CALL-IN DISCUSSION; OZANICH CHAPTER 7: PLACEBOS Tomorrow, Tuesday, October 1st, the call-in discussion group will be discussing Chapter 7 (Placebo Yo-Yos and Nocebo No-Nos) in Steve Ozanich's book The Great Pain Deception starting at 9 pm Eastern Time. It lasts an hour, sometimes a little longer. Phone lines will open half an hour early so you can talk to hosts and early callers. Here's how to join the discussion (for detailed instructions, visit http://go.tmswiki.org/connect ): If you're connecting by phone, dial 1 646 583 7415 and when prompted enter the pin code 21558901. If you're connecting via your computer (Fuze Meeting), go to www.fuzemeeting.com/fuze/app/48fb7aa8/18311499 and follow the instructions from there. Before summarizing Steve Ozanich’s chapter 7, a few words from Walt Oleksy, not a doctor but a researcher and believer in TMS: What is a placebo? The word comes from the Latin word placeo meaning “I please,” and is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient. Sometimes patients given a placebo (also called “sugar pills”) treatment will have a perceived or actual improvement in a medical condition, a phenomenon commonly called “the placebo effect.” The placebo effect can be produced by inert tablets, by sham surgery, and by false information. In medical research, placebos are given as control treatments and depend on the use of measured perception. Placebos can have a surprisingly positive effect on a patient who knows that the given treatment is without any drug, as compared with a control group who knowingly did not get a placebo. In one common placebo procedure, a patient is given an inert pill, told that it may improve their condition, but not told that it is in fact inert. This may cause the patient to believe the treatment will change their condition, and this belief may produce a subjective perception of a therapeutic effect, causing the patient to feel their condition has improved – or an actual improvement in their condition. The placebo effect points to the importance of perception and the brain’s role in physical health. However, the use of placebos as treatment in clinical medicine, as opposed to laboratory research, is ethically problematic as it introduces deception and dishonesty into the doctor-patient relationship. The United Kingdom Parliamentary Committee on Science and Technology states that “prescribing placebos usually relies on some degree of patient deception” and “prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment.” Now Walt’s summary of Steve Ozanich’s chapter 7: Steve says, early in his chapter: “I firmly believe that ultimately every healing is mediated by the so-called placebo effect: that is, our deepest beliefs can heal or harm, even alter the expression of our DNA, as Dr. Bruce Lipton implies in the opening page of this book.” (That opening, in the book The New Biology – Where Mind and Matter Meet by Dr. Lipton, PhD, reads: “Some of our current beliefs in our truths about medicine are actually not very correct at all – there’s a revolution going on in the healthcare area, but it’s at the leading edge of research… it really should come down to the people… We’ve really been messed up by some ideas that are not absolutely correct… nature is simple in how she does everything – once I explain this, then you really start to see how powerful you have been, but how limited you have because of alterations in our belief about how wonderful we’ve been. You’re not controlled by genes – you’re actually controlled by perceptions of the environment – perceptions being beliefs.”) Ozanich also quotes Dr. Andrew Weill, from The Healer Archetype: “I am well aware that belief is a powerful influence on the outcome of treatment… the true source of healing is inside us – not outside.” Ozanich write in chapter 7: “TMS healing doesn’t come from blind belief – it’s quite the opposite. It comes from a deeper understanding of what’s happening within because the truth is the fastest path to freedom. There is no ritual with TMS healing, or magic, or honestly intentioned deceit – only a new awareness. “Credence that TMS healing is not a placebo comes from the fact that pain oftentimes leaves when knowledge is gained. This would be much more difficult if there was a real injury. “Dr. Sarno points out that the fact that so many thousands of people heal through reading his books is proof that the TMS process is not a placebo. There’s no physical interjection or personal interaction of any kind in the healing process. So it’s not only the mere belief that heals people from chronic pain, it’s also an understanding of the process. When the physician explains to the sufferer exactly what is occurring, he is in essence taking away any placebo effect. I believe Dr. Sarno would agree that this was one of his most amazing findings regarding TMS – in explaining how the pain process works, his patients began to heal. “With the placebo it’s the belief in the drug – or act – that ratifies the body’s constitution to free itself. The belief rallies the will to change, which in turn transforms the body.” Steve says that when a doctor erroneously tells a patient they have a bad back or shoulder or knee, suffering naturally increases due to the “nocebo effect,” and the doctor has delayed the patient’s healing indefinitely with faulty medical advice, and harmed the patient. He then goes on to write about surgery and other types of placebos including chiropractic manipulation which he calls “the therapeutic sugar pill.” He says a person may feel better at the end of lengthy visits of spinal adjustments but he is healing with or without the treatments, because he believes the adjustments heal him with hands-on healing touch. But he says there is nothing wrong with having a chiropractic spine adjustment, provided you understand that pain does not come from structural misalignment or degeneration. Then it can be considered a muscular-skeletal massage that temporarily relieves some tension. But he also cautions that spinal manipulation can and often does perpetuate the pain by strengthening the person’s concept of misalignment, in the depths of the unconscious mind, much like physical therapy, which he considers another placebo. Steve asks, “Is TMS healing a placebo effect?” He answers it saying “Yes, if the definition of a placebo is predicated solely on your belief, the central mechanism of all healing. “I do, though, differentiate between TMS healing (finding the truth about yourself) [meaning that one or more repressed emotions cause our pain] and healing by being ‘fooled’ through surgery, drugs, chiropractic, acupuncture, etc.,” all of which may ease the pain temporarily but not permanently. Steve concludes saying that if your back hurts, it should heal within a reasonable time frame. “If after a few months there is no healing, begin looking at an emotional and conditional process behind the continuing pain.” Steve cites a “20/2o0” television episode, “Dr. Sarno’s Cure,” when an attorney had seven herniated discs and was in severe pain, but it left him weeks after experiencing Dr. Sarno’s exam and lecture about TMS healing. I hope you will join the call-in Tuesday night and share your thoughts on placebos and TMS healing, especially those who retain some degree of doubt that their pain is psychologically-caused and not structurally.