In short, when we think something will work, its chances of doing so increase dramatically.
Dr. Hall then refines that idea by giving it a sharper explanation: "What’s effective is not the placebo," meaning the benefit patients derive from a "dummy" pill, "but the meaning of the treatment." She hypothesizes that the power of the effect depends on four variables:
atient expectancy; motivation (the desire to improve one's health); a certain amount of conditioning, including from advertising; and endogenous opiates, or pain-relieving chemicals produced in the brain, which copy the effect of pain-relievers such as opiates.
To that end, it isn't so surprising to hear her claim: "A substantial percentage of the effects from antidepressants may be placebo effects." Her assertion jibes with one that PT blogger Dr. Philip Newton made on this site last December:
"In some controversial cases, such as selective serotonin reuptake inhibitor (SSRI) anti-depressants," he wrote, "placebo effects are thought to account for a major proportion of the positive effects of a drug."
Kirsch’s claims appeared to receive a big boost from a meta-analysis published in January in the Journal of the American Medical Association and widely reported. The study concludes that “there is little evidence” that antidepressants are more effective than a placebo for minor to moderate depression. But, as a Cornell psychiatrist, Richard Friedman, noted in a column in the Times, the meta-analysis was based on just six trials, with a total of seven hundred and eighteen subjects; three of those trials tested Paxil, and three tested imipramine, one of the earliest antidepressants, first used in 1956. Since there have been hundreds of antidepressant drug trials and there are around twenty-five antidepressants on the market, this is not a large sample. The authors of the meta-analysis also assert that “for patients with very severe depression, the benefit of medications over placebo is substantial”—which suggests that antidepressants do affect mood through brain chemistry. The mystery remains unsolved.
Kirsch’s claims appeared to receive a big boost from a meta-analysis published in January in the Journal of the American Medical Association and widely reported.
The study concludes that “there is little evidence” that antidepressants are more effective than a placebo for minor to moderate depression. But, as a Cornell psychiatrist, Richard Friedman, noted in a column in the Times, the meta-analysis was based on just six trials, with a total of seven hundred and eighteen subjects; three of those trials tested Paxil, and three tested imipramine,
one of the earliest antidepressants, first used in 1956. Since there have been hundreds of antidepressant drug trials and there are around twenty-five antidepressants on the market, this is not a large sample.
The authors of the meta-analysis also assert that “for patients with very severe depression, the benefit of medications over placebo is substantial”—which suggests that antidepressants do affect mood through brain chemistry. The mystery remains unsolved.
Kirsch’s claims appeared to receive a big boost from a meta-analysis published in January in the Journal of the American Medical Association and widely reported.
The study concludes that “there is little evidence” that antidepressants are more effective than a placebo for minor to moderate depression. But, as a Cornell psychiatrist, Richard Friedman, noted in a column in the Times, the meta-analysis was based on just six trials, with a total of seven hundred and eighteen subjects; three of those trials tested Paxil, and three tested imipramine, one of the earliest antidepressants, first used in 1956. Since there have been hundreds of antidepressant drug trials and there are around twenty-five antidepressants on the market, this is not a large sample.
The authors of the meta-analysis also assert that “for patients with very severe depression, the benefit of medications over placebo is substantial”—which suggests that antidepressants do affect mood through brain chemistry. The mystery remains unsolved.
reference Is Psychiatry a Science? By John M. Grohol, Psy.D.
Te Rauparaha composed "Ka Mate" circa 1820 as a celebration of life over death after his lucky escape from pursuing Ngati Maniapoto and Waikato enemies. He had hidden from them in a food-storage pit, and climbed back into the light to be met by a chief friendly to him – Te Whareangi (the "hairy man").
The haka as composed by Te Rauparaha begins with a chant:
Kikiki kakaka kauana! Kei waniwania taku tara Kei tarawahia, kei te rua i te kerokero! He pounga rahui te uira ka rarapa; Ketekete kau ana to peru kairiri Mau au e koro e – Hi! Ha! Ka wehi au ka matakana, Ko wai te tangata kia rere ure? Tirohanga nga rua rerarera Nga rua kuri kakanui i raro! Aha ha! Then follows the main body of the haka: Ka mate, ka mate! ka ora! ka ora! Ka mate! ka mate! ka ora! ka ora! Tenei te tangata puhuruhuru Nana nei i tiki mai whakawhiti te ra A, upane! ka upane! A, upane, ka upane, whiti te ra!
Oh we've moved the subject to rugby now you're squirming like a worm on a hook
You are my moment and my dream, My glorious word within the sounds, You are as beautiful as you are the secret, You are the truth as much as the lust.
Stay unreachable, silent and far, As for dream of happiness is more than happiness itself. Be one time flame, as youth. Let your shadow and echo be all to be remembered by.
Heart is writing its history on a falling tear, On an immense pain that love marks its target. The truth is only dreaming of the soul. Kiss is the most beautiful meeting in the world.
You are the image of my apparition, Your sunny décor knitted through my dream. You were the fascination of my thought, Symbol of all conceits, defeated and icy-cold.
But you don’t exist, neither you ever did. Born within my silence and despair, From the Sun of my heart you were shining Because everything we worship – we have created ourselves."
Your eternal eyes,young woman, two long nights in the desert of sea; two dark scared fairy tales that have a hint of doubt in the branches of pines.
Two silent ships with black flags two women in black,quiet on their prayers. two midnight rivers through sharp landscape two messengers of pain that hunt by night.
Eyes of my woman,dark triumph of body that were drunk with eternal sadness found their space in her purity and their heavenly kingdom in her sin.
From tears shed in huge vigil those endless eyes shine just for that with distant and strange shine of anxiety like some eyes that have seen God himself.
On their endless net,they keep all dark ectasies of dreams they have, Unclearly seen eyes,on wich bottom lies dark and big weakness of despair.
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