You know the placebo effect. A doctor gives you a new drug that he says the folks at the Mayo Clinic have just developed and haven't yet been allowed to produce commercially, a drug that does incredible things to get rid of whatever ache, pain, or misery is driving you wild. You feel better after taking the stuff for just two days. And it's a problem that 30 other cures never dislodged. Unbeknownst to both you and your doctor, there was nothing in the pill but filler. Yet it worked!

Is this the stuff of rumor and of street mythology? No. The placebo effect has been proven over and over again in scientific studies. Scientists pooh-poohed it during the 1970s and 1980s, but when mind-brain medical approaches took hold in the 1990s, folks noticed that the placebo effect is not only real, but that it's sometimes more powerful than real pharmaceuticals, than top-notch standard medical care, and even than surgery.

Which leads to a question. Why is the brain able to grab hold of the body and yank it into health when a doctor hands you a sugar pill and tells you it's a new miracle drug? And why is your brain able to convince you to literally drop dead when you know your son in law wants your money, and has hired a top black juju practitioner to cast murderous spells on you, to put fatal amulets under your car seat, and to sprinkle deadly powders made from your own hair and lizard tongues on your doorstoop? How can a runaway belief in a futuristic drug or in a deft black magician, how can a rampaging fantasy, reach down into your cells and either pep them up or throttle them fatally?

Pain and health are determined in part by social input. However in many cases what's good for the social group is not so hot for the individual. Those who believe they're cursed by juju, voodoo, or by their own obnoxious personality will be more likely to shrivel up and die--not as a survival mechanism for themselves, but as a contribution to the group's collective adaptive powers--its superorganismic intelligence. This is neither noble nor just, but it is evolutionarily sound. Which means that we who have a sense of justice have to find ways around such evolutionary curses. Witch doctoring is one avenue around the pain of depression, illness, and death. Western medicine is another, but, alas, it ignores the importance of social input and relies instead on pills and the scalpel--surgery.

What in the world is the relationship between hard-nosed bio-building-blocks like mitochondria and leukocytes and absurd whimsies or deep but fantastical beliefs?

An individual is a node in a learning machine, a cell in the larger body of society. The flip side of the placebo phenomenon is the bush doctor or witch doctor phenomenon. In numerous hunter-gatherer tribes, the witch doctor comes to heal you when you're ill. In addition to a lot of mumbo jumbo, the witch doctor, according to Laura Bohannon, checks out your social connections. Are you having difficulties with your wives, your brothers in law, your tribal chief, or the tribal thief? Why this focus on social connections? Because frayed or severed social ties lower immune system response and invite illness. The reconnection of social ties heals. The mumbo jumbo reconnects you to society's conceptual grid. When an American or British doctor tells you that your pain in the stomach is nothing to worry about, it's simply gastritis, you feel relieved. The strangeness of the pain and the lack of control it demonstrated had confused and frightened you. Admit it, you were afraid it was cancer; something society says is an automatic killer.

The words the doctor uttered made you feel rooted and safe. But they were a Latin incantation with no content. Gastritis simply means "pain in the stomach." The doctor repeated what you told him in a foreign language. A language that hinted that he had control over that which you could not master on your own. He put you in a comfortable social grid. If he'd gone further--as the bush doctor does--he'd probably have discovered that your pains began when you started having early morning fights over the same issue over and over again with your wife. Her family, whose respect you valued, was lined up on her side. So was one of your kids, who was away at college and whose presence you sorely missed. The bush doctor would have brought your wife, your in-laws, and your son into the healing process and used it as an opportunity to knit you not only into society's conceptual grid but into the intimate grid of personal relations. Witch doctors have a pretty good record of healing using these two forms of social stitching. Our doctors might do better if they used them both as well.

Studies show that attachment in itself does as much as placebos. However the authority that the giver of a placebo appears to wield also makes a large difference in the sugar pill's effectiveness.

Why should authority be so important? Mary Douglas, the British anthropologist, distinguishes between two forms of social connection??grid and group. I've twisted her ideas a bit to fit the data I've been pecking away at for the last few decades. Here's how the concepts emerge after a bit of nipping and tucking. Group relationships are cozy, warm, and intimate--relationships with children, wives, husbands, lovers, close cousins, brothers, sisters, etc. In other words, group relationships are the sort that feminist sociological thinker Carol Gilligan feels women are particularly good at nurturing. Grid relationships involve a more abstract social hierarchy--the vast and invisible conceptual framework that knits together a large-scale society. Gilligan feels that men are particularly good at architecting these more impersonal relationships.

Meanwhile, what does this have to do with the individual as a cell in the society, or as a node in a learning machine? A cell, when it's given the signal that it's not needed, goes through programmed cell death--apoptosis. It kills itself from the inside out--allowing a genetic chain reaction to set in that opens its boundaries, its cell wall, and lets its innards leak away. A node in a neural net that moves down the wrong road to solving a problem at hand has its power and its connections to other nodes in the system shut down.

The witch doctor takes an individual who is receiving self-destruct signals from a social group that no longer seems to need him and reverses the signals. He knits frayed relationships and turns an individual from an unwanted outsider into a needed insider again. He makes the patient a useful and productive member of society. Reassured of this role, the individual's internal self-assessment devices--his inner-judges, to use the language of my book Global Brain, or his comparator mechanisms, to use the term coined by evolutionary theorist Michael Waller--give him the thumbs up instead of the thumbs down. As a consequence, his immune system is juiced up again and his psyche is no longer focused on turning the minor pains we experience all the time into major preoccupations. Voila, quite often the patent is healed.

See my nurse on the way out. She will give you the standard bill for a consultation with me. It will cost you $120. Next patient please!

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