From the McGill Reporter
Before he was a psychiatry professor and researcher, Amir Raz was a magician — and the two occupations aren’t as different as you might think. As Canada Research Chair in the Cognitive Neuroscience of Attention, Dr. Raz is interested in deception and how people’s physiology is influenced by their expectations of what is about to happen.
Dr. Raz is one of the keynote speakers at this year’s Trottier Public Science Symposium “Mind Matters: The Body-Mind Connection” (Oct. 23 – 24). In advance of his Oct. 23 lecture, The Placebo Effect, Dr. Raz spoke spoke to the Reporter about everything from hypnosis in medicine, the connection between magic and science and the ethics of physicians prescribing placebos.
Voltaire maintained that “the art of medicine consists of amusing the patient while nature cures the disease.” What is your opinion of that view?
In the 18th Century, when Voltaire thrived, medicine was very different from how we practice it today; many a therapy back then was a placebo intervention. Today we know a bit more than we knew back then; it’s rather difficult to shrink tumours, lower cholesterol, and heal meningitis just by entertaining folks and waiting for healing to take place. And yet, I really love this nearly 300-year-old proverb even today.
Voltaire wrote a lot: more than 20,000 letters, more than 50 plays, dozens of treatises on science, politics and philosophy, and several books on history; repeatedly, his caustic wit got him into trouble. A lifelong deist who was often critical of organized religion, he said and wrote many things that were antithetical to the common wisdom of his time. Many of his maxims, not just about placebos, continue to reverberate today. Placebos work through expectations, suggestions, and the meaning we attribute to objects, concepts, and events. Sometimes, as Voltaire himself noted, narratives and rituals show us that “Faith consists in believing when it is beyond the power of reason to believe.”
Hypnosis is part of the clinical armamentarium. Few have never heard of hypnosis but most know little about the potential of this mind–body regulation technique for advancing science and clinical medicine. Type hypnosis into your favourite search engine and you too may confound lay entertainment with clinical intervention, hypnosis with hypnotherapy, and fact with fad.
On the one hand, many individuals approach hypnosis with skepticism — regarding it as an arcane and questionable phenomenon —bewilderment, and even fear. On the other hand, as a psychological technique which elicits profound alterations in consciousness after only a few words of suggestion, hypnosis can make certain individuals undergo remarkable experiences: see things that are not there, fail to see things that are there, lose control over voluntary motor functions, and feel as if they were young children.
Following hypnosis, moreover, some people can execute responses to previously arranged cues without really knowing what they are doing or why they are doing it. And, given appropriate suggestions, they can forget all they did or experienced while hypnotized until the suggestions are terminated and the relevant memories come flooding back. The clinical value of these phenomena should be self-evident.
I am not a big fan of stage hypnosis — hypnosis for show — in the same way that I don’t advocate a brand of psychotherapy or surgery for one’s entertainment pleasure. Unlike medical and psychological hypnosis, stage hypnosis is unregulated to the extreme, often practiced by performers with questionable credentials, and entails some risks for lay participants. I am aware that many colleges and universities invite stage hypnotists to treat their crowds, but I can think of better and safer ways to achieve such amusement.
Magic and science lead an interesting dynamic.I am interested in the crosstalk between the kind of unusual questions that magic tricks can allow us to probe in scientific experiments, on the one hand. And, reciprocally, how a more scientific understanding of some magical phenomena may improve and invigorate the art and practice of magic. My colleagues and I have recently put out a whole volume on this theme.
Magicians have dazzled audiences for many centuries; however, few researchers have studied how, let alone why, most tricks work. The psychology of magic is a nascent field of research that examines the underlying mechanisms that conjurers use to achieve enchanting phenomena, including sensory illusions, misdirection of attention, and the appearance of mind-control and nuanced persuasion. Most studies to date have focused on either the psychological principles involved in watching and performing magic or “neuromagic” — the neural correlates of such phenomena. Whereas performers sometimes question the contributions that modern science may offer to the advancement of the magical arts, the history of magic reveals that scientific discovery often charts new territories for magicians.
The biggest trick to using placebos clinically rests with the ability to use them both ethically and judiciously. Determining what’s ethical is tenuous: what was ethical yesterday is not necessarily ethical today; determining what’s judicious changes as a function of litigiousness, clinical standards, professional regulation, etc. Copious evidence shows that placebos are powerful and that they can bring about therapeutic relief in many clinical domains. However, at least in North America, the current informal climate stipulates that using placebos comprises bad form, poor professional judgment, and involves patient deception. These trends are slowly changing by gaining a better scientific understanding of how placebos work, how we can utilize them even without subterfuge, and by devising protocols and guidelines that take recent research findings into account.
Mad in America | The placebo effect: What it is and why you should know about it
October 20, 2017