Aug 17, 2021
When I was doing my research for this podcast, I came across a book online that had been written by Mitchell Smolkin. But this book was not a book that I had written. The name of this book was called Understanding Pain: Interpretation and Philosophy and had been written over 30 years ago when I was about 12 years old.
I was surprised and I did a bit of digging and it turns out that now living in Arlington, Virginia is another Dr. Mitchell T. Smolkin, a retired internist who, in his life, also has had a deep fascination and interest in the human being’s struggle to deal with pain and how they do so through philosophy and religion and how we contend with the often existential crises that painful events and physical symptoms caused us in our lives.
It was quite moving for me. It was another sign that what I am doing is worthwhile. I dug a little deeper and contacted his son and he put me in touch with his father. So on today's podcast, I have the great pleasure of interviewing, drumroll please, Mitchell Smolkin.
What really caught my attention on today's podcast, which surprised me to an extent with the candour Mitchell addressed it, has to do with the placebo effect. Placebo, from Latin, means “I shall be acceptable or pleasing” and refers to what is often ruled out with the scientific method. It is a nonorganic cause and effect when it comes to treatment, and it needs to be separated from actual cause and effect so that we can replicate and disseminate tools, methodologies, and medication that will have a similar effect across the board.
When I was having a chance to read over my summer vacation, I was floored as I was connecting yet again with different scientific developments in psychology that seemed to suggest placebo playing a significant role. In this instance, it was in the field of neurofeedback, a method of retraining the brain for a number of psychological conditions. Once again, I was confronted with the notion that the personality, passion, commitment, patience, and idiosyncratic nature of the doctor plays a significant role in outcomes. And as a result, there is criticism that there isn't enough evidence that this actually works. And yet, for people who practice this, the anecdotal evidence from their practice, their clinical experiences overwhelmingly support the outcomes that they see every day with people. This is of course an old and important fault line, and a difficult one to cross when it comes to agreement on the efficacy of certain treatments.
I remember shaking my head because every time that I investigate a new area of the field, it seems to come down to the power of human relationships. I often reinforce this point, and you've probably heard me say it on this podcast before, that so much of what we see and experience as mental illness or difficulties in living are relational. I focus and dwell on this because it strikes me then that if we're going to make headway in terms of helping the human organism feel safe again or sometimes for the first time, it is going to have to happen in a relational context. And so I'm not surprised that as we search for new ways to treat individuals, groups, and families, that we keep coming back to this notion of the placebo effect.
I was very touched and I thoroughly enjoyed talking to Mitchell. For me, to be honest, it was emotional and I felt a certain calm in our conversation and a different kind of pace with the two of us just sitting with some of these questions of how we contend with suffering. What an amazing experience that the two of us, who have never met and share the exact same name, have spent a great deal of our professional lives thinking about these issues.
My final comment will be something that I perhaps gleaned from my conversation with him: the humility that we all have to bring to these issues in our lives. Sometimes all we can do is sit with somebody and marvel at the awesomeness of the questions that these crevices in our lives provoke in us. This is not easy to do when there is such a hunger for answers and for peace of mind which of course I long for as well.
I hope you enjoy this conversation with Dr. Mitchell T. Smolkin.
Show Highlights:
- Mitchell’s career history.
- How being an internist is different from being a physician.
- How Mitchell bridges his philosophical interests with his daily clinical work of dealing with people who are physically ill.
- Why he shows his patients that he’s willing to talk and the result of doing so.
- How mental illness can disguise itself through physical symptoms.
- The healing power of relationships.
- How seeing a doctor in a white coat can be a placebo in and of itself.
- The tension of finding meaning in life.
- Why we need to sit with unanswered questions and drop the pressure to find answers.
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Supporting Resources:
Understanding Pain: Interpretation and Philosophy by Dr. Mitchell T. Smolkin
Mitchell Smolkin is a sought-after clinician, speaker, and author. For media and interview requests please contact his publicist Randy Phipps at randy@rpcommunications.net. For all other inquiries, please send mail to info@mitchellsmolkin.com.
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