(music) Placebo, Belief and Expectation Let me bore your pain away #32 Jason Newland 5th May 2025

Hello and welcome to Jason Newland.com. My name is Jason Newland and this is Let Me Bore Your Pain Away. Please only listen when you can safely close your eyes. Also, only listen to this when you know the cause of your chronic pain and you have permission from your doctor to listen to this.

Otherwise, please gain permission from your doctor or your medical practitioner. This is not a replacement for therapy or any medical advice. This is just me chatting about the subject and hopefully in the process helping to reduce the physical discomfort that you've been feeling.

I'd like to say thank you to those of you that listen because these recordings have become, I don't want to use the word popular because that's a bit overstated, but they've definitely become one of my more popular podcasts now. And yeah, so I appreciate that because I've only really been doing regular, regular ones of these more recently. And when I started doing them, when did I start doing them? I'm just going to go back, have a quick look.

The first one I did was 18th of August 2022. And then the 10th one I did was 2nd of January 2025. So you see there was quite a big... I did five in 2022.

And I think I did three in 2024 or three, you know, anyway, so I'm now at number 32. Now this is the 32nd one. So I've done quite a few this year.

I think it's making some weird noises. Right, I'm distracted. So before I go on, just let you know that my website has all my recordings, which you can stream and download.

There's also in the menu, you've got podcast apps, you've got playlists and podcasts. So you can kind of go through lots of different things, thousands of recordings. And I've got a Facebook group called Jason Newland's Boring Group.

I may shortly have an Instagram group. And what else? Oh, I've got a YouTube channel at Jason Newland, which is basically every podcast I do goes onto the YouTube channel now. So it's another place, another place you can listen.

I did, I got rid of my SoundCloud accounts, which I didn't realize was going to have an effect on people. So I had a few people contact me, I've tried to get them back, but they're deleted now. So they're gone.

But you can listen to me. On my website, you can listen on all of the major apps, podcast apps, Spotify, Apple podcasts, CastBox, all those. And also on YouTube, as well as directly on my website.

And I post all the new recordings on to my Facebook group. Wow, that was a lot, wasn't it? So today, I just had the urge. I don't really know why.

I feel the urge to talk about placebo and belief, which may seem like a strange thing to talk about when it comes to chronic pain, relief. But it's Yeah, in a sense of like, if you give someone a placebo, placebo tablet, if I can say the word, then you know, is it going to have the placebo effect? Probably not. I'd say possibly definitely not because it works because they don't.

They don't know it's a placebo. It's kind of logical, I suppose, really. And I thought I'd look into this, the placebo effect in chronic pain, just out of interest, really.

Because the placebo effect is something that has been and is still used today. In studies, scientific studies, medical studies, to find out the efficacy of maybe a new medication or a new treatment. And, you know, they put people into groups, give the correct medication to they give medication to all three, but they don't tell the three groups who's in each group.

They'll all have the same condition. And let's say it's a new diabetic medication, or it's a new pain relief for someone with arthritis in their foot, for example. So your three groups, one gets the new medication, one gets no medication, and one gets the placebo medication.

So you've got three people. That's probably not a good example. I'm not sure if the one who gets no medication, because that would be placebo.

But so you've got ones that just have no medication. And it's to see how the person feels after a week or two weeks or whatever. Because sometimes people with no medication can have effects that are positive as well.

Or maybe they'll have one group that has just has the old medication. But they won't tell the people what it is. So they'll get tablets.

So if they said they got two groups, I'm not explaining this very well, am I? Yeah. So you got both two groups, both get in placebo, both get in tablets. I should have thought this through before I started.

I thought about it in my head for about five minutes. And which shows you how much effort I go into. So one group has the new medication.

One group has the placebo. Now, neither of them know which they're going to get. And then they judge about whether or not it works.

And it's like this new drug that's supposed to be useful. And they test it. And the placebo generally always get a high level as well high level of success.

Now, I think if the people are told there's two groups, one of you is going to get the new medication, one of your group is going to get the placebo. I think if someone's told that there's a 50% chance that they're going to get a placebo, which will just be like a sugar pill, which has nothing, mind you, a pill full of sugar would be quite nice, unless you're diabetic. And I'm kind of on the cusp of diabetes at the moment.

So I love sugar. But it doesn't love me back. You see the size of my back.

Anyway, so if you know there's a 50% chance of placebo, how's that going to affect the outcome? It's a weird one. But anyway, I kind of done a little bit of research a little bit of a little look, kind of a roots up exploration of how placebos can help to relieve chronic pain. And sort of looking into psychology, neurobiology, and some clinical data.

So I'm just like looking, looking through it and just seeing what comes up. Now, when I first started learning about hypnosis, and learning about NLP, which is neuro linguistic programming, placebo was mentioned a lot. The idea that actually telling someone that a sugar pill is just the pill that they get mean given is a new wonder drug.

And if the person really believes it, because it's about belief as well. So that's why I'm kind of looking at placebo and belief. Because without belief, the placebos doesn't have the power.

placebo needs that energy of belief. And that's Vinny in the background, chomping on a chew, chewy bony thing, in case you're wondering what the noise is in the background. In a way, hypnosis is reliant upon, I would say, I don't know, it's not reliant on belief.

But there's the more belief you have. For example, if you listen to me regularly, maybe you've listened to me for years, doing other different recordings. Maybe you've been listening to these recordings for years.

Although there was quite a big gap between each recording. And you're a regular listener, or you become a regular listener, you're going to expect to feel more relaxed. You're going to expect me to come out with some weird things as well, which I'm going to do, I'm going to say some stuff that you won't normally hear in these kinds of recordings.

But you'll also, that expectation is mixed with belief. Because you believe, what is expectation other than you believe something's going to happen, you believe that you're going to have, you're going to feel a certain way. So to say you expect to feel relaxed is you believe you're going to feel relaxed.

You expect to, for the part of your body that was troubling you before, to feel more comfortable is that you believe that you're going to feel more at ease and more peaceful and loose and calm in that part of your body. So that's kind of what expectation is really, isn't it? It's just belief. And so placebo and belief as well is kind of the same word is placebos expectation, it's expecting something to happen, something positive to happen, because you believe that it's going to happen.

So you expect to feel relaxed in your body, you expect your mind to calm down and become slower, your thoughts slowing down and almost to the point where you realise they're not necessarily needed right now. As you focus on my voice, you expect that and you believe it's going to happen because it's happened before maybe. You know, it's like a, I don't know, like self fulfilling prophecy or something like that.

I'm not sure if prophecy is the right word. That sounds way too spiritual, way too esoteric for me. So I think everyone knows what the word placebo means, but I'll mention it just in case.

You should see what the correct definition of is in the dictionary. So look, a placebo effect is the portion of symptom change produced by the psychosocial context of treatment. Expectations, conditioning, therapeutic ritual, rather than by any direct pharmacological or physical action of the treatment itself.

Wow, that's a mouthful, isn't it? So it's based and you think about it, yeah, placebo has a lot to do with healing anyway. So if someone goes to have an operation, hip replacement, for example, and they're expecting to feel relief when they wake up after the operation, they're expecting to feel grateful because they're no longer going to be having that discomfort that they used to have. They're expecting to, to be walking, they can imagine themselves walking freely again soon with a bit of rehabilitation, a little bit of rest, a little bit of exercise, physiotherapy, whatever.

But their expectation is positive. And a belief is there that it's just a very positive situation. And because it's such a, I'm not going to say simple operation, it's just a very often done operation.

Millions of them are done around the world every year. So it's one of those almost like just a stand, it's almost like having your tonsils out now. It's not, but you know, I mean, it's like the fear that would have been there 50, 40 years ago doesn't need to be there anymore, because it's, you can literally knock on the doors in your street and probably find two or three people have had their hip replaced, hip replaced, hips replaced.

If I can get the words out. I mean, you might only live in a small road, so maybe not in that road. But just on my little estate where I live, I've met three people that had their hips replaced.

It's kind of more of a standard thing these days. So when you expect the recovery, when you expect to feel calmer, and to feel that relief, then your healing is going to improve. And that belief is technically a placebo effect, because you've almost talked yourself into believing that that during, or before, during and after the operation, you're going to be fine.

And every stage, every step of that process leads you towards freedom, leads you towards where you want to be, where you're looking forward to being. So it's kind of powerful that, I quite like that, you know, the idea that we actually use that placebo effect on ourselves. And it's more powerful when we do it on ourselves.

But it doesn't seem like a placebo effect. Because it's real. It's not a little sugar tablet.

It's not a fake, fake medicine. No one's tricking you. No one's pulling the covers over your eyes.

You know, I mean, no one's like manipulating you. And you're not manipulating yourself. You're not tricking yourself.

You just believe, based on the evidence you have, that everything's going to work out fine. And when you've got that belief, and the expectation that when you wake up from the operation, you're going to actually feel relaxed and calm. And you'll almost feel that part of your body healing.

Like it's healing in front of you. You're observing it heal. So that feeling that maybe before you would perhaps have given it a name, you know, the thing could begin with P. Maybe you experience that physical sensation in a different way.

So it's now begins with H. Healing. I did notice years ago, this is weird, I had a really dodgy back. And my upper back, not my lower back.

So I've got arthritis in my lower back. But my upper back was problematic. And I think there's a lot to do so I don't get... Back then, I wasn't getting out enough.

And I went to the doctors, and they put me on these super strong medication to help with it. So of muscle relaxers, and because it is muscular, and made my brain go weird, to be honest with you, I had to stop taking them. Because it was weird that they didn't really agree with me.

And I thought they were just painkillers, but they weren't. They were as well, but muscle. Like, nah, no thanks.

So I've got this strap, strap on thing, where I should rephrase that, shouldn't I? It was like a brace, back brace thing. Is that the right word? And my friend helped me put it on. It was basically to, not to stretch, but to straighten, I suppose, just straighten my back.

Because I was a bit of a sloucher, which is weird because I'm only three foot tall. I should be looking up at the sky a bit more often. Oh, look at those things, what's that? Clouds.

And it was weird because I didn't like it, so I took it off. But I started doing exercise, and after about two weeks of doing gentle exercises, gentle stretches, and going for regular walks, I was in the field, and I was walking Andre. This is, you know, a few years back.

And I could feel my lower, no, I could feel my back, but I had a different feeling. It was almost like it was the same feeling, but it felt different, if that makes any sense. I wasn't seeing it, I wasn't experiencing it, I wasn't thinking about it in the same way.

It was, and I said this before, and I don't know why, but I sometimes feel that when the part of your body that maybe needs to be feeling more relief, more calmness, it's like my lower back, sometimes, if I give it a bit of attention, a bit of love and kindness, you know, a bit of whatever this is, you know, a bit of calm, a bit of, you know, sometimes it feels a little bit itchy, not scratchy itchy, but just a little bit, oh, almost like parts of that part of my body, parts of it

are kind of, I don't know how to explain it. Do you know that, um, that sherbet you can get, and you put it in your mouth and it starts to sparkle? I don't know, it's got this really, I just love it, and it just like, basically pops out of your mouth, it's like, it's really nice. I mean, I haven't had any since 2004, but, which is weird that I remember that, it was Christmas.

I did a lot in 2004, but it's a whole year, isn't it? And it felt a little bit like that, like it was coming out of my back, like a gentle sparkling, definitely a feeling, but not a feeling that felt the same as what it was before, so your part of your body don't feel the same, it feels having that sparkly kind of sensation, which is strange, but it's at the same time, unusual, maybe not, might not class as pleasurable, but it's definitely a weird sensation. Yeah, so I get that sometimes, and I just, I

noticed that back then, when my back kind of sorted itself out. That's another thing that I found weird, while my upper back was being problematic, my lower back, I had no problems with it.

It's almost like I could only focus on one part at a time. My body would only allow me to really, it's like it could only be grumpy at one part of my body at the same time, it couldn't be grumpy at more than one part. It's weird.

I suppose if I really tried hard, I might be able to, but it's a little bit like pleasure, isn't it? It's sometimes focused, or when you've been doing a lot of walking, you take your shoes off. What do you notice? First of all, you notice how much relief your feet have. Or if you get in from a cold day, you walk in and you take your coat off, and you realize how loose your shoulders feel, because they were kind of a little bit restricted before.

You might notice how light your body feels not having that big coat on. And when you take your parachute pack off, you realize, oh, it's much easier to walk without that one back. Next time I go to the supermarket, I'll leave it at home.

That's all these little things just like you notice. And when you sit down after, you know, you've been busy, like, oh, it's nice. Or you close your eyes.

And all you can hear is Vinnie doing his utmost to be as noisy as possible in the background. So look at a placebo effect for the subject that we're focusing on. So, basically, and I'm sure a lot of people would know about neuroplasticity, and which is, or neuroplasticity, which is something that neuroscientists have really kind of, it's not like a recent discovery, but I've read a couple of books on it.

And it's fascinating. A lot of the technology, or a lot of the knowledge rather, has come from people that have had medical conditions affected the brain, which has then affected parts of the body, like with restrictions. And how that there was kind of for a while a fixed idea that well, first of all, the left side of the brain operates the right side of the body, the right side of the brain operates, operates the left side of the body.

And there's certain parts of the brain operate speech, and all these different things, which is, you know, it's true. But when someone, let's say, has had a stroke, the, I don't really like mentioning medical conditions when I do these, but they realize that the brain can start to rewire and change, sort of rewire itself, so that the parts that wouldn't normally be used to operate the other side of the body start doing so. And hence, I think the term plasticity, neuroplasticity, I could say the first two times, the second and third, the first two times, and the second and the third, I think it might be time to go to bed.

So neuroplasticity, it can affect, it can help, you know, basically your brain changes, your brain can adapt, it's not set. And it's, these are the old things, remember I used to say, oh, you can't teach an old dog new tricks, and oh, he's setting his ways, and then, and all that stuff. Well, actually, what I'm really saying, I think all them years was, your brain is set, that's it, and that's all you got.

And I think it's quite exciting, really, the idea that actually we're not just set, our brains are not just set in stone, and that's all we've got. You know, it's like, a house is wired, and that's it, or we've got one, or a computer, imagine if we were still running our laptops or our computers, off of Windows, the first Windows, which is probably what, the 90s, in the 90s. We couldn't do any of the stuff we do now.

Or we still have the same, you know, it's the circuitry, everything changes, and it's adapted, and I realise that's man-made, but the brain adapts. And even now, you know, even neuroscientists and specialists, they're still only, only got started on the brain, really. They still know a million times more than I'll ever know, but in, compared to what they will know in, let's say, 20, 30, 50 years time, they've just started.

It's phenomenal. I mean, in 50 years time, the brain and computers and all that stuff, it will all be mixed together anyway. I mean, there's already Neuralink and all that stuff that's already being done, and it's amazing.

I think it's absolutely amazing that someone who, 10 years ago, well, you could say now, is maybe stuck in a wheelchair, quadri, quadriplegic, can't move, can't do anything, and with a small procedure, they can start to do things, start to use a computer just with their thoughts, and maybe even have one of those skeletal, robotic skeletal frames. There's so many things can be done. It's phenomenal.

Stuff like that excites me. Don't understand it all, but it excites me. But then, a chocolate Easter egg excites me, so it doesn't take a lot, to be fair.

So, I'm just having a look. There's quite a lot of information here about placebos. The main thing, really, is placebos have shown to be effective, and there was a story, probably years ago, I don't know if it's true.

In fact, I might just look this up. So, stories of when placebos were effective. It's very hard to type and talk at the same time, which is weird because that's what I used to do for a living.

I wasn't just typing and talking, but I was working in a call centre, typing the whole time and talking as like now. So, I just thought, I suppose the question is hypnosis placebo? Now, you know, this is not a hypnosis session. This is not a therapy session.

This is just me talking about placebos and belief in conjunction with chronic pain. That's what this is, in the hope that it might help to be useful. Because I do say, I mean, I didn't say this time, but quite often I will try and say, notice how the part of your body feels at the beginning of recording, or before you start listening to the recording, zero to 10, 10 being, zero being the lowest and 10 the opposite.

And then notice how you feel at the end. You know what? We can introduce something else into the melting pot that is placebo and belief, superstition. I mean, ultimately, isn't that what superstition is? It's believing in something.

It doesn't have to make sense. And quite often, with superstitions, there is no sense to it. There is quite often no logic to it.

But it's about how it feels for that person. I remember when I was in sales, there was this bloke and what was his name? Steve, Steven. Okay.

Excuse me. I'm spoiling myself. He, yes, no, it's Steve.

Anyway. Make a bit more noise, please, Vinnie. Whatever his name was, he had this thing where he would go up, because there'd be a board.

And every time he'd get a sale, he'd go up and write down the number, you know, change the number from seven to eight or whatever it is. And what he used to do, he'd wipe it out, put in the new number, wipe it out, put in the new number, wipe it out, and then put in the new number again. So he'd wipe it out, he'd wipe out the new number twice, wipe out the old number once, then he'd wipe out the new number twice, and then put it in lastly.

And that was his superstition. He was one of the best sellers. It was only car insurance, but he was still, he literally put no effort in selling.

In a sense of it is natural. And he just did it. He was so good.

So naturally good at what he did. And the sales manager decided, you know, in their, in their little thing is, they decided, you know what, you tell us when you got a sale, and we'll put it on the board. And he stopped selling.

Because he wasn't going up there and doing it himself. It affected him. He wasn't getting the sales that we normally get.

Now, some would argue, well, it's that. Maybe it's that walk. It's that like, getting up and showing everyone that he's got another sale.

Maybe it's just that break that process, that procedure, that ritual. Another thing people would do to wind him up is that actually rub out the number. So you have to keep getting up and put the number and we'd wipe it out for twice before putting it in again.

And people just to wind him up knowing that it was something it was superstitious about, and then wipe it out just to wind him up. And it affected his performance. So I found that quite interesting.

I personally have been, this is an old trick, but I'd never heard of it before. And when I was 17, 16, 17 working in a chip shop. Yeah, I turned 16.

So I was 16. Went around my boss's new house. And all the staff around there, we were drinking.

I got drunk. And then at the end of the evening, everyone gathered around as he showed me that I'd been drinking non-alcoholic lager the whole time. And everyone laughed at me.

So again, that's a placebo, isn't it? It was a horrible experience. And, you know, it wasn't a nice, nice thing to do to someone. But I genuinely felt drunk until I saw that it was not alcohol.

I wonder if they'd have given me alcohol all night and just showed me that I wasn't drinking. They showed me like, oh, you've been drinking non-alcoholic. How would that have affected me? Because the alcohol is already in my system.

I don't know. That's just just chucking it in the air, really. So.

You got some things here. There's this actual. So look, so here's a study was done.

It's Houston, Texas, USA, VA Medical Center, 1995 to 2000 orthopedic orthopedic orthopedic surgeon J. Bruce Mosley recruited 180 military veterans with grinding knee osteoarthritis. It's weird, isn't it? Just the description lets you know exactly what it is. In the operating room, a third received the usual arthroscopic debridement.

And which I'm pretty sure is filing, filing it down. Another third got an arthroscopic leverage. I've got no idea what it is.

And the final group had nothing more than three skin insertions while the team pretended to operate moving instruments, splashing saline and even talking through a fake procedure. So. So what's that? 60, 120.

So 60 people had nothing done other than a couple of insertions under local anaesthetic. And. No treatment whatsoever.

Wow. Two years later, the sham surgery group could walk and climb stairs every bit as well as those who'd had the real operations. Pain scores overlapped completely.

And one participant later told reporters he'd run out of excuses not to mow the lawn. The trial reshaped orthopedic guidelines around the world. So there's some things that perhaps they wouldn't be allowed to do anymore.

But isn't it interesting, don't you think, that believing that you can feel relaxed and believing that you can recover fully and believing that you can have relief, maybe believe that you deserve relief. Expect relief. So this is a study in Lisbon, Portugal, 2016.

Right, just let you that that last one. Controlled. This was in the National Library of Medicine.

And. So, yeah, wow. OK.

Citation. Mosey, JB, O'Malley, K. Peterson, Menk, Brody, Kuykendall, Hollingsworth, Ashe, Ray. So controlled trial of osteoscopic surgery for osteoarthritis of the knee.

That's just I just absolutely it boggles my boggles my noggle that does. So this one is Lisbon, Portugal, 2016. Capsules literally labelled placebo.

That's funny. Literally labelled placebo. Eased, stubborn, low back pain.

So 97 adults whose backs had ached for an average of 14 years were split into two groups. Both kept their usual treatment. But one group also took two white pills twice a day from a bottle that read open label placebo in bold letters.

It's hard to read that out without laughing, to be fair. And. Not everybody's going to know what the word placebo means, but possibly I'm just chucking it out there.

I imagine most people do, but then. If it was in Portugal, was was it written in English or was it written in Portuguese or in Spanish? So, you know. That's just a few questions to cover in my head.

Anyway, after just three weeks, usual and worst pain were down about 30%. A change large enough for clinicians to call it much improved. I'd say down 30% is much improved, wouldn't you? Minimum pain felt 16% while actually rose while in control.

Minimum pain fell 16%. But in the other group, it actually rose 25%. So the people that didn't take the placebo pills.

Didn't. And then there's that one. That's that's the thing.

Do you imagine if you're in two groups? Well, you're only one group, but there's another group. You're both. Both groups got the same condition.

So let's say for my example, everyone in my group's got lower back arthritis like me and all the other group have got it as well. Same thing, same situation. We're all doing our exercises.

We're all doing what we need to do and, you know, to try and help it. But I'm in a group and the other group are taking these pills. I'm not I'm not allowed to take these pills.

And maybe I feel put out like that's not fair. We're in a trial study. They're the ones with the pills.

Maybe not knowing that they're placebo. Thinking so in a sense, the placebo effect is working opposite. It's a negative placebo effect on the other people watching and thinking you've got the good pills and it's helping you.

Which. Has the opposite effect by making them feel worse. Maybe it's just just checking that out.

So no deception, just a clear explanation that placebos activate mind body self healing. And. I mean, they do, but generally, I mean, placebos do activate mind body self healing and they do help to relieve chronic pain and to help someone feel more relaxed.

I mean, usually if the person don't know it's a placebo, the fact that they know it's a placebo, that is. A bit. I don't know.

Very fascinating. So but then you think about it sometimes. By taking action.

Whether it's. Listening to a recording, listen to some weirdo like me rabbiting on about all kinds of weird things. Taking action, doing something different.

Thinking differently, wrapping your mind around the idea that actually things can change and things will change and things have changed in the past. They will change in the future. And this is just another one of those things that will change.

And when you decided. That those things are going to change. And you start making those decisions to do different things, such as listening to this.

You've kind of opened up that. I suppose you could call it you've. Got in touch with that neuroplasticity in your brain to affect your nervous system in a positive way to make changes.

You kind of open yourself up to the idea that actually you're not stuck, you're not set in any one particular way of thinking about things. There's millions of different ways to think about something. And it can affect you in a real positive way when you start to realize that actually.

You're not limited in a way that you maybe thought you were. You got more flexibility, more options. I want to say more options.

I'm talking like infinite, infinite options. Because you choose what you do next. Every second of every day, you choose what you do next.

You don't have to do anything, you don't have to say anything. Of course, we have to breathe. There's things that we have to do, but I'm talking about things that you do consciously.

You choose. You know, some people say, oh, yeah, you have to go to work. Yeah, you do if you want to pay the rent and buy the food and all that stuff.

You don't have to, you choose to. It takes that that victim mentality out of it, that feeling sorry for ourselves. When you realize and when I realized that actually, it is a choice.

No one's making you listen to this. And I keep, this is my choice not to get rid of that metal thing sticking out of my desk. And I keep banging it whenever I'm on a recording.

I choose to both moan about it and to do nothing about it at the same time. It's a choice. I could just remove it.

Or I could just not mention it. But for some reason, I don't do either of those things. Oh, look at this, a single saline and if it's saline or saline jab squirted into the back of it.

Yeah, so put into the back, a single saline jab. Okay. Researchers, I'm just reading this.

Researchers gave 101 chronic back pain patients a brief mind body explanation, and then an open label subcutaneous injection of sterile saline. Pain intensity dropped for four weeks with secondary gains in mood and sleep. Brain scans revealed stronger connectivity between the medial prefrontal cortex and brainstem pain control nuclear or nuclei.

So the very circuitry mapped in classic deceptive placebo studies, suggesting that the brain doesn't care whether the treatment is real, only whether the meaning feels real. I just can't repeat that. The brain doesn't care whether the treatment is real, only whether the meaning feels real.

And follow up reports showed durable function. Durable functional improvements at 12 months. See, the only reason why placebo wasn't continued, like put into mainstream medicine, as far as I know, maybe it has been, but we don't know about, is because of the ethics, I suppose, the ethics of it.

The idea of lying to people. But, I don't know. Here's another one.

More than 1,000 people with chronic lower back pain were randomized to A, traditional acupuncture, B, fake acupuncture, where needles were inserted shallowly at non-meridian points, or C, standard medical care, i.e. physiotherapy, pain meds, exercise, advice. Okay, so. Blimey, so that's quite a few people, isn't it? So one, three groups, one with traditional acupuncture, one with fake acupuncture, and one with just standard medical care.

After six months, about 50% of both acupuncture groups reported meaningful relief, versus 25% of those getting conventional care. So, the press, they would do this, wouldn't they? The press spun the finding as even sham acupuncture works. But investigators highlighted a deeper lesson, a tactile, time-intensive ritual delivered with confidence can beat many drugs.

I've had acupuncture a few times over the years. I'll tell you what was weird. Did you know, I don't know if it's still the same, but I wasn't allowed to give blood because I'd had acupuncture in the last two years.

This is a while back. That's weird. I think if you had a tattoo or acupuncture, you can't give blood.

And I really was in, to be fair, I wanted to see what the biscuits were like. I've heard good things, but never mind. So ritual, I do wonder, to be honest with you, when, because when I had, I had a shoulder injury, 2005, and I ended up with two steroid injections.

I do wonder what would have happened if they gave me the first steroid injection, which did the job. And they told me, you can have one. This will last you for six months.

You can have one every six months and eventually it will heal anyway. It will just, you know, it'll begin to feel better, but you know, it'll just do the job. And after the first one, the second one they gave me one, which was just placebo.

We don't lose like saline or whatever it was that they squirt in. How would that have affected? How would that have, what would that have done? Because I genuinely, when I went and had the second one, I was genuinely expecting it to work. Because the first one, I couldn't believe how well it worked.

You know, I went from being like a, yeah, quite a high level of what's it to practically nothing. And I thought, wow. I just, I remember thinking to myself, wow.

It's one of those wow moments. I do find it interesting that there's, there's something about that, you know, it's all about the acupuncture, something about a bit of care, a bit of kindness, a bit of attention. So with the, you know, putting the needles on and with acupuncture, there's also like maybe the talking, maybe some soft music, the relaxation, and gentleness, considering it's needles is still quite gentle thing.

And, and it is, I guess, quite ritualistic, especially if you haven't done more than once, because it will be like you're going through the same process again, even if the needles may be put in different parts. And I always found it weird when I had, I remember I went to this trainee acupuncturist. And I might say, he did it for like half price or 20 quid or something.

And he was a friend of mine. So I just like, okay, cool. I didn't have much money.

He was training. And I'm walking, I see him, I say goodbye. I'm walking down the street and I hear him yelling.

I'm thinking, oh no, he's realized the money I gave him was a fake 20. And he comes running up to me. I said, I'm sorry.

I'm sorry. He said, well, what do you mean you're sorry? He said, sorry about the fake 20. He said, fake 20? I said, that's why you're calling me, isn't it? He said, no.

I said, oh, forget about that then. I said, well, what is it? He said, you gave me a fake 20. I said, no, I was joking.

He said, I said, well, why are you calling me? He said, oh, I forgot to take a needle out. It was still one in your head. So I said, all right, just take it out now if you want.

He said, no, can we go back inside? I said, why? He said, there's too many. What, too many people around watching? He said, no, there's too many needles stuck in your head. There's about 20 left.

I just forgot about them. How can you forget about needles being stuck in someone's head? And that's a true story. Well, it's a semi-true story, but it did, it did leave some needles in my head.

I'm not sure if he ever got them back. I did, oh, one thing I did when I was working while volunteering in a drug rehab center, doing relaxation sessions with groups. And there was a lady there that worked there and she did ear acupuncture.

And she used to put these things on people's ears. And she did it on me once and it was so weird. It felt strange, like on the ear lobes and just looking around, everyone was like sitting around, there's tinfoil things on their ears.

And I was there just talking and relaxing people like in a group setting. So maybe there's like 12 of us. And she was going around readjusting their ear lobes.

It was just, yeah, surreal. Which one of those do you find most fascinating out of the studies? The fake operations, I find, you know, that's just, that's just crazy. It seems the more you do, the more you build it up.

It's, I don't know, it's like, I don't want to say the word con, con job, or like a big, it's the long game, you know, the bigger the magic trick is. And the longer it takes, and the more you put into it, and the more distractions there are, the bigger it gets. And I went and saw Derren Brown in about 2005 to 2007 in theatre.

And he started his show before we even got into the theatre. He had things posted and he was watching people walking into the foyer. He had sort of subliminal stuff in the foyer.

He was basically messing with people before they even got to their seats. And he showed it at the end, what he'd done. And I know for a fact, he wasn't showing everything.

You know, even the way he showed it, how it was done, probably wasn't how it was done. I still find it weird is, so I think the injections of sterile saline. Again, that's another thing.

It's like, wow, to be able to believe, to really believe that something is going to be useful for you can be useful for you. I mean, I think that's one of the things with the, I think with medical practitioners today, they kind of have to be more honest than they used to be. I don't mean in a way like they were deceptive.

But there's ways of being deceptive, which is useful to the patient, which will set the patient up for to have that belief and expectation that things are going to be really good. And, you know, that kind of side of things. But it seems I don't know, maybe I'm wrong, but it seems that this is more of a practice of going through every single situation that could happen.

And when someone's in a hospital bed or sit in the other side of a doctor's desk, that person is very susceptible. You know, it is in a sense a little bit like they say, a deer in the headlights, especially in a serious sort of scenario. So whatever the doctor says next is so, so important and so powerful.

In the same way as if someone's about to have an operation, what the doctor says to them or what the surgeon says to them before they get taken into the theatre, it can have such a positive effect or opposite depending on how they've been talked to, what's been said to them. And then, you know, with beliefs, what do we say to ourselves? What self-limiting things do you say to yourself? I mean, that get in the way of you feeling more comfort, more relaxed. Because when you're listening to me babbling on, you're not thinking in your mind with that same self-limiting self-talk.

Because it's not that my voice is taken over and everything, but it's probably what you're more focusing on as you're drifting. And when you drift, you're going to be absorbing any positive suggestions or ideas rather than suggestions. So I'm not giving any suggestions, I'm just talking.

But any ideas that you wrap your mind around that can be useful for you. And you really can notice, you can notice how you feel different. Because belief is not mere wishful thinking.

It's actually a signal that recruits the parts of your body, your prefrontal, limbic, whatever, and mobilizes the parts of your brain and your, you know, all that stuff that experts know about. It rewrites the brain's predictions about pain. Because if you hold the knowledge that actually what you think affects your brain, affects your mind, and that affects your body.

And when you remember that your brain doesn't care if it's real or not. I found that very powerful, that sentence. Your brain doesn't care.

It doesn't care. And there's something about that, that sticks in my head, is it's not bothered. Because placebo research doesn't say that pain's all in the mind, it shows that the mind is part of the body's pain control circuitry.

So by consciously shaping expectations and ritual, or our beliefs, instead of just leaving up to chance, by consciously focus on it, we invite the brain's own pharmacy to join the team. And there's no side effects, no withdrawal, just that can be like a quiet ally, a friend working in the background, doing what it needs to do. I mean, in a way, we've got that anyway, in our brain, all the things that are automatic.

When you think about it, most of our body, pretty much everything is automatic within the body. You can sit there or lie down and everything works on its own. So I think it's interesting.

Expectancy. There's a few things you can do. You can do things like ritualize self care.

So that's a regular meaningful actions created. And to basically make you feel better. So that's, it's no different in some ways to, you know, if you clean it, you brush your teeth, you do certain things in a certain order.

And it feels nice to do it like that. And you get used to doing like that. And you expect your mouth to feel clean and fresh.

Once you've brushed your teeth, you expect it. There's been times when I've been distracted, and I've gone to the door, you know, someone's knocked on the doors, I've just gone in the bathroom. And I go to bed and I'm thinking, oh, I thought I'd clean my teeth because my teeth, maybe I've just got just amazingly fresh breath.

But it's just, maybe it's all the mints that I eat when I'm in sleep. But sometimes expecting, there's been times when I've, it's not very often if you look at my belly, but it's times when I've forgotten to eat. Like I've just been so busy doing something.

And I thought I'd had my meal, and I hadn't. But I didn't miss it because I kind of just expected to have had it. And because it's almost ritualistic, because it's the same kind of thing that I would do every day back then.

And not a lot of thought goes into it. But you expect, I mean, a bit like in sales as well, those people expect to do well, do well. You know, those people in sports, they might have a special coin or a special ritual that they do before they get into the ring, or before they go onto the football pitch.

Something that means something to them has nothing to do with what they're doing, not really. But has a huge effect on their brain believes that it's helping Vinny's trying to catch a fly. But your brain believes that those rituals are helping.

You know, doesn't matter if it is or not, because your brain believes it, so therefore it is. If you believe that rubbing, rubbing your knees has an effect on your confidence, then it will. Rubbing your knees will have an effect on your confidence.

It's a weird one, isn't it? Really. You got the therapeutic thing as well. So empathy releases endogenous opioids and oxytocin, according to this.

So really choose clinicians who take time and validate your experience. So when you're seeing a physician or therapy person, find someone that's going to take their time, it's going to be gentle, because that can really have an effect, a positive effect. And it's a practical way of kind of tapping into the placebo science.

Because ultimately, you could argue having someone, it may someone's going to give you an injection into your back. And so let's say someone, a doctor can inject me in my back with something that's going to help with the arthritis. It shouldn't really make any difference if it's someone that's completely cold to me, just, you know, bend over like, no, send me back.

Okay. And just like just do the back or someone that's being gentle and kind and takes a little bit of time, asks me how I am. Make sure that I'm okay with the procedure and I understand that I'm going to feel better afterwards.

And as opposed to someone just saying, Come on, please show up and just sticking the thing in. That's it done. Goodbye.

Next. I had a doctor once and I joined the surgery, and I'm just moved to a different town. So it's 2010, no 2007.

And he's really a bit aggressive, not like he wasn't punching me or anything, but he's like, calling me out, Come on, let's have a fight, fist fight. No, it wasn't like that. But he said, What medication you on? I said, I don't know.

You have to, and he kept going into this big, big lecture about he, all his patients have to know exactly what medication I'm on. And like, you know what? You know, it's fairly new medication. And I didn't know what it's called.

I didn't know what the I knew it was for. I didn't know what is some of the names of medications long in it? Like, is it named based on Latin? I think it's like ridiculous. Some of the names, petrocholine, shalom.

But no, you must know what I didn't like him after that. I'm sure he was a really good doctor, but it was just a little bit. And then I saw another doctor, when he wasn't there, I was stuck with him.

But I didn't have to see him luckily. And then I see another doctor who was there, who he wasn't there that day. So luckily, I saw a different doctor.

And she was lovely. And she looked at my file and said, Oh, I think we need to refer you. And this is for a different thing to my background.

And she really sort of set the ball rolling for getting me some help. And to be taken. I don't know, seriously, we're just being taken carefully to be treated.

Gently. With respect. And I suppose in a way it's useful.

If we can aim to do that ourselves. And treating ourselves with respect. I also says on here, listening to audio content can also in itself function as a therapeutic ritual that primes listeners expectancy of relief.

Oh, a lot of words there. I still find that interesting. Just the old idea of the brain.

The brain doesn't care. If you tell, if you tell the brain, if you tell yourself, you're gonna feel relaxed, you're gonna feel calm, then I guess that's what's gonna happen. You tell yourself that you're not going to notice Finny jumping up and down trying to catch that fly.

He loves to fly. That's his favorite thing. He loves to fly more than any toy.

And he can't catch it. He's never put it, well, he might do one day. But you know, the fly can, but it can fly, can't it? And he can't quite reach.

He's only tiny. Hi, Vinny. You're a tiny little sausage.

Oh, I said the word sausage. You're a tiny little doggy. You're a tiny little doggy.

If I say, stop staring at me. If I say that word, S, you know, end of UJ, begins with SOS. Oh, no.

He's staring. I haven't got any to give him. Don't stare at me like that.

I don't have any. They're his favorite things. My neighbor, obviously, gets him a packet from the petrol station.

They're only like a pound. He loves them. They're like those really, they're, I don't know what they are.

More like rubbery. Yeah, yeah. I don't, I wouldn't eat it myself.

But he loves them. Right, he's distracted by the fly again. So I'm going to go.

So I hope this has been mildly, mildly something. I don't know what, but something. Something.

So I'm going to go. I'm not sure how focused this has been, to be honest with you. I don't know.

But, you know, it's just me talking. So thank you for listening. Let me know how you get on.

And remember to be kind to yourself because you do deserve to be happy. And be gentle with yourself. You deserve to feel safe.

Lots of love. Bye.