MIND OVER MATTER
A lover of words and eternally-nascent philosopher captivated by the human condition, I am shocked it took me this long to learn that placebo, in Latin, means “I shall please.” Anyone with remotely similar interests already knows that fascinating information about the placebo effect is widespread. And why not? Research describing what happens when we are on the receiving end of a placebo is nothing short of astounding. Understanding that our bodies, most importantly our remarkably plastic brains, may undergo changes in response to being exposed to an inert substance is astonishingly empowering.
Much to their chagrin, pharmaceutical companies are compelled to demonstrate that their drugs outperform a placebo. And rightly so (indeed, there may soon be a well-justified push within the medical community for certain surgeries to reliably outdo “sham surgeries”). Do you know that such an obligation frequently proves to be more difficult in the good ole USA? That’s because the placebo effect occurs with greater frequency and intensity here in America than in many other countries! Another remarkable tidbit is that the placebo response has been shown to increase as the delivery of an inactive substance becomes more extreme (if pills produce results, shots will generate better ones).
Many people acknowledge that the placebo (as well as its cousin, the nocebo) effect manifests due to our expectations – in other words, such responses are a consequence of motivated reasoning and confirmation bias. Then again, some studies show that when a “treatment” is clearly labeled as a placebo (as a substance having only inactive ingredients), the mere ritual of taking that inert “therapy” can nonetheless result in an improvement of symptoms. Like I said: astounding!
The subtitle of this reflection, a story about death, breaching whales, and the power of placebo, indicates there are three entangled topics to consider. Having just briefly touched upon only one, a subject which will be revisited, it is time to speak about the sudden and shocking death of a special friend.
Ragnar tragically died in the spring of 2017 at the age of fifty. Those who knew him well remember fondly his unique personality and uplifting disposition. I suspect that each loved one who survives him is coping with the conspicuous absence of this exceptional individual in differing ways.
Having met while attending graduate school in the mid-nineties, I quickly learned that Ragnar was a tried and true academic who, with great passion and a keen mind, studied cognitive-behavioral science. Despite being admitted in to different programs, our mutual interest in psychology, perception, and the curious workings of the human mind ensured we periodically ended up in the same seminars. I’ll say this for studying philosophy of mind: there are few activities that will reveal compatibility and expose contrasting viewpoints as quickly as investigating consciousness, what it is, and what entities manifest it. While we challenged each other plenty when it came to many metaphysical matters, where it truly counted we were like-minded. A fun-loving friendship blossomed.
Last winter, Ragnar reached out to me after almost a decade of our not being in close contact. When sharing our disbelief with how much time had passed, we confessed we lacked any reasonable justification for not being in touch given how much we enjoyed each other’s company. We committed to scheduling periodic FaceTime chats, allowing us to catch up on what had transpired during our long hiatus as well as hammer out some details for a much needed in-person encounter.
Without disclosing specific details of our deeply personal and candid conversations, I will divulge that the unsettling nature of his death left me feeling terribly distraught. I worried that Ragnar may never truly be at peace. Certainly I was not at peace. In early June, I found myself sharing this fear with a therapist. After listening intently, she suggested that I ask Ragnar for a sign indicating he was no longer struggling.
I chuckled and noted that if I asked for sign I would inevitably see one given my understanding of psychology and human cognition. “That’s how the mind works,” I may have said aloud, immediately thinking of the power of placebo and confirmation bias. She too giggled, encouraged me a second time, and assured me that I would recognize the sign when it was offered.
And so, on my regular morning bike rides, I would find myself not just “talking” to Ragnar as I had done in the last days of May, but requesting that, if he were so inclined, and if such things were in fact possible, would he be willing to provide me with some kind of sign indicating that he was liberated from any kind of suffering. Despite having this almost daily ritual go unanswered for the entire month of June, I was not deterred. After all, although I was willing to “talk” to Ragnar and ask him for a sign, I remained unconvinced that there are souls, let alone that such entities could or would grant the wishes of the living. Amidst all this uncertainty, I felt clueless as to what the sign might be assuming I would get one.
People who know him well probably associate Ragnar with canines because, for much of his life, he faithfully carried with him a stuffed animal, a dog named Vinstri. Vinstri’s white fur matched Ragnar’s platinum hair and alabaster skin. Moreover, Vinstri’s perpetual puppy dog-like state served as an appropriate analogy for Ragnar’s ever youthful, sometimes mischievous, yet consistently good-natured demeanor.
Vinstri didn’t just relocate with Ragnar from continent to continent, they took regular vacations together. Unsurprisingly, this globe-trotting stuffed animal has admirers all over the world. Vinstri, naturally, has a Facebook page chronicling his and Ragnar’s adventures. (Including some of Vinstri’s most awkward moments: getting a much needed bath!) What matters here is that Vinstri routinely barked; well, more accurately, he characteristically “voffed.” With Ragnar at the computer’s helm, Vinstri voffed for people’s birthdays and notable accomplishments, he voffed minutes both before and after Ragnar’s many marathons, he voffed for love, beauty, camaraderie, and a host of other significant life events.
As you can see, voffing about voffable occasions is voffably distinctive to Ragnar. So, I figured this sought after sign may manifest itself through a dog, perhaps via a little green man (you’ll just have to trust me on that), or maybe just a fair-skinned Icelandic fella’ with some Viking-esque designation. And…yet…nothing: there was no obvious communication from the ethereal realm of souls after an entire month of being watchful. Acknowledging my skepticism about the after-life (and whether it is even productive to contemplate such matters) led me to suspect that confirmation bias could be a causal factor: I expected no sign and, lo and behold, I was seeing no sign. That is, until July arrived.
A day after celebrating American Independence, while cycling along the coast of California, I spotted what appeared to be whale spouts. I pulled off the road, kept my eyes glued on the water, and within minutes saw a breaching whale. A humpback thrust itself, head first, out of the ocean, twirled around, and landed with an enormous splash. Glorious!
For twelve years I had been living next to California’s central coast, yet I had only been teased with infrequent glimpses of spouting whales. I had become impatient in my desire to witness the impressive and splendid sight of a breaching whale. Petty or not, I envied others (especially visitors!) when listening to them boast of their amazing and plentiful whale encounters – sometimes, they reported with glee, when simply standing near the pier! I began to suspect some locals were pulling my leg, given the amount of time I spent alongside the ocean racking up no such experiences. Zero, nada.
Deeply touched by this phenomenal bucket-list event, I immediately and enthusiastically shared my story with anyone who would listen; with joyful tears and immense gratitude, I recounted the details of my experience. I vowed to cherish this beautiful moment forever!
The next day, while again riding along the coast, I caught another glimpse of a spouting whale. I slowed down, watched curiously, and was rewarded with the magnificent sight of another breaching whale. “Wow,” I thought to myself, “this is incredible!” I got teary-eyed, sighed with awe, and continued my ride with a wide and joyous smile plastered on my face. I even “told” Ragnar about it.
Now, I am aware that this is going to sound far-fetched, but the very next day, while on a long coastal bike ride, I noticed more spouting. I parked by my bike and walked up a hillside for a better look. Moments later I saw a breaching whale. While feeling overwhelmed with wonder as well as a bit dazed and confused, I witnessed a second whale breach!
It was at that point that it occurred to me that blissful breaching whales could be Ragnar’s sign. It’s not that I’m dim-witted or anything, it’s just I had no compelling reason to associate Ragnar with whales. I thought to myself, “If this is your ‘I’m at peace’ sign, Ragnar, I am going to need you to voff at me again.” I waited. Much to my disappointment, no further breaches occurred. When lingering about no longer seemed sensible, I returned to my bike and headed back.
About 5 miles from home, I caught the sight of more spouting. I dismounted my bike and shouted within my mind, “Ragnar, show me!” Within seconds I saw a breaching whale. “Okay, okay, message received,” I thought, “You’re at peace, Ragnar; your soul is having a voffable experience now. I finally get it.”
Throughout July and August, I regularly witnessed the superb sight of whales breaching, so much so that I lost count of the number of days I viewed such grand occurrences (let alone the exact number of jumps and twirls themselves). To boot, I estimate that I saw more breaches on September 1st than I did in all of July and August combined. Seriously – I likely witnessed 100 or more breaches in a couple of hours! That particular morning played out much like a grand finale of a fireworks display; yet this particular show involved humpback whales, one after the other after the next, launching themselves into the air and spinning around before returning to feast on more krill.
Oh, and just so you know, along with breaching whales come displays of tail waving, fin flapping, and even barrel-rolling. Sparing you the chore of learning about my most notable experiences, I will testify that the performances I was blessed to witness last summer were more stunning, satisfying, and significant than I ever imagined. What’s more, I derived untold joy, great relief even, from being able to share some these phenomenal events with both loved ones and strangers.
When we chatted earlier in the year, Ragnar lovingly reminded me that my mindset and musings are, from his perspective anyway, granola. Such an upbeat attitude was alien to him even if admirable, within his sights but not yet within his grasp. Had I lost a different friend this year, if Ragnar were here to listen to this personal account, I expect he would have been enchanted yet chuckled often. Acting as a spokesman of atheism, he would insist that my dear dead friend no longer existed to offer any sign of wellbeing. The magnificent and unexpected breaching whale experiences would be explained away as a lucky coincidence. Even so, Ragnar would have delightfully noted that my endearing ability to overcome (or at least find value in) emotional hardship is rooted in my commendable dedication to maintaining the tranquil optimism of a hippy-dippy, wannabe Buddhist monk.
Perhaps this skeptical (if not realistic) perspective resonates with you: all this granola, feel-good mumbo-jumbo can easily be accounted for by appealing to what makes us susceptible to a placebo response in the first place. Sure, I’m on board. I am definitely not naïve enough to think that simply believing something makes it so. For instance, insisting you don’t have terminal cancer (when you do) isn’t going to prevent your body from succumbing to the cancer.
Even so, the brain-body connection is nothing to scoff at. The placebo response should not be thought of as something which is fake, as physiological changes can result from a person’s taking a placebo. In other words, the effects are real even if the specific treatments aren’t. Depression, pain, sleep disorders, menopausal symptoms, irritable bowel syndrome, asthma, as well as undesired side effects of genuine drug treatments have all been alleviated or mitigated in response to taking a placebo. Unsurprisingly, there is a growing portion of the medical community which is pushing for greater exploration into how to ethically and effectively incorporate placebos into holistic treatment plans. And, again, why not? Given painful symptoms and distressing conditions can be better managed, reduced, or otherwise improved by the sheer power of belief, patients are in reality left happier if not healthier.
The placebo effect is where biology and psychology intersect. Indeed, my guess is that this commonplace phenomenon has an underlying cause which we may never fully understand nor appreciate. I suspect that this same mechanism of consciousness is responsible for other staggeringly suggestive findings. For example, pregnant mothers experiencing significant emotional duress are more likely to give birth to infants who have genetic predispositions to certain diseases; those suffering from high levels of stress (depression or anxiety) are more likely to become ill or, in cases where they are already sick, are at increased risk for their symptoms worsening; consistent meditation and mindfulness practices alter the physiology of our brains. These findings (and many more!) reveal the undeniably awesome potency of our mental states and give renewed meaning to the phrase mind over matter.
Frequently enough, it seems, people find it all too easy to dismiss talk of the spiritual. Perhaps worse, there are those who seem to relish in diminishing the mysterious and marvelous workings of the mind. Many will be eager to point out the placebo effect has merely done its job pleasing me. Hardliners will outright deny that Ragnar is enjoying some kind of metaphysical peaceful existence. Yet why should that be what matters?
Without hesitation, I will humbly admit that we lack any persuasive proof that our pleas to those who have passed are received let alone answered. So, yeah, when it comes down to it, I have no clue whether Ragnar’s actual soul is actually at peace. Yet here is what I do know for a fact: I feel Ragnar is at peace and thus I am at peace.
In the face of a tragic loss of a loved one, a youthful friend filled with tremendous promise, instead of feeling robbed or cheated, I feel fortunate and grateful. I recognize that I am blessed to have walked upon this planet while he was here; I am blessed that we got to meet one another when we did; I am blessed that we reconnected after such a long hiatus; and, despite not knowing it at the time, I am blessed that I got to say goodbye to a dear friend before he died. Ragnar’s untimely death has provided me with an opportunity to flourish. As I chronicle those words with great confidence, I picture an amused Ragnar celebrating that he, even after dying, is contributing to my granola-ness.
Perhaps it will sound odd to admit this, but in some ways I feel closer to Ragnar than ever – with great consistency he is inspiring me to note what a voffably voffable day it is. A powerful psychological and emotional connection has been established which is not only irrefutable but likely irreversible. I suspect that whenever I see breaching whales in the future, I will at once envision a playful and joyful Ragnar, a delighted being freed from the burdens endured by the human body he formerly occupied. When alongside the ocean, I smile at the thought of my dear friend, Ragnar; and I remain curious whether he is going to spoil me by dramatically improving the chances that I’ll encounter the spectacular sight of blissful breaching whales.
What is truly more impressive and awe inspiring: that Ragnar’s soul would be behind any of this, or that what has transpired is mostly the result of a myriad of malleable activity manifested by my mind? Arguably more granola than ever, I opt for feeling enormously empowered. Even if limited to my personal ponderings perpetuated by the possibility of witnessing more breaching whales, whatever remains of my special friend reminds me to embody a lighthearted eagerness to experience joy with abandon. I choose to believe the two of us have been given an on-going opportunity to laugh together at a grand inside joke; one that is exceedingly humorous, deeply touching, and profoundly transformational.
Death is mysterious, and so is its aftermath, grief. There is no single model that explains everything and answers all questions, so we need to learn how to deftly toggle among many perspectives. The author calls out the junction of physiology and psychology, for example, and you can feel her work to reconcile what she thinks with what she witnesses and what she feels. This is so much the work of processing death; really, at least for my money, it’s so much the work of being human. (Yes, hence our belief that wrestling with the idea of death is essential to a living a full life.)
And in the face of all this ambivalence, she finds her way to playfulness. If you can get there honestly, play is one of the all-time great coping skills when bumping up against hard facts that won’t be changed. A sense of possibility can take root again. It’s in her interpretation of the whales and also in the embracing of Ragnar’s made-up language (“voffing”). This spells openness, and, importantly, it also spells safety. Play and safety feed off one another. And while safety is key to managing trauma, play is a wonderful (and psychologically advanced) way to reframe and create from loss, making life more than simply a tally of events. How helpful too to note that playfulness and grief can coexist.
Does it matter whether Ragnar had anything to do with the whales breaching? Not really, just as the author suggests. When dealing with mystery, truth takes on a naked subjectivity. The real question is whether associating the two serves her well and brings her closer to handling reality, which clearly it does. That is . And, even barely knowing Ragnar, it’s easy to see how the association would make him smile (and give the two old friends something juicy to debate). And being able to picture a lost loved one smile at you is beautiful way to work with grief.
And I can’t help but cheer her casual mention of therapy. Doing so helps normalize our universal need for help.
-BJ Miller, MD