4 ms·

Well... maybe. Whenever I see folklore like this I always suspect there are real effects but they may be attributed incorrectly. For instance, an ancient Greek

Well... maybe. Whenever I see folklore like this I always suspect there are real effects but they may be attributed incorrectly. For instance, an ancient Greek feels sick, and worships at the temple of Apollo to ask the god to heal him. The Greek starts feeling a bit better when they leave. Apollo or the placebo effect? My first thought with telling the bees is that just speaking our thoughts to an impartial third party can help ease our burdens and make us feel better. Maybe it's a therapist, a stranger at the bar, or a garden of bees. Now this doesn't explain the supposed effect of bees dying/leaving if the practice is not followed, but it could explain why the practice continues.

tsimionescu 5y ago
> Apollo or the placebo effect? Note that the placebo effect is not about real improvement perceived by the sufferer except in a few very specific symptoms (pain, high blood pressure, and some psychiatric illnesses, mostly). In most cases, the placebo effect is simply optimistic interpretation/collection of data by people wanting to see the medicine work.
- smaddox 5y ago
  I'm curious why you think this. Is there some research to support this view? From what I've read, the placebo effect seems quite real, with quite physical effects. And the surgical placebo effect is stronger than the medicinal placebo effect. It's not so absurd if you fully accept that the connection between mind and body is bidirectional.
  - andyjohnson0 5y ago
    Placebos aren't curative. It's well known that they can affect a subject's perception of how their condition is progressing, and this may have physical consequences: e.g. a reduction in psychological stress leading to reduced blood pressure, etc. But the placebo won't affect the underlying condition. They don't make the brain somehow cure the body. Quote: "Placebos won't lower your cholesterol or shrink a tumor. Instead, placebos work on symptoms modulated by the brain, like the perception of pain. "Placebos may make you feel better, but they will not cure you,"... "They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea." https://www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect https://www.health.harvard.edu/mental-health/the-power-of-th...
  - philwelch 5y ago
    There are multiple factors that contribute to the placebo effect. The psychosomatic response is one of them. "Optimistic interpretation/collection of data by people wanting to see the medicine work" is another factor, but one that's typically removed by double-blinding. With some conditions, just plain reversion-to-the-mean is also part of the placebo effect--if you take a pill to cure your headache and your headache goes away, who's to say the headache wouldn't have gone away of its own accord anyway?
    - austinjp 5y ago
      Hmmm nit picking but I think regression to the mean is different from placebo. Regression to the mean: most headaches go away within a few hours. Placebo: your favourite brand of paracetamol seems to cure headaches quicker than the unbranded version. They can interact, of course.
      - tsimionescu 5y ago
        Placebo refers to any effect where a patient's outcomes seem to improve for reasons not related to the specific intervention attempted. Regression to the mean, incorrect data collection, psycho-somatic effects etc are all elements of placebo, in various degrees in various instances.
        austinjp 5y ago
        Well, fair enough. To split hairs ever finer, though... Placebo is present in all circumstances, as is nocebo. Regression to the mean is a statistical phenomenon. It can help aid understanding of the size and role of placebo effects, but it isn't a part of the placebo effect. Ditto data collection and analysis. But yeah, I'm probably splitting hairs :)
  - tsimionescu 5y ago
    I am curious why you think that it is different. The base assumption should always be that non-medicine have non-effects - apart from perceived effects and the desire to "co-operate" with the study (which is why we double-blind tests are so important). [0] is a Cochrane study that looked at this. Quoting from their conclusions: > We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient‐reported outcomes, especially pain and nausea, though it is difficult to distinguish patient‐reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed. [0] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003974.pub3/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
    - austinjp 5y ago
      The Cochrane review only looked at randomised placebo-controlled trials. That's reasonable, and a good and necessary thing to do. But by definition it hasn't looked at non-randomised trials, or pragmatic trials (i.e. under "real world" conditions) or circumstances where a "pure placebo" is impossible or unethical (e.g. suicide prevention programs, pregnancy termination procedures, etc). It also does point out that "pure placebo" can have a small but real effect. Clinically meaningful effects are important: if patients feel that something doesn't work well or they don't like it, then it doesn't matter how convincing the statistical analysis is, the intervention will have poor uptake. Outside of pharmacology trials, "pure placebo" is rare. Every intervention contains a degree of placebo and nocebo. This is normal and we shouldn't seek to deny it, or we risk wasting resources on meticulously designed interventions that work well in tightly controlled lab conditions but fail horribly in the real world. Caveat: I fully believe that most modern medicine generally works (although often not for the reasons we think) and wouldn't want my comment to be misconstrued as bashing medicine.
      - tsimionescu 5y ago
        > But by definition it hasn't looked at non-randomised trials, or pragmatic trials (i.e. under "real world" conditions) or circumstances where a "pure placebo" is impossible or unethical (e.g. suicide prevention programs, pregnancy termination procedures, etc). They looked at quality studies, not bad studies that fail to control for all the confounding factors, yes. > This is normal and we shouldn't seek to deny it, or we risk wasting resources on meticulously designed interventions that work well in tightly controlled lab conditions but fail horribly in the real world. Randomized controlled clinical trials do happen in the real world, not in the lab, at least in general. They are the best possible way to study these effects, since real sick people in real hospitals are administered real/placebo medicine by real healthcare professionals. The data is collected by these professionals, who do not know whether they are administering placebo or real medicine. And what we see in these conditions is what we expect a priori: for some conditions (those that are known to be semi-consciously controlled), there are real improvements from the placebo effects, for others only the real medicine has any effect at all. I really don't understand what your point is. You claim that you believe that modern medicine works, but you also claim it "often" works for reasons that we don't understand - are you implying most modern medicine is placebo? If so, why is it improving overall?
- deleted 5y ago
  [deleted]
mkmk 5y ago
Maybe it's as simple as a tradition that helps make sure that nobody forgets to take care of the beehives (an important part of a community's agricultural infrastructure) when somebody dies or leaves the home (due to marriage, etc.)
- TimTheTinker 5y ago
  That's an excellent observation.

tsimionescu 5y ago

> Apollo or the placebo effect? Note that the placebo effect is not about real improvement perceived by the sufferer except in a few very specific symptoms (pain, high blood pressure, and some psychiatric illnesses, mostly). In most cases, the placebo effect is simply optimistic interpretation/collection of data by people wanting to see the medicine work.

smaddox 5y ago
I'm curious why you think this. Is there some research to support this view? From what I've read, the placebo effect seems quite real, with quite physical effects. And the surgical placebo effect is stronger than the medicinal placebo effect. It's not so absurd if you fully accept that the connection between mind and body is bidirectional.
- andyjohnson0 5y ago
  Placebos aren't curative. It's well known that they can affect a subject's perception of how their condition is progressing, and this may have physical consequences: e.g. a reduction in psychological stress leading to reduced blood pressure, etc. But the placebo won't affect the underlying condition. They don't make the brain somehow cure the body. Quote: "Placebos won't lower your cholesterol or shrink a tumor. Instead, placebos work on symptoms modulated by the brain, like the perception of pain. "Placebos may make you feel better, but they will not cure you,"... "They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea." https://www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect https://www.health.harvard.edu/mental-health/the-power-of-th...
- philwelch 5y ago
  There are multiple factors that contribute to the placebo effect. The psychosomatic response is one of them. "Optimistic interpretation/collection of data by people wanting to see the medicine work" is another factor, but one that's typically removed by double-blinding. With some conditions, just plain reversion-to-the-mean is also part of the placebo effect--if you take a pill to cure your headache and your headache goes away, who's to say the headache wouldn't have gone away of its own accord anyway?
  - austinjp 5y ago
    Hmmm nit picking but I think regression to the mean is different from placebo. Regression to the mean: most headaches go away within a few hours. Placebo: your favourite brand of paracetamol seems to cure headaches quicker than the unbranded version. They can interact, of course.
    - tsimionescu 5y ago
      Placebo refers to any effect where a patient's outcomes seem to improve for reasons not related to the specific intervention attempted. Regression to the mean, incorrect data collection, psycho-somatic effects etc are all elements of placebo, in various degrees in various instances.
      - austinjp 5y ago
        Well, fair enough. To split hairs ever finer, though... Placebo is present in all circumstances, as is nocebo. Regression to the mean is a statistical phenomenon. It can help aid understanding of the size and role of placebo effects, but it isn't a part of the placebo effect. Ditto data collection and analysis. But yeah, I'm probably splitting hairs :)
- tsimionescu 5y ago
  I am curious why you think that it is different. The base assumption should always be that non-medicine have non-effects - apart from perceived effects and the desire to "co-operate" with the study (which is why we double-blind tests are so important). [0] is a Cochrane study that looked at this. Quoting from their conclusions: > We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient‐reported outcomes, especially pain and nausea, though it is difficult to distinguish patient‐reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed. [0] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003974.pub3/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
  - austinjp 5y ago
    The Cochrane review only looked at randomised placebo-controlled trials. That's reasonable, and a good and necessary thing to do. But by definition it hasn't looked at non-randomised trials, or pragmatic trials (i.e. under "real world" conditions) or circumstances where a "pure placebo" is impossible or unethical (e.g. suicide prevention programs, pregnancy termination procedures, etc). It also does point out that "pure placebo" can have a small but real effect. Clinically meaningful effects are important: if patients feel that something doesn't work well or they don't like it, then it doesn't matter how convincing the statistical analysis is, the intervention will have poor uptake. Outside of pharmacology trials, "pure placebo" is rare. Every intervention contains a degree of placebo and nocebo. This is normal and we shouldn't seek to deny it, or we risk wasting resources on meticulously designed interventions that work well in tightly controlled lab conditions but fail horribly in the real world. Caveat: I fully believe that most modern medicine generally works (although often not for the reasons we think) and wouldn't want my comment to be misconstrued as bashing medicine.
    - tsimionescu 5y ago
      > But by definition it hasn't looked at non-randomised trials, or pragmatic trials (i.e. under "real world" conditions) or circumstances where a "pure placebo" is impossible or unethical (e.g. suicide prevention programs, pregnancy termination procedures, etc). They looked at quality studies, not bad studies that fail to control for all the confounding factors, yes. > This is normal and we shouldn't seek to deny it, or we risk wasting resources on meticulously designed interventions that work well in tightly controlled lab conditions but fail horribly in the real world. Randomized controlled clinical trials do happen in the real world, not in the lab, at least in general. They are the best possible way to study these effects, since real sick people in real hospitals are administered real/placebo medicine by real healthcare professionals. The data is collected by these professionals, who do not know whether they are administering placebo or real medicine. And what we see in these conditions is what we expect a priori: for some conditions (those that are known to be semi-consciously controlled), there are real improvements from the placebo effects, for others only the real medicine has any effect at all. I really don't understand what your point is. You claim that you believe that modern medicine works, but you also claim it "often" works for reasons that we don't understand - are you implying most modern medicine is placebo? If so, why is it improving overall?
deleted 5y ago
[deleted]

mkmk 5y ago

Maybe it's as simple as a tradition that helps make sure that nobody forgets to take care of the beehives (an important part of a community's agricultural infrastructure) when somebody dies or leaves the home (due to marriage, etc.)

TimTheTinker 5y ago
That's an excellent observation.