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    Great Expectations


    The skinny:

    To determine whether physiologic responses to a drug could be changed by expectation, and what role placebo effect might play, 14 medical students were given
    either epinephrine or placebo. Measurements of subjective response and response
    of plasma free fatty acids, blood glucose, and heart rate were made, Stimulant
    expectation was engendered by suggestion of epinephrine-like effects, and sedative
    expectation by suggestion of barbiturate-like effects. Of 8 drug subjects, 8 had a
    greater FFA response under stimulant expectations, and 7 had greater subjective,
    blood glucose, and heart rate responses. In 6 placebo subjects, there was no dis-
    cernible effect of expectation in any measure.


    The title of the above abstract is from an old research paper from the 60s entitled Drug-Set Interaction: Psychological and Physiological Effects of Epinephrine Under Differential Expectation. It's something I see cited a fair lot. In plain English, the study went like this: They told a bunch of folks that they were being given either a sedative or a stimulant, but gave them either adrenaline or placebo. The people who were given placebo didn't really feel anything special, but the folks given adrenaline felt what they were told - The sedative-expectation people felt sedated, and the stimulant-expectation people felt stimulated, even though it was all the same chemical being administered... Everyone knows what that chemical feels like, because everyone (save for some head cases) has had an adrenaline rush, so imagine having one but thinking it felt like a sleeping pill just because you were told so!

    I always thought that this had a lot to do with not just psychosomatics and pharmacodynamics, but everyday experience. I don't know how that idea can be scientifically validated, but bet some analogous studies have been done somewhere out there on the idea that your expectations prior to the event of any experience determine more than anything the outcome of what you feel about the experience. Outside of science, I've found that my own nonscientific experimentation throughout everyday life inspired by this study has been significant towards making me a happier person. I've also found that certain aspects of spirituality and philosophy (Particularly buddhism) have something to say about this. Not to say that I'm one of those 'the secret' dorks who believes with anything close to absolute conviction that expectations, attitude, and vapid 'positive thinking' have EVERYTHING to do with "manifesting" reality - Just that it's a subject worthy of actual scientific consideration outside of pharmacology. If anyone has any links or anything like that which has to do with non pseudoscientific consideration of this, that would totally make my day! :)

    Mon, Jan 11, 2010  Permanent link

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    nagash     Mon, Jan 11, 2010  Permanent link
    not exactly about the expectation phenomena, but Wired published a great article about the placebo effect... that's really worth a read : )
    gamma     Mon, Jan 11, 2010  Permanent link
    If the nature is against placebos (it is killing the patients on placebo meds), then placebos should not exist as a phenomenon. If they exist, then it is because of the mind. Mind that thinks positive or negative is exhibiting tendency to be accurate. Accurate mind will survive and accurate mind thinking positive will heal the body.

    (improvisation)

    2 + 2 = 4

    HelloAlexCL     Tue, Jan 12, 2010  Permanent link
    "But the best demonstration by far is experience, if it go not beyond the actual experiment."
    -The Father of Science

    Psychosomatacism is at fault in that it presupposes a division between body and mind. Placebo effect doesn't quite cut it in explaining the phenomenon because it retains this dualism. The fact is, the experience of a thing is always the primary datum, rather than the thing itself. The mind has the potential to experience anything.
    HelloAlexCL     Thu, Jan 14, 2010  Permanent link
    wow my comment was really vague...

    Pre-conditioning (or conditioning in general) constitutes Buddhist causality, known as the chain of "dependent arising." The formula of dependent arising in its most succinct form is "this existing, that exists; this arising, that arises; this not existing, that does not exist, this ceasing, that ceases." Dependent arising conceives of causality as the conditioning of one moment on the next - an organic kind of structure, like the one that creates those beautiful Mandelbrot sets (in 3D!). In some of the most ancient Buddhist texts, it is said that he who sees dependent arising (the pattern of conditioning) sees Dharma itself. In traditional Buddhism, dependent arising is applied to the idea of self, revealing that "I" do not subsist as an entity that remains constant but as a chain/cluster of physical and mental events that are causally linked.

    In accordance with this conception of causality, karma or "action" is considered a mental act or intention. The distinction between intention and action is thus deconstructed as they are subsumed under karma. Here is a really great explanation of dependent nature (a different term from dependent arising, but it might be fruitful to conflate the two momentarily) that I hope will bring this stuff together:

    "The dependent nature is the causal flow of consciousness itself: it is the sequence of one moment of consciousness produced by it own previous moment and going on to produce its own subsequent moment. This ongoing stream of consciousness can appear in two different modes. For ordinary persons, it appears with a dizzying variety of sensory and mental objects, and each mental moment except for the deepest sleep is replete with such an object. Asanga's and Vasubandhu's analysis of mental and sensory objects, however, demonstrates that none of these objects is ultimately real. Nevertheless - and this is the key ontological claim - the conclusion that the objects are ultimately unreal does not adequately account for the fact that those objects are appaering. Instead, one must see that denying the ultimate, independent reality of those objects is the same as affirming their conventional, dpendent existence within the mind itself. To put it another way, when one sees the color blue, the apparent existence of the blue object as an external, independent object is false. But the fact that it is appearing to consciousness is undeniable, and since the Yogacara analysis shows that it could not be external and independent of the mind, it must be within the mind itself. Seeing that flow of mind in that way - namely, as devoid of the apparent subject-object duality - is to see the perfect nature. Thus all objects and all subjects are not distinct, but this is not to deny their reality altogether. Rather, the denial of subject-object duality still leaves intact the causal flow of mind in which all those apparently dualistic experiences are occurring." (subject-object duality is referred to as the "constructed nature" (making three natures in total)).

    Being the causal flow of consciousness itself, the dependent nature should be placed ahead of the other two (constructed and perfect). These other two are just two different modes of the dependent nature. It should then be clear that this notion of causality is a central tenet of Buddhism. What all this suggests is that (pre-)conditioning is not some kind of aberration or deception that can be fully accounted for as psychosomatic, but is rather the underlying nature of consciousness itself. I think this is why it relates to "everyday experience." (I take consciousness and experience to be synonymous).

    If they didn't use adrenaline in the experiment, only placebo, and it proved effective in sedating the subjects, then the placebo might even be considered a more effective medicine. It could produce the same result (mental image) whilst (initially) bypassing the physiological.

    It's too bad the study was only single-blind (the experimenter was to privy to when he was administering the placebo). This accounts for the ineffectiveness of the placebo to do much of anything at all. It would be truly odd if the administration of the placebo yielded the same results in a double-blind study.
     
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