Toward Understanding the Placebo Effect: Investigating a Possible Retrocausal Factor

What if consciousness is not an emergent property of the brain? Observational and empirical challenges to materialistic models

The nature of consciousness is considered one of science's most perplexing and persistent mysteries. We all know the subjective experience of consciousness, but where does it arise? What is its purpose? What are its full capacities? The assumption within today's neuroscience is that all aspects of consciousness arise solely from interactions among neurons in the brain. However, the origin and mechanisms of qualia (i.e., subjective or phenomenological experience) are not understood. David Chalmers coined the term "the hard problem" to describe the difficulties in elucidating the origins of subjectivity from the point of view of reductive materialism. We propose that the hard problem arises because one or more assumptions within a materialistic worldview are either wrong or incomplete. If consciousness entails more than the activity of neurons, then we can contemplate new ways of thinking about the hard problem. This review examines phenomena that apparently contradict the notion that consciousness is exclusively dependent on brain activity, including phenomena where consciousness appears to extend beyond the physical brain and body in both space and time. The mechanisms underlying these "non-local" properties are vaguely suggestive of quantum entanglement in physics, but how such effects might manifest remains highly speculative. The existence of these non-local effects appears to support the proposal that post-materialistic models of consciousness may be required to break the conceptual impasse presented by the hard problem of consciousness.

Investigating expectation effects using multiple physiological measures

The study aimed at experimentally investigating whether the human body can anticipate future events under improved methodological conditions. Previous studies have reported contradictory results for the phenomenon typically called presentiment. If the positive findings are accurate, they call into doubt our views about human perception, and if they are inaccurate, a plausible conventional explanation might be based on the experimental design of the previous studies, in which expectation due to item sequences was misinterpreted as presentiment. To address these points, we opted to collect several physiological variables, to test different randomization types and to manipulate subjective significance individually. For the latter, we combined a mock crime scenario, in which participants had to steal specific items, with a concealed information test (CIT), in which the participants had to conceal their knowledge when interrogated about items they had stolen or not stolen. We measured electrodermal activity, respiration, finger pulse, heart rate (HR), and reaction times. The participants (n = 154) were assigned randomly to four different groups. Items presented in the CIT were either drawn with replacement (full) or without replacement (pseudo) and were either presented category-wise (cat) or regardless of categories (nocat). To understand how these item sequences influence expectation and modulate physiological reactions, we compared the groups with respect to effect sizes for stolen vs. not stolen items. Group pseudo_cat yielded the highest effect sizes, and pseudo_nocat yielded the lowest. We could not find any evidence of presentiment but did find evidence of physiological correlates of expectation. Due to the design differing fundamentally from previous studies, these findings do not allow for conclusions on the question whether the expectation bias is being confounded with presentiment.

Predicting the unpredictable: critical analysis and practical implications of predictive anticipatory activity

A recent meta-analysis of experiments from seven independent laboratories (n = 26) indicates that the human body can apparently detect randomly delivered stimuli occurring 1-10 s in the future (Mossbridge etal., 2012). The key observation in these studies is that human physiology appears to be able to distinguish between unpredictable dichotomous future stimuli, such as emotional vs. neutral images or sound vs. silence. This phenomenon has been called presentiment (as in "feeling the future"). In this paper we call it predictive anticipatory activity (PAA). The phenomenon is "predictive" because it can distinguish between upcoming stimuli; it is "anticipatory" because the physiological changes occur before a future event; and it is an "activity" because it involves changes in the cardiopulmonary, skin, and/or nervous systems. PAA is an unconscious phenomenon that seems to be a time-reversed reflection of the usual physiological response to a stimulus. It appears to resemble precognition (consciously knowing something is going to happen before it does), but PAA specifically refers to unconscious physiological reactions as opposed to conscious premonitions. Though it is possible that PAA underlies the conscious experience of precognition, experiments testing this idea have not produced clear results. The first part of this paper reviews the evidence for PAA and examines the two most difficult challenges for obtaining valid evidence for it: expectation bias and multiple analyses. The second part speculates on possible mechanisms and the theoretical implications of PAA for understanding physiology and consciousness. The third part examines potential practical applications.

Predictive physiological anticipation preceding seemingly unpredictable stimuli: a meta-analysis

This meta-analysis of 26 reports published between 1978 and 2010 tests an unusual hypothesis: for stimuli of two or more types that are presented in an order designed to be unpredictable and that produce different post-stimulus physiological activity, the direction of pre-stimulus physiological activity reflects the direction of post-stimulus physiological activity, resulting in an unexplained anticipatory effect. The reports we examined used one of two paradigms: (1) randomly ordered presentations of arousing vs. neutral stimuli, or (2) guessing tasks with feedback (correct vs. incorrect). Dependent variables included: electrodermal activity, heart rate, blood volume, pupil dilation, electroencephalographic activity, and blood oxygenation level dependent (BOLD) activity. To avoid including data hand-picked from multiple different analyses, no post hoc experiments were considered. The results reveal a significant overall effect with a small effect size [fixed effect: overall ES = 0.21, 95% CI = 0.15-0.27, z = 6.9, p < 2.7 × 10(-12); random effects: overall (weighted) ES = 0.21, 95% CI = 0.13-0.29, z = 5.3, p < 5.7 × 10(-8)]. Higher quality experiments produced a quantitatively larger effect size and a greater level of significance than lower quality studies. The number of contrary unpublished reports that would be necessary to reduce the level of significance to chance (p > 0.05) was conservatively calculated to be 87 reports. We explore alternative explanations and examine the potential linkage between this unexplained anticipatory activity and other results demonstrating meaningful pre-stimulus activity preceding behaviorally relevant events. We conclude that to further examine this currently unexplained anticipatory activity, multiple replications arising from different laboratories using the same methods are necessary. The cause of this anticipatory activity, which undoubtedly lies within the realm of natural physical processes (as opposed to supernatural or paranormal ones), remains to be determined.

Electrocortical activity prior to unpredictable stimuli in meditators and nonmeditators

Advanced meditators occasionally report experiences of timelessness, or states of awareness that seem to transcend the usual boundaries of the subjective present. This type of experience was investigated in eight experienced meditators and eight matched controls by measuring 32 channels of EEG before, during, and after exposure to unpredictable light and sound stimuli. The experiment postulated that if some aspect of consciousness extends beyond the present moment, then prestimulus electrocortical signals should differ depending on stimuli that were about to be selected by a truly random process, and that if such experiences were catalyzed through meditation practice, then prestimulus differences should be more apparent in meditators than in nonmeditators. Each of the 32 EEG channels was baseline adjusted on each trial by the electrical potential averaged between two- and one-second prestimulus, then for each channel the average potential was determined from one-second prestimulus to stimulus onset. The resulting means across subjects in each group were compared by stimulus type using randomized permutation procedures and corrected for multiple comparisons. Within the control group, no EEG channels showed significant prestimulus differences between light versus sound stimulus conditions, but within the meditator group five of 32 channels resulted in significant differences (P < .05, two tailed). Comparisons between control and meditator groups showed significant prestimulus differences prior to audio tone stimuli in 14 of 32 channels (P < .05, two tailed, of which eight channels were P < .005, two tailed). This outcome successfully replicates effects reported in earlier experiments, suggesting that sometimes the subjective sense of awareness extending into the future may be ontologically accurate.

Imaging the placebo response: a neurofunctional review

An emerging literature has started to document the neuronal changes associated with the placebo phenomenon. This has altered placebo from being considered a nuisance factor in clinical research to a target of scientific investigation per se. This paper reviews the neuroimaging literature on the placebo effect, and illustrates how imaging tools can improve current understanding of brain mechanisms underlying the placebo response. Imaging studies provide evidence of specific, predictable and replicable patterns of neural changes associated with placebo administration. In general, placebo responses seem mediated by "top-down" processes dependent on frontal cortical areas that generate and maintain cognitive expectancies. Dopaminergic reward pathways may underlie these expectancies. Placebo-induced clinical benefits also involve disorder-specific neuronal responses, yielding neurofunctional or neurochemical alterations similar to those produced by pharmacological treatments.