A Visual Overview of English 201
Friday, December 14, 2012
Preface/ Introduction
Welcome to English 201
Hello and welcome to my brief overview of English 201. Throughout this semester I was required to write 3 research based papers, 2 personal ( in my opinion fun papers to write) and create a power point as well. As you scroll down you will learn about the highly debated topic of nature vs. nurture. You will learn about the corrupt land of big pharmaceutical companies and how doctors use the placebo effect to help patients heal all on their own. During this semester our class read a story entitled Ideas by Patricio Pron. I chose to research why Pron wrote a story about a young boy who leaves home with no explanation.
There is a power point presentation about how to use logic in argumentative writing rather than emotions. There is a short story about a young girl and her first trip to New York City and some personal thoughts and reflections about Dr. Martin Luther King Jr.
So now that you know what you are about to feast your eyes upon please sit down and enjoy everything I have had the pleasure of learning this semester!!!
Thursday, December 13, 2012
Third Paper
Nature, Nurture or Both?
For years psychiatrists have studied
families and children and questioned how they become the adults they are. Genes
can work by influencing our behavior which can channel us into certain
environments. They also influence our susceptibility to certain kinds of
environmental stressors (Rice). How much of a person’s personality is affected
by nature and genes that are passed down and how much is affected by the way
they are raised? How much influence does a mother have on children and does the
way a parent treats a child influence the way they are treated by others? And
does the way a child act affect how others perceive them and in turn treat
them? Maybe there will never be a clear answer because humans are affected by
both in so many ways. Nature is what molds us within the womb but nature can
manipulate nature. It is not uncommon to here that people don’t change but that
is not an entire true statement either. Children learn and amend their behavior
every day. As adults, it gets harder to modify the day to day routines and
attitudes but with the right help and support people of every age make choices
to become someone a little different than they were yesterday. This is not to
say that there are certain things engrained into our DNA, just that both create
each individual ever born.
There are so many arguments for the
nature vs. nurture debate. In Nicholas Christakis’s article Forget About Nature vs. Nurture. The Answer
Lies Between Christakis’s says, “No child is born able to read; this task
is learned from parents and teachers in social settings. In other words, one of
our most essential abilities as humans—reading—is the product of the
combination of innate and learned traits.” This statement is so powerful using
very few words. There are so many things as humans that we do, such as reading
that we don’t really take the time to understand how many people helped teach
these skills.
There have been many things that for
a long time were believed to be determined entirely on our culture. For
example, our choice of friends, or voting patterns that have turned out to have
deep evolutionary roots. Christakis was a part of a study that discovered
people seek out friends that have similar genetic variants that they do way
beyond physical characteristics. “Peoples genetic variants can change over time
due to early social experiences such as education, poverty, malnutrition and
child abuse” (28).
A study conducted using Norwegian
rats proved that a great deal of how our behavior as adults is significantly
affected by the way we are handled by our mothers as infants. The greatest
discovery made by researcher Michael Meaney was that loving behavior learned
from mothers is passed on to offspring in the next generation. Researchers
discovered that the pups whose mothers licked and groomed them more during
nursing tended to be less fearful and less responsive to stress. Even the female
offspring of attentive mothers tended to have similar practices with their own
pups. The pups with less attentive mothers had pups that followed suit. “It
would be shocking of the same process was not working in humans. That would
imply that maternal care is essential for a rat, but not for us,” Meaney said
when asked about the correlation
he was trying to make between rats and humans. When negativity is detected in
the home the key is to change the family dynamic early on. If a family can
learn how to come together constructively and manage to change the interaction
between parents and children the results can be carried across multiple
generations (22).
As we learn from the behavior of
rats it opens up many doors and questions about not only a positive learning
environment but also some negative or difficult genes that can be passed down.
Staff writer Rob Stein for the Washington post and Cardiff University
researcher Frances Rice answered questions about children carried by a
surrogate mother. Research has shown that children whose mothers smoke during
pregnancy have an elevated antisocial behavior as opposed to children of
nonsmoking mothers. The big question is if a child is biologically related to a
smoking mother but carried by a nonsmoking surrogate would that child have the
same preexisting condition of being antisocial or could the nonsmoking
surrogate influence the child’s behavior while still in the womb? Stien’s
opinion is that if the biological mother has a genetic predisposition to
antisocial behavior it would be unlikely that child would have a different
outcome. Stien’s theory is a prime example of the nature playing a huge role in
not only a person’s childhood but also as an adult (Science: Nature vs.
Nurture).
When asked about siblings that were
adopted into different homes both Stein and Rice agree that the biological
siblings, even though they are not raised in the same home, would have more in
common with each other than with the children they were raised with. Stein
believes that genetic predisposition plays the biggest role in personalities
and behavioral traits but Rice has a slightly different view. She believes that
if a child is prone to something like antisocial behavior that there is an
element of inheritance that comes with it but it is also very probable that
there was some conflict within the adopted family as well (Science: Nature vs.
Nurture).
While Stein seems to fall more on
the nature side of the argument he recognizes that many other factors can be
attributed to the outcome of a person as an adult. More complicated behavioral
traits are both a combination of genes and environment. It is widely accepted
(not scientifically proven) that complex behaviors (such as risky behavior)
involve multiple environmental factors and multiple genes of small effect. If a child inherits a gene that makes them
more prone to risky behavior it doesn’t mean they will grow up to be a jet
pilot or jump out of airplanes for a living, but the way they manage their
biological designators steer them to a more thought out path of safely doing
risky activities (Science: Nature vs. Nurture).
Rice seems to fall somewhere in the
middle of nature vs. nurture. There have been studies about infants learning
while in the womb and Rice supports and backs with some of her personal research.
She has discovered that baby’s are able to “learn” stories that are read to
them during the late stages of pregnancy. When tested after they are born the
infants prefer to listen to the story that was read to them rather than a new
one. This is possible because a babies hearing is functioning before they are
born. What is difficult about this particular argument is how does one decide
if this is nature or nurture? It could be considered nature because the infant
is still in the womb and growing but it could also be considered nurture
because the mother is instilling a story to her child that has meaning to her
(Science: Nature vs. Nurture).
Perhaps
one of the most fascinating theory of nature and nurture is how we project
ourselves determines how people naturally treat us especially siblings. The
easiest way to dive into this theory is to use a stereotypical family where the
mother stays home therefore having the most influence in childrearing. In a
study conducted where the researchers watched the behavior of mothers and how
it influenced the way the other siblings would treat a child it was noticed
that positive maternal encouragement for new experiences were positively
associated with the way older siblings treated their younger brothers or
sisters. On the flip side of this coin hostility and inconsistency were
positively related to hostility and negativity between the siblings. Children
raised in these kinds of environments were also less likely to have good social
skills in school and are not open to helping others or new teaching experiences
(1248 Reiss, David et al).
The mechanism that creates to
co-variation between mother and children is unknown, but it is known that a
mother’s influence on her children will stay with them for their entire life.
One theory about the way children treat each other is a learned routine from
their parents. Children imitate or model their parents’ behavior toward them
which carries into the way they treat others. At a very young age children
internalize interactions with their parents and it is turned into a working
model of self in relation to others which then translates into social behavior.
Both of these theories emphasize that nurture plays a greater role in a child’s
life than nature (1248 Reiss, David et al).
Although a parent plays such a huge
role in a child’s life children also have an active role in creating their
interactions with parents and others. “It is possible that the consistency of a
child’s experience with parents and siblings may be evidence of a child’s
stable interactional style, prompting similar behavior with different
relationship partners and eliciting similar responses” (Reiss, David et al).
Genetic traits that can be passed down, such as temperament affect a child’s
interpersonal behaviors and have an impact on emerging and continuing
relationships.
Early childhood temperament is a window
into adolescent behavior. If a child possesses behavior patterns such as
aggressive tendencies they are most likely to be somewhat angry adolescents but
have been reported to become highly stable over time depending on the
environment they are raised in. When looking at this pattern of behavior both
nature and nurture play a huge role in how different of an adult a child can become.
This however is not always the case. More often than not genetically influenced
traits can lead to how they are treated by others which also plays a part in
the person a child develops into. For example, if a child is active, social and
smiles often they appear friendly and cheerful to others eliciting nurturing
responses. Children that come across distant and shy usually seek out solitary
activities such as reading. They may give off the vibe that they want to be
left alone and for other children to keep their distance. This type of behavior
can elicit negativity from other children. Young children especially cannot grasp
what kind of behavior they are showing to others and they also don’t understand
that they are treated similarly to the attitude they are portraying (1249
Reiss, David et al).
Despite prior evidence for strong
genetic influence between mothers and siblings research shows that environment
plays a much bigger role than it was believed to in the past. Adolescents have
consistent experiences with both mothers and siblings in part because of some
common environmental factors. There is a general family climate that can shape
the interactions across various subsystems. Mothers play a vital role in
shaping their own relationships with their children but also how the children
create relationships with each other. Mothers that treat all of their children
similarly have the result of the children treating each other the same way.
Children will carry the model of the working relationship she has with each
individual into their own interactions even when she is not present to
intervene how they treat one another. If a child and mother are experiencing
problematic exchanges, that will carry through to create antisocial behaviors
and escalate to involve other siblings as well. A mother’s behavior toward a
adolescent mirrors an adolescents behavior toward their siblings. This
hypothesis described is referred to as a passive genotype-environment
correlation (1258 Reiss, David et al).
If
one child experiences aggressive and hostile relationships with a parent while
a sibling is sheltered from the direct negativity it will inevitably affect the
way both children interact with each other. It would be most likely that the
child experiencing the direct negative behavior will treat the more sheltered
sibling in a similar manner. This kind of family environment only initiates
negative reactions from all relationships and is usually carried over into
their adult life (1259 Reiss, David et al).
As a conclusion for the argument nature
vs. nurture it is becoming more accepted that both play a vital role in who we
are as children, teens adults and parents. In the article Goodbye Nature vs. Nurture Debate Matt Ridley argues that modern
genomics has shown that the nature/nurture debate invokes a meaningless
opposition. He states “The discovery of how genes actually influence human behavior,
and how human behavior actually influences genes, is about to recast the debate
entirely. No longer is it nature vs. nurture but nature via nurture. Genes are
designed to take their cues from nurture.” A great way to sum up this statement
is asking the question do some parents pass on smart genes to their kids or do
they pass on books to aid their curiosity?(M., S., and B. M.).
In the end there will never be a way
to scientifically prove whether nature or nurture id key in how children behave
as adults but it will forever be a topic of discussion among scientist and
psychologist for many years to come. There will always be new tests available
but there will also always be children that are the exception to the rule.
Trying to determine how much of a trait is produced by nature/genes and how
much by nurture/environment is as useless as asking if the drumming we hear is
produced by percussion or an instrument.
Works Cited
Christakis,
Nicholas A. “Putting the Social into Science. Forget About Nature vs. Nurture.
The Answer Lies Between.” Time 178.24 (2011): 28 MEDLINE. Web. 26 Nov. 2012
M.,
S., and B. M. “Goodbye Nature vs. Nurture Debate.” New Scientist 207.2778 (2010): 03. Academic Search Complete. Web. 26 Nov. 2012
Reiss,
David et al. “Adolescents Relationships to Siblings and Mothers: A Multivariate
Genetic Analysis.” Developing Psychology 35.5
(1999): 1248-1259 PsychARTICLES. Web.
26 Nov. 2012
Stein,
Rob. “Science: Nature vs. Nurture.” Washington Post, The n.d.: Newspaper Source
Plus. Web. 26 Nov. 2012
White,
Paula. “Nature vs. Nurture.” Heart and
Soul 7.2 (2000): 22. MasterFILE
Premire. Web. 26 Nov. 2012
Thursday, December 6, 2012
Analysis Essay 2
Ideas
of a Dirty War
“War is more
than a true chameleon that slightly adapts its characteristics to the given
case.”
Carl
Von Clausewitz
Symbolism is something that authors have
used within many works of fiction to touch on very hard and sensitive subjects
without having to throw it in their readers face. “A symbol is a term, a name,
or even a picture that may be familiar in daily life, yet that processes
specific connotations in addition to its conventional and obvious meaning”
(Jung 20). Pron has made a masterpiece of symbolism within his short story Ideas. During the Dirty War in Argentina
thousands of children, college student s and infants were taken from their
families and mothers. Many were killed and some were blessed enough to return
home. The story Ideas is about a
young boy who leaves one day without any explanation. The people throughout
town see him in spurts but he never offers an explanation as to why he left or
what his intentions were. Slowly more and more children began to join him
living a nomadic life away from their families. Ideas can be interpreted as a
symbolic work of literature about the young children taken from their families
during the Dirty War.
The
story Ideas is about a young boy
named Peter. Every day after school he comes home and has the same routine. One
day his father his father hears him come home but when he goes upstairs to find
his son he has left. What the poor father doesn’t know is that Peter will not
be returning for a number of stressful days. He rallies the community and vows
to never stop looking until his son is found. Within the story Pron introduces
another short story. The reader is introduced to a woman who goes mad and
claims that her son is dead. As the story progresses the reader discovers she
never even had a son. Other children begin to disappear with Peter and they are
randomly spotted throughout the village and the forest. Before long the
children begin returning home. None are hurt, sick hungry or tired and none of
them talk about their experiences while they were gone. It’s as if the children
were never gone. Pron states very bluntly one of the reasons he wrote Ideas and some of the meaning behind it.
“We [children] are all ideas thought up by our parents, and we
vanish before or after them."
To understand how Ideas could be symbolic of the war in
Argentina there must first be an understanding of “dirty war.” One of the biggest
questions asked is how is dirty war any different than a civil war? Isn’t a
dirty war just a subset of civil war? Christopher Cramer outlines critical
features that constitute a civil war but he admits that civil war exclude,
“state led massacres where there is no organized or effective state oppression,”
(380). In the article War in the Gray Smith
and Roberts outline the differences between dirty war and clean war. In a
“clean war” war is openly constituted and it is known who the main protagonists
are. In a “dirty war” there is no formal declaration of hostility. Acts of
violence are initiated without any forewarning (Pron blog).
In a clean war, after
the open declaration of war there is an understanding of accepted modes of war.
They are governed by an acceptance that once the war has begun its conduct will
be bound to certain rules, laws and conventions. Dirty wars do not recognize
these laws and conventions. There is no distinction between combatants and
non-combatants. The whole point of a dirty war could very well be that the
civilian populace is explicitly targeted. In Argentina there was an explicit
connection between the communication of fear and eliminating any threat to
state but also dissuaded people from joining or creating any antigovernment
forces. The population was ruled through fear of arrest or assassination
(381-382).
The Dirty War that took
place in Argentina lasted from the 1970’s till the mid 1980’s. During the Dirty
War many children, mainly college students, were taken from their homes and
never returned. Pregnant mothers were kidnapped only to have their new babies
taken from them at birth and given to military families that supported the war.
There were no clear rules or lines drawn to protect the innocent. It was as if it
was genocide but no deaths were documented or recorded, young people simply
disappeared and were never seen again. It is believed that most of these young
people were taken to detention centers, where the majority of them were
tortured and killed. General Jorge Rafel Videla defined a terrorist as “not
only someone who plant bombs but a person whose ideas are contrary to Western,
Christian civilization.” Sixty students from Manuel Belgrano High School
disappeared simply for joining the student council (Goddard 82).
In April of 1977 a
group of woman came together and called themselves the Madres de Plaza de Mayo.
It was founded by a woman named Azucena Villaflor. She and many mothers with
the same story as hers came together every Thursday in front of the
Presidential Palace in Buenos Aires. They would march in silent protest around
the plaza wearing white handkerchiefs embroidered with the names of their
missing children. What makes these woman so unique in Argentina is their
positions as mothers and housewives combined with the constraints of military
rule produced a novel set of circumstances and practices (Goddard 85). When the
Madres first embarked upon their journey they didn't have a plan set in place.
It was never intended that 35 years later the mothers would still be marching
and be protected by Human Rights Groups around the world (Pron blog).
There are so many ways Ideas could be compared with the brutal
history of Argentina, Pron’s birth place. When Peter and the other children
from the village disappear it would not be far-fetched that he symbolizes the
missing children from the war. Peters father embarks upon his mission to find
his son he rallies the village around him. The village quietly look for the
missing children and every once in a while get a glimpse of them either in the
village or along the forest. This could represent the Madres de Plaza de Mayo.
The white clothes that the mothers wore embroidered with their missing children’s
names are reminiscent of the small glimpses of the missing children throughout
the village. The silence of the families in Ideas
represents the oppression of the Argentinean civilians silenced by fear of
their government. Carl Jung States, “The psyche has evolved and some contents
of modern mans unconscious resemble products of the mind of ancient man” (66).
This could very well explain how the dictators of Argentina believed they were
a part of the greater good for the country. They were primitive thinkers that
felt they could control the way everybody in their country thought. They were
close minded and tried to mold their people into what they wanted them to be
rather than molding themselves to the way their country needed them to be.
Patricio Pron was born
in Rosario Argentina in 1975. He was brought into this world while Argentina
was in the midst of The Dirty War. Pron grew up mainly in Argentina but has
lived all over Europe. Pron was raised in Tablada and studied Social
Communication at the National University of Rosario. When
he wrote Ideas he was living in
Germany in the same town Ideas takes
place in. Pron has had his written works published in not only English but also Norwegian, French, Italian, Dutch and
German. Pron is not only a talented writer he is also a translator and a critic
as well. Having all these gifts gives him the opportunity to make sure that all
of his talent is translated as accurately as possible and that everything is
written to the best of his ability. One of the greatest gifts Pron has given
his readers is the gift of personalizing his work. Molina states it best when
he says, “his writing based much
of its strength in presenting situations and characters in a very intense
depth, almost painful, and explicit text actually very little about them.”
When
Patricio was asked about being not only a writer but a critic as well, he
answered, “Both
experiences complement one another well, contrary to what people usually say,
since a great number of writers are also readers and we have opinions about
what we read. Not all writers read, however but those who do, do not see any
obstacle to talking about what we read, in particular if we are talking about
books that contribute beauty and sense to a world that tends to be lacking in
both.” This answer alone gives the reader a very intimate look into how
Patricio feels about his work. He is very passionate about his work and the
world of literature (Aguirre).
Pron brings to light
some very real and scary troubles throughout the world. Civil wars rage on in
many places other than South America. When families are torn apart by choice of
the government they never know if they will ever see each other again. In the
case of so many missing children from Argentina some were reunited with their
families while other chose to not meet their biological parents. Unfortunately
most of the children remain lost and will most likely never be reunited with
the people who love and miss them. War is a necessary evil in our world but
when it is in the hands of ruthless, corrupt leaders it becomes nothing but
evil. We are blessed to have such a talented author who can bring this terrible
event to light with the beauty of his words.
“While combat between
federal forces and Chechen rebels has for the most part ceased ‘disappearance’,
torture and the summary execution of detainees continues, marking the
transition from casual internal arms conflict into classical ‘dirty war’, where
human rights violations and not the conquest or defense of territory are the
hallmarks.” (Smith 378)
Works Cited
Aguirre,
Osaldo. ”Literature as a Domain of Lies.” The
Capitol. Signs, Oct 19, 2008. Online. Nov 1,2012.
Goddard
V. Demonstrating Resistance: Politics and Participation in the Marches of
Mothers of Plaza de Mayo. Focaal [serial
online] Dec. 2007; 2007(50):81-101.
Goldman,
Francisco. “Children of the Dirty War.” New
Yorker88.5 (2012):54. MasterFILE,
Premire. Web. 28 Oct. 2012
Jung,
Carl G. Man and His Symbols. Garden
City: Doubleday and Company Inc., 1964. Print.
Smith,
M.L.R.,and Sophie Roberts. “War in the Grey: Exploring the Concept of Dirty
War.” Studies In Conflict & Terrorism
31.5 (2008): 377-398 28 Oct. 2012
Tommy (tommyk11). “Reading Reflections for Feb 2, 2011.” Tommy’s Blog Tues, Feb 8, 2011. Online.
Nov 11, 2012
*there was no last name for this blogger and no sponsor
Zongrone, Courtney. “blog entry.” Ideas Tues Feb 1, 2011. Online. Nov 11, 2012
*there was no sponsor for this blog
Monday, December 3, 2012
Personal Writing 2
Contemplating
Martin
Martin Luther King Jr. will go down
in American history as a man who had a
dream. He fought oppression and inequality with peace and not violence. He was
able to point out the wrong doings of our great country with eloquence and
grace.
One of the greatest qualities of his
speech was how he painted a very real and sad picture of what was happening to
black men all over the nation. He used words such as manacles, quicksand,
chains and whirlwind when he describes what the black population has been
subjected to. And even after all of this he asks his followers to remain
steadfast and serene in their quest for equality. “Let us not seek to satisfy
our thirst for freedom by drinking from the cup of bitterness and hatred. We
must forever conduct our struggle on the high plain of dignity and discipline.”
With this sentence alone he uses something small like a cup to describe
bitterness and hatred and then changes to a huge beautiful image of a plain
when describing dignity and discipline. He shows us through imagery how vastly
different these emotions and tactics can be.
When Martin Luther King talks about
the different areas each person will return home to his uses words to describe
the oppression that also descried where they are. “I have a dream that one day
even the state of Mississippi, a state sweltering with the heat of injustice,
sweltering with the heat of oppression, will be transformed into an oasis of
freedom and justice.” He uses the word sweltering knowing that it describes
something as simple as the weather and turned it into something that describes
the inequities of the times. When he uses the word oasis it hydrates the reader
or listener to go out and change what they can change, to find the oasis and
satisfy their needs.
Personal Writing 1
It Was Almost The Best Day
By: Morgan Theiler
Today is the day, the first day she will go to New York City
by herself. She has been there before and knows how to navigate the streets,
how to find her way from one place to another but she has never done it alone.
As she steps onto the escalator and watches the sunlight disappear she turns
around to look at the subway that she can’t get onto fast enough. She breathes
in the familiar smell, the smell of people, the smell of metal and the smell of
adventure.
She
steps into the subway and finds a seat next to business man. He is so caught up
in his paper and the monotony of his daily commute he doesn't even notice her
sitting next to him. As the train starts to rumble and shake the exhilaration
inside her grows more than she ever knew it could. She can feel her lips curls
into an uncontrollable smile that spreads across her face. The train rocks smoothly
from side to side so she closes her eyes and envisions the concrete jungle she
is about to become a part of. She imagines getting lost in a sea of strangers
each with somewhere to be and an agenda to adhere to. She sits quietly and
let’s her mind take her through streets and alley ways, to buildings she has
never been to before and places that the whole world has seen in pictures but
only she is lucky enough to get to go to.
The rocking of the train begins to
quicken. It is no longer the peaceful sway of the subway she is used to. The
lights above her flicker and the calm businessman is no longer engrossed in his
newspaper. She closes her eyes to return to the day she is about to have but
when she opens them again the concerned look of her neighbors face has turned
to panic. The screeching metal of the wheels is the last thing she hears and
the crisp ironed suit falling toward her is the last thing she sees. She doesn't get to go to the city today. She doesn't get to breathe in the thick
muggy air that she loves and she doesn't get lost in the sea of people that she
longed to get lost in.
Essay 1
The
Placebo Effect
The human brain is a phenomenal muscle.
It is the root of every individual and how each person reacts to not only the
people around them but also how humans react to themselves both mentally and
physically. The brain has the ability to protect people when they are scared,
forget memories that are hurtful and even cure them when they are sick. So if
the human brain is so powerful why do placebos work for some people and not
others? Are placebos an effective treatment and is there any evidence that they
actually work? When is it appropriate to use a placebo in lieu of a medication
that works? Doctors have been trying to
come to an agreement for years now on whether or not placebos are useful. One
of the biggest concerns is there is no way to control a placebo in a clinical
trial.
There are many factors involved when it
comes to studying the effects of a placebo. First is the patient a good
candidate and open to the idea of a placebo? How can the FDA control placebos
when there are no guidelines. For example the ingredients in a placebo are
rarely disclosed so each type of placebo is very different. Is there a way to
create a control?
The biggest obstacle for doctors and
scientists is finding a good candidate for placebos. Because so much of what
humans can do and overcome is compelled by the human brain it is nearly
impossible to test placebos. Author Bagley from Newsweek wrote an article called Placebo Nation: Just Believe. In
it he compares placebos to the magic feather of Dumbo the flying elephant
(Owens 817). Dumbo didn’t need the feather to fly it simply gave him the
confidence to do it. Medication can be very similar. There are many times when
the public doesn’t need medicine to fight off an illness just something to
trick the body into feeling better. Instead of being happy that our bodies can
fight off illness completely on its own the majority of people are outraged
when they discover that the medicine prescribed to them was nothing short of
expensive magic feathers.
New studies have shown that placebos are
physiologically measurable with condition specific pathways. With these new
studies also comes new testing. In the past doctors conducting a clinical trial
that involves placebos would have the daunting task of finding the right
candidate for placebo testing. This effort was largely abandoned because of
inconsistent results. “The widespread conclusion was there was no reliable
individual difference factor at work in placebo responding that has been a
major stumbling black for placebo theorist for decades,” (Owens 818). One of
the things that doctors have discovered throughout their research is the wrong
person for placebos. Any patient with negative expectations for treatment
effectiveness, be it a placebo or actual medication, has a much less likely success
rate than those with a drive to be well again. These groups of people are known
as “nocebos.” An individual with a placebo-prone personality will only create a
placebo effect in the presence of positive beliefs and companionship. These
naturally vary from one situation to the next. Even a person that is prone to
the placebo effect can become a nocebo based on the individuals around them.
In the article The Quantification of Placebo Effects Within a General Model of Health
Care Outcomes explains a study completed at three research sites (The
University of Washington Medical Center, the Neurology Center of Fairfax, VA
and the Multiple Sclerosis Association of America, Cherry Hill, NJ). These
three facilities recruited candidates with MS through flyers, mailing and word
of mouth. The three sites were able to take on 117 test subjects. Subjects were
randomly assigned to either the “treatment first” or “placebo first” upon
arrival to the study. At the end of the study the placebo responders “were more
confident that the sham treatment was the active device compared to those who
didn’t respond,” (819 Owens). This study did not only have the expected outcome
but gave placebo theorist exactly what they were looking for. “Positive
expectancy is an essential factor in understanding placebo effects,” (Owens 819). Since placebos are such a questionable
form of treatment it is difficult to know when there is a definite need for
them and when doctors are simply testing their effects. It is general knowledge
that there is no cure for the common cold. Research has shown that placebos
make up 85% of the efficiency of cough medications. The advertising and
packaging alone for these medications begin to get patients brains working
toward feeling better without even taking the medicine. The physiological
effects of cough medicine are initiated by the physical properties of the
medicine such as color, taste, smell and texture. The placebo effect consists
of several components; natural recovery, regression of cough response, effects
of sweetness, voluntary control and effects of the expectancy of the treatment
(Eccles 55).
There have been many positive things
that have come from placebos being used in clinical trial for the common cold.
It used to be that the active ingredient codeine was the standard prescription
for colds. Placebo controlled clinical trial have shown that there is a lack of
efficiency in codeine and placebos have better effects and no addictive side
effects. Many over the counter brands add the bitter taste that the public is
used to tasting to cough syrup to make them feel like they are taking a more
effective treatment. In fact the active codeine in cough syrup had little, if
any specific pharmaceutical effect on the cough.
In order to understand why placebos work
there must be an explanation as to how they work. The placebo effect for a cold
has three major working properties. Ron Eccles explains why placebos have such
a high success rate in cough medicines in his article Importance of Placebo Effect in Cough Clinical Trials The taste of
the cough medicine triggers the mouth to salivate more therefore opening airway
secretion and allowing to irritation in the throat to begin to heal itself. The
bitter sweetness in the medication also numbs the throat to a degree and the
patient is then not thinking about the cold as much. Many ancient cultures used
honey when they were suffering from a cold. The honey would coat their throat
and has medicinal qualities as well. One of the biggest hurdles these people
had to overcome was the quality of medical attention they were able to provide
for their people. Not only did homey help alleviate the coughing symptom, but
it never goes bad. And the biggest argument for a placebo working is the
sensory effect such as taste and smell. Some of the main ingredients in cough
syrups are sugar, honey and spicy substances such as capisum, or bitter
substances such as lemon. These ingredients cause reflex salvation and promote
secretion in the airway (55).
There are very few people in this
world that would complain about placebos in cough medication. When it comes to
the common cold most people are happy to feel better and move on without a
runny nose or sore throat. But what about patients that suffers from more
severe illnesses such as cancer or mental illnesses such as depression?
Many cancer patients are plagued with
rough side effects from chemotherapy such as nausea, vomiting and a major
decline in energy. There is no proven medication on the market to completely
relieve patients of these symptoms but it is not an uncommon practice for
doctors to prescribe a sugar pill to counteract these side effects. Many of
these doctors have to pick and chose who they are going to prescribe these
placebos to because the patient has to be open to feeling better. They must
have a positive outlook for their recovery or the sugar pill will never work.
A doctor by the name of William Potter
was intrigued by placebos and took on the task of testing placebos with mental
illnesses such as depression. The idea behind his research was to better
understand how a placebo could work if the patient was starting their treatment
as more of a nocebo candidate. Potter discovered that the majority of patients
suffering from depression seamed to get healthier simply with doctors empathy
than the pill itself. Since the 1980’s, “two comprehensive analyses of
anti-depressant trials have uncovered a dramatic increase in placebo response”
(33). In a study conducted in Chicago in 2007 almost half the doctors polled
admitted that they knowing prescribed medications that were either completely
ineffective or a very low dose of an effective medication to evoke a placebo
effect (Silberman 41).
Geography also played a major role in
placebos and depression. It is not surprising that Americans had the highest
percentage of taking to antidepressants. The idea that a pill would make one
feel better was not very farfetched for a culture that is surrounded with the
notion of instant gratification. It was found that color also effects the way
people react to a placebo, for example a light blue pill (blue is considered a
stress relieving color) were far more effective that an angry red pill
(Silberman 37).
It is safe to say that placebos
defiantly have a place in the medical field. Placebos work, maybe not for the
population as a whole but there is enough proof that there is no reason they
should not be used as a form of healing. Now for the big question, can the FDA
regulate what placebos are made of and if so how?
As placebos became more commonly
tested in clinical trials the more doctors discovered that the human brain had
the ability to control so much of a person’s healing. From 2001 to 2006 20% of
new drugs being tested were cut after they were put against placebos. Over half
of new medications are dropped because they can’t beat the sugar pills. Steve
Silberman writes, “It’s not that old drugs are getting weaker, it’s as if the
placebo effect is getting stronger” (33).
In the past there have been control
treatments for nondrug interventions such as sham surgery, sham acupuncture or
even sham procedures. So if there is a control for these wouldn’t a placebo
fall under the same category, sham medicine? In the article What’s in Placebos: Who Knows? six
colleagues come together and try to determine an answer. “No substances are
known to be physiologically inert, and no regulations guide placebo
composition” (532).
These colleagues collaborated using four
major medical journals, The New England
Journal of Medicine, JAMA, The Lancet and Annals of Internal Medicine. Within
these journals they discovered 176 eligible studies. In eight of these studies
both pills and injections were used and in one study both injection and
intranasal spray were utilized to administer the placebo. There were a total of
86 studies using pills, 65 studies of injection and 26 studies using other
treatment methods. In all 176 studies the placebo ingredients were seldom
disclosed and were particularly rare of pill based studies. What these
colleagues were able to conclude was that “disclosure of the actual (chemical)
differences between the placebo and test drug is not required,” (Howick et al
534).
As a result of placebos not being
regulated by the FDA there are those of the mindset that the use of placebos
should be few and far between. Vanessa Clifford writes, “The use of placebos in
clinical trials can only be justified ethically when no proven active treatment
is available as a comparison, and conversely when a proven active treatment
exists, the use of placebos is unethical” (361). For Clifford the issue is not
whether or not placebos work but when it is ethical to use them or not. Her
argument is that so many medical patients spend a lot of money for health care
and it is not right for them to be given “medicine.” Even in clinical trials
there is a flaw for testing placebos. Clifford not only believes placebos
should only be used when there are no options for medication but the same goes
for clinical trials as well. She believes placebos should only be introduced in
a clinical trial when there is no proven effect treatment for the condition
(363).
When placebos were first introduced into
the medical field they were used for managing or pleasing a patient when the
diagnosis was uncertain or there was no specific treatment available. Other
doctors and scientist have recently debunked this thesis. In 2001 a Cochrane
review showed that placebos worked their magic best when the patient was in
pain or was heavily open to suggestion.
As one generation of medical
professionals retire and a new younger generation begins to take their places
the way placebos are tested is changing. When placebos were first being studied
the majority of their use was to make patients believe they were being treated
properly. This however was before the days of informed consent and medical
professionals didn’t have to give their patients full disclosure (Clifford
363). Many drug makers are embracing the power of the placebo effect and have
the drive to understand it better. They are learning the mechanics behind it so
they can design trials that help doctors understand the difference between the
medicine itself and the body’s innate ability to heal itself.
It has been proven time and again that
placebos can work. The difficultly that comes with a placebos is how much they
actually work. There are some people who psychiatrically are better suited for
a placebo while others have either made peace with their illness or have no
drive to get better. There is also proof that cough medicine is nothing more
than a placebo. There is no cure for the common cold yet most people have some
sort of cold remedy in their medicine cabinet. It is clear that placebos work,
they make a huge part of western medicine and while the use of them is in need
of some perfecting they do help people for the better not for the worst.
Works
Cited
Clifford V. The
Placebo Mystique: Implications for Clinical Trial Methodology. Journal Of Pediatrics & Child Health [serial
online]. June 2011; 47(6): 361-366. Print.
Eccles R.
Importance of Placebo Effect in Cough Clinical Trials. Lung [serial online]. February 2, 2010; 188:53-61. Print.
Jeremy Howick,
et al. “What’s in Placebos: Who Knows? Analysis of Randomized Controlled
Trials.” Annals of Internal Medicine 153.8
(2010): 532-W. 189 Health Source:
Nursing/Academic Edition. Print.
Owens, Justine
E., and Martha Menard. “The Quantification of Placebo Effects Within a General
Model of Health Care Outcomes.” Journal of Alternative & Complementary
Medicine 17.9 (2011):817-821. Health
Source: Nursing/Academic Edition. Print.
Silberman Steve,
“The Placebo Problem.” 20 Best American
Science Writings 2010 31-44. Print.
Semester Reflection
Reflecting on a Challenge
What an amazing and challenging semester it has been! I can honestly say when I entered this class I had NO IDEA that it was a research based writing curriculum. I have always really enjoyed writing and while I realize there are far better writers than myself out there I think I write a pretty good paper! Now I have to clarify, when I say I can write a pretty good paper I mean a pretty good fictional paper. I love diving deep into my imagination to see what I can find and who I can create. So needless to say this was a very challenging class for me. Challenges aside I think and hope I rose to the occasion! I can honestly say that hours of research and reading went into my papers and as a result I am very far behind on my TV shows I enjoy and fiction books I love to read.
I have thoroughly loved the challenges this class provided! It forced me to think in a way that is very foreign to me but allowed me to learn that I can find a way to argue on paper. I learned how to sift through other peoples research in order to find exactly what I was looking for (or hopefully something close). There were many late nights reading quietly with my bedside light on while the rest of my house slept soundly knowing that if I didn't finish or turn the assignment in on time I would be more than disappointed in myself.
As I look back on this semester I see three papers written, 2 that I am proud of and one that literally kicked my ass. A patient teacher that took time out of her day to help me through my ass kicking paper and faceless peers who offered insight on how to make my work even better.
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