Placebo

I’m at the rock climbing gym, and I have decided to climb a 5.11 route.* I know that it is too hard for me. I think about the distinctions in the grades as they were described by a seasoned 5.13 climber I met: “5.7s and 5.8s are beginner climbs. Most people can climb them within days,** once they have the hang of the movements involved. 5.9s and 5.10s are intermediate: your technique needs to be developed, and you need to have developed some finger and upper body strength. 5.11s and 5.12s are impossible: you must cling to imaginary holds and float up the wall on sheer strength of will. Harder than that? Unimaginable. You must have suction cups on your fingers.” And yet he does it, and others do it, all the time.

If he says that even good climbers think these climbs are impossible and the holds imaginary, I decide that I will just use my imagination. I will imagine, as I place my fingers on hilariously tiny ledges – touching them with half of the first pad on three fingertips on each hand, I snort incredulously – and my feet on what feel like almost imperceptible nubs of plastic, that this scant purchase is enough to hold me on the wall. It will even let me push farther up. I imagine that it is enough, and I find that I am still there, still clinging to these impossible holds, but my weight is starting to hurt my fingers. Hardly daring to breathe, I imagine that I can take one hand off and reach the next hold. I imagine that the subsequent pinching motion I must make with my thumb and first two fingers is enough to pull me to the next hold, and suddenly I am there. Again, again. I stop thinking and only feel the next and the next and the next move. I am halfway up the wall. I cannot believe it. I look around and think, “This is impossible,” and as I snap back into reality, I fall.

***

Here’s a thing: placebos work. When researchers give a control group a placebo in clinical studies, some of those people get better. More people given a placebo get better than a control group given nothing. This effect – the Placebo effect – has been thoroughly established and is not fully understood. What is a placebo? It’s nothing, but it does something. How?

A placebo makes people believe that they are taking something that will make them better. It seems that what is working is that belief itself. A general presumption among the public is that if the illness got better from nothing other than belief, it wasn’t a “real” illness to begin with; that person simply wasn’t “really” sick. But what makes an illness real? They had to have been experiencing symptoms and received a diagnosis to enter the study. But the placebo still worked – or, people are just spontaneously getting better more often with a placebo than with nothing at all. Possible, but unlikely.

I would argue, however, that it’s wrong-headed to discount the seriousness of the illness in those people; instead, we ought to look at the power the mind exerts over the physical body. More than that, we need to be clear that the mind is a part of the physical body. In our exceedingly digital and abstract society, we tend to look at the mind as the objective observer of the body and its experience, but that, in fact, is not fully possible. Not only can perception change reality within the body (as with a placebo, in some cases), but the body can also influence the mind. There are a number of hypothesis currently being researched on the role that, for example, the microbiota living in the digestive system plays in the development of mental health issues. In that way, diet may directly influence mental health. Chronic pain linked to orthopedic injury is known to be linked to depression, so much so that anti-depressants are part of the standard, accepted treatment plan for long-term pain. The acts of smiling and forced laughter are linked to noticeable improvements in mood. The mind-body connection is prolifically researched and still not fully understood, but it could be that we must move away from the idea of a mind-body connection and instead explore why we ever thought they were separate entities at all. Perhaps when a mind-body disconnect occurs, it is a prime opportunity for new pathologies to bloom and multiply.

***

A common practice in sports psychology is to counsel athletes to spend time visualizing a particular move successfully from start to finish. It’s very common in rock climbing, because often, climbers will work on a single route for dozens or even hundreds of attempts before completing the route without falling (a “send”). When the athlete visualizes the move, they are actually activating motor cortex in their brain – the same part of the brain that is activated in order to physically complete the move. Similarly, as this article by Jim Lohr in Scientific American states, “Studies have shown that the same brain regions become active when a person performs a task and when a person observes someone carrying out a task.” Watching someone else successfully complete an unfamiliar movement may allow us to complete the same movement.

As your motor cortex “learns” a movement, it becomes less conscious and more automated. This is commonly referred to as “muscle memory.” It’s what makes people better at sports and anything else they do. And it can be developed by something as simple as thinking about your move – just imagining it.

***

I am not claiming that a drug should not have to display a stronger and more predictable effect than a placebo to be considered useful. I’m a natural skeptic – or at least a trained one (as my sister and I always remind each other, our father always taught us to “Believe half of what you read and none of what you hear” and “Consider the source”). So I am not in a rush to put reactive substances into my body without good cause. Instead, I want to reframe my perspective: to honor the physicality of my thoughts and feelings, as well as the mental effects of felt physical sensations. I believe I’ve found a lot of health and strength in that mindset – even if that belief is just a placebo.

*A note on the Yosemite Decimal System (YDS): Just like standard versus metric measurements, no one uses YDS to grade climbs outside of the United States. The original Yosemite system included a range of graded inclines from 1.0 (a flat path) to 4.9 (a harder, exposed scramble – scrambles are generally now graded class II-IV, which roughly correspond to YDS grades). The 5.0 grade is more or less vertical and requires the protection of a rope in the case of a fall, but climbing anything up to 5.5 is about the difficulty of climbing a ladder. If you go to a climbing gym, you’ll start on 5.5s and 5.6s to get a grasp on the movements required in climbing.

If you’re into bouldering…well, I can’t help you, bro.

**It took me something like a year to climb a 5.8, so.

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