Talk about a rock and a hard place: A Newsweek magazine article suggests that antidepressant drugs, the darlings of a multi-billion-dollar industry and doctors far and wide, are not significantly more effective in treating depression than placebos.
The article is more nuanced than that but that is the thrust of it. Academics, doctors, pharmaceutical companies and a variety of others are greeting the research with a combination of fear and scoffing. But the research seems quite careful ... or at least it seems quite careful third-hand from a news magazine.
Depression is no joke for anyone who has or continues to suffer it. It may come in various forms and in various intensities, but it is no joke. Depression can be as debilitating, if not more so, than many physical afflictions. The idea, whether true or false, that a pill might alleviate or possibly cure depression is tremendously attractive. The affliction is real, and the pharmacological treatment is ....
Well, dubious. In blind tests, those taking a particular medication and taking placebos often seemed to have very similar reductions in depression. Not always, but in statistically significant numbers. So -- what to do? A $4 prescription or a $60 prescription?
But placebos rely on the patient's belief that the medication will be effective. You cannot tell someone they are getting a placebo and expect it to work. You have to pretend that it is a real medication and not just a sugar pill.
In Zen Buddhism, there are the lines:
Wishing to entice the blind,
The Buddha has playfully let words
Escape his golden mouth.
Heaven and earth have ever since
Been filled with entangling briars.
Buddhism ... a sugar pill. But there is a multi-billion-dollar industry of temples and texts and rituals that promises to treat a very serious and document-able illness ... suffering or uncertainty in people's lives. But calling Buddhism a sugar pill leaves the diseases it addresses to wreak havoc. The consumer needs to believe in order for the placebo to work.
One thing you can say for Buddhism that frequently cannot be said for other philosophical or religious persuasions: At least Buddhism is willing to admit its complicity in the placebo business. Sometimes that admission is placed on the back burner while the consumer makes a credulous effort -- sometimes a hell of an effort -- to find a cure for a debilitating disease. And sometimes the consumer attempts to leap over to placebo medication's demands and refuse to put intimate effort into what is, in essence, a lie.
But because the disease is daunting and debilitating, Buddhism will probably continue to offer its nostrums ... offer them with a straight face and a loving heart. Naturally there is room for snake-oil salesmen who will make a bundle off credulous consumers, but in general, in the hands of the well-versed, Buddhism is benevolent in its playful directions: It is the disease that wracks the consumer that is the point.
A rock and a hard place: Credulity is absolutely essential and yet credulity is not the point. It is the debilitating disease that makes the lie worth telling -- a lie that points to the truth ... and a wonderful truth it is.
Some philosophies and religions point to an unremitting need for credulity... how else could they sustain their houses of worship? But Buddhism has the decency to 'fess up when the time is right and the disease is defeated.