{"id":7174,"date":"2021-07-27T08:37:49","date_gmt":"2021-07-27T08:37:49","guid":{"rendered":"https:\/\/aurelis.org\/blog\/?p=7174"},"modified":"2021-07-27T08:37:50","modified_gmt":"2021-07-27T08:37:50","slug":"placebo-in-chronic-functional-pain","status":"publish","type":"post","link":"https:\/\/aurelis.org\/blog\/pain\/placebo-in-chronic-functional-pain","title":{"rendered":"Placebo in Chronic Functional Pain"},"content":{"rendered":"\n<h3>This is the blogified abstract of a congress talk that I delivered in Montreal several years ago.<\/h3>\n\n\n\n<p>You find the whole talk as delivered in Montreal at [see: \u201c<a href=\"https:\/\/www.researchgate.net\/publication\/347891748_Placebo_as_Communication_to_Neuronal_Networks_in_Chronic_Functional_Pain\">Placebo as Communication to Neur(on)al Networks in Chronic Functional Pain<\/a>\u201d]<\/p>\n\n\n\n<p><strong>Meaning, expectation, hope, belief\u2026<\/strong><\/p>\n\n\n\n<p>These can be seen as alternative explanations for the placebo effect, as different mechanisms through which the placebo \u2018works,\u2019 or different ways to approach one underlying phenomenon conceptually.<\/p>\n\n\n\n<p>In each case, we still have to explain how, for instance in the domain of placebogenic pain relief, the psychological, \u2018immaterial\u2019 construct translates into something \u2018material,\u2019 such as endorphin release in the brain. This is the old Cartesian problem of mind\/brain dualism.<\/p>\n\n\n\n<p><strong>Connectionism<\/strong><\/p>\n\n\n\n<p>After three decades of almost purely cognitive symbolic theorizing, connectionism came fully back in the 80ies, with the landslide double-book by Rumelhart &amp; McClelland \u201cParallel Distributed Processing\u201d (PDP) in 1986.<\/p>\n\n\n\n<p>The idea is that any concept (thought, feeling, meaning\u2026) is equivalent in the brain to the activation of a network of neurons. Each such network (or pattern) is distributed over a large area of neurons. Many patterns can be active simultaneously, in parallel.<\/p>\n\n\n\n<p>The involved neurons contain only sub-conceptual information, the complete concept being emergent from the activation of a pattern.<\/p>\n\n\n\n<p><strong>Meanwhile, a torrent of cognitive data are compatible with this theory<\/strong><\/p>\n\n\n\n<p>not opposing cognitive symbolism but complementing it.<\/p>\n\n\n\n<p>In the field of Artificial Neural Networks (branch of A.I.) this has led to many breathtaking realizations.<\/p>\n\n\n\n<p><strong>This theory solves the Cartesian problem.<\/strong><\/p>\n\n\n\n<p>The activation of a pattern is not \u2018causal to\u2019 but indeed equals \u2018having a thought.\u2019 A neur(on)al pattern can be seen as something \u2018immaterial\u2019 and \u2018material\u2019 simultaneously.<\/p>\n\n\n\n<p>As an analogy, the paint and canvas of a painting are \u2018all there is\u2019 materially seen, yet should not let us forget the art, which is what the painting is about.<\/p>\n\n\n\n<p><strong>Subconceptual Processing Theory<\/strong><\/p>\n\n\n\n<p>This further develops PDP, forming an explanation in one parsimonious sweep of placebo, empathy, consciousness, subconscious mental processing, the etiology of chronic functional pain, etc.<\/p>\n\n\n\n<p>Any concrete \u2018feeling of pain\u2019 is an emergent perception that equals the activation of one or more neur(on)al patterns. A suggestion (such as diminished pain) surrounding an analgesic placebo can be seen as communication with such patterns. The match at this level is direct.<\/p>\n\n\n\n<p><strong>Moreover, one can open up placebo towards this level<\/strong><\/p>\n\n\n\n<p>making it possible to use the underlying phenomenon of placebo in a direct, rational and overt way in full respect to the patient, as indeed we have done and are further investigating.<\/p>\n\n\n\n<p>As another domain that makes heavy use of suggestion, hypnosis has taught us quite a lot about how to do this. That makes the question of whether placebo deception is appropriate, at least partly obsolete. Even more, it shows us that:<\/p>\n\n\n\n<p><strong>Placebo is only one way to \u2018communicate directly with subconceptual patterns\u2019.<\/strong><\/p>\n\n\n\n<p>It may not even be the most efficient, let alone ethical way.<\/p>\n\n\n\n<p>Opening up placebo this way brings human warmth, deep meaning, and hope in an entirely rational manner back into the center of medicine as a whole.<\/p>\n<div data-object_id=\"7174\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_no_cat cbxwpbkmarkwrap-post \"><a  data-redirect-url=\"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174\"  data-display-label=\"0\" data-show-count=\"0\" data-bookmark-label=\" \"  data-bookmarked-label=\" \"  data-loggedin=\"0\" data-type=\"post\" data-object_id=\"7174\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\"  style=\"display:none;\" > <\/span><\/a> <div  data-type=\"post\" data-object_id=\"7174\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-7174\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3>\n\t\t<form name=\"loginform\" id=\"loginform\" action=\"https:\/\/aurelis.org\/blog\/wp-login.php\" method=\"post\">\n\t\t\t\n\t\t\t<p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Username or Email Address<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p>\n\t\t\t<p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Password<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p>\n\t\t\t\n\t\t\t<p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Remember Me<\/label><\/p>\n\t\t\t<p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Log In\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174\" \/>\n\t\t\t<\/p>\n\t\t\t\n\t\t<\/form><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>This is the blogified abstract of a congress talk that I delivered in Montreal several years ago. You find the whole talk as delivered in Montreal at [see: \u201cPlacebo as Communication to Neur(on)al Networks in Chronic Functional Pain\u201d] Meaning, expectation, hope, belief\u2026 These can be seen as alternative explanations for the placebo effect, as different <a class=\"moretag\" href=\"https:\/\/aurelis.org\/blog\/pain\/placebo-in-chronic-functional-pain\">Read the full article&#8230;<\/a><\/p>\n<div data-object_id=\"7174\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_no_cat cbxwpbkmarkwrap-post \"><a  data-redirect-url=\"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174\"  data-display-label=\"0\" data-show-count=\"0\" data-bookmark-label=\" \"  data-bookmarked-label=\" \"  data-loggedin=\"0\" data-type=\"post\" data-object_id=\"7174\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\"  style=\"display:none;\" > <\/span><\/a> <div  data-type=\"post\" data-object_id=\"7174\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-7174\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3>\n\t\t<form name=\"loginform\" id=\"loginform\" action=\"https:\/\/aurelis.org\/blog\/wp-login.php\" method=\"post\">\n\t\t\t\n\t\t\t<p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Username or Email Address<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p>\n\t\t\t<p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Password<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p>\n\t\t\t\n\t\t\t<p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Remember Me<\/label><\/p>\n\t\t\t<p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Log In\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174\" \/>\n\t\t\t<\/p>\n\t\t\t\n\t\t<\/form><\/div><\/div><\/div>","protected":false},"author":2,"featured_media":7175,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"spay_email":"","jetpack_publicize_message":""},"categories":[27,71],"tags":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/aurelis.org\/blog\/wp-content\/uploads\/2021\/07\/1128.jpg?fit=963%2C557&ssl=1","jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p9Fdiq-1RI","jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174"}],"collection":[{"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/comments?post=7174"}],"version-history":[{"count":1,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174\/revisions"}],"predecessor-version":[{"id":7176,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/posts\/7174\/revisions\/7176"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/media\/7175"}],"wp:attachment":[{"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/media?parent=7174"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/categories?post=7174"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/aurelis.org\/blog\/wp-json\/wp\/v2\/tags?post=7174"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}