A Nation of Placebo Addicts

Essentially, it strikes me as dis-empowering and potentially opening people up to exploitation that we do not address the role of placebos. Many, if not most are aware of their existence, but the ramifications seem to make no difference in how we approach healthcare, as well as other areas.

The power of the placebo effect is essentially to "trick" a person into feeling better. That is, by applying a neutral intervention (therapy, pill, or other treatment), the person is able to heal or to speed recovery. This improvement is often attributed to the "natural power of the body to heal itself", but there seem to be a couple components that make it more than just wishful thinking. First, of course, the 'patient' believes that the intervention will work. This is crucial, and the part that leads to mis-attribution to super-natural causes. The second is the setting and/or provider, which lends credence to the intervention. Think about the difference between getting a prescription from a respectable, older-looking person wearing a white lab coat in a clean and modern clinic versus being tossed a bottle by a ratty, greasy guy in torn jeans outside the local mini-mart. Similarly, the difference between listening to your favorite music on a quality sound system at home versus sitting quietly in the audience of demure sophisticates at an intimate performance versus being in a raucous crowd of drugged-up hippies at a standing-room-only event. The setting influences your experience, for better or worse. These two factors, personal expectations of and the setting around an intervention, lead to how successful a placebo is. Being explicit, or telling a patient, about a placebo can actually have little impact on the outcome.

How much better would it be to use this power intentionally? Properly asserting that the power lies with me, rather than outside myself, we could build a more whole society of confident people. Of course, it would be vital to acknowledge the limitations of placebos, and continue to rely on appropriate treatment for medical conditions. However, adding in that it is important how we perceive our own treatment—the positive or negative attitude we hold—could improve our odds of success. At the very least, it highlights how treatment is a joint effort between provider and patient, rather than a supplicant begging for healing from a god-like Doctor, as it has historically been portrayed. This is where the dis-empowerment comes in.

Additionally, there is potential in utilizing this tendency in order to dismiss quackery and scams. By assuming that a positive belief will tend to improve chances of success, we can analyze failure more critically. Recognizing the tendency to 'fall for' something we want to work, but that does not perform, could be important. When something succeeds, we may be more likely to examine whether it was due to sheer placebo effect. From media to "alternative medicine", knowing that we are improving conditions for ourselves just through our approach. Because we believe in the TV personality (the 'setting' of the 'treatment'), we could question whether it was the placebo effect all along. Rather than relying on "experts" we could get better at spotting quacks and fraudsters.

https://en.wikipedia.org/wiki/Placebo

https://www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect

This One Simple Trick....

When we try to pick out anything by itself, we find it hitched to everything else in the Universe.

The above quote comes from John Muir, an important figure from the 19th century.

Life is never one thing at a time, but that is how we tend to convey or discuss things. The singular focus of an essay, the headline that conveys one idea, the single-solution presentation, or the click-bait advertisement are at once attention-grabbing and succinct enough to "drive engagement". One major contributor to this is the endless demand of time from so many competing areas. With limited time for comprehension, the tendency is to be pulled to shorter and shorter answer-focused outlets. So much of what we read, watch, and listen to is designed to be consumed quickly—and often to provide the answers without the understanding an audience deserves. Worse still is the exploitation of this time crunch by those who wish to sway opinion, and provide not just quick, but emotionally manipulative material. This allows them to dictate what is important and what should be done about it to a credulous, if weary, audience.

The concern here is treating others as means to one's own ends, which is what describing and treating people as "consumers" or "customers" does. Working our own ends upon others as though their value is only what they can provide us is simply in-humane. Once more, however, this is an expedient solution to the quandary of how to deal with others, and not just in a business context. Essentially, we have here the "How to Win Friends and Influence People" approach, which shows how to use tricks to get others to submit. It is a perspective that has inveigled its way into popular consciousness through much of the self-help industry. This approach is not actually about helping oneself to be a better human, improve connection, or understand others, rather how to achieve goals despite the needs, beliefs, and actions of others. The scam-or-be-scammed view on life reduces us to mere exploitation machines, each desperate not to be duped. It also makes the world a worse place to live in. Thinking of others as obstacles to be overcome, rather than fully human beings with goals and inherent dignity of their own is—and here I will be blatantly prescriptive—wrong. It creates a world where people tend to experience insult and disregard, which entices them to do the same. This attitude then spreads, influencing more people, and continues the chain of desperate individuals attempting to dupe others before they get duped. By pointing this out, I actually do hope to influence you, but in the other direction.

The inherent difficulty of writing [because I write, but this also applies to visual or audio works] is how it does not—and cannot—convey reality. Both intentionally and unintentionally, writers use what's pertinent, important, attractive, or persuasive. This immediately narrows what can be included, and reduces the full context to something more easily digestible. At best, it is a distillation of the nebulous and illumination of the dimly understood. Too often, it is bullying or prescriptive and lacks respect for the reader. I can only hope that my own efforts are about starting or expanding conversations by sharing from an unusual perspective. As we come to it now, at the end of an essay it is common to make the "call to arms" or present an "actionable item" which will solve the elucidated problem. Simply, we need to get better at nuance. This, however, necessitates a number of other steps, such as: comfort with uncertainty, expecting disagreement, accepting differences, willingness to change (opinions and more), and devoting time to topics. These are all just thoughts, however, until some of you readers decide to act on them; in essence, this does not matter until you make it.

At least, I hope, the wending path of this blog post suffices to demonstrate the continued truth of the included quote. It may be that is the message, that when we begin to consider others, we find it leads back to ourselves.

Business as Usual

Interesting things can be done a number of ways or take a multitude of forms. If there were only one type of flower or bird, they would be boring. Useful, even essential, but dreadfully monotonous to only see one shape and color repeated endlessly wherever one looked, like grass. Playing a game that has only one outcome or way to progress is dull; the excitement of playing is in not knowing what will happen. Whether I win or lose, how we get to the end is novel each time — in a good game, anyway.

People talk about business as if it were interesting; there are entire TV channels and reams of magazines devoted to discussing business. The truth is that business is boring. Not in the sense of filling out forms or collecting data about productivity, although that is certainly tedious. People act as if there is some variability in business or there are novel discoveries waiting to be made in conducting business. While advertising and methods of payment have certainly changed over time, the business of selling is unchanged and unchangeable from ancient history into the future. All it consists of is getting more for something that what one paid. Whatever it is, from bikes to jewelry, clothes to food, babysitting to writing, every single action in business is determined by this simple, underlying principle: buy low, sell high. Whether it is goods or services, the only thing that matters is that I get paid more for something than what I paid to get it. There is no mystery, no novelty, nor any innovation here.

You knew this already. Everyone has heard "buy low, sell high" or that business must turn a profit. This is so commonplace that we don't talk about or recognize it; because it is so ubiquitous, it is trivial. The only thing interesting about this is the mystical, reverential attitude people have about "business". It places emphasis on a tool, the simple practice of conducting trade. Concurrently, this attitude extends to those who conduct it. The reason for pointing this out is simply to question the legitimacy of this worship of business and suggest that the attention paid to the subject would be better spent on other pursuits.

Keeping Down the Jonses

In medicine, the term 'anosognosia' means the patient cannot recognize their own condition. A person literally cannot conceive of the issue or connect the cause with the effect of their own suffering. This is similar to — although distinct from — when we cannot examine own situation as objectively or dispassionately as an outsider could. While this is a common and important human flaw to be aware of, it is different than the patient's blindness: the inability to connect varying symptoms with the underlying disease. It is also different than having others mislead or deny information that would allow one to understand the problem; the term gaslighting may come to mind for some. We need to be clear about these different causes and conditions in order to recognize how to fix our situation. The objective here is to expand the conversation and provide better tools for examining our collective problems.

Additionally, individuals and groups attempt to exploit ignorance, confusion, and desperation by offering self-serving explanations. It is the reason we have scammers, fascists, demagogues, and "influencers" explaining away all problems as due to "godless living", "too many immigrants", "raising 'soft' children", "not 'grinding'/'hustling' hard enough", etc. The insistence that these are all personal or individual issues, despite impacting every person in the society. Claiming that mass shootings are just "lone instances" or "disturbed individuals", rather than the result of choices and influences that pervade the culture. Demanding that nobody look at the arrest, sentencing, and incarceration of minority persons — let alone the violence surrounding law enforcement towards same — as a systemic problem. The 'individual responsibility' narrative serves to maintain things as they are, and benefits those who feed off such conditions. If we were to (or were able to) examine our situation with objectivity and allow for systemic or systematic oppression, we could find solutions that we could not otherwise.

However, the suggestion here is that there exists a greater case of anosognosia than even the collective blindness to violence, inequality, or suffering that people live with every day. In fact, I propose that it is the root cause of those symptoms. It may seem odd to refer to conditions as diverse as police shootings, economic inequality, theft, houselessness, addiction, everyday callousness, political apathy, excessive imprisonment, despair, and extractive practices as anything other than causes themselves. This is due to the blindness — often enforced by self-interested parties — which society has about these terrible conditions being outgrowths of a pervasive condition which supports them. Yet, after seeing the connections, one can recognize a great number of issues as symptoms of that underlying, unacknowledged root cause. Whatever name we know it by, the notion that there is some immutable scale of more and less deserving persons dictated by natural principles. The assumption that there are people who should not have power, privilege, or prestige. This is the underlying belief that makes it possible for otherwise caring and compassionate people to blame victims and excuse the mistreatment of others, thus allowing a system of oppression and suffering to continue.

Let us briefly examine one example as practice at seeing the pattern. While houselessness (previously, homelessness) has been around a long time, people in the U.S. are experiencing it in greater numbers over the past few years. There are a number of rationales for ignoring it, many bordering on the absurd. For this example, set aside budget and history, let us set aside the mundane world and imagine instead that all humans, no matter their limitations or choices, deserve food, shelter, health, and autonomy. If every person were thought of and treated as worthy and deserving — and our systems were oriented to actually ensuring the life and liberty of its citizens — then nobody could be unhoused. If the life of any person living "on the streets" was valued just as highly as any celebrity, it would be impossible to allow that person to continue to live in those conditions. Once, and only when, this ridiculous attitude is abolished, will we begin to progress into the future.

It is only because we allow ourselves to believe that there are deserving and undeserving, worthy and unworthy, valuable and disposable people that so many forms of suffering continue. It causes us to fear being put into the "unworthy" group and look down on those who are called "unworthy". It leads to systems which thrive on and contribute to the prejudicial notion of hierarchy.

The First Step in Fixing a Problem is....

Not so much a mystery as it is an assumption. Anyone in a recovery program will recognize, "The first step in fixing your problem is admitting you have a problem." Others might say it is, "...defining the problem", "...understanding the root cause", or "...recognizing there is a problem". These are all very pithy and goal-oriented. You may have surmised, by this point, that I have a suggestion which differs from these. This is correct, and not only that, I believe it is a vital difference. The baked-in assumption is that we can fix the problem, since the sentence begins with, "...first step in fixing...". It is here that we have already lost a large number of people, because they do not believe a fix is possible. It may seem strange or illogical to imagine that anyone could think we are just stuck with problems, that there is no solution for some things. However, this is the issue underlying many conflicts in relationships and life: one side thinks we can fix it and the other side does not.

In a previous post, I made mention of growth and fixed mindsets. These terms refer to the belief that either change for an individual is possible or not, respectively. In terms of nature versus nurture, one with the fixed mindset will hold that nature wins out and cannot be changed. This can be expressed, "Some people are just born bad" or "You can't fix stupid". This may seem to some as an antiquated notion, something that has been superseded by progress and scientific discovery. However, the fact we can hear people continue to use such expressions should be enough to demonstrate the tenacity of this perspective. It is this attitude that poses a barrier in fixing problems, ironically enough. Those with a fixed mindset will work around the difficulties that others present, assuming that there's nothing to be done to change those others' actions. "It's just the way they are," they will shrug to themselves as they assume the other person cannot change. Rather than pointing out this other person's actions as being problematic, looking for ways to fix the situation, or even contemplating how to address the problem, these folks will take it upon themselves. This situation or attitude may begin to seem familiar, as you contemplate times in your life when someone acted this way.

The point here is not that people are incapable of change, and certainly not to berate anyone for thinking such. Having experienced such change in my own life, I hold with the growth mindset and can attest that it can happen. Because of this, I can believe that the same is possible for you, even if you currently hold a fixed mindset. My hope in writing this is to point out how the presuppositions we do not recognize can end up sabotaging our efforts to make things better. Therefore, my suggestion is that the first step in fixing a problem is simply to believe change is possible.