1056: Placebo & Nocebo Effects | Skeptical Sunday

1056: Placebo & Nocebo Effects | Skeptical Sunday

This transcript is yet untouched by human hands. Please proceed with caution as we sort through what the robots have given us. We appreciate your patience!

[00:00:00] Jordan Harbinger: Welcome to Skeptical Sunday. I'm your host, Jordan Harbinger. Today I'm here with Skeptical Sunday co-host neuroscientists, psychologists, and science communicator Helena Hartman. On the Jordan Harbinger Show. We decode the stories, secrets, and skills of the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you.

Our mission is to help you become a better informed, more critical thinker. And during the week, we have long form conversations with a variety of amazing folks, from spies to CEOs, athletes, authors, thinkers, performers. On Sundays, though we do skeptical Sunday, we're a rotating guest co-host, and I breakdown a topic you may have never thought about and debunk common misconceptions.

Topics such as Why the Olympics are kind of a sham, why tipping makes absolutely no sense, sovereign citizens, diet supplements, ban foods, GMOs, toothpaste, crystal healing diet pills, internet porn and more. And if you're new to the show or you wanna tell your friends about the show, I suggest our episode Starter Packs.

These are collections of our favorite episodes on persuasion negotiations, psychology, disinformation, cyber warfare, crime, and cults and more. That'll help new listeners get a taste of everything we do here on the show. Just visit Jordan harbinger.com/start. Search for us in your Spotify app to get started today.

Did you know that you can literally move mountains, figuratively, literally move mountains of of pain with your mind just by popping a sugar pill? Expectations are a powerful driver of emotions. But what do expectations have to do with placebo and something called no SIBO effects. In other words, sugar pills that make us feel good or bad.

Can we systematically use those in actual medicine and what goes on in our brain and body when we try to trick it into feeling better? Dr. Helena Hartman takes a deep dive into the neuroscience of expectation effects and the placebo and no SIBO effect. Of course. Spoiler alert, yes, it works. And no, it's not just in our heads.

[00:01:54] Helena Hartmann: Hi, Jordan. How is it going on the other side of the pond?

[00:01:57] Jordan Harbinger: Uh, today I've got quite a headache, so I guess I could be better. It's probably a little bit of a lack of sleep. Kids will do that to you, but it's just, it's not going away.

[00:02:06] Helena Hartmann: Oh, I'm sorry to hear that, but don't worry. What if I tell you that I have the solution for your pain or basically any issue?

[00:02:13] Jordan Harbinger: I am all ears. What is it? I'm I, you know, I'm not big on shoveling Tylenol down my throat, so I'm all ears.

[00:02:19] Helena Hartmann: Do you have any tic-tacs or smarties at home?

[00:02:22] Jordan Harbinger: We have tic-Tacs. Yes, but what does that have to do with my headache?

[00:02:25] Helena Hartmann: So we're going to channel the power of the placebo effect to get rid of your headache.

Just take one of those and believe that this is a treatment that will get rid of your pain to make it more understandable. Your positive expectations will then work its own magic to make you feel better

[00:02:42] Jordan Harbinger: placebos. Yes. We talk about this regularly on the show, and I know we had at least one episode on this a while back, but remind me in our listeners what the placebo effect is.

Once again,

[00:02:52] Helena Hartmann: the term placebo comes from Latin and means, I shall please. Simply define the placebo effect as any positive, physical or psychological change that occurs after taking medication without an active ingredient or after a sham treatment such as simulated surgery or infusion of a simple saline salt solution.

And it's not only present in fake treatments, placebo effects also play a role in conventionally prescribed, intrinsically effective, or pharmacologically active treatments. Mm-hmm as positive expectations can influence the outcome of treatment and the pharmacological efficacy of treatment medication.

This effect is dependent on many different things, but two of them stand out our expectations and our prior experiences.

[00:03:41] Jordan Harbinger: So that was a mouthful, but it totally makes sense, right? I take something and I believe in that thing that I'm taking, and it works alongside the medicine, actually doing something else like numbing my pain in the nervous system or whatever the no SIBO effect on the other hand.

That's kind of new to me. I feel like I've heard of that before, but is that like a weird little sibling situation we got here? The other side of the coin,

[00:04:03] Helena Hartmann: you're not wrong. Kind of. So the nocebo effect is often termed the placebo's evil twin in lay language because it does the complete opposite. Instead of making us feel good, it makes us feel all the bad things, pain, nausea, depression, you name it.

Basically. Any negative effects on health that you could imagine ever. The Latin word for this means I shall harm.

[00:04:26] Jordan Harbinger: So first of all, I thought nocebo was a made up word in English, like a play off the word placebo. They just do the word no in front of it. I didn't realize that was also Latin. That's kind of funny.

[00:04:35] Helena Hartmann: Yeah. And that one always takes people by surprise. And the nocebo effect is much less known than the placebo effect. Mm. But if a patient discovers, for example, that a certain medication has been tolerated poorly by someone they know, a friend or family member. The medication is more likely to be less effective or cause side effects in that patient.

The best example of nocebo effects in daily life is the development of these side effects. There are studies showing that extensive warning or explanation of side effects leads to a higher probability to develop just these effects. In other words, those who fear symptoms intensely enough, often get them, and this is particularly true for symptoms that occur UN specifically with many illnesses.

And this can even happen online.

[00:05:20] Jordan Harbinger: Yeah, because we kind of think placebo, okay, it works for pain or it works for anything, which we'll get into, I'm sure. But no sibo. I never think about it, but. You mentioned that if people who fear symptoms intensely enough, often get them, and you said it's particularly true for symptoms that occur un specifically with many illnesses, what's un specifically mean?

I haven't heard that word before either.

[00:05:41] Helena Hartmann: It basically means very generic symptoms that could occur in any disease such as headaches, stomach pain, or feeling nauseous. And these. These are symptoms we often experience and have. So we also notice them more often and they are more prone to occur in nocebo effects.

[00:05:57] Jordan Harbinger: This just occurred to me, this is totally the explanation for like voodoo or witch doctors and stuff, and it's like you go there and you're like, I wanna put a curse on my neighbor. And they do all this stuff, but I noticed often in voodoo and things like that, I don't know, I'm no expert, but it requires you to put like the doll in front of the person's house where they're gonna find it or like nail it to their door.

So they see it and they go, what the heck is this? This must be some voodoo. And they go to the witch doctor. And the witch doctor's like, yeah. Have you been having stomach pains or any headaches and they're like, oh my God, for sure I have. Right. And it's all just no SIBO stuff. And then you pay them for the placebo of, I don't know, like burning chicken feathers in your face.

Yeah. And you get better.

[00:06:36] Helena Hartmann: Yeah. That's basically it. And I think if I want people to take one thing away from this episode, it's that the placebo effect is everywhere and the no SIBO effect is too.

[00:06:44] Jordan Harbinger: Yeah. Everywhere. Including online. You said this could happen online. What do you mean by happen online? How can medical symptoms occur?

On the internet.

[00:06:52] Helena Hartmann: Well, for example, if many other patients report a certain side effect of a medication online, the probability increases that someone who reads about it, and this can be online in a newspaper anywhere, basically, they will first expect this previously unnoticed side effect and then actually feel it.

The nocebo effect is caused by intensive engagement with health information in the digital world nowadays. It can hinder the healing process and even promote illness. A very fascinating and very significant example of how no SIBO effects spread via social media is the COVID-19 pandemic. It is well known that vaccinations against COVID-19 can have adverse effects, but in one study it also turned out that side effects were reported more frequently.

Also described as stronger when people who were exposed to negative reports of post vaccination reactions on social media, so negative ones, and through personal contact before the vaccination. I.

[00:07:49] Jordan Harbinger: I see. So basically if you are inundated with like, oh, I got the vaccine and now I have headaches, you're much more likely to have headaches if you then go get the vaccine.

[00:07:58] Helena Hartmann: Exactly. Interesting. Yeah.

[00:07:59] Jordan Harbinger: It doesn't somehow surprise me that reading WebMD all day can make the situation worse because whenever I go on there, I'm like, oh, I have a weird headache kind of in the back of my head. Maybe I ate too much risotto and then it's like, oh no, maybe actually looks like I have stage four cancer.

Right. So it's like just one more reason to get rid of social media, I guess.

[00:08:17] Helena Hartmann: So true. So true. And these unpleasant symptoms occur particularly frequently when many people are warned about them, and that can be online or in real life. For example, in a study compared to a control group, without prior information, people suffered more frequently from, so-called altitude headaches, if they went up a mountain to hike, even if just one person in the headache group, so in the No Sea Group was made aware that they could occur before they ascended the mountain.

The probability was particularly high the more people told each other about it over the course of a week. These negative expectations had real and measurable effects on the body. Compared to the uninformed control group, the scientists detected increased headaches and more prostaglandins and thromboxanes in the saliva of the mountain climbers.

Who had learned about these high altitude headaches before climbing the mountain? Then in the group who hadn't learned about these headaches,

[00:09:14] Jordan Harbinger: I see

[00:09:14] Helena Hartmann: these two products are certain metabolic products that increase pain in the body.

[00:09:19] Jordan Harbinger: That's interesting. So if you're going hiking, I. Maybe tell the group leader not to tell everybody, Hey, we're going up really high.

A lot of you're gonna get sick. 'cause I've definitely gone on hikes where that's all anyone talks about. And did you take your altitude medication? Hey, I have extra altitude medication. Anyone needed altitude medication? And of course, one person is like, I can't take it. I'm allergic to it. And they're just debilitated and can't do anything even though they've never had altitude sickness before, because nobody will shut the hell up.

About how this is definitely gonna happen unless you take the medication. Yeah, yeah, exactly. Geez, it sounds like we're never really safe from no SIBO effects. You can go up the highest mountain and the no SIBO just gets worse. So it's not just in our mind. Right. Our bodies actually triggered to produce, you said like thromboxanes and prostaglandins, these chemicals that actually increase pain.

Are being produced in higher quantities or whatever as a result of basically the annoying guy next to me who won't shut the hell up about his headache. That's damning and disappointing, I suppose.

[00:10:16] Helena Hartmann: And I have one last striking study for you from the domain of pain where the no SIBO effect is best researched and exemplified.

I. One study investigated the consequences of doctors preparing their patients for the injection of a local anesthetic by announcing it as the worst part of the treatment similar to a big B sting. It turned out that these patients felt significantly more pain during the procedure then those who were told that the injection would help them feel comfortable during the following procedure.

And today because of this, medical students are already taught to announce an injection such as this one as a small prick that you hardly feel at most. Or to distract patients before a vaccination or blood sample by asking them questions or chatting about the weather. Basically anything that doesn't make them focus on the needle.

[00:11:05] Jordan Harbinger: Yeah, like I feel like it would be really awful to have somebody be like, Hey, this is gonna hurt a lot, by the way. It's like, dude, I don't really need to know that. Like, let me find out in the moment I, I guess placebo and no SIBO effects are pretty intense stuff. And it sounds basically like a self-fulfilling prophecy either way.

[00:11:23] Helena Hartmann: Yeah, they are exactly that. Both of them. When we expect something to happen, we pay more attention to the information that confirms our suspicions, and that means we notice them more frequently. Let's say a patient went home with a new medication and their friend told them on the way home that that medication worked wonders for them.

This will lead to a quite positive expectation and thus the medication might even work better in comparison to when he hadn't gotten that information. Expectations can be positive, negative, or basically anything in between.

[00:11:55] Jordan Harbinger: Gotcha. So we have two siblings here. Two sides of the same coin. The good and maybe evil's a strong word, but I'm gonna go with evil 'cause I love a good villain story.

[00:12:03] Helena Hartmann: Yeah, me too. Unfortunately, we still know way too little about no sibu effects, how they develop, and most importantly, why they persist. These little fellows are very hard to get rid of. The nocebo effect probably plays an even greater role in everyday life than the placebo effect, but it is much less well researched, and this is partly for ethical reasons, because deliberately triggering negative patient expectations often pushes the boundaries of medical ethics.

This is why we're doing research at my lab with controlled experimental studies to find out more about placebo and nocebo effects and how we can systematically use them in healthcare, but also in daily life.

[00:12:43] Jordan Harbinger: You know, it's funny if you wanna study this stuff, it's like, well, it's kind of unethical to tell your patients that this is gonna hurt because then it's gonna hurt more and ethics this, ethics that.

But if you're just a really crappy doctor, you can tell the patient that it's gonna hurt all you want and that it's gonna be terrible and uncomfortable, and it's just like, well, I'm just being honest. So, because I feel like I've gotten plenty of treatments where the doctor's like, this is not gonna be good.

You're not gonna like this. This is gonna be uncomfortable. This is gonna feel violating. And I'm like, dude. Relax. I wasn't even thinking about that. I was just gonna do some Instagram while you're crawling up. My Keyser. I don't need to know the details. But then that's not unethical. I just find that kind of humorous, right?

Like one-on-one bedside manner being terrible. No problem doing it in a lab for the benefit of science. Well watch out young lady. We're gonna revoke your license. Here. I thought researchers doing clinical studies actually did not like the placebo effect because they don't know if it's the drug having an effect or the placebo effect that the participants are experiencing.

Right. Isn't that why studies are always like, well, this did 1% better than placebo. Because that's like the base, right? The baseline,

[00:13:47] Helena Hartmann: yeah, exactly. Very true. So the placebo effect is often the bad part in clinical studies, just because it can jeopardize the introduction of novel drugs. So researchers generally need to show that the drug that they developed works better than the placebo effect, and this is why they compare a group who has taken the drug to a group who has received a placebo.

So a sugar pill, I. We're, however, from the experimental side, looking at it from a kind of different perspective, we want to use the effect by adding it on top of the pharmacologically effective treatment, like the cherry on top of the drug cake, I guess.

[00:14:23] Jordan Harbinger: Mm-Hmm. Drug cake. Hmm. So

[00:14:25] Helena Hartmann: we're studying how expectations affect the brain and body so that we can use them as a booster in therapy and.

The goal really is to systematically use the placebo effect to our advantage to boost these drug and other treatment effects.

[00:14:38] Jordan Harbinger: I mean, it seems like a good idea if it's gonna happen anyway. You might as well use it to row in the same direction that you're trying to go with the other painkillers or whatever.

You know, it feels better than aop, opioid painkiller, mindless consumerism. We'll be right back. This episode is sponsored in part by Nord, VPN. I travel a lot, which means I'm constantly jumping onto public wifi at airports, hotels, coffee shops, basically a hacker's playground. That's why I started using Nord.

VPN Nord. VPN gives you top tier security with next gen encryption and a strict no logs policy. So nobody's snooping on your data, finding out what you did and selling it to data brokers. And the best part, it's super fast. You're not even gonna notice it's running. There's nothing worse than waiting for a page to load when you have a crappy, like free VPN.

So even if you're not constantly traveling or using public wifi, A VPN, like Nord, VPN, still a smart move. Your online privacy is at risk even at home because your internet provider will track your activity and will sell your data, which is complete bs. But they do it anyway because they don't care about you.

And one feature I love is the ability to change my virtual location with one click. I actually use this a lot. That lets me access content from over 60 countries. So when I'm abroad and I wanna access us streaming services like Netflix or whatever, or I'm curious what's on in the uk. Nord. VPN's got me covered and with one account covering up to six devices, I got my phone, laptop, smart tv, and all of Jen's stuff is also all protected.

[00:15:55] Jen Harbinger: Get Nord VPN's two year plan plus four months extra@nordvpn.com slash Jordan harbinger. It's risk free with Nords 30 day money back guarantee.

[00:16:04] Jordan Harbinger: This episode is also sponsored by SimpliSafe. Alright, home security. If you wanna keep your family safe, you don't wanna deal with hassle and crazy costs, you gotta check out SimpliSafe.

We even set it up at my parents' house, my in-laws houses. Whether I'm setting the system before bed or we're heading out town, the peace of mind is really unbeatable. I can check the cameras anytime from my phone, like, yeah, all right. The house is still standing, and knowing that Simis Safe's live agents can respond within five seconds of an alarm going off is really next level protection.

They can also talk to intruders in real time, which could stop the crime before it even happens. Imagine some guys sneaking around and suddenly hearing like, Hey. What do you think you're doing? We're we're watching you look in vain for something valuable at the Harbinger residence. I've even had a few neighbors get hit with break-ins and every time I'm just like, man, if they'd had SimpliSafe, they would not have been such an easy freaking target.

It's so easy to set up. There's no long-term contracts. It's like a buck a day less, and don't just take it from me. Simply Safe's been named Best Home Security System by US News and World Report for five years straight.

[00:16:56] Jen Harbinger: We've partnered with SimpliSafe for an exclusive 50% discount on a new system, plus a free indoor security camera with fast protect monitoring.

Just go to simplisafe.com/jordan, but the 50% offer is for a limited time only. So be sure to order today@simplisafe.com slash Jordan. There's no safe like SimpliSafe.

[00:17:13] Jordan Harbinger: Hey, y'all. Check out our newsletter, Jordan harbinger.com/news. Every week, Gabriel and I, we break down an episode or a takeaway that we've been thinking about that week.

Something you can apply to your life. It's just a little tiny bite. We revamped the format. It used to be kind of a bit long. Now we're doing something different. Check us out. Jordan harbinger.com/news is where you can find it, and I really appreciate all the feedback we've gotten there so far. Jordan harbinger.com/news.

Now back to skeptical Sunday. So you're saying these effects, do they work in all kinds of treatments?

[00:17:46] Helena Hartmann: Yeah. Yeah, that's true. The placebo effect literally is everywhere. They don't work at all in the same way or strength, but still they are there and they work. I. For example, high price brand labels.

[00:17:57] Jordan Harbinger: Okay, so gimme the fancy expensive sugar pill with the colorful labels.

Got it.

[00:18:03] Helena Hartmann: Yeah. And on top of that, the use of invasive placebos, like an injection or a sham surgery and high placebo dosage

[00:18:10] Jordan Harbinger: actually. So not even pills. Inject the sugar straight into my veins and, I don't know, make it a double.

[00:18:15] Helena Hartmann: Yeah. Coming right up. And that actually increases the expectations towards the benefits of a placebo treatment.

Which then in turn boosts the placebo effect. It also makes sense that taking a higher dosage, for example, two pills per week as opposed to a one-time dose just works better.

[00:18:32] Jordan Harbinger: Mm.

[00:18:32] Helena Hartmann: And lastly, more precise and clearer expectations work better than unclear ones. If you tell someone this pill will reduce your headache in 30 minutes, people can form a clearer expectation than if you tell them that this pill will help you feel good at some point.

Placebo effects are also higher when people have directly experienced pain relief previously through a process called classical conditioning. Or when they have observed it in somebody else. This is called social observational learning

[00:19:03] Jordan Harbinger: conditioning. Do Pavlov's salivating dogs have something to do with this?

[00:19:07] Helena Hartmann: Yes, exactly. Apparently you paid attention in biology class.

[00:19:10] Jordan Harbinger: Hmm.

[00:19:11] Helena Hartmann: So placebo effects are basically learning phenomena. This means that we learn to expect a certain outcome. For example, pain relief. This learning can happen in many different ways. In science. We like to use three methods quite often, which are also sometimes combined with each other to boost it even more.

So first we tell people about the benefits and positive effects of a treatment. This is also called verbal suggestions. Second, we let them experience that the treatment works directly. This is the conditioning. So just like Pavlov, who rang a bell every time he brought food for his dog, we are associating the treatment, let's say a sugar pill with something positive.

For example, pain relief. After a while, the dog of Pavlov learned that the bell signaled food and started salivating already when just the bell was rung and no food was brought in. The same way people learn to associate the treatment with pain relief over time.

[00:20:05] Jordan Harbinger: Yeah. I always wondered if it's all about expectations, how come my bottle of headache medicine doesn't say within 20 minutes you should experience relief.

I guess they can't say that because it's different for everybody. So it'd be like false advertising if they say that, but I feel like that would make the medicine work better based on what we're learning right now.

[00:20:23] Helena Hartmann: I completely agree, but this is really dependent on, for example, body size, height, weight, everything.

So I think, I guess you're right. That is why they don't do that.

[00:20:31] Jordan Harbinger: Yeah, I mean, you should experience relief within 20 minutes unless you're really fat or really tall or really heavy, in which case it might take a little bit longer, let's say 40 minutes. Then it's like, but if you're really small, it might be like 10 minutes.

And then you just have a label that's three pages long and nobody reads it, so it stops working. Yeah. I don't know. There's a balance in there somewhere. Sounds like we're still animals after all. And we mention expectations a lot again, and it's quite fascinating how all this stuff works.

[00:20:56] Helena Hartmann: Yeah. We don't realize this, but our whole life is determined by expectations which fluctuate between.

Positive hope and negative fear, but exactly how positive or negative these expectations are largely depends on experiences we have had. And remember, this applies to basically all areas of life, including medicine, and it is those expectations and previous experiences that patients take with them when they go, for example, to a doctor or a therapist.

And researchers have known for a long time that these expectations can influence physical symptoms, the course of a disease, and the efficacy of treatments. In my lab, we study how positive or negative expectations affect pain processing. For example, how does believing a treatment will reduce or increase your pain, actually change your pain processing?

[00:21:48] Jordan Harbinger: Okay. Our expectations are obviously very important, but surely they're not so powerful that they can, I dunno, change the effect of. Real medication, right?

[00:21:58] Helena Hartmann: Actually, they are. Expectations are everywhere, and this means that they have a huge influence on our life. Optimistically. We swallow the tablet because it helped the last time, or we take one for the first time and are upset to read about its potential side effects.

In either of these cases, our expectations differ hugely and maybe as a result the effects of the same medicine due to, I'll give you an example. In 2011, my current supervisor, Dr. Ulrich Inger, and some colleagues of hers did a fascinating study showing just how powerful expectations are. Are you ready to hear it?

[00:22:33] Jordan Harbinger: Yeah. I'm all ears.

[00:22:34] Helena Hartmann: So listen to this. She and her team gave participants a potent opioid painkiller as an infusion three times, but each time they told participants something else. They varied the expectations. In the first round, they told participants the truth, which is that they got a potent painkiller in the second round.

They told them that they actually get something that will increase their pain and get this positive. Treatment expectations made the medication twice as effective at relieving pain, whereas negative expectations coupled with a worry that the pain might get worse ensured that it lost its effect. In a final round where participants were not told anything about the infusion, the painkiller had its normal intended effect that is the drug effect, but that was only half as much pain relief as the positive expectation round.

So these study results seem to explain why some people with chronic diseases do not respond well to pain medication. They're often desperate and anxious and have lost faith in medicine. This can reduce, or even as in this study, completely reverse the effect of medication that is actually supposed to be effective.

[00:23:44] Jordan Harbinger: Oh, interesting. That this is really, really cool stuff and it seems like we obviously definitely need to be investing probably just as much into persuasion and positive expectation framing as we should be in investing into these pain killing drugs themselves. Because I'm thinking of. You know when people have chronic pain and they go through every medical thing and then suddenly they're like, the thing that worked for me was putting an opal stone on the deck and charging it with the moon and then putting it under my pillow.

Yeah. And you're like, what are you, how on earth is fentanyl not working for your back pain, but like putting this stone outside and doing this nonsense ritual and putting it under your pillow is helping. And the reason is because they don't believe in the medicine anymore. Right. But they believe in this thing that their, like psychic told them.

So they're like, well, this is working for me because the placebo effect is as strong as the drug, or in this case the no SIBO effect kind of like eliminated the effect of the drug, which is, it's really amazing how powerful our brains are when it comes to pain. It's really just, I know this is your area of study, but I'm learning about it kind of for the first time and it's really incredible.

[00:24:52] Helena Hartmann: I agree. And honestly, scientists believe in the placebo effect too. And full disclosure, I have a little bag with some puppets under my pillow that take all my worries away so I sleep better. And that works for me. So I think everybody can do what they want and use the placebo effect to their advantage.

[00:25:09] Jordan Harbinger: That's great. And although other scientists are laughing at you right now, but maybe they should get their own puppets maybe,

[00:25:15] Helena Hartmann: but we do have to be a bit careful here. So this was a single study that found this really fascinating result. So in order for us to believe it more, ideally we would replicate that study.

That means we repeat the same study and check whether we find the same effect. Again, if we do, this makes us more confident than what we observe is actually real. But if we don't,

[00:25:36] Jordan Harbinger: yeah, it makes us less confident, I guess, because nobody's repeated this with a larger sample size and whatever.

[00:25:42] Helena Hartmann: Yeah, exactly.

The first finding might have been a false positive, so we find something, even though it's not true. Like me telling you you're pregnant after you've eaten three pizzas. This is why research is cumulative. Over time, we get more and more puzzle pieces and try to make sense of it all together. I. We need many studies on the same topic.

Just to start and understand it,

[00:26:04] Jordan Harbinger: to be fair, if you eat three entire pizzas, you will definitely feel and possibly even look pregnant at the time. For sure. Personal experience here over here. So trust me, I having a good authority, good personal authority, but what actually physically happens in the brain and body

[00:26:22] Helena Hartmann: expectation effects such as placebo or nocebo effects are no coincidence, nor are they just in our mind.

On the contrary, they're based on complex psycho neurobiological processes in the brain.

[00:26:34] Jordan Harbinger: Psycho neurobiological is an awesome word. That is a $10 word right there.

[00:26:39] Helena Hartmann: Yeah. Simply believing that a certain treatment is effective has been shown to activate mechanisms in the body that improve the treatment outcome.

This can also be described as a kind of internal pharmacy of the body that everybody just carries around with them. For example, imaging techniques can be used to show that certain areas of the brain, for example, pain relief systems are activated during this process. In the field of pain therapy or pain research, the placebo effect has been particularly well studied.

If a patient expects a remedy or medication to relieve pain, pain relieving substances known as endorphins are released in the brain and can even alter transmission of pain in the spinal cord. This relieves pain, for example, back pain or headaches, even though the patient has not taken a real painkiller.

[00:27:30] Jordan Harbinger: Wow. So are you saying that a sugar pill can make our spinal cord feel less pain? So this is interesting because it sounds like the placebo effect is not just the brain feeling the pain and being like, I'm not gonna feel that because I took a tic-tac, but it's all over the body. The whole body's being juiced up with endorphins that are like, nah, we're not gonna feel the pain because I got my puppets under my pillow, or whatever.

[00:27:51] Helena Hartmann: Yeah, exactly. In the study I just described, the authors found that placebo analgesia, so an inner treatment that allegedly reduces pain, actually reduced participant's pain, AKA, the placebo effect that was measured by asking the participants to rate the pain they feel on a scale from zero. I feel nothing to a hundred.

I feel everything in all of it. But it also led to reduced pain related activity in the brain and spinal cord.

[00:28:19] Jordan Harbinger: So does the placebo effect only work for pain? Because I worry that people are gonna be like, I can cure everything with placebo effect. Let me dump my chemo meds in the toilet and go get a bag of puppets.

They're like, go get a stone to charge under the moon. People could take this too far, I think.

[00:28:35] Helena Hartmann: Yeah, I completely agree. And we have to always be careful because some of these findings are very specific. So the spinal cord involvement study was quite unique to pain, but there's more, if we look beyond pain.

There's also research on placebo effects in mental health conditions such as depression or other physical conditions, for example, involving the immune system in the body. Studies indicate that the nocebo effect triggers processes in the central nervous system that can lead to physical changes. In this system, fear of pain can block opioids and inhibit dopamine leading to increased rather than decreased pain.

Really, they have effects on our whole body hormones, neurotransmitters, physiological responses, brain activity, et cetera.

[00:29:20] Jordan Harbinger: Wow. So you, you research all of that and you listen to every single episode of the show without fail. That's really amazing.

[00:29:26] Helena Hartmann: Yeah, I'm a wizard. Honestly, I wish I could do even more, but my time is also very limited and I focus my work specifically on expectation effects in pain.

In the treatment expectation research Center where I work, we collaborate with many different researchers in Germany and beyond to investigate the impact of patient's expectations on the efficacy of medical treatments in many bodily systems, chronic pain, depression, but also the immune system. We do experimental studies in healthy participants and also clinical studies with different patient groups.

Some groups even do research on placebo effects in animals.

[00:30:06] Jordan Harbinger: I think it's really cool that so many people are researching this, and I'm very curious about the immune system stuff. That's a different show, of course, a different episode of this podcast. But if you can, I. Make your immune system stronger with placebo.

That is incredible.

[00:30:21] Helena Hartmann: I agree.

[00:30:21] Jordan Harbinger: That's a game changer and I would love to talk more about that offline and see if there's another episode about that that we could do. That's awesome. Fascinating and hopefully real again, it's so cool that so many people are researching this stuff. Do these effects affect everyone in pretty much the same way, I'm guessing?

No, because bodies are so different and there's 8 billion of us, but you know how uniform is this?

[00:30:42] Helena Hartmann: Yeah. So placebos work in general and in principle, but not for everyone, and not for everyone in the same way. The effects can vary from person to person, symptom to symptom, and even disease to disease.

Genetic factors certainly play a role, but personality traits could also be important. Some people are inherently optimistic, positive, and open-minded. They might respond better to placebos than somebody who is more anxious, skeptical, and critical.

[00:31:10] Jordan Harbinger: Oh, crap. Anxious and critical. I feel attacked. But, uh, go on.

And also, did we just ruin the placebo effect for everyone with this episode? Like, sorry, your bag of puppets was working great last week, but now you know it's placebo, so you're not gonna. No more benefit from you. You gotta go out and get rocks now.

[00:31:25] Helena Hartmann: Well, the good news is that individual expectations can change everything.

So just change your expectations and you'll be good.

[00:31:31] Jordan Harbinger: Fine.

[00:31:31] Helena Hartmann: The cool thing is that there can even be a placebo effect when patients know they're taking a pill without an active ingredient. I. This gives us an idea of just how powerful these mechanisms can be.

[00:31:42] Jordan Harbinger: That's actually really good news right then.

Then that was what you tried in the beginning of the episode, making me eat a tic-tac and telling me it will still work against my headache, even though I know that tic-tacs are just little literal sugar pills. Was that what that move was there?

[00:31:55] Helena Hartmann: Yeah, exactly. That was what researchers call an open-label placebo.

In other words, you know that what you're taking doesn't actually have any pharmacological substance in it. Mm. It is basically inert. This new concept is currently still being studied a lot, but from ours and other studies, we know that open label placebos seem to work better when the person is in need of relief and has some kind of symptoms that they wanna get rid of in healthy, young adults with nothing to improve and.

Generally a nice lifestyle. It's actually not surprising that these effects are much smaller or even absent. There's even one step further. Jordan, imaginary placebos.

[00:32:35] Jordan Harbinger: Okay. Before we get onto what that is, 'cause that sounds like some Jedi stuff, I'm curious what you think if I tell my kids that their gummy vitamins that they take at night will make them tired and sleepy.

I mean, one, I know I'm just lying to my kids and calling it an open-label placebo, but. I dunno. Parents are with me. I might be okay with that. Do we think that might work or is it just mostly, again, with pain,

[00:32:57] Helena Hartmann: I guess it would only be an open-label placebo. If you told your kids that. It is the placebo effect and they're not actually gonna make them tired, but if they believe in it, then it will do something.

It would be more of a deceptive placebo if you tell them that it will make them tired. But I think it could work. Yeah, so you should try it. I

[00:33:12] Jordan Harbinger: think I'm fine with deceptive placebos also. 'cause sometimes I just want them to go to the sleep. Alright, so imaginary placebos. Placebos are already inert and work anyway.

Now they can also be literally imagined. How does that work?

[00:33:28] Helena Hartmann: Yeah, that is apparently a thing. I also had a hard time believing when I read it first. Basically, when you take an imaginary placebo, you don't have anything physical that you ingest or apply to your body. You just imagine taking it like a kind of ritual you do every day, where you imagine vividly that you are ingesting a pill.

For example, and it is these rituals and learning experience that fuel placebo effect. So it's, I'm actually in the end, not super surprised that it works. If we have these ritual and these expectations, they can already fuel the placebo effect quite well.

[00:34:02] Jordan Harbinger: So you literally just pretend you're taking medicine.

I'm drinking my medicine now with an empty hand. Nothing in it. And that actually works,

[00:34:12] Helena Hartmann: it seems. So first studies show, for example, that test anxiety in healthy students was lower in the groups who are taking either an open-label placebo or an imaginary placebo compared to a control group. The two placebo groups did not differ in their effects, meaning that they were equally effective in reducing test anxiety.

But again, we need more evidence to make us believe these findings and not trust a single study that we read.

[00:34:37] Jordan Harbinger: Sure. I, it's so easy to trick ourselves, I guess. Let me ask you this. If I give myself or someone else for that matter, a shot of vitamin B12 or saline solution, like you said before at the top of the show, and I tell them.

This is going to make you ace your exam because it helps your brain fire on all cylinders, something, something. And they're like, great. I give them the saline solution, the injection, right? We're already talking about invasive. What if it's something that gives them a little bit of like a niacin flush too, like there's another effect linked to it that they can feel and see.

They're like, wow, I'm really warm. This stuff's really working. Does that increase the placebo effect because they're actually getting like a pharmacological. Result, even though it's not the same result that they're going for like, like them being warm is not gonna help them ace the test. Them being warm is a side effect of, I don't know, niacin or something that's in that shot or B12, does that increase the placebo effect of them?

I don't know, feeling better as well. Does that question make sense? That was all over the place.

[00:35:36] Helena Hartmann: Yeah, it totally makes sense and I'm glad that you asked it because it does, and these placebos are so-called Active Placebos. It means that you get something that is supposed to, for example, have a pain relieving effect, or it's gonna make you be more concentrated at an exam, but it also has a side effect.

I remember a study where the side effect was like a little burning in the nose. They got a nose spray that was supposed to make them feel less pain, and actually people felt less pain because the side effect that they felt. Made them more confident and believing in the fact that they actually took something that is gonna help them.

[00:36:11] Jordan Harbinger: That's what I was thinking. 'cause it, they might go like a shot that makes you better in exam. That's not a real thing. And then it's like, oh crap, this is burning a little bit. I guess I am taking the limitless pill here or the, I guess I did get a magical injection from Jordan. It's just seems like that would work on me, I think is why I kind of came up with that.

Right. And I, I know. That pre-workout stuff. For example, you take these pre-workout things that are just like usually loaded with caffeine, but if they also include other stuff that makes you feel flushed or turns you red, you really do feel like you are on, you're just ready to do your one rep max in the gym or something.

And I feel like they add that in there to enhance the psychological effect. Of this pre-workout stuff, and probably because it's a cheap way to make something look like it's working or feel like it's working.

[00:36:56] Helena Hartmann: Yes, that's completely true. And in the case of the protein that you're taking before the workout, I guess that's kind of like an open label placebo, or at least has an open-label placebo effect to it.

If I would give you the nose spray and you'd feel the burning in your nose, that would be called a deceptive placebo.

[00:37:12] Jordan Harbinger: Is that even allowed? Like not telling people the whole story? I'm not saying, you know, me selling that in law school, which I didn't do, I kind of regret not doing it. Me selling that in law school, that's obviously not allowed.

But what about the ethics of research or medicine? Because it, I think it's a good thing because you're telling patients that who are gonna undergo, I don't know, chemo or something, that this is gonna make them feel better. I'm all for it, but on the other hand, it's kind of like. While you are giving them a drug that you're lying to them about, I don't know.

Where do the chips fall on this one?

[00:37:38] Helena Hartmann: Yeah, that's a super important point. In clinical practice, of course not. So doctors prescribe drugs to people for their illnesses and you won't find a doctor prescribing smarties or tic-tacs instead and not telling the patient about it. This is very unethical. These are all people who are in need of help and seek advice from a healthcare professional.

In research, we have strict ethical guidelines as well about what we can and cannot do. Most importantly is that the benefits need to outweigh the risks for the participants. I. Especially when investigating no SIBO effects. We have to be very careful because participants might have a strong negative feeling coming up in the experiment and we of course want to avoid that, especially in pain studies.

Yeah,

[00:38:21] Jordan Harbinger: I was gonna ask exactly that. Like how do you even get people to sign up for these studies? If I had some chronic pain or whatever, I'm not sure that I'd sign up to literally get fake medicine. It seemed, it would almost be insulting and, and maybe a waste of time

[00:38:34] Helena Hartmann: People, especially patients who are in pain or who have.

Symptoms that they are in need of relief are actually very keen on helping out researchers and promoting research. Otherwise, it's all about the incentive. So usually we pay participants a certain monetary compensation, and at least in my studies, they have the benefit of getting to see what their brain looks like from the inside.

And then it's all about information. You tell them how long they will lie in the brain scanner, how many shocks or heat stimuli they will get, and you make sure that they know they can cancel the study at any point. Participant comfort really is my highest priority because my studies can be very long and taxing, but it also automatically leads to better data.

And oh, I usually bring chocolate as a bribe.

[00:39:20] Jordan Harbinger: I mean, I prefer cash, but I know times are tough. When I was in college. They were offering. I remember this one study they were offering a hundred dollars to sunburn, one of your butt cheeks. Just one. Sadly I missed out on that one and, but I, man, I don't know.

It was tempting a hundred bucks back then. It's a lot of beer.

[00:39:37] Helena Hartmann: I am glad your butt cheek is okay though, and

[00:39:40] Jordan Harbinger: me too.

[00:39:41] Helena Hartmann: Since my studies are completely voluntary, that means only people who are interested in science or the money sign up. This is good on the one hand because the participant is motivated. On the other hand, the findings might not generalize to other people who wouldn't have signed up for such studies or who are generally not interested in participating.

[00:39:58] Jordan Harbinger: That's true. I I can also imagine having one of your cheeks so sunburned that you can't even sit down. It's like, uh, I'm not sure how, I'm not sure how much I love science after that. You know what's better than first degree burns on one of your butt cheeks. The deals on the fine products and services that support this show.

We'll be right back. This episode is sponsored in part by Better Help. You know, as kids, we're always learning new stuff, but once we're adults, that just kind of fades for many of us. And the good news, there's always room to grow just in a different way. It's one big reason why I'm a believer in therapy.

Jen and I both have our own better help therapists. We check in with 'em every week. I love that it's all online. No matter how chaotic things get, you can always fit it in. You fill out a quick questionnaire and I mean, it really is fast. It's like seconds. You get matched with a therapist that takes like a day or two max, and if you ever wanna switch, which is normal, you never really wanna feel comfortable with who you're talking to.

It's super easy. It's a couple clicks. You don't have to talk to them. You don't have to have like a breakup conversation with your freaking therapist, and there's no extra charge for that stuff either. It's just so much easier to deal with issues in your life before they spiral, even if they seem really minor right now, we all think we got it all handled.

There's just real, real value in getting ahead of stuff and for those wondering, yes, they also have couples counseling through their sister site regain, which I also recommend. So no excuses folks.

[00:41:13] Jen Harbinger: Rediscover your curiosity with Better Help. Visit better help.com/jordan today to get 10% off your first month.

That's better, HE p.com/jordan.

[00:41:22] Jordan Harbinger: This episode is also sponsored by Progressive. Hey y'all. Whether you love True crime or comedies, celebrity interviews, news, even motivational speakers, you call the shots on what's in your podcast queue, right? And guess what? Now you can call the shots on your auto insurance too.

Enter the name Your Price Tool from Progressive. The name your price tool puts you in charge of your auto insurance by working just the way it sounds. You tell Progressive how much you wanna pay for car insurance. They show you a variety of coverages that fit within your budget, giving you options, and that's something you'll wanna press play on.

It's easy to start a quote and you'll be able to choose the best option for you fast. It's just one of the many ways you can save with Progressive Insurance. Quote today@progressive.com to try to name your price tool for yourself and join the over 28 million drivers who trust progressive, progressive casualty insurance company and affiliates pricing coverage match limited by state law.

Once again, thank you for listening to and supporting the show. All the deals, discount codes, and ways to support the show are all in one searchable, clickable place. Jordan harbinger.com/deals. Now for the rest of skeptical Sunday. All right, so my curiosity, nearly satisfied for now, but can we systematically use these effects in medicine?

Because from what you tell me, these are amazing. I mean, they're almost as powerful as that opioid painkiller. In terms of the pain. It seems like we should do everything we can to harness these effects.

[00:42:33] Helena Hartmann: Yeah, we can and we should totally. I am a hundred percent with you on that. For example, 17% of Germans that is around 12 million people suffer from long lasting chronic pain.

So more attention should be paid to the power of expectations in medicine than has previously been the case, just because it has been shown to help maximize the efficacy of medication and other treatments. In the future, doctors should definitely pay more attention to the previous experiences and expectations of their patients.

When selecting, for example, new treatments, the aim must really be for patients to start treatments with positive expectations and avoid negative ones. And if necessary, these expectations in the beginning could be raised with psychological support or a nice conversation with the doctor where people feel comfortable and like they have somebody who cares about them and who's gonna help them.

In the end,

[00:43:27] Jordan Harbinger: it seems like it's all about setting people up in the right way. Yeah. Like, you ever go to the doctor and they're just really cold and you feel like you're, they're rushing you through there. It's a totally different experience than someone who's like, Hey, so how you doing? Oh, you know, this, that, and the other thing.

Oh, we're gonna take care of you. Don't worry about that. You know, how are the kids? And you're just like, oh, wow, this person actually gives a crap. This is amazing. My, my back pain's already feeling better, sitting on this bench in a gown that is open in the back with my butt hanging out. It's really incredible.

And also I'm, I always come back to my kids, you know, like my son was doing things like, oh, I feel sick. And I'd give him a, like a gummy one gummy, which is like a vitamin C gummy. And I'd be like, this is the medicine for your belly. And he would take it every day and he is like, oh, I'm all better now. And it doesn't just work on kids.

I thought it worked well on toddlers, but I should start doing it to myself.

[00:44:14] Helena Hartmann: Yeah, totally. And actually as part of the research center where I work, we also collect anecdotal examples of placebo and nocebo effects from our patients and participants in the studies. And one striking kids example I have for you is.

A girl said that her dad always puts magic paper on her seatbelt when she's sitting in the car and they start driving somewhere and that helps her to not feel nauseous and get sick.

[00:44:39] Jordan Harbinger: That's really good. I gotta use that. My daughter loves to just projectile vomit after like three minutes in the car 'cause she's looking out the window.

I, there's so many use cases for this as a parent, it's like I need just different colored gummies for every single ailment and I need to keep them in the central center council of the car. Unbelievable.

[00:44:57] Helena Hartmann: Yeah, and it's not only for the parents or the healthcare professionals. These findings are also of interest to the pharmaceutical industry where developing new approaches to treatment, and it also applies to active ingredients.

The pharmaceutical form dose of certain medications or even the patient information leaf, lets that people get together with their medication. For example, positive patient expectations could reduce D or require dose of a medication and therefore minimize the risk of side effects. The placebo effect can also accelerate healing after surgery, manual therapy and psychological interventions.

But how exactly it does this and under what conditions is still the focus of research. And I think we're gonna be busy for quite a while just to find out everything we can about placebo and no SIBO effects.

[00:45:43] Jordan Harbinger: I didn't think about lowering the effective dose, right? If somebody's taking like fentanyl for a back issue.

And they're having all kinds of side effects, or maybe it's developing a habit or they're relying on it, or they can't function because they're always on this opioid painkiller. If you can get them to also have the placebo effect and you can cut the dose in half or down by, you know, a third, that's huge.

I mean, that could literally save someone's life, especially if you're talking about a, a medication that's quite dangerous. So, really cool.

[00:46:12] Helena Hartmann: Yeah, that's totally true. There's even studies going on in our research center where people start off with a hundred percent of the real medication and then gradually this gets replaced by placebo so that it could go to a 50 50% of drug and placebo in the end, and people might still be able to learn that the benefits stay.

They won't need as much of the medication anymore because they can boost their drug effect with the little 50% that they have with the placebo effect.

[00:46:41] Jordan Harbinger: Yeah, it's frankly, it's amazing. I really didn't know the placebo was this pronounced. Before we come to an end though, I really, really don't want people to think.

The placebo effect can cure their cancer or some other very real disease. So they don't need chemo anymore 'cause they've got, you know, foot reflexology. I just, I really wanna be careful with this 'cause the effects of placebo are amazing, but they can't replace actual medical treatment.

[00:47:09] Helena Hartmann: Yeah, that's a good point.

Jordan. Thanks for bringing that up. I think it's good that we end the show with this with some realism. It's very important to clarify that the placebo effect also has limitations, even though we try to systematically use it and study it, it cannot really replace gold standard therapies in many medical conditions.

For example, cognitive behavioral therapy for people with depression. Or medication for cancer, like you said. On top of that, there are actual fake or sham treatments being deceptively sold to people, and those can do serious harm. In the case of homeopathy, this is not too bad. Best case, the placebo effect works really well to improve your health, but in the worst case, nothing happens and you just lost some money.

[00:47:50] Jordan Harbinger: Yeah, we did a whole skeptical Sunday about homeopathy. That was episode 8 82, and it's like, yeah, hey, if you wanna take this for a headache, fine, but if you're taking this for your pancreatic cancer, you're going to die.

[00:48:00] Helena Hartmann: Yeah, I love that episode by the way, but there are many expensive and harmful treatments out there, so I would as a recommendation, double check each treatment suggestion and its source to make sure it is legit before you start buying or using it.

For example, professional doctors will generally not shy away from explaining to you how a treatment works and why it is the best for you as a patient. It is important to close with the fact that the placebo effect is great, but it is not a magician or works a hundred percent all the time, and we definitely still need more research to find out which placebos work for who and in what situations.

[00:48:39] Jordan Harbinger: Spoken like a true scientist, you always got a hedge. Thank you so much for giving us an insight into placebo and no SIBO effects today. So amazing. I mean, this stuff just blows my mind. I feel like I miss my calling. If I was a better student, I would've been a scientist. I definitely learned a lot, and I'm sure all the listeners did as well.

And when we chatted prior to recording this episode. You actually told me that next to your research job you do other forms of science communication, which makes sense 'cause this is a really good episode. Tell us a little bit more about that. 'cause I know people are interested in science. They might wanna find out more about what you're doing.

[00:49:10] Helena Hartmann: Yeah, of course. I'd love to. I actually have my own project called Science and Fiction, where I explain scientific research with fictional short stories. Do you like to read?

[00:49:21] Jordan Harbinger: Well, I have no choice. Yeah, I read one or two books per week at this point.

[00:49:25] Helena Hartmann: Me too. My favorite genre is science fiction with very dystopian endings, hence the name of the project.

I started it during the pandemic where I realized I not only enjoy reading, but also creative writing a lot, and I'm really passionate about explaining my research or other people's research to people who might have a bit of a harder time than me to read scientific papers that are endlessly long and really, really complicated.

[00:49:49] Jordan Harbinger: Yeah, I feel you. I read some of these studies sometimes, just so you know. If somebody makes a claim, I can maybe kind of check it. Yeah. They make me fall asleep a lot of the time. It's like needless complication. I feel like that's, your colleagues love to complicate things needlessly and hedge, and it's like, okay, for God's sake.

[00:50:05] Helena Hartmann: Yeah. I feel exactly the same. Researchers often use very complex language that not even other scientists understand. It's really frustrating and. My project science fiction hopefully solves that issue. It is meant as a space for people who like to learn about science, but also read science fiction at the same time.

And I want it to be kind of like an open door into science and its results. Each contribution in my project includes a fictional short story, a scientific publication related to the story and the heart of it, which is an easy to understand summary of the publication and explanation of its connection to the story.

[00:50:42] Jordan Harbinger: So if I or somebody listening right now also likes writing, can we also contribute to the project?

[00:50:48] Helena Hartmann: Definitely, I'm always looking for guest contributors, so just go to the project's website, science and fiction.net and you can have a look. You'll find all the information you need about how you could contribute.

Just as a little spoiler alert, there are also some stories about taking pills that will change your life forever. And dogs behaving very weirdly.

[00:51:08] Jordan Harbinger: It's, uh, quite a cliffhanger. And thank you again. That's it for today. I'm gonna go and try out that tic-tac idea to get rid of the headache. If my kids have eaten all the tic-tacs, I guess I can just imagine taking pretend tic-tacs for risks and side effects.

Uh, yeah, ask your local scientists. Thank you so much, Helena.

[00:51:24] Helena Hartmann: Thank you so much for having me on the show.

[00:51:28] Jordan Harbinger: If you're looking for another episode of the Jordan Harbinger show to check out, here's a trailer with Arthur Brooks.

[00:51:34] Clip: Anytime you catch yourself comparing yourself to others, you have to stop and say, that's what I'm doing.

Don't do that. Oh

[00:51:40] Jordan Harbinger: God. Easier said than done. Yeah, I know, but although you've,

[00:51:42] Clip: once

[00:51:42] Jordan Harbinger: you know that the knowledge is power. I was just at a bachelor party and some of my friends were like, oh man, some of our friends, they just became like high school teachers and I was like, well, lemme stop you right there.

You know how happy those people are. They figured out what they wanted to do when they were like 24. They got married to somebody they'd been dating for a while. They had kids well before age 30. They're satisfied with what they're doing. In a lot of ways. They have way more free time than you and I. We cannot sit back and judge.

We're wired in a way that we're always dissatisfied. They're wired in a. Way where that is fine. I'm jealous of that On many levels, one in six Americans have actually stopped talking to a family member because of the election. That's pretty scary. It's

[00:52:19] Clip: almost one in five now. Yeah. Politics has become super, you know, hyper attenuated in our, in our culture where, uh, it's taken on this outsized role and importance to assume ad hominem.

This is what you were saying, it's like Jordan made this joke on Instagram, and so therefore I know what's residing in the depths of his heart. Right. I, I bet you he bears an. Towards some racial groups, a wild leap, but that's exactly what we're talking about. Motive, attribution, asymmetry on the basis of ad ho, don't be that guy.

93% of us wish the country were more united. You're part of the problem when you do that. So I got a win win win proposition for our listeners and viewers today. Number one is I'm gonna make you more persuasive. I'm gonna make you happier, and I'm gonna start a social movement in your heart in a tiny little way to bring our country together, and that's answering hatred with love.

As much as you possibly can

[00:53:12] Jordan Harbinger: for a great discussion on how we can bridge the divide in our relationships, our country, and even within our families. Check out episode two 11 with Arthur Brooks here on the Jordan Harbinger Show. Thank you so much for listening. Topic suggestions for future episodes of Skeptical Sunday to me, jordan@jordanharbinger.com.

Show notes on the website, transcripts in the show notes, advertisers deals, discounts, and ways to support the show. All at Jordan harbinger.com/deals. I'm at Jordan Harbinger on Twitter and Instagram. You can also connect with me on LinkedIn. Helena Hartman is over@helenahartman.com. We'll of course link to that in the show notes.

This show is created an association with Podcast one. My team is Jen Harbinger, Jace Sanderson, Robert Fogarty, Ian Baird and Gabriel Mizrahi. Our advice and opinions are our own, and I am a lawyer, but I am not your lawyer. Do your own research before implementing things you hear on this show. Also, we may get a few things wrong here and there, especially on Skeptical Sunday.

If you think we really dropped the ball on something, please do let us know. We are usually pretty receptive to that. Y'all know how to reach me, jordan@jordanharbinger.com. Remember, we rise by lifting others. Share the show with those you love. And if you found the episode useful, please share it with somebody else who could use a good dose of the skepticism and knowledge we doled out today.

I think there's a lot of really useful stuff here in this episode, especially for parents, as long as you're willing to lie to your kids like me. In the meantime, I hope you apply what you hear on the show so you can live what you learn, and we'll see you next time.