Chapter 1: What is the placebo effect and how does it work?
In 1995, a 29-year-old construction worker arrived at an English hospital with a six-inch nail through his boot. He was screaming in pain. Every attempt to extract the nail just made the screams louder. Finally, the team sedated him and removed the boot. They looked at the nail. No blood. They looked at the foot. No wound. The nail had pierced nothing but the empty space between his toes.
The physical injury wasn't real. Only the pain was. You've probably heard of the placebo effect. You take a sugar pill and your insomnia goes away. But the effect can also work in the opposite direction, a nocebo effect. The expectation of relief or pain can create its own relief or pain.
Chapter 2: What is the nocebo effect and how does it impact our health?
This principle does not apply for everything. If you have a torn ACL or Achilles, sugar pills will do absolutely nothing for you. But if you're suffering from an illness with a psychological layer, pain, insomnia, depression, anxiety, expectation itself can be its own medicine. The science podcaster Shankar Vedantam wrote this in the Washington Post several decades ago.
Quote, after thousands of studies, hundreds of millions of prescriptions, and tens of billions of dollars in sales, two things are certain about pills that treat depression. One, antidepressants like Prozac work. And two, so do sugar pills. Placebo effects fascinate me because they seem to touch on some really profound truths about life. We do not live in the world as it quote-unquote is.
We live in the world as we expect it to be. We often see the world just as we expect it to look. The psychologist William James once wrote that, quote, faith in a fact can help create the fact. In medicine, faith in recovery can create the fact of recovery. This is exactly what we call a placebo effect. but we see this all the time in ordinary life too.
Chapter 3: Can belief in prayer have psychological benefits for non-believers?
Confident people are sometimes more successful, and it's not because confidence increases their IQ, but rather because it increases something else. Motivation, the ability to weather failure, the number of opportunities undertaken. Self-confidence creates the conditions for success. And on the flip side, socially anxious people are sometimes the most alone.
Their self-doubt creates the conditions for their self-isolation. The point here isn't as simple as just like believe in yourself and great things will inevitably follow. I think that would be pablum, nonsense. What I really mean here is something more like we are always living in a world partly created by our beliefs, even when we don't recognize exactly what those beliefs are.
And a part of seeing reality clearly and living life well is actually stopping to think hard about what assumptions have I made about the world that shapes the way I see it? Today's guest is Nir Eyal, the best-selling author of a new book, Beyond Belief, on the research behind how our beliefs shape our life.
We talk about placebos, nocebos, self-confidence, doubt, but we start with belief in the realm of religion by discussing an idea that I first read in Nir's work. In keeping with the power of belief, there's all sorts of evidence that prayer has psychological benefits, even in the absence of deep religious faith.
And so we begin our discussion of this enormous subject with a very specific question. Can you believe in prayer without believing in God? I'm Derek Thompson.
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Chapter 4: How do major world religions influence belief and performance?
This is Plain English. This episode of Plain English is presented by Audi. We all know that feeling, a change of plans, a new opportunity. Instead of overthinking, what if you just said yes? With the all-new Audi Q3, the answer is easy. It's made for the yes life, with the power and room to handle whatever pops up. Yes to adventure, yes to right now.
Because saying yes without hesitation, that's real luxury. The all-new Audi Q3, made for the yes life. Learn more at AudiUSA.com. Nir Eyal, welcome to the show. Great to be here, Derek. Thank you so much. You and I have known each other for a while. Do you remember how we met?
Chapter 5: What role does self-confidence play in success?
No, I don't. Do you? So no, I don't remember. You just sort of like appeared in my life. And I don't really recall exactly how. I feel like we initially started corresponding when I was writing about smartphones and compulsion and addiction, and then got really interested in your work on those subjects. We've just like... remained writer friends for the longest time. I loved this book.
I mean, you've written about technology. You've written about how companies hook us. You've written about how to resist the temptation of digital compulsion. This new book was a really interesting departure from some of those themes. It's a book about the power of belief in life. And I would love to start with religion.
Chapter 6: How can beliefs shape our perception of reality?
Tell me about your personal history with Judaism.
Well, I grew up in a pretty secular family, and the last time I prayed before I embarked on this line of research that I've been steeped in the past six years, the only time before that that I ever prayed was when I was six years old. And I remember my family had been in the country for only three years, and in very short order, they got scammed out of basically every penny they had by some...
some scam artist american who took advantage of a new immigrant family that barely spoke the language and my family was in a really tough situation and i remember going outside before anyone else woke up in the morning and i would lay on my driveway and i would look up at the sky and i would have a conversation with this voice that i called god and um it was very comforting at the time i distinctly remember that
But then as I got older, I thought, well, if I can't prove that I'm talking to anybody, if nobody's listening, what's the point? Why am I doing this? And I didn't pray again for decades until I started this line of research, which became my book, Beyond Belief.
And I kept coming across the power of prayer, how people who pray live longer, they have more friends, they make more money, they contribute more to their community. All these great things happen to people who pray. But I thought that was kind of inaccessible to me because I didn't have a particular faith. I didn't have a conviction in the supernatural.
And so I just thought that was off limits to me. Until I read a study that changed everything, which was this study where they had three different groups. And they asked them to do all the same tasks. The task was to, it's a pain tolerance test where they ask people to put their hands in very, very cold water.
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Chapter 7: What are the limits of the placebo effect in medicine?
And the test is to see how long they can last in that cold water. And so in these three groups, one, they said, just don't do anything. Just let us see your pain tolerance by seeing how long you can last in this ice cold water. The second group were people who prayed with some kind of faith tradition. So they were identified as Jewish or Catholic or Muslim or whatever the case might be.
They had a prayer practice. The third group was the most interesting to me. These were people who did not have any particular faith, but they were taught how to pray and a particular protocol on how to pray. And they said, if you don't want to say the word God, you can substitute something else, something meaningful to you. It can be the universe. It can be mother nature.
It can be some of all forces. It doesn't really matter. You can substitute any secular interpretation of that you want. And so that's what they did.
Chapter 8: How can we cultivate positive beliefs to enhance our lives?
And what was interesting in the results of this study is that not only did the people who prayed from some kind of faith tradition show much greater pain tolerance, they could last much longer in this pain tolerance experiment than the people who didn't have any kind of faith background and weren't taught to pray, but even the people who didn't have a particular faith but learned how to pray
also enjoyed those pain tolerance benefits. So it turns out that prayer works even without faith. You can still get a lot of the benefits. And so that kind of opened my mind to explore this further, to see, well, what have I been missing out on?
It turns out I'm not alone, that the largest religious group in America today are the nuns, not the Catholic nuns, the N-O-N-E's, the people who have no religious connection in terms of any particular faith.
And it turns out that those people have problems associated with that lifestyle, that in fact, people who call themselves spiritual but not religious, which is millions and millions of Americans today, turns out that they suffer more from depression and anxiety disorder than people who do have a particular faith.
But for someone like me who didn't connect with any particular faith, I wanted to see, could I find those benefits? And that's exactly the mission I went on.
And the reason this story really resonated with me is that I grew up Reformed Jewish. I had a bar mitzvah. I, you know, read the Haftarah and a Torah portion and loved it and found something really beautiful and mystical and beyond the veil of knowing about Judaism that really appealed to me when I was younger.
And today I would say that my relationship with Judaism sometimes feels like a relationship of last resort. Like when I'm afraid that something bad might happen or very desperate for something good to happen. Hmm. I find myself almost automatically saying the Shema, which for folks who aren't Jewish listening is just a very basic, very ancient prayer of a call to God.
And the Shema will just materialize my lips is what I think I wrote in the essay that I published on my Substack introducing some ideas from your book. And for years, I've wanted this deeper relationship with faith without being able to really put that yearning in context. And your book really succeeded in putting that yearning in context.
I would love for you to go just a little bit deeper on this concept of faith as pain tolerance. Why is that an important idea?
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