Saturday, August 17, 2013

Social Placebos

The theoretical psychologist Nicholas Humphrey argues that humans are genetically programmed for caution. As an example of this, he cites the curious effectiveness of placebos.

Consider what happens when the human immune system fights a disease. Suppose you have a disease that causes you to function at 90% of your usual capacity. You could struggle on for weeks at this level, feeling slightly run-down. Or your immune system could mobilize a full attack on the disease, during which you will feel terrible, you may have a raised temperature and other unpleasant symptoms, and you may be unable to carry out your normal activity for a few days. Most of the symptoms of disease are actually caused by the immune system trying to eliminate something or other.

In some situations, a full immune system response might be dangerous, as it makes you vulnerable to all sorts of environmental threats that you would be unable to protect yourself against. So instead of responding instantly to the first signs of a disease, it makes sense for the immune system to wait until the person is in a safe place to undergo this phase. For example, shelter, warmth, supply of food and water, someone else to keep the fire burning and watch out for wolves.

So what kind of signal triggers the immune system to start fighting? We can identify three possible signals. Firstly, when the person stops working hard and enters a period of relaxation. (This is why so many people get ill on holiday and at Christmas.) Secondly, when the person anticipates some future period of stressful hard work. (This is why so many people get ill before exams.) And thirdly, when the weather changes. (Which is why people get ill in the Autumn and Spring.)

According to Humphrey, the placebo acts as another signal of this kind. Especially when provided by a healthcare practitioner with the appropriate bedside manner, it indicates to the immune system that it is safe to mobilize a full response. It is as if the witch doctor is providing some level of "reassurance" to the body.

In a recent article, Humphrey extends this idea to social placebos, or what he calls Placebos at Large (New Scientist, August 2013, subscription required). He suggests that social symbols and rituals perform a similar reassuring function, allowing people (individually and collectively) to take bold action.

People love mocking "health-and-safety" regulations, promoted by the much-derided "nanny state", as if these regulations hold us back from being the enterprising, rebellious souls we would otherwise be. Humphrey quotes the sociologist Frank Furedi, who says, "in a world where safety has become an end in itself, society constantly promotes symbols and rituals to transmit the need for caution".

Humphrey offers a contrarian interpretation. He believes that in many areas of our lives we humans are, by nature, cowards. Left to follow our instincts we tend to be much more cautious than we need be – indeed, more cautious than is good for us.

So we are often presented with warnings that don't tell us anything - such as packets of peanuts that solemnly announce that they "may contain nuts". By laughing at these unnecessary warnings, we are able to project our real fears of alien food onto some bureaucratic Other, and feel (irrationally) reassured in the illusion that packaged food is safe for everyone except those with weird and antisocial food allergies.

Thus the implicit message of these warnings is a paradoxical one - no need to worry, nanny will do all that nasty worrying for us. Nanny as witch-doctor.

And in the corporate world, there is a wealth of corporate signals and rituals that are used to enable corporate change, including the appeal to corporate witch-doctors, also known as consultants. People often complain that corporate placebos and platitudes don't work - but the point is that they actually do work, but in a mysterious way. Isn't this an example of what Margaret Heffernan calls Willful Blindness?

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