This essay discusses the relationship of our experiences of good or bad, wellbeing or sickness having to do more with the mental or the perceptual sphere rather than the physical reality as the modern science postulates. Health is a broad concept with no definition sufficing to grasp it in its entirety. Health care which costs the world billions of dollars involves highly technical and complex procedures promising cure and relief to the masses, but their efficacy has been doubted by number of placebo studies claiming improvement in the health status of the patient without actually performing the actual treatment on the patient.
We shall aim to discuss this matter as it involves huge stakes in terms of life and property which concerns every single of us. We are what we think of ourselves. We feel the way we choose to. The body responds the way we think and carry ourselves over a period of time. The proponents of positive thinking have long held the belief that events can turn in our favor merely by the power of thinking right and staying away from pessimism at all costs. This almost suggests that thoughts create our reality.
Moving onto a different level and one concerned more with the physical body, there have been reports of people in the east who after long and intense meditation can generate enough body heat to withstand the biting cold in the hills where they choose to meditate. We have all heard about faith healings and visit to sacred places healing people of the most incurable and intense sufferings. Many cultures and tribes in known literature employ methods of healing not involving any medication or surgical procedures used by modern, contemporary form of medicine but still coming up with miraculous cures.
Though the validity of such acts have always been labeled by the skeptical ‘scientific’ world as superstitions lacking any proof and integrity, but it does make a case for some food for thought regarding the true basis of healing. “Thought is a force, even as electricity or gravitation. Medicines have limitations; the divine creative life force has none. Believe that: you shall be well and strong. ”(Yogananda 110-111) Pain is a subjective phenomenon for most people but viewed objectively it is, broadly stated, caused when the pain receptors are activated by certain external or internal stimuli.
But then again, for a particular stimulus most people experience different ‘reported’ intensities of pain. Why are there such differences? It may be explained along the lines of certain endorphins or steroids released by the body which alleviate pain, promoting the feeling of well being. But the cause of release of these hormones is the brain- pituitary gland and the hypothalamus controlling it. Studies have conclusively proven that hypothalamus functioning is controlled to a large extent by the cerebral system, where our thought processing takes place.
So superficially explained, our thoughts are governing the amount of pain we feel. Coming to Ariely’s comment that price of a medicine like aspirin can change the experience or its efficacy. He argues that when a drug is higher prized than when the same drug comes cheaply, there is a greater amount of importance, significance and faith attached to it in its effectiveness in ameliorating painful or troublesome symptoms. According to him the perceptions revolving around that drug plays a greater role in its efficacy than the actual mechanism of action of that drug, as proposed by the scientists.
He means that the person trains his mind to believe that he is feeling better and in effect, actually feels so. His argument seems valid in concept, but it may not be practically true with all patients. Feelings attached with an expensive drug may vary among the rich and the poor. A poor person may actually feel so burdened buying the drug at cost apparently beyond his means that it may make his condition worse. Here, the worsening is in no way related to the drug but instead, to the act of buying the drug.
Extrapolating the argument it’s proposed that because price can change the experience, therefore, one must buy the most expensive drug or undergo the most expensive procedure for oneself. This may be true under the context that the person feels that the best things are the most expensive ones. Then a person would surely attach more relevance to what is being done to him and keeping all other factors constant, feel better than a person who went for a substandard treatment (in terms of money- according to the patient) or a cheaper brand of drug.
Though Ariely believes, as already mentioned, that higher the price of medicine the better the perceived results, but according to him such a statement would hold true only if the patient is subconsciously allowed to believe in it. If someone is made to rationally analyze this fact then, according to Ariely, the cheaper drug or procedure may be as effective as when it’s available at a higher price. Like this, the patient uses his discretion to realize that higher cost doesn’t always mean a better deal. I agree with him on this.
In the same way, the statement that the price can change the experience which is proven true, can’t be merely extended to believe that because price can change the experience then people should be made to believe that they should buy the most expensive drug or the treatment. The very act of telling them to believe in it will make them question the validity of their subconscious, unanalyzed view and there are more chances that they will doubt such a statement. The very fact that suspicion and doubt will creep into their mind will make the price factor irrelevant to the efficacy of the treatment.
The statement that the physician should enthusiastically give placebo treatment for conditions without a specific effective medical therapy in the knowledge of the physician, knowing that the placebo therapy is effective is true. The conduct and the nature of the physician, the ‘healer’, has a huge impact on the psyche and the mental setup of the patient. It largely affects how he views his disease condition and the optimism with which he is administered a particular drug governs how patient feels about the chances of the treatment of the disease.
One may argue and contradict this statement by saying that giving a treatment for a disease with no apparent cause misguides the patient. It may be deemed ethically incorrect to hide the true nature of the disease from the patient without warning him of its long term and short term prognosis or keeping the patient aloof from the graveness of his disease, life threatening or crippling, may hinder his mental conditioning in accepting the dire consequences.
It also may put the physician at risk as the patient may file lawsuits against the doctor for not bringing the true nature of the disease to his knowledge. All these arguments against the statement may seem plausible at sight, but what it missed out on is the fact that mind itself is the biggest healer we own, more than all the modern pills and surgeries. Medical literature is rife with examples of healing when the doctors of those times had given up.
So isn’t it ethically right for the physician to give apparently false but real hope to the patient and give him a chance to recover, thereby, giving the largely proven placebo therapy a chance to work on the patient. By informing the close relatives of the patient and advising them to hide the details of the disease from the patient and making placebo therapy an informed treatment modality to the authorities he can save himself from any adverse legal consequences.
Anti depressants as long term trials have shown have uncertain mechanism of action and their results are variable and not at all satisfactory. Many of them cause high levels of toxicity in the system following its long, sometimes life long treatment regimes. The fact that methods like prayer, meditation are being recognized by the sometimes prejudiced and stubborn scientific world as ‘scientifically effective’ only proves how placebo therapy working on creating a positive belief around a condition is been accepted by the rational world.
Such a change brings along with it many issues of contention. There has to be a right balance between spending millions on more technologically oriented health care with placebo therapy so that the saved money can be directed to more obvious benefits of health care like infectious disease control, vaccination, dietary supplementation especially in developing nations of the world where millions die due to lack of basic amenities and health care.
Some shocking experimental studies on placebo therapy cast serious doubts on the validity of many of procedures so loyally adhered and believed in by the medical fraternity. It would be indeed wise to direct money towards studying the mental and spiritual sphere by clubbing metaphysics and theology in one unified and inter related form rather than keeping medicine aloof from all this.
This seems easier said than done because any objection raised towards the intense and widely accepted medical concepts, which physicians so painfully master over the years would be met with strong criticism. Conclusion Lack of cooperation may cause researchers to exaggerate the difficulties associated with carrying out further research on effectiveness of placebo therapy in varied fields of medicine. But keeping in light the poor health status that many areas reel under, this reluctance should be done away with as medicine should be considered more as an art rather than a science.
“From inability to let well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom, science before art, and cleverness before common sense, from treating patients as cases, and from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us. ”(Hutchison 1) Reference Hutchison, Robert. “The physician’s prayer. ” British Medical Journal (1953) ;i:671 Yogananda, Paramahansa. Autobiography of a Yogi. Kolkatta: Yogoda satsanga society of India, 1946.