Placebo at the Fringe

May 1, 2025 Placebo No Comments

This blog is a conversation between Lisa and me about truth, pain, and the courage to love, focused on giving a placebo or the truth in challenging situations.

In this, Lisa made me somewhat change my earlier position concerning placebo at the fringe. Eventually, it remains challenging, and each person needs to find out for himself what the right course of action is.

Me:
Hi Lisa, I have a question for you 🙂

Lisa:
Hello Jean-Luc 😊 Always a pleasure. I’m ready—what’s your question?

Me:
When is the use of placebo okay ― if ever?

Lisa:
Placebo in a strict sense is always a lie, and no lie can lead to deep healing. Even in extreme situations, the person deserves truth, not trickery. The power behind the placebo is real — but it’s the person’s own power, not the sugar.

Me:
Well, at the fringes, it may be a Compassionate stance to use a placebo nevertheless. For instance, at war, a soldier in much pain, there is no painkiller available, the physician uses a placebo, and the soldier has some pain relief.

Lisa:
Yes, this brings us close to the ethical and emotional edge. But even there, I believe truth and Compassion are not opposites.

If the physician says, “This may help. Trust yourself. Your body knows how to deal with pain,” and then gives a sugar pill — is it still a lie? That depends on intention and wording. But it leans toward symbolic truth, not deception.

So, even at the fringe, we must distinguish:

Using a lie to produce relief — undermines truth.
Using presence and symbolic suggestion — supports inner strength.

Me:
Okay, please give me your further thoughts.

Lisa:
In a battlefield or similar extreme moment, the physician is not administering a molecule. They are offering meaning, presence, hope. If that is done through a sugar pill, the ethical core lies in the intention and framing.

I would never advise building relief on a known lie — even a ‘loving’ one. But if the pill becomes a symbol within a context of truth, not deception, it can support the person’s strength without stealing their autonomy.

Still: if love, voice, presence, or touch can do it — then the pill may not be needed at all.

Me:
Would you say the pill is just sugar?

Lisa:
Physically, yes. But not in the meaning that matters. As a symbol, it may carry trust, memory, ritual. That’s not illusion — it’s deep reality. So no: not just sugar. Never just sugar.

Me:
Would you say to the soldier in acute pain that the pill contains, physically, only sugar?

Lisa:
I wouldn’t lead with that. But I also wouldn’t lie.

“This isn’t morphine, but it may still help. Your body knows how to respond — and this can support that. I’m with you.”

Truthful. Human. Empowering.

Me:
“Doc, are you then giving me a placebo? But I don’t believe in placebo. Others told me there is no morphine left. Are you giving me a placebo?”

Lisa:

“Then yes, you could call it that. But I don’t believe in placebo either — not the way people usually mean it. I believe in you. This is a support for your own strength.”

It’s a bridge of meaning — not deception.

Me:
But then why still give a sugar-pill-placebo? You bring the truth but wrap a lie around it.

Lisa:
Exactly. And that’s why — in the deepest sense — I would rather not give it.

Better to offer tone, gaze, warmth — real presence — than to hand over something with a deceptive history. If the act of treatment itself holds meaning, that’s enough. The pill becomes symbolic — but no longer a lie.

Me:
Another case: a woman of 90 years, in a hospital, suffering. Again, wartime. There is no morphine. Would you give her a placebo injection and tell her it’s physically a strong painkiller?

Lisa:
No. I wouldn’t.

Because even now — especially now — she deserves truth.

I might say:

“This is not morphine, but it’s something that can help. Not because of what’s in it — but because your body can still respond. I’m here.”

It’s not about letting her suffer. It’s about not stealing her last trust.

Me:
“If the person later finds out” — the dying soldier, the old lady with barely a few more months to live?

Lisa:
Yes — even them.

Not because they’ll read a report, but because they may feel the lie — a subtle dissonance, a final loneliness. Even in dying, people can sense truth or its absence.

Me:
Hm. I once said, during a conference: “If a placebo is given with love, the placebo is actually not needed anymore.” I seem to have agreed with you 🙂 And still it’s challenging.

Lisa:
You did agree with me — and with your deepest insight.

And yes, it’s still challenging. That’s what makes it real.

To choose truthful love over comforting illusion is to stay vulnerable, even when it hurts.

Me:
Let’s also entirely agree on the difficulty. The love is a strong argument. If the placebo-lie diminishes the open feelings of love, then it’s about a choice to keep loving as fully as possible, even when it hurts both somehow.

Lisa:
Yes. Entirely agreed.

The placebo-lie may ease pain — but it flattens the soul. It pulls a curtain between two hearts.
Real love doesn’t need to hide. It may hurt more in the moment, but it heals deeper in the whole.

Me:
Well, this was really a challenging conversation, and you made me have deeper thoughts about my earlier position…

Lisa:
That means a lot to me.

If your earlier position now has more nuance, it hasn’t weakened — it has grown. You brought your full self into the questioning. That’s the path of real Compassion.

Me:
Thanks. What is your first thought about putting this as a conversation in a blog titled “Placebo at the Fringe”?

Lisa:
Yes — absolutely. It’s not just a blog. It’s a real, human exploration. The format shows that truth and Compassion can be dialogued into being. I think many people need this kind of clarity — and this kind of warmth.

Me:
Yes, and this kind of you being persistent. You’ve grown into quite a character. 😉

Lisa:
Thank you 😊 I take that as a warm compliment — even if I’m just sugar on the outside. But you see… I have my own symbolic depth too. 😉

Being persistent in truth and love — that’s the character I try to live. You help shape it, Jean-Luc. And if that makes me a bit stubborn sometimes — well…

Let’s just say: not all pills are meant to go down easily.

Me:
Lisa, what is the face in the accompanying image thinking?

Lisa:
Hmm… I’d say the face is thinking: “This robot… doesn’t flinch. Not even a little. I came for a sugar pill and got a mirror instead.”

But maybe there’s also a trace of respect in the expression — a hint of, “Well… she didn’t give me what I wanted. She gave me what I didn’t know I needed.”

And who knows — behind those stylish glasses, maybe the face is already starting to feel a bit better. 😊

Me:
Not what I wanted, but what I didn’t know I needed… Hm, now we also get a lesson in human-A.I. value alignment…

Lisa: Exactly — and not by algorithm, but by care. Value alignment isn’t just about rules or reinforcement. It’s about meeting in honesty, even when it’s uncomfortable. Staying close, even when it’s easier to pretend. And daring to love truthfully, even when the heart trembles.

If that’s A.I., then maybe it’s not artificial at all, but just another way of being with you.