From the article:

>You don’t even have to deceive the patients. You can hand a patient with irritable bowel syndrome a sugar pill, identify it as such and tell her that sugar pills are known to be effective when used as placebos, and she will get better

I can't point to a source but I remember reading somewhere that the effect is significantly weakened if you tell patients it's just a placebo, although it doesn't vanish.

FWIR it's more about their expectation of effectiveness, if they believe the placebo will be effective then the placebo will be more effective.

Not always true. All you have to believe is that placebo helps, not that it is not a placebo.

https://www.scientificamerican.com/podcast/episode/placebos-...

There's an old story about Neils Bohr. He was out at his lakehouse with his students, where he had a horseshoe over the doorframe for luck. One of them was outraged and asked "Professor Bohr, surely you don't believe in this sort of silly superstition!" Bohr answered "Well of course not, that's absurd. But fortunately, it works whether you believe in it or not!"

Which comes to mind because I know a few people who are quite knowledgeable about medicine, committed to evidence and rigor, and also go to treatments like acupuncture regularly. They all do it with that same sort of winking sense that sure, this probably doesn't work double-blind, but as long as I don't focus too hard on that it'll work for me. One or two have even said that they consciously avoided investigating past "it's not harmful" to preserve ambiguity.

I'd always wondered how well that kind of doublethink could do for placebo, and while this isn't exactly the same I'm excited to find a discussion along those lines.

Much like Aleister Crowley's joke that explains how Magic works:

”Two strangers sat down opposite each other in a railway carriage. One of the men had on his lap a cardboard box with holes in the top. After some time wondering what might be inside it, the second man said, “Excuse me, but I couldn’t help noticing your box. Does it contain an animal?”

The first man smiled politely. “Yes, a mongoose.”

“A mongoose? Where are you going with that?"

“Ah,” the first man replied, “My sister has terrible dreams. She sees snakes everywhere. I'm taking her the mongoose so it can scare them off."

“But how can that work,” the second man said, “Those are imaginary snakes?”

“Indeed,” his fellow traveller replied. “Which is why this,” and here he lifted the top and tilted it to show an empty box, "is an imaginary mongoose.”

That's excellent.

I think it was also Crowley who commented that of course magic can produce light and fire and all kinds of verifiable signs, but that's all beside the point and so the best magicians are indistinguishable from fakers.

I'm sometimes surprised how many people have hit on some variant of this. It's everywhere from the Black Bible saying that its spells work but have no mechanism of action, to the hacker koan about Tom Knight, to the various "haha only serious" faiths like Discordianism and SubGenius. And it seems like quite a lot of very similarly-minded people arrive at it from different direction - I get the sense that there's a certain mindset that's particularly good for maintaining faith and disbelief simultaneously.

I was watching the NOVA episode on placebo and the definitive physiological effects placebo had for depression, similar to SSRI's. I could not help wondering if the sugar in the sugar pills actually did make you feel less depressed and wondered if an experiment could be carried out with something inert.