't want to
judge you anyway, because I don't want to be judged.
So we've been talking about Placibo's primarily for pain management.
For a patient that would have to take viagra, mm hmm,
if you give them a placebo viagra, do they get
(22:43):
the desired effect?
Speaker 5 (22:46):
Probably they will.
Speaker 3 (22:48):
I mean, has anyone to your knowledge as anyone, don't
don't research on that because I also think I have
to assume a large part of that result is psychological.
Speaker 7 (23:00):
Absolutely, there are studies showed that side the effects of
treatment for prostate cancer that actually, you know, delifless the
physician described have reduction of a libido and sexual dysfunction.
So those patients who are alect about the side effects
(23:20):
of cancer related the therabists tended to experience a larger
amounts of side effects for dysfunction compared to those patients
who were taught in a different way or even not
told about the side effects related to sexual functions. So
(23:42):
they're literally the mind somehow influence in both the positive
and negative way, and the azybol the bar between of
the placebo works in a more you know, effective way.
I mean when we need that. If someone tells us
you will experience the science of defense, this will become self
(24:04):
profit most all the time.
Speaker 6 (24:07):
Belief is the oldest medicine known command. So thank you,
thank you very much for coming on, and work faster
and harder.
Speaker 5 (24:12):
Would you please or at least believe you believe you are.
Speaker 6 (24:16):
Yes, we believe you are and that will that will
help Jason, And thank you for coming on.
Speaker 4 (24:21):
Thank you doctically.
Speaker 1 (24:22):
Appreciate your work than you you.
Speaker 6 (24:34):
Just inside you may you may need to placey of
us for the for for little j Why.
Speaker 4 (24:39):
Can't I can I not be spec with it? Why
do you know what I see?
Speaker 3 (24:45):
I knew the minute I said started talking about sexual
dysfunction you were going to make it.
Speaker 5 (24:49):
Excuse me?
Speaker 4 (24:50):
And when you assume.
Speaker 6 (24:51):
Would yeah, you're pretty right here, You're right based on
a Plazero fifty, you would have done the same to me.
Speaker 5 (24:57):
It is.
Speaker 6 (24:58):
It's really interesting how powerful the mind can be and
what what it can do.
Speaker 3 (25:04):
You're right, there was so that that whole thing I
was sharing with the doctor about that notion of turning
pain to pressure for me came from when I watched
and an old Star Trek episode, And there was a
Star Trek episode where they get sucked into this galaxy
and they they are back in the Old West.
Speaker 4 (25:22):
They're actually at the the.
Speaker 3 (25:23):
Ok Corral, and they're going to be replaying this moment
in history where they're going to be in the gunfight.
Speaker 4 (25:28):
And what Spock realizes is the whole thing.
Speaker 3 (25:31):
Everything though it feels real and tangible to their senses,
all of it's an illusion, he says, when you know that,
the illusion is ineffective. So if you know that the
bullets are not real, when they get fired at you,
they won't hurt you. And the humans are going, well, that's.
Speaker 4 (25:47):
Great for you. With your vulcan brain, you can do that.
But if we have even a shadow of a doubt,
we're dead. And so he does the Vulcan mind mold
on them, convinced that the.
Speaker 5 (25:59):
Bulletin reload. Now they of.
Speaker 3 (26:01):
Course the bullets don't hurt them, and the aliens go, oh,
you're fascinating.
Speaker 5 (26:05):
I love you.
Speaker 6 (26:06):
Bring up Star Trek, and every time we have Star Trek,
I'll say, why do they have to go to the
transporter room?
Speaker 5 (26:10):
Anyway?
Speaker 3 (26:10):
I just so that that got me to, you know,
the same thing. And then the other thing that was
true for me is years ago, I used to have
a kind of a bad ssiatic thing. I would might,
I'd tweak my back all the time. And we were
in Vegas. This happened when you and I were in
Vegas and we were doing the Donnie Clay Show and
my back was bad, and you know, and then you're
(26:31):
in Vegas and you're keeping weird hours and you're not
sleeping in your own bed. And I get up one
morning and I already bad back tweaks again. And a
friend of mine had given me this book called Healing
the Back by doctor John Sarno.
Speaker 4 (26:42):
Now John Sarno is a backstort.
Speaker 6 (26:44):
What is it?
Speaker 3 (26:44):
Howard talked about around and you know, he's a back surgeon,
so he knows that there are mechanical reasons why people
have back pain and back failure. But he also had
done a lot of research about patients that were stressed,
patients that were exhausted, patients that you know, just where
a lot of this pain could be psychosomatic or self inflicted.
(27:05):
And I was reading the book and my my friend,
who gave it to me, said, just read the book.
I said, I don't have time to do a program.
She said, no program, Read the book. I said, what
do you mean, read the book. I'm gonna have to
do a thing. There's exercises. She said, just read the book.
So I had read when this thing happened. I had
read only about five chapters, but I understood the gist
of it, which was, you know, there's a psychosomatic component.
And I got up that morning I retweaked my back
(27:27):
and in the room I yelled out, all right, I got.
Speaker 4 (27:31):
At I'm exhausted, I'm stressed, I'm this.
Speaker 3 (27:34):
I'm not pick something else, pick something else other than
the back pain. By that night, the back pain was gone,
and I have never tweaked my back again.
Speaker 4 (27:46):
And that was how many years ago?
Speaker 5 (27:47):
We were doing that? A long time ago.
Speaker 6 (27:48):
And I've heard how we talk about other people talk
about unbelievable.
Speaker 5 (27:53):
Did they have a cliff notes version?
Speaker 4 (27:55):
I just gave it.
Speaker 3 (27:56):
But it's it's that a lot of people experiencing true pain,
real pain, debilitating pain in their back, were having it
exacerbated by the fact that they were holding onto a stress.
They were holding on to which is really dangerous stuff.
Unce you decide to let it go. Look, I believe
that's why we had her on. It's fascinating to me
the advance was going to make But somehow it's a
(28:17):
learning a part of the brain. So if you could
stimulate that part of the brain yourself without having things
that If we could do that, there's a whole area
of things that I've thought about where they could be
placeboie things and we'd still have a like imagine a
placebo vacation, not an actual vacation, but you think you're
on vacation. Imagine placebo foods. You're eating a sandwich, but
(28:40):
you placebo it's a steak. Imagine a different career. You're
you're digging a ditch, but you're imagining that. You know,
sexual partners that I just always wondered about that. David,
what's happening to.
Speaker 4 (28:58):
David in your imagination? How are you feeling, sir?
Speaker 1 (29:02):
My imagination? I feel great.
Speaker 9 (29:04):
But did you tell the end of that Vegas backstory?
Speaker 1 (29:07):
Because you were.
Speaker 9 (29:07):
Saying pick something else, pick something else, or was that
just went to the viager question.
Speaker 4 (29:12):
No, it's actually what happened.
Speaker 3 (29:13):
But is by the end of that day, that chronic
backman that I had been having for weeks was gone.
Speaker 4 (29:19):
I mean, was was so gone to the point that
it was not.
Speaker 3 (29:22):
An issue for me. It wasn't inhibiting anything. And over
the next few days it was completely gone. And I've
never tweaked my back again.
Speaker 5 (29:30):
Is he still around that off?
Speaker 3 (29:31):
Because for a while was out there and all the
book is still very much available, Healing the Back Doctor
John Sarno. But it was, it was remarkable, and it
really I think it was this sort of violent expulsion
of emotion where.
Speaker 1 (29:46):
I went I got by the way.
Speaker 6 (29:47):
You realize we're kidding and joking, but when you say
a place of a vacation, you know what that is.
That's meditation. Yes, it's taking a different place. So and
that pot that's only been around.
Speaker 3 (29:57):
Or some people call it a staycation where you suddenly
look at the place you are in a different way
and take it in for its beauty, take it in
for what's positive and wonderful about it, rather than going
it's the rut of you know, it's the same, you know,
I believe.
Speaker 5 (30:09):
That, David, what do we have or virtual reality?
Speaker 9 (30:13):
No mistakes? Today, you guys were really hitting it out
of the park. But the thing that occurred to me
was that that a placebo of course, is anything that
seems to be a real medical treatment that that isn't.
I thought that I'd sort of looked for a few
of those things that most of us considered to be
facts but are in fact not true, okay, all such.
Speaker 1 (30:34):
As, Oh, I don't know, how about bagpipes?
Speaker 4 (30:37):
Where were bagpipes invented?
Speaker 3 (30:39):
Not in Ireland, not in Scotland, not in Scotland. I
think they were probably if I had to guess, I
would say it was someplace like a Turkey or you know,
something like, Yes.
Speaker 9 (30:54):
Ancient Turkey and Egypt have have found in fact they
were made from dogs skin and boats.
Speaker 4 (31:01):
So that I did not know.
Speaker 6 (31:02):
By the way, can you imagine who's the first guy
to sit around and go, I bet if we're blown
to death, we got a high g.
Speaker 5 (31:07):
I mean, seriously, you always want.
Speaker 4 (31:09):
Reverse a little hole in each We'll get four notes.
Speaker 5 (31:12):
You got it?
Speaker 6 (31:13):
You gotta get busy still, Hey mo, how's still talking about?
Speaker 5 (31:17):
From there in the dog?
Speaker 1 (31:18):
So yeah, all right, ancient Egyptian.
Speaker 4 (31:21):
How that's an interesting.
Speaker 1 (31:25):
And and who said, boy, we've done a great job that.
Speaker 4 (31:29):
We've really you're knocked.
Speaker 5 (31:34):
Everybody, all right.
Speaker 1 (31:36):
Napoleon not short?
Speaker 9 (31:39):
He was.
Speaker 4 (31:39):
He was like five seven.
Speaker 1 (31:42):
There was a there is not short.
Speaker 6 (31:44):
No, but they picture him Billy Bardy. They say like that,
he's this really small person. He's not that small.
Speaker 4 (31:51):
Five seven is not short.
Speaker 3 (31:53):
Well, because I'm very not short, adjacent that's short.
Speaker 4 (31:56):
I'm five five.
Speaker 5 (31:57):
Well that's short.
Speaker 6 (32:02):
You know, when you go to the musement park, if
you can't go into tilted world, I can't.
Speaker 5 (32:05):
Yeah.
Speaker 9 (32:07):
The thing, yeah, no, the rumor, the myth is that
he was five to two. But apparently back then there
was something called French inches, which were a different measurement.
Speaker 5 (32:20):
Five years.
Speaker 4 (32:21):
Well, we're all aware, we're all aware.
Speaker 9 (32:23):
Yeah, yeah, they went back.
Speaker 1 (32:31):
Two more quick ones. Drinking milk does not produce mucus.
Speaker 9 (32:35):
So if you're sick and you're mucacy and stuff like that,
you could drink milk, not gonna not three products don't
don't produce.
Speaker 5 (32:41):
No generations of Tilden's are not wrong with that.
Speaker 4 (32:44):
I'm sorry.
Speaker 6 (32:44):
I cannot alter my belief system. There mere scientific studies
I'm going to.
Speaker 9 (32:50):
And the last one that got me was, it's quite
likely that Vincent van Go did not cut.
Speaker 1 (32:57):
Off his own ear.
Speaker 4 (32:59):
Who cut it up?
Speaker 9 (33:01):
Well, uh, they think that it was Paul Gogan who
came at him with a rapier of some kind, and
they they came up with this story when the authorities
showed up and and van Go didn't want Gogain to
be a risk.
Speaker 3 (33:17):
That would be an incredibly dexterous lunge to come at
a guy, and you know that's like a surgical strike
to lop off an ear.
Speaker 4 (33:28):
Well, I don't think.
Speaker 1 (33:30):
I don't think the whole thing was lopped off.
Speaker 3 (33:31):
I think the whole thing was not lopped off. In
a matter of fact, there was I saw what I
do in my spirit time. There was a huge documentary
on van Go about the controversy of.
Speaker 5 (33:41):
Of the ear.
Speaker 3 (33:42):
They they have presented what seemed to be ample proof
that it was self inflicted.
Speaker 4 (33:48):
But that what he did is he didn't take the
whole year.
Speaker 3 (33:51):
It was kind of on a diagonal and he left
sort of the top ridge and got.
Speaker 5 (33:56):
Them based on this. What was the reason that he did.
Speaker 4 (33:58):
He was madly in love.
Speaker 3 (34:00):
It's this prostitute that he was seeing and she was
not leaving her life to make her way.
Speaker 5 (34:05):
We don't.
Speaker 3 (34:07):
He was he and he was you know, uh, clinically depressed,
and and then that was the kapper and so he
as a gesture of he's dying, dying love or or despair.
Didn't want to despair. Did it turn the prostitute around?
Speaker 5 (34:23):
No?
Speaker 4 (34:23):
I think she went what they called the geen darns.
Speaker 5 (34:26):
Did they say? I'm sure? Did they save the ear?
Did try to reattach it or I don't.
Speaker 3 (34:30):
Know, but there was I believe I'm remembering this very sporadically.
I think they made a death mask of van Go
and that's how they know.
Speaker 6 (34:37):
That part of his ear was still there, because all
the pictures him with the thing that right, dirty not
pictures dirty rot.
Speaker 5 (34:46):
You put you put some clean on.
Speaker 6 (34:48):
Yeah, they didn't know that back they didn't know from
David Snyk you very much, It's very welcome. I think
the amazing thing was he took up Placebo for the
Pain of the Year and was still screaming and was
still he was actually the model for Munches of the
screen Placo.
Speaker 5 (35:05):
The first experiment in place above failure.
Speaker 4 (35:08):
So there you go exactly.
Speaker 6 (35:09):
No, thank you, David, very good and she was fascinating.
Thank you, And I hope she's doing her work so
we can get plus cibos sooner rather than later. And
one last thing would hell, because you have asthma. I do,
And she's absolutely right. If I leave that, I never
have an asthma problem. If I leave the house without
the inhaler, I'm like, oh.
Speaker 1 (35:25):
So.
Speaker 6 (35:25):
In twenty eleven, one group received an inhaler with albuterol. Yeah,
another group gun inhaler with a placi about third group
got a sham acupuncture before it's got nothing to study.
Authors evaluated lung function on two metric software port from
the patients on the asthma symptoms. Yeah, if you go
by software, it looks like the placebo, a butterol, and
the sham acupuncture are all equally effective.
Speaker 5 (35:44):
That amazing act.
Speaker 3 (35:45):
I know, I know from when I have had I
know I don't get asthma attacks. But there are times
when I go ooh, that feels tight. And if you
start to panic, it makes it word, it makes it worse.
And if you go all right, so stretch open an up,
take a couple of deep breaths.
Speaker 5 (36:01):
It's amazing.
Speaker 6 (36:02):
With all the research, we still don't know a lot
about the human body.
Speaker 3 (36:05):
What do yes, I know a little more about.
Speaker 5 (36:11):
Thanks.
Speaker 3 (36:13):
Thanks for being I need to forget next time, producer, Laurie.
Speaker 6 (36:17):
Thanks for even hanging and not walking out on us.
We really appreciate that, and for producing the day that.
Thank you the most importantly. Thank you for watching, listening,
and contributed. I made the contributing part up. I don't
know what they contributed.
Speaker 5 (36:29):
They contributed, that's.
Speaker 2 (36:32):
Another episode if Really Really comes to a close. I
know you're wondering about unusual examples of the no cebo effect,
in which people experience symptoms without actual cause.
Speaker 1 (36:42):
Well, you bet your sweet sugar pill. There are plenty.
Speaker 2 (36:45):
But before I share some of those, let's thank our
guests to doctor Luana Kaloka. You can watch doctor Koloka's
fascinating research with her many videos on YouTube and ted Talks.
Additional contact infolk and we found in our show notes
at Reallyno Really dot com. Our little show hangs out
on Instagram, TikTok, YouTube and threads at Really No Really Podcasts,
(37:05):
And of course, you can share your thoughts and feedback
with us.
Speaker 1 (37:08):
Online at Reallynoreli dot com.
Speaker 2 (37:11):
If you have a really some amazing fact or story
that boggles your mind, share it with us and if
we use it, we will send you a little gift.
Nothing life changing, obviously, but it's the thought that counts.
Check out our full episodes on YouTube, hit that subscribe
button and take that bell. So here updated when we
release new videos and episodes, which we do each Tuesday,
(37:31):
So listen and follow us on the iHeartRadio app, Apple
podcasts or wherever you get your podcasts. And now to
answer the question, are there any unusual examples of the
no cebo effect? Well, recently, a man in his twenties
was rushed to a hospital after accidentally jumping onto a sharp,
six inch long nail which went.
Speaker 1 (37:52):
Right through the soul of his workboot.
Speaker 2 (37:53):
The nail proved to be so painful that he had
to be given major painkillers before attempting to remove it,
But when his boot was finally removed to doctors discovered
that the nail was actually located between the guy's toes. Apparently,
the man's excruciating pain was created by the belief that
the nail had gone through his foot. In another reported incident,
a kitchen worker accidentally got himself locked inside a walk
(38:15):
in freezer unit and sadly died of hypothermia several hours later. However,
the report claims that the freezer was actually not working
at the time, and whatever chill the man perceived was
left over from when the motor had been on. The
freezer was actually warming up while he was in there,
but he apparently succumbed to the belief that the cold
was severe and as bizarre as it sounds, Indigenous people
(38:37):
of Australia practice a ritual called pointing the bone, in
which a sharpened bone that has been endowed with a
curse is pointed at someone condemned to death. As reported,
once the unfortunate soul realizes they have been quote unquote boned,
they usually die within three days from no other obvious reasons.
So while it seems that placebos and no sebos are
(38:59):
active and have a place in this world, I'm just
going to say categorically, I like my meds the way
I like my friends as real as possible. So by
for now, my unseen unknown podcast listening piles, you guys
are my besties? Really No Really, is a production of
iHeartRadio and Blase entertainment,
Now Really.
Speaker 2 (00:06):
Really Real Hello, and welcome to Really Know Really, with
Jason Alexander and Peter Tilden, who note that subscribing to
our show has improved the health of our subscribers, or
at least it seems that way, because as much as
we'd love you to subscribe, it might just be a
case of the placebo effect.
Speaker 1 (00:25):
A recent YouTube video shows.
Speaker 2 (00:27):
College freshmen acting obviously intoxicated after drinking what they were
told were several beers, but the beers were completely non alcoholic,
hence the placebo effect, which refers to a fake treatment
of ailments by administering sugar pills in place of an
actual medication that is nonetheless successful. So how does it
work and how can it be so powerful and defective?
(00:49):
To answer that and other questions, we sought out the
world's foremost expert on placebos, doctor Luana Coloca, And what
we found out is a prescription for a fascinating episode
or a viable substitute anyway.
Speaker 1 (01:02):
And now here are two guys who are almost as
good as the real thing, Jason and Peter.
Speaker 3 (01:08):
There is a product that Jerry Seinfeld does a great
routine about that actually is a good pick me up
for me, is the five hour energy shot works? I
find it works. As Jerry said, why five hours five
hours of energy? You need an hour, two hours, four hours,
(01:29):
six or eight hours? Who needs five hours? They probably
did research that said, oh people, people will like the title.
Speaker 4 (01:38):
Five five hours, five.
Speaker 5 (01:40):
Hours, seven hour energy drinking. I don't have, Yeah, I
don't doing anything that long.
Speaker 4 (01:43):
Six hours hard to say.
Speaker 3 (01:45):
Two hours, you know, one hour, two hours you barely
get through late. I'm just thinking if they told me
it was a five hour energy shot, and I drank
it and it was grape juice, but I go.
Speaker 6 (02:00):
Well, and that discussed. Today's episode is about the power
of nothing right placebo effect, which basically started. I should
mention that it's being recognized as powerful enough that the
American Medical Association considers it ethical to use placebos to
enhance healing on their own. I was trying to find
something to denote how powerful this can be. So a
(02:23):
twenty six year old man was taken to an emergency
room after arguing with his girlfriend. He attempted suicide by
swallowing twenty nine capsules of an experimental drug that he
obtained from a clinical trial that he was testing on antidepressants.
When he arrived at the hospital, he was sluggish, shaking, sweating,
had rapid breathing. His blood pressure was extremely low eighty
over forty, and his pulse was one ten doctors who
(02:46):
are finally successful at raising his blood pressure. Over the
course of four hours, they injected him with six leaders
of saline solution. His blood pressure increased to one hundred
and over sixty two, which is at the lower end
of the normal range, but his pulse remained high. On six.
What finally cured the patient wasn't anything the hospital emergency
room staffed it. Instead, a doctor from the clinical trial
(03:07):
arrived at the hospital. He told the patient that those
antidepressant tolls weren't antidepressants because he had been randomized into
the control arm of the trial, he had overdosed on placebos.
Within fifteen minutes, the patient's blood pressure stabilized at one
twenty six over eighty and his heart rate dropped to
a perfectly normal eighty beats per minute, which shows you
the power of thinking you've taken something that he can
(03:31):
actually physically manifest itself. An overdose of placebo. The guy
thought he was going to die, and it actually took
yeah pretty pretty amazing.
Speaker 3 (03:40):
So that's that's a power that cut in all directions,
Like if I if I want to tell myself that
the chocolate cake I ate was really just a placebo,
will I not Will my insulin level not spike? Will
my beltline not expand?
Speaker 6 (04:03):
But the placebo effect, And they're also said there's a
no cebo effect, which is the opposite, which is about
believing that something's bad for you.
Speaker 3 (04:11):
Well, I have a question for our guess because I
was once in a desperate situation given a drug that
was the only thing that solved it. But I want
to know if it could have been solved with because
it is a pain management thing, and that is an
area that pusedly. Placebos have had a great deal of efficacy.
Speaker 6 (04:28):
And by the way, seventeen ninety nine is the beginning
when a British physician named John Hagar set out the
test this quack remedy. It was expensive metal rods named
perkinstractors that purported to draw disease in the body, and
he pitted the metal rods against wooden rods that looked
the same. Four or five patients with rheumatism reported that
(04:50):
the pain improved.
Speaker 3 (04:51):
Well, that is supposedly the science behind natural healers or
shamanistic healers, and a.
Speaker 4 (04:58):
Lot of it is.
Speaker 3 (04:59):
You know, there was one one thing I read in
the research you sent me that said, left alone nothing,
you don't do anything.
Speaker 4 (05:07):
Three out of five times people just get better.
Speaker 3 (05:09):
Nature takes nature. So if you if you say, oh, oh,
I'm making.
Speaker 4 (05:14):
You better, I'm making gaha making you better.
Speaker 3 (05:19):
Along with natural feeling, the mind goes, oh, I do
you know what?
Speaker 4 (05:23):
I feel a little better?
Speaker 3 (05:24):
And that that that is you know, I say what
acupuncture may be or acupressure or reiki or shaman is.
Speaker 6 (05:32):
The minerals that you take forever. But man, I say something,
I feel a little better. Whatever you did, what I
just did to you, I feel a lot of that.
Speaker 3 (05:39):
That's the ancient practice of BS.
Speaker 6 (05:45):
But it is fascinating how the mind, the mind actually
can heal itself.
Speaker 3 (05:51):
So we went out and found a placebo expert.
Speaker 5 (05:56):
Yeah, why wouldn't we do that?
Speaker 6 (05:57):
Why wouldn't we Why wouldn't we could stop in this?
Speaker 4 (06:00):
Why would they agree come on our show?
Speaker 5 (06:02):
Hey, we have said every episode I.
Speaker 4 (06:04):
Know we have with us today.
Speaker 3 (06:06):
Doctor Lewana Coloca is an empowered distinguished professor at the
University of Maryland and the director of the Placebo Beyond
Opinions Center, which I need to find out more about.
It's at NIH funded, internationally recognized expert. Doctor Klocha and
her team research human pain modulation in patients suffering from
(06:26):
chronic pain, hoping to deepen understanding of placebo and no
Cibo effects, which is what we've been talking about. She
has an MD, a PhD in neuroscience, a master's degree
in neuron Oh my god, she's done postdoctoral training at
the Brain Imaging Center in Stockholm, Sweden. And it is
a pleasure to welcome you, to really know, really, doctor
Lewana Kaloka.
Speaker 4 (06:46):
Nice to see you, Thank you very much.
Speaker 6 (06:50):
So I wanted to just alert you the fact that
I just told a story that I thought was one
of the better examples of the guy who overdosed when
placebo went to the hospital and because he took all
the antidepressants and his blood pressure, everything responded as if
he had overdosed until the doctor said you were in
the placebo group, and then within fifteen minutes to adjust it.
And that kind of is the most dumb down way,
(07:11):
easiest way to show the power of the brain that
the brain believes something, it can actually create physiological response
to something that's not happening, which is insane.
Speaker 7 (07:22):
The brain is very powerful and still one of the
organs will know less. So we truly excited to use
plusy boats as a tool to understand how the brain
can influence body responses.
Speaker 3 (07:36):
Was there a particular bit of research or an event
that because you really this is like part of your
full time work in research, was there something that just
made you go, oh, I just want to know more
about this placebo thing.
Speaker 7 (07:50):
Actually there is. I was a fresh PhD student and
I had to finish my medical degree since a few
months and I started starting plasive effects with Parkinson patients
receiving a very complex surgical procedure that we call diffibent stimulation.
(08:10):
I was very skeptical. I even told my.
Speaker 8 (08:14):
Mentor I wanted to do science that really matters, and
I didn't feel like Placibo is exactly that in those
science until I was in the interpretative room and we
started recording neurons from a patient with only local ants teacher,
(08:35):
so it was collaborating with pass and so on, and
then we gave a Placibo that was subercutaneous injection of
the fake doose of dopamine.
Speaker 7 (08:46):
Actually it was just a selling solution, and we started
recording and the spike of the neurons decreased as if
we had given the active treatment. They add apomorphine, which
is shocking.
Speaker 5 (09:04):
It was shocking.
Speaker 6 (09:05):
So you're saying instead of dopamine, you gave it fake dopamine.
Speaker 5 (09:09):
Exactly.
Speaker 7 (09:10):
The patients heard better, they said, oh, I feel better,
might remor disappear. A neurologist enter into the room to
assess the rigidity and was also decreased. The most important
for me as neurophysiologist, I was on the left side
before the equipment. See the spike of the neurons, and
(09:32):
the spike become flower and as if we had given
the active treatment.
Speaker 4 (09:39):
So it wasn't just the patient's experience.
Speaker 3 (09:43):
You could actually see that the body was responding neurologically
as if it had received.
Speaker 5 (09:49):
The real thing.
Speaker 7 (09:50):
I love that you say that, because as a NEUROSCIENTI
I want something changing in the brain for me as
much as as physician opinion of a patient. The release
of I want something true, you know, so objective, and
that objective sign was the reduction of the spike and
(10:13):
the neuronal activity as if the patient had receive an
active treatment. So for me, when we go wine all
the results, the clinical evidence and the objective evidence, but
me pujective evidence it's real.
Speaker 3 (10:29):
So you mentioned something in that example that I that
I want to ask about. Years ago, I started getting
kidney stones and the first time I got one, I
was I was on a set and I was being
treated with vicodin. I it wasn't working, and eventually I
was rushed to the hospital. Now, I have never in
(10:51):
my life prior to this moment, had morphine.
Speaker 4 (10:54):
But vicodin wasn't helping. Nothing was helping this pain.
Speaker 3 (10:57):
All of a sudden, they gave me morphine and instantaneously
my pain disappeared. My question to you is if they
had just told me I was getting morphine, would I
have had the pain reduction? Even though I don't know
what morphine feels like.
Speaker 7 (11:16):
Some patients respond very well even if they never had
the experience. Some other patients may not. But the Blasibo
research started with beech Air that was an anesthesiologist working
with saltiers in Sicily during the Second World WARLD and
it odd soldiers this is morphine your pain will be released,
(11:41):
and the observe that some patients were able to manage
their pain, do not feel pain, whether some patients do
not do that, and that is one of the main
line of research in my lab currently. We are interested
to know where this lucky one and those people a
little bit less if.
Speaker 6 (12:00):
People, yeah, well you also did you did the thing
that was fascinating to me where I know you did
the pain experiment where you would show a red light
when you when you hit people with a certain voltage,
and a green light when it was low. And after
a while you started messing with it and doing the
high voltage but showing them green, and they didn't feel
the pain that they had registered that they felt when
it was a red light. So the mind was told
(12:22):
to associate low with green and it adjusted.
Speaker 7 (12:26):
We observe the fifty five percentage of people responding to that.
It's a huge number. We don't even get this proportion
of responder when we run a try and or pharmacological
treatment of paint. Five is a very large proportion and
it may explain why many trials for pain, chronic acute
(12:50):
pain pain because the placebo response is so relevant. That's
somehow creating what we would call it sell effects. It
masks the effects of the active treatment.
Speaker 6 (13:04):
If the results are so good, do doctors ethically can
they prescribe a placebo.
Speaker 7 (13:10):
We call this open labeled placibo, telling patients we give
you placypo And over the last you know, five seven years,
several labs have published that even placibo and telling patients
they're taking placibo improve different kind of pain disorders, no
back pain as their tritis, irritable bowel syndrome related the pain.
(13:38):
And we felt too bad to let them go without anything.
So what do we start doing was telling a patient, look,
that is how you respond in this cant while we
were running this brain imaging experiment, and we offer you
the possibility to continue to benefit in another way. The
(14:03):
only way we have to give you placimbol. And you
understand this are placibo that you will bring home and
you will take for forty five days. So we start
doing that. The results are amazing. Their clinical pain decrease
when they receive open label placibo, and they understood, they
(14:28):
verbalized get it. They still respond that's that is not
one day, you know.
Speaker 6 (14:36):
So you're sending a home with forty five days of
sugar pills and their pain is still gone, even though
I know that it's sugar pills. Is it is it?
Is there a guess? Is it the attention they're getting?
Is it the treatment that they're getting.
Speaker 7 (14:49):
We have several control groups and still they receive the
attention because we were monitoring people without we call no
LP without any placibo. So the people that is the
more were, you know, monitoring daily the information and the
interaction with my team, they didn't improve. So there must
(15:11):
be something in the action of choosing to take up
placbo that trigger probably again this endogenous mechanism more healing.
Speaker 3 (15:26):
After Could has anyone tried or do you do you
speculate that this could work the other way? So, for instance,
if you have a patient who is now addicted to
an opioid, is there has anyone tried a placebo opioid
to sort of get them off opioids where their mind
(15:49):
is thinking, well, I'm still getting this thing, but in
fact they are not.
Speaker 1 (15:53):
This is.
Speaker 3 (16:04):
Has anyone tried a placebo opioid to sort of get
them off opioids where their mind is thinking, well, I'm
still getting listening, but in fact they are not.
Speaker 7 (16:17):
This is brilliant and it should be the next line
of research to try to use placebo to taper the
opioids or help those people. So today we don't have
any trial begin done with open label placibo, and it
is still an open question. And the challenge has been
(16:39):
and the offer this podcast will help to be contacted
from many patients who use opioids to manage their pain.
The challenge is to enroll patients who use oois and
that has been the you know, difficulties so far, but
(17:00):
we do want to do that. We do to enroll
patients to work with us because this is literally an alliance,
a partnership where we want to see how the brain
can play a or in helping managing given situations that
are very difficult.
Speaker 6 (17:17):
Does this have to do also, because again there's a
novel effect, which is if you're negative and you believe
it's not going to work. Does this have to do
with a level of I mean there are different levels
of positiveness in people and dourness and sadness and depression
that other people are more apt because they're more positive,
they're more hopeful.
Speaker 4 (17:37):
Yes.
Speaker 7 (17:38):
Absolutely, What do we consistently see is that those people
who tended to be distress fearful tend to have lower
expectations of benefit, and often they also have lower plasive effects.
But what is interesting is that place ebo somehow, or
(18:02):
even in people without any of we see people that.
Speaker 8 (18:06):
We ask you know, how much do you wish to improve?
As well?
Speaker 7 (18:10):
Letter everything? I have zero, there is nothing that can
help me. Well, when we do this rhet the green
exposure to reduction of pain, we can observe plasive effects
even in hopeless people, people who don't believe, people who
don't have anymore desire a drive to.
Speaker 6 (18:32):
Improve our people are doctors right now writing prescriptions for
policles for people.
Speaker 7 (18:39):
No, I don't think so not yet, So I.
Speaker 3 (18:42):
Can't go to the CBS yet.
Speaker 5 (18:45):
I'm generic.
Speaker 7 (18:49):
Some of my colleagues hope that that will be the
next step that at least in the States, we're not there.
You can't prescribe about as.
Speaker 3 (19:01):
There is something that I have done for years that
I discovered I could do and it has been very
helpful to me.
Speaker 4 (19:09):
So I don't get migraines.
Speaker 3 (19:10):
But you know, like anybody, I get a headache now
and then if I take a pain reliever it's great.
It knocks my headache out, but there are times when
I don't have it nearby. So I have been able
to mentally change the sensation of pain to a sensation
of pressure. And when it's pressure it it doesn't. I
(19:31):
just say to myself, Okay, where does it hurt. Okay,
it hurts right there. So don't think of it as
like this throbbing, radiating thing that's irritating your nerves. Think
of it as literally someone is pushing from the inside,
like a massage from the inside. It's just pushing on
that spot and what you're feeling is the tenderness of
the spot.
Speaker 4 (19:50):
And by doing that.
Speaker 3 (19:52):
Emotionally, I don't go oh something, you know, it's like
when you Sometimes it can actually take the headache away.
What it can certainly do is keep me at a
place where I'm very comfortable until I can get to
a place where I can lie down on a massage
ball or get to a pain reliever.
Speaker 7 (20:11):
The experience is shed is so important because in chronic
pain patient or those who have even acute pain, this
scene can be amplified by the level of attention with pain.
So when you describe the lack of ability to have
the drug. You know, the logos of control. You want
(20:31):
to be in control, so you say, okay, in one hour,
I will be home. I can lie down and I
feel better. And many times we take up and kill
immediately because we want Somehow, this feeling of pen reduction
and the response also can occur quite fast, even before
(20:53):
you know we metabolized to that medication. Feeling that how
the placebo component is power fully. You know, many time
we experience an lgsmmediately after taking appeal. That is a
ready deplasible component. Also, it is interesting that we panic
when we don't have access to a bankiller. Unfortunately, for
(21:16):
many patients this sort of ability to tackle the inner
mechanism of descending modulation of a pain become a very
unusual or difficult because they never tried or they never
were told of, and so the action of them is
(21:39):
taking appill immediately and then if the first doesn't work,
taking two or three or four and then escalating to
the next more powerful pain medication that mechanism can create.
You know, this sort of need of escalating and multitaire
(22:00):
be and so on. That is why I still believe
that even treatments that may work by virtual of placbo
mechans so important as long as they empower a patient
to be able to harness what I love to call informacy.
Speaker 5 (22:18):
We all have that.
Speaker 3 (22:21):
Has anyone this is good? This is my last question,
because you're gonna all judge me. I don't want to
judge you anyway, because I don't want to be judged.
So we've been talking about Placibo's primarily for pain management.
For a patient that would have to take viagra, mm hmm,
if you give them a placebo viagra, do they get
(22:43):
the desired effect?
Speaker 5 (22:46):
Probably they will.
Speaker 3 (22:48):
I mean, has anyone to your knowledge as anyone, don't
don't research on that because I also think I have
to assume a large part of that result is psychological.
Speaker 7 (23:00):
Absolutely, there are studies showed that side the effects of
treatment for prostate cancer that actually, you know, delifless the
physician described have reduction of a libido and sexual dysfunction.
So those patients who are alect about the side effects
(23:20):
of cancer related the therabists tended to experience a larger
amounts of side effects for dysfunction compared to those patients
who were taught in a different way or even not
told about the side effects related to sexual functions. So
(23:42):
they're literally the mind somehow influence in both the positive
and negative way, and the azybol the bar between of
the placebo works in a more you know, effective way.
I mean when we need that. If someone tells us
you will experience the science of defense, this will become self
(24:04):
profit most all the time.
Speaker 6 (24:07):
Belief is the oldest medicine known command. So thank you,
thank you very much for coming on, and work faster
and harder.
Speaker 5 (24:12):
Would you please or at least believe you believe you are.
Speaker 6 (24:16):
Yes, we believe you are and that will that will
help Jason, And thank you for coming on.
Speaker 4 (24:21):
Thank you doctically.
Speaker 1 (24:22):
Appreciate your work than you you.
Speaker 6 (24:34):
Just inside you may you may need to placey of
us for the for for little j Why.
Speaker 4 (24:39):
Can't I can I not be spec with it? Why
do you know what I see?
Speaker 3 (24:45):
I knew the minute I said started talking about sexual
dysfunction you were going to make it.
Speaker 5 (24:49):
Excuse me?
Speaker 4 (24:50):
And when you assume.
Speaker 6 (24:51):
Would yeah, you're pretty right here, You're right based on
a Plazero fifty, you would have done the same to me.
Speaker 5 (24:57):
It is.
Speaker 6 (24:58):
It's really interesting how powerful the mind can be and
what what it can do.
Speaker 3 (25:04):
You're right, there was so that that whole thing I
was sharing with the doctor about that notion of turning
pain to pressure for me came from when I watched
and an old Star Trek episode, And there was a
Star Trek episode where they get sucked into this galaxy
and they they are back in the Old West.
Speaker 4 (25:22):
They're actually at the the.
Speaker 3 (25:23):
Ok Corral, and they're going to be replaying this moment
in history where they're going to be in the gunfight.
Speaker 4 (25:28):
And what Spock realizes is the whole thing.
Speaker 3 (25:31):
Everything though it feels real and tangible to their senses,
all of it's an illusion, he says, when you know that,
the illusion is ineffective. So if you know that the
bullets are not real, when they get fired at you,
they won't hurt you. And the humans are going, well, that's.
Speaker 4 (25:47):
Great for you. With your vulcan brain, you can do that.
But if we have even a shadow of a doubt,
we're dead. And so he does the Vulcan mind mold
on them, convinced that the.
Speaker 5 (25:59):
Bulletin reload. Now they of.
Speaker 3 (26:01):
Course the bullets don't hurt them, and the aliens go, oh,
you're fascinating.
Speaker 5 (26:05):
I love you.
Speaker 6 (26:06):
Bring up Star Trek, and every time we have Star Trek,
I'll say, why do they have to go to the
transporter room?
Speaker 5 (26:10):
Anyway?
Speaker 3 (26:10):
I just so that that got me to, you know,
the same thing. And then the other thing that was
true for me is years ago, I used to have
a kind of a bad ssiatic thing. I would might,
I'd tweak my back all the time. And we were
in Vegas. This happened when you and I were in
Vegas and we were doing the Donnie Clay Show and
my back was bad, and you know, and then you're
(26:31):
in Vegas and you're keeping weird hours and you're not
sleeping in your own bed. And I get up one
morning and I already bad back tweaks again. And a
friend of mine had given me this book called Healing
the Back by doctor John Sarno.
Speaker 4 (26:42):
Now John Sarno is a backstort.
Speaker 6 (26:44):
What is it?
Speaker 3 (26:44):
Howard talked about around and you know, he's a back surgeon,
so he knows that there are mechanical reasons why people
have back pain and back failure. But he also had
done a lot of research about patients that were stressed,
patients that were exhausted, patients that you know, just where
a lot of this pain could be psychosomatic or self inflicted.
(27:05):
And I was reading the book and my my friend,
who gave it to me, said, just read the book.
I said, I don't have time to do a program.
She said, no program, Read the book. I said, what
do you mean, read the book. I'm gonna have to
do a thing. There's exercises. She said, just read the book.
So I had read when this thing happened. I had
read only about five chapters, but I understood the gist
of it, which was, you know, there's a psychosomatic component.
And I got up that morning I retweaked my back
(27:27):
and in the room I yelled out, all right, I got.
Speaker 4 (27:31):
At I'm exhausted, I'm stressed, I'm this.
Speaker 3 (27:34):
I'm not pick something else, pick something else other than
the back pain. By that night, the back pain was gone,
and I have never tweaked my back again.
Speaker 4 (27:46):
And that was how many years ago?
Speaker 5 (27:47):
We were doing that? A long time ago.
Speaker 6 (27:48):
And I've heard how we talk about other people talk
about unbelievable.
Speaker 5 (27:53):
Did they have a cliff notes version?
Speaker 4 (27:55):
I just gave it.
Speaker 3 (27:56):
But it's it's that a lot of people experiencing true pain,
real pain, debilitating pain in their back, were having it
exacerbated by the fact that they were holding onto a stress.
They were holding on to which is really dangerous stuff.
Unce you decide to let it go. Look, I believe
that's why we had her on. It's fascinating to me
the advance was going to make But somehow it's a
(28:17):
learning a part of the brain. So if you could
stimulate that part of the brain yourself without having things
that If we could do that, there's a whole area
of things that I've thought about where they could be
placeboie things and we'd still have a like imagine a
placebo vacation, not an actual vacation, but you think you're
on vacation. Imagine placebo foods. You're eating a sandwich, but
(28:40):
you placebo it's a steak. Imagine a different career. You're
you're digging a ditch, but you're imagining that. You know,
sexual partners that I just always wondered about that. David,
what's happening to.
Speaker 4 (28:58):
David in your imagination? How are you feeling, sir?
Speaker 1 (29:02):
My imagination? I feel great.
Speaker 9 (29:04):
But did you tell the end of that Vegas backstory?
Speaker 1 (29:07):
Because you were.
Speaker 9 (29:07):
Saying pick something else, pick something else, or was that
just went to the viager question.
Speaker 4 (29:12):
No, it's actually what happened.
Speaker 3 (29:13):
But is by the end of that day, that chronic
backman that I had been having for weeks was gone.
Speaker 4 (29:19):
I mean, was was so gone to the point that
it was not.
Speaker 3 (29:22):
An issue for me. It wasn't inhibiting anything. And over
the next few days it was completely gone. And I've
never tweaked my back again.
Speaker 5 (29:30):
Is he still around that off?
Speaker 3 (29:31):
Because for a while was out there and all the
book is still very much available, Healing the Back Doctor
John Sarno. But it was, it was remarkable, and it
really I think it was this sort of violent expulsion
of emotion where.
Speaker 1 (29:46):
I went I got by the way.
Speaker 6 (29:47):
You realize we're kidding and joking, but when you say
a place of a vacation, you know what that is.
That's meditation. Yes, it's taking a different place. So and
that pot that's only been around.
Speaker 3 (29:57):
Or some people call it a staycation where you suddenly
look at the place you are in a different way
and take it in for its beauty, take it in
for what's positive and wonderful about it, rather than going
it's the rut of you know, it's the same, you know,
I believe.
Speaker 5 (30:09):
That, David, what do we have or virtual reality?
Speaker 9 (30:13):
No mistakes? Today, you guys were really hitting it out
of the park. But the thing that occurred to me
was that that a placebo of course, is anything that
seems to be a real medical treatment that that isn't.
I thought that I'd sort of looked for a few
of those things that most of us considered to be
facts but are in fact not true, okay, all such.
Speaker 1 (30:34):
As, Oh, I don't know, how about bagpipes?
Speaker 4 (30:37):
Where were bagpipes invented?
Speaker 3 (30:39):
Not in Ireland, not in Scotland, not in Scotland. I
think they were probably if I had to guess, I
would say it was someplace like a Turkey or you know,
something like, Yes.
Speaker 9 (30:54):
Ancient Turkey and Egypt have have found in fact they
were made from dogs skin and boats.
Speaker 4 (31:01):
So that I did not know.
Speaker 6 (31:02):
By the way, can you imagine who's the first guy
to sit around and go, I bet if we're blown
to death, we got a high g.
Speaker 5 (31:07):
I mean, seriously, you always want.
Speaker 4 (31:09):
Reverse a little hole in each We'll get four notes.
Speaker 5 (31:12):
You got it?
Speaker 6 (31:13):
You gotta get busy still, Hey mo, how's still talking about?
Speaker 5 (31:17):
From there in the dog?
Speaker 1 (31:18):
So yeah, all right, ancient Egyptian.
Speaker 4 (31:21):
How that's an interesting.
Speaker 1 (31:25):
And and who said, boy, we've done a great job that.
Speaker 4 (31:29):
We've really you're knocked.
Speaker 5 (31:34):
Everybody, all right.
Speaker 1 (31:36):
Napoleon not short?
Speaker 9 (31:39):
He was.
Speaker 4 (31:39):
He was like five seven.
Speaker 1 (31:42):
There was a there is not short.
Speaker 6 (31:44):
No, but they picture him Billy Bardy. They say like that,
he's this really small person. He's not that small.
Speaker 4 (31:51):
Five seven is not short.
Speaker 3 (31:53):
Well, because I'm very not short, adjacent that's short.
Speaker 4 (31:56):
I'm five five.
Speaker 5 (31:57):
Well that's short.
Speaker 6 (32:02):
You know, when you go to the musement park, if
you can't go into tilted world, I can't.
Speaker 5 (32:05):
Yeah.
Speaker 9 (32:07):
The thing, yeah, no, the rumor, the myth is that
he was five to two. But apparently back then there
was something called French inches, which were a different measurement.
Speaker 5 (32:20):
Five years.
Speaker 4 (32:21):
Well, we're all aware, we're all aware.
Speaker 9 (32:23):
Yeah, yeah, they went back.
Speaker 1 (32:31):
Two more quick ones. Drinking milk does not produce mucus.
Speaker 9 (32:35):
So if you're sick and you're mucacy and stuff like that,
you could drink milk, not gonna not three products don't
don't produce.
Speaker 5 (32:41):
No generations of Tilden's are not wrong with that.
Speaker 4 (32:44):
I'm sorry.
Speaker 6 (32:44):
I cannot alter my belief system. There mere scientific studies
I'm going to.
Speaker 9 (32:50):
And the last one that got me was, it's quite
likely that Vincent van Go did not cut.
Speaker 1 (32:57):
Off his own ear.
Speaker 4 (32:59):
Who cut it up?
Speaker 9 (33:01):
Well, uh, they think that it was Paul Gogan who
came at him with a rapier of some kind, and
they they came up with this story when the authorities
showed up and and van Go didn't want Gogain to
be a risk.
Speaker 3 (33:17):
That would be an incredibly dexterous lunge to come at
a guy, and you know that's like a surgical strike
to lop off an ear.
Speaker 4 (33:28):
Well, I don't think.
Speaker 1 (33:30):
I don't think the whole thing was lopped off.
Speaker 3 (33:31):
I think the whole thing was not lopped off. In
a matter of fact, there was I saw what I
do in my spirit time. There was a huge documentary
on van Go about the controversy of.
Speaker 5 (33:41):
Of the ear.
Speaker 3 (33:42):
They they have presented what seemed to be ample proof
that it was self inflicted.
Speaker 4 (33:48):
But that what he did is he didn't take the
whole year.
Speaker 3 (33:51):
It was kind of on a diagonal and he left
sort of the top ridge and got.
Speaker 5 (33:56):
Them based on this. What was the reason that he did.
Speaker 4 (33:58):
He was madly in love.
Speaker 3 (34:00):
It's this prostitute that he was seeing and she was
not leaving her life to make her way.
Speaker 5 (34:05):
We don't.
Speaker 3 (34:07):
He was he and he was you know, uh, clinically depressed,
and and then that was the kapper and so he
as a gesture of he's dying, dying love or or despair.
Didn't want to despair. Did it turn the prostitute around?
Speaker 5 (34:23):
No?
Speaker 4 (34:23):
I think she went what they called the geen darns.
Speaker 5 (34:26):
Did they say? I'm sure? Did they save the ear?
Did try to reattach it or I don't.
Speaker 3 (34:30):
Know, but there was I believe I'm remembering this very sporadically.
I think they made a death mask of van Go
and that's how they know.
Speaker 6 (34:37):
That part of his ear was still there, because all
the pictures him with the thing that right, dirty not
pictures dirty rot.
Speaker 5 (34:46):
You put you put some clean on.
Speaker 6 (34:48):
Yeah, they didn't know that back they didn't know from
David Snyk you very much, It's very welcome. I think
the amazing thing was he took up Placebo for the
Pain of the Year and was still screaming and was
still he was actually the model for Munches of the
screen Placo.
Speaker 5 (35:05):
The first experiment in place above failure.
Speaker 4 (35:08):
So there you go exactly.
Speaker 6 (35:09):
No, thank you, David, very good and she was fascinating.
Thank you, And I hope she's doing her work so
we can get plus cibos sooner rather than later. And
one last thing would hell, because you have asthma. I do,
And she's absolutely right. If I leave that, I never
have an asthma problem. If I leave the house without
the inhaler, I'm like, oh.
Speaker 1 (35:25):
So.
Speaker 6 (35:25):
In twenty eleven, one group received an inhaler with albuterol. Yeah,
another group gun inhaler with a placi about third group
got a sham acupuncture before it's got nothing to study.
Authors evaluated lung function on two metric software port from
the patients on the asthma symptoms. Yeah, if you go
by software, it looks like the placebo, a butterol, and
the sham acupuncture are all equally effective.
Speaker 5 (35:44):
That amazing act.
Speaker 3 (35:45):
I know, I know from when I have had I
know I don't get asthma attacks. But there are times
when I go ooh, that feels tight. And if you
start to panic, it makes it word, it makes it worse.
And if you go all right, so stretch open an up,
take a couple of deep breaths.
Speaker 5 (36:01):
It's amazing.
Speaker 6 (36:02):
With all the research, we still don't know a lot
about the human body.
Speaker 3 (36:05):
What do yes, I know a little more about.
Speaker 5 (36:11):
Thanks.
Speaker 3 (36:13):
Thanks for being I need to forget next time, producer, Laurie.
Speaker 6 (36:17):
Thanks for even hanging and not walking out on us.
We really appreciate that, and for producing the day that.
Thank you the most importantly. Thank you for watching, listening,
and contributed. I made the contributing part up. I don't
know what they contributed.
Speaker 5 (36:29):
They contributed, that's.
Speaker 2 (36:32):
Another episode if Really Really comes to a close. I
know you're wondering about unusual examples of the no cebo effect,
in which people experience symptoms without actual cause.
Speaker 1 (36:42):
Well, you bet your sweet sugar pill. There are plenty.
Speaker 2 (36:45):
But before I share some of those, let's thank our
guests to doctor Luana Kaloka. You can watch doctor Koloka's
fascinating research with her many videos on YouTube and ted Talks.
Additional contact infolk and we found in our show notes
at Reallyno Really dot com. Our little show hangs out
on Instagram, TikTok, YouTube and threads at Really No Really Podcasts,
(37:05):
And of course, you can share your thoughts and feedback
with us.
Speaker 1 (37:08):
Online at Reallynoreli dot com.
Speaker 2 (37:11):
If you have a really some amazing fact or story
that boggles your mind, share it with us and if
we use it, we will send you a little gift.
Nothing life changing, obviously, but it's the thought that counts.
Check out our full episodes on YouTube, hit that subscribe
button and take that bell. So here updated when we
release new videos and episodes, which we do each Tuesday,
(37:31):
So listen and follow us on the iHeartRadio app, Apple
podcasts or wherever you get your podcasts. And now to
answer the question, are there any unusual examples of the
no cebo effect? Well, recently, a man in his twenties
was rushed to a hospital after accidentally jumping onto a sharp,
six inch long nail which went.
Speaker 1 (37:52):
Right through the soul of his workboot.
Speaker 2 (37:53):
The nail proved to be so painful that he had
to be given major painkillers before attempting to remove it,
But when his boot was finally removed to doctors discovered
that the nail was actually located between the guy's toes. Apparently,
the man's excruciating pain was created by the belief that
the nail had gone through his foot. In another reported incident,
a kitchen worker accidentally got himself locked inside a walk
(38:15):
in freezer unit and sadly died of hypothermia several hours later. However,
the report claims that the freezer was actually not working
at the time, and whatever chill the man perceived was
left over from when the motor had been on. The
freezer was actually warming up while he was in there,
but he apparently succumbed to the belief that the cold
was severe and as bizarre as it sounds, Indigenous people
(38:37):
of Australia practice a ritual called pointing the bone, in
which a sharpened bone that has been endowed with a
curse is pointed at someone condemned to death. As reported,
once the unfortunate soul realizes they have been quote unquote boned,
they usually die within three days from no other obvious reasons.
So while it seems that placebos and no sebos are
(38:59):
active and have a place in this world, I'm just
going to say categorically, I like my meds the way
I like my friends as real as possible. So by
for now, my unseen unknown podcast listening piles, you guys
are my besties? Really No Really, is a production of
iHeartRadio and Blase entertainment,
Hosts And Creators
Peter Tilden
Jason Alexander
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