Keith Douglas
Recap
Last time, I wrote more about realism and discussed Haack on the (de)merit(s) of fuzzy logic, addressing along the way the question of how one picks a logic. Also, implicit is the question of logical correctness – what concerns should govern that choice (if there is one). I received no comments and thus will move.
This time…
I was rereading a book on social problems which I have had for a while. This is a rather old book, and it also thanks, if I am not mistaken, a long-time contributor of comments, Alex B! (He apparently worked on the index.) This is interesting at least on a personal level. Thanks Alex, for his work then – and now. The book is a sort of (I’d guess) textbook for roughly 300-level courses in sociology of social problems and perhaps social science methods. It points out (rightly, as far as I can tell) that the American approach to sociology was closer to what I’d call applied than basic science from the get-go. I also find it very interesting that sociology of mental health seems to have been part of the field for a long time – it explains my sister finding an out-of-date undergraduate course in the subject years ago to annoy her – even as primarily an undergraduate honours psychology student. Incidentally, the text is very Canadian – that might be why the Europe / US contrast is present.
All this is preparatory to bring up today’s topic. Buried, as they say, in a footnote in this text (in a discussion basically of industrial or organizational sociology) is a strange remark. It tells us that the placebo effect in medicine is the same “thing” as the Hawthorne effect in industrial social psychology, as both are “self-fulfilling prophecies”.
This struck me as being strange. This month’s column is therefore an analysis of this claim. First, I’ll (as an outsider to both social psychology and clinical disciplines) try to summarize both without prejudicing the question, then walk through an analysis of commonalities and differences. I will then look at the “self-fulfilling prophecy” aspect. Finally, I will end with a question about identity.
The Hawthorne effect occurs when interventions in a workplace show productivity or worker satisfaction improvements regardless of the characteristics of the intervention. This can even include reversals. (Turning up the lights one week and then back down the next, both having – temporary – effects.)
The placebo effect is a positive, subjective response to any medical or medical-esque intervention. Subjective here should not be read as dismissing the effect – it is perfectly real, it just happens in the nervous (and perhaps endocrine) systems, not the affected organs. It is also sometimes confounded with other sorts of immunological responses and is often the reason for proper trials of medical treatments.
Are these the same “thing”? Well, both have to do with reporting of what appear in both cases to be subjective conditions (again, this is not a dismissal). Both seem to manifest themselves statistically – not everyone reports the same effect. There are differences – it seems. For one, it is unclear to – someone search better than mind – that there is the equivalent of the nocebo effect in the Hawthorne cases. In medicine, the nocebo effect is the dual to the placebo – people given inert substances report negative concerns. This is, incidentally, one reason why saying that such-and-such a pseudotreatment is fine because “at least the people so treated will get a placebo effect”. They could very well suffer a nocebo effect for no good reason. (Of course, in many cases, they may suffer other problems!) Another difference seems to be in the fact that the anatomy is linked in a way that the social systems are not; the Hawthorne effect seems to be more social and does not rely on distinct but overlapping processes. What do you think the similarities and differences are? I’ve left some as an “exercise to the reader” – after all, this column is about provoking thought, not spooning answers and “complete” analyses.
On the “self-fulfilling prophecy” question. I don’t think either the placebo or the Hawthorne effect necessarily involves a prophecy (steelmanning Merton’s metaphor as just a way of saying “prediction”). I think for the same reason, “self-fulfilling” is unhelpful. If the executives at a corporation take advantage of the Hawthorne effect to temporarily improve their worker complaints records, saying to them that they have repainted the doors green one year and then back to blue the next, maybe then they are. But that’s in my view a sort of second-order concern. Moreover, it goes “through the heads” of the workers in a way that presumably the placebo effect does not – though this is hard to pin down precisely. Why? Because the nervous and immune system (and endocrine, etc.) are linked closely. Similarly, a worker doesn’t have to say to herself, “Hmm, I feel much better now that we have green doors!” to report on an employee satisfaction survey that she feels better at work – yet presumably something in her brain registers the difference – otherwise she wouldn’t report the mood change. (Those who want to talk about unconscious/conscious here can, but I think that’s a bit of a hammer to crush a peanut situation.)
Let’s finish by looking at the identity matter itself. What counts as “the same or different” here is not obvious. I don’t even know how to put the two concerns into a common bin that would be helpful – “matters that happen to humans” is too broad – since it would include catching COVID-19, feeling indigestion and suffering when a loved one dies. Suggestions? The common bin is itself likely related to an identity condition. Those who know some object-oriented programming may know that in many languages it is useful to override the identity operator – something that would give traditional metaphysicians a fit, but I think I’m still okay with it. (I did this for events in my 2001 MA thesis at UBC, after all!)
As usual, send in your topics, and I’ll be happy to consider them, and keep those natural intelligences in your life healthy and happy.