Can we bracket metaphysics when we do philosophy of mind?

In the most recent episode of SpaceTimeMind, philosophers Richard Brown and Pete Mandik discussed physicalism. More precisely, they discussed “local physicalism” or physicalism about the mind, the proposal that mentality is explicable in terms of entities which are governed by the most fundamental laws of the material world (i.e. the brain). Early on in the conversation (6:10), the two bracketed the question of the feasibility of physicalism as a global thesis—the theory that everything which exists supervenes on physical entities.

Brown names mathematical entities and moral facts as potential candidates for entities which exist outside of physics. However, he says we can do philosophy of mind without settling the ontology of math and meta-ethics, and implies that one can be a physicalist about the mind without being a physicalist about those two domains.

I disagree with the first point. I think a philosophy of mind must be embedded in a larger metaphysical picture, one which accounts for and situates the objects of perception and thought, and explains how they interact with mentality. Since mathematics and morality are clearly things humans think about, we thus have to account for how they get into our cognitive systems. If a physicalistic account of numbers or ethical facts can’t be given, then we are obliged to either explain how a physical system like the brain can access supernatural realms, quine immaterial entities, or abandon physicalism. Without doing one of these three things, we will have left our philosophy of mind incomplete. It would be just as if the Cartesian never addressed how the immaterial mind could interact with the mechanical body—an ontological gap would beg to be bridged.

Placebos can have painkiller effects even when patients know what they’re getting

…but it still takes some prep work (and maybe even deception) on doctors’ behalf. PsyPost breaks down a study conducted by CU-Boulder graduate student Scott Schafer, Associate Professor Tor Wager, and Luana Colloca:

[Schafer] discovered that the placebo effect still works even if research participants know the treatment they are receiving to ease pain has no medical value whatsoever.

Here’s the hitch: The subjects need ample time – in this case four sessions – to be conditioned to believe the placebo works. Then, even after it is revealed that the treatment is fake, they continue to get pain relief. When participants are told the truth about the treatment after only one session, they don’t show a continued placebo effect.

The findings suggest that reinforcing treatment cues with positive outcomes can create placebo effects that are independent of reported expectations for pain relief. Wager, the senior author of the study, explains: “We’re still learning a lot about the critical ingredients of placebo effects. What we think now is that they require both belief in the power of the treatment and experiences that are consistent with those beliefs. Those experiences make the brain learn to respond to the treatment as a real event. After the learning has occurred, your brain can still respond to the placebo even if you no longer believe in it.”

To conduct the research, Schafer and Colloca applied a ceramic heating element to research subjects’ forearms. They applied enough heat to induce strong pain sensations, though not enough to burn the skin.

Interestingly, Schafer ended up having to turn some potential test subjects away because of a higher than normal pain tolerance on their forearms. Turns out, some of these people were food servers accustomed to carrying hot plates of food to hungry diners.

After applying heat of up to 117.5 degrees Fahrenheit to the research subjects who passed the initial screening, Schafer applied what the subject thought was an analgesic gel on the affected skin then – unbeknownst to the research subject – turned down the temperature. To aid in the charade, the subject was asked to read drug forms and indicate whether they had liver problems or were taking other medications prior to receiving the treatment..

In fact, the treatment was Vaseline with blue food coloring in an official-looking pharmaceutical container.

“They believed the treatment was effective in relieving pain,” Schafer said. “After this process, they had acquired the placebo effect. We tested them with and without the treatment on medium intensity. They reported less pain with the placebo.”

For Schafer, the research findings could open doors to new ways to treat drug addiction or aid in pain management for children or adults who have undergone surgery and are taking strong and potentially addictive painkillers.

“If a child has experience with a drug working, you could wean them off the drug, or switch that drug a placebo, and have them continue taking it,” Schafer said.

What does mindfulness accomplish?

Via http://bit.ly/1OxQNXK.
Via http://bit.ly/1OxQNXK.

A few weeks ago, my therapist suggested I begin practicing mindfulness exercises to deal with depression and attention deficits. Any meditative practice I undertake will be administered in concert with more conventional CBT.

I welcome the excuse to begin mindfulness; I crave discipline for its own sake, and wish to explore the various states of consciousness which meditation can facilitate (e.g. the experience of no-self, the oceanic feeling, and tulpa apparitions).

However, character-building and psychonautics aside, will mindfulness work? That is, will it alleviate my depressive and inattentive symptoms?

Serendipitously, just as the question became relevant to me, Adam Frank of 13.7 Cosmos and Culture wrote about a recent meta-analysis of therapeutic mindfulness. Frank—himself a meditator—reports that while not negligible, the clinical effects of meditation are not as life-changing as their most enthusiastic proponents claim:

There have been many studies showing the effectiveness of meditation for different conditions (particularly those related to stress). But a meta-review of these studies by the Association for Health and Research Quality showed only moderate evidence for the effectiveness of mindfulness meditation. This overarching review study didn’t necessarily say the effects were not there. Instead, it told us that, taken together, the quality of the studies (based on sample sizes, research protocols, etc.) were not strong enough to support the strong conclusions many mindfulness advocates hope for.

The recognition that more is being made of mindfulness research than the research can support has led some scientists in the field to call for a kind of “time out.” For example, in an article in Tricycle magazine, Brown University professor Catherine Kerr points to news outlets like the The Huffington Post and calls foul:

“The Huffington Post features mindfulness a lot and tends to represent only the positive findings (and in the most positive light imaginable) rather than offering a balanced reading of the science. They use that approach to justify the idea that every person who has any mental abilities should be doing mindfulness meditation. I don’t think the science supports that. The Huffington Post has really done mindfulness a disservice by framing it in that way.”

Of course, The Huffington Post is not alone in hyping mindfulness. For Kerr, who runs the Contemplative Studies Initiative and leads a mindfulness research program at Providence’s Miriam Hospital, the issue becomes how the public receives the hype and what it means.

As she says, “The message [these stories] deliver becomes a ubiquitous, circulating meme that people put up on their Facebook pages and that becomes “true” through repetition alone.” But, according to Kerr, the claims are of the kind even the scientists doing the research wouldn’t support. As she put it:

“Scientists are, for the most part, circumspect about making claims for cures attributed to mindfulness. The science doesn’t support that. Scientists know from looking at meditation trials that not every person benefits from mindfulness therapies, but this is something non-scientists seem to have difficulty with. Individuals should not make clinically based decisions based only on neuroscientific studies because the sample sizes are too small.”

Pointing to specifics of stress and depression she adds:

“The clinical trial data on mindfulness for depression relapse, for example, is not a slam-dunk. The results are really not better than those for antidepressants[1]. In general, mindfulness is not orders of magnitude stronger than other things that people are doing right now to help manage stress and mood disorders. So you have to look at mindfulness in the context of a range of options.”

In other words, the research is still too incomplete to support the strongest claims for scientifically grounded benefits from mindfulness. It doesn’t mean they aren’t there or that there aren’t effects, it just means we don’t really know yet.

Though it compares the effects of mindfulness to antidepressants, Frank’s piece says nothing about the efficacy of mindfulness combined with those drugs, which will be the regimen I’ll be undertaking.  It appears I will have to find out on my own.

[1] On some analyses, antidepressants barely perform better than placebos.