Placebos vs Talismans
Sometimes, semantics are important.
The word placebo has been bandied about freely for all kinds of reasons, but what are we actually talking about when we use the word “placebo”?
In the research sense, a placebo represents uncertainty. A placebo is the substitute for the active treatment. It looks, feels, sounds, tastes, and smells like the active treatment. It’s only difference is that it has no active properties.
BUT the point of the placebo is not to convince the person receiving it that it is in fact the real thing, but rather to make it impossible for them to tell whether it is active or not. In most classic two-arm placebo-controlled trials, participants are told that they will receive one of two treatments AND that one of them is an inactive treatment. Participants enter into treatment not with the belief that they are receiving the active treatment, but with the inability to be certain about which one they are getting.
This is different than what I’m going to call a talisman. And the difference between a placebo and a talisman is that the point of a talisman is to convince the person receiving it that it is, in fact, active. The point of a talisman is certainty.
In the story of Dumbo, Dumbo believes in a feather that will give him the power of flight. There’s no uncertainty there. Even though Dumbo can fly without the feather (the feather has no active flight-giving properties to Dumbo), he does not fly because he isn’t sure whether the feather will give him the power of flight or not. He believes not only that he can fly with the feather, but also, that he CANNOT fly without it. That’s the degree of certainty with which Dumbo places in the feather. In order for the feather to work, Dumbo can’t be uncertain. He has to be all-in.
The feather is not a placebo. It’s a talisman.
There are some writers and coaches who believe that taking advantage of the placebo effect is beneficial; but what they’re really talking about is the talisman effect. If you believe that something is going to work; if you’re going all-in, then it’s no longer a placebo. Placebos by their nature, carry uncertainty, and therefore, don’t require belief or an all-in commitment. Participants in placebo-controlled trials are only all-in on the process, not the treatment.
The superficial difference is that “talisman” has one more letter than “placebo”. The deeper difference is that a talisman, in this sense, requires deception — even if that is deception to oneself.
