Transcript: Interview with Kristi Erdal from Episode 019

This is the interview with Kristi Erdal from episode 019 of the You Are Not So Smart Podcast.


Kristi Erdal

Our guest is Kristi Erdal, a psychologist at Colorado College who discovered placebo sleep along with one of her students, Christina Draganich. Draganich wondered if such a thing might exist after reading all the literature on placebos, and Erdal helped her create the research methods she used to test her hypothesis.

David: Kristi Erdal, you are an expert on so many things in psychology.

Kristi: Oh, goodness gracious.

David: But we want to talk about something that you’ve recently done, some interesting research that’s gotten a lot of attention. And that’s on the placebo effect, and specifically placebo sleep. But before we get into placebo sleep, I think we all have a layperson’s understanding of what the placebo effect is. But from an expert’s point of view, what is the placebo effect?

Kristi: Well I don’t think it’s actually that much different – expert versus layperson. I think we’re all familiar with the placebo effect, and even in the manner in which it’s been conducted in scientific research. Every drug is tested at this point with a placebo controlled design, where some groups get the real drug – if you will – some get the placebo drug. And then you see how behavior, or illness, or health changes at the end of those studies. And so I think most people do actually have a pretty good knowledge of how placebos are supposed to work. And that is the way they work in scientific research, specifically in drug pharmaceutical research.

David: So I guess the most common example that comes to mind is, you tell someone you’re going to give them a pill to alleviate pain. And they don’t know whether or not they’re getting a real pill or a sugar pill, or a pill that is completely inert. And then, if you give someone this pill that has no medicine in it, and they feel that that pain has been alleviated, that is the placebo effect.

Kristi: There it is, exactly.

David: So, what do we know about how that works? How does it happen?

Kristi: Yeah, I think we know a lot, but probably not as much as we want to know. The placebo effect seems to have an explanation in 2 – some people say competing theories, but frankly I think they’re integrative theories. One is the basics of classical conditioning, that is your body has learned over the course of 20, 30, 40, 50, 60 years that going to a doctor, getting a pill makes you feel better – and has learned how this operates. And therefore, the classical conditioning takes effect, and when you get a new substance that an authority figure tells you is going to help, your body goes into motion saying, “Oh, I know what to do.” And it starts feeling better. The other “competing” theory is expectancy – more of a, perhaps, conscious process where you expect something to happen, and therefore you have some endogenous mechanism – we’re not really sure exactly what that might be – that will then make it happen, will make it be so. And so, whether it’s conscious or non-conscious – or both, frankly, that’s my vote – it’s probably operating in both of those ways.

David: And what about it is still sort of a mystery to us at this point?

Kristi: Yeah, for me I think the mystery is – what parts of the brain are really lighting up when this is happening? And are they unique to the placebo effect, or are they just consistent with what might be happening when you’re taking a real drug? For me, that is the next interesting place. Neuro-imaging – is something different happening in the brain, or is the brain just engaging the typical thing that happens on its own?

David: Now is it, for instance in the typical example, I’ve also seen studies where people would be given mild electric shocks, and they’re given a cream. And the cream is – has no medicinal qualities, but they feel that it alleviates the pain of the– Is, are they actually – is this person actually experiencing pain alleviation, or are they just believing that they’re feeling this?

Kristi: Right, and actually what’s the difference, right? I think there’s evidence to suggest in these different experiments, that they’re actually having pain alleviation. You can tell that by certain other physiological indicators that are suggesting a decreased heart rate, for instance. There’s some new research on how psychologists induce pain is by putting arms in ice cold water. And if you give very different experimental protocols, you can actually alleviate the elevated heart-rate that is experienced when you have pain. And so, there are things that are changing, and that does suggest that the person is not experiencing pain they way they would normally be.

David: Okay, so this brings up like, a zillion questions as it should. And one of the things I love about this is that, okay, the placebo effect is something that is now part of the scientific method, yet that very thing that’s part of the scientific method is also having to undergo scientific scrutiny because we don’t quite understand that thing either.

Kristi: Yes. Right, exactly.

David: Which is great, I love that. So I think that some people, a little bit of woo woo comes in here, and that is – the placebo effect suggests that we have the power to make our own bodies feel less pain, or to experience certain healing effects. And it’s some way to alter the physiology and the biology of our body through belief, or concentration and meditation. How far away is that assumption from being the truth?

Kristi: I don’t that’s very far away at all. I think the woo woo that you mentioned, is when people start talking about mind and mind control and things like that. Whereas I think most of us are quite comfortable in the behavioral sciences saying something is happening in the brain. I mean, everything we think, do, believe is electrical and chemical. So this has to be that, as well. And we just haven’t really ironed out exactly what’s happening. And we haven’t ironed that out for a lot of things. So I think those of us in this area are a bit more comfortable with a little bit of the unknown, but it’s not that we think there’s some aura, or faith based issue, or soul, or something like that necessarily coming in. It’s just something we haven’t yet figured out in how the brain is exerting this control over the body, in the way that it does with everything else. With digestion, with movement, with all sorts of other things.

David: I think what’s weird about it to me is like, there’s a – and you mentioned this in your latest paper. That if a person pays – if 2 groups of people pay for an energy drink, and one person pays a reduced price for that energy drink, then they will get less of a stimulating effect from that drink. And there’s also placebo alcohol.

Kristi: Yes.
David: Where people are told they’re given alcohol, and they feel intoxicated.

Placebo caffeine, where people are told they’re given caffeine and they feel like they’re getting the effects of stimulation with non… In your study, you mentioned this research that if you tell people that their job has exercise benefits in their health plan, then they actually over the next month will have a weight decrease, blood pressure, body fat, hip to waist ratio, all that stuff will be affected. And then you also go on to say that, if you tell somebody that they’re drinking a 620 calorie milkshake, but they’re actually drinking a 380 calorie milkshake they will expanse a decline in ghrelin, a peptide.

Kristi: Yeah. Isn’t that cool? Let’s just put that out there, that that is incredibly cool. Because you know that you’re not conscious of how your peptides are being excreted.

David: Okay yeah.

Kristi: So you know that. I, before reading that article, had no idea what ghrelin was. I didn’t know really how my gut peptides were related to what I knew I was consuming. So, yeah, obviously most of us are not at all conscious about, well, most of the things that are going on in our body. And so what – who is conscious about this? Well, your brain seems to know; your brain controls all of this. And when you are looking at that shake, and you’re seeing the extra chocolate sauce, and the extra caramel, and the extra thing. Then your brain is saying, “Okay we get it. We get that this is going to have a lot of calories, so we don’t need to excrete the ghrelin that we would if we were really hungry.” And it knows, and so it does it. And I think that’s what we’re talking about – this kind of subconscious classical conditioning. Your body is conditioned over the course, again, of 20, 30, 40, 50, 60 years of your own behavior, to know what it needs to do to keep you fit, to keep you digesting, to keep you healthy, perhaps. And so it makes all these associations for you, and then when you trick it by giving a light shake, when it’s supposed to be getting a 600 calorie shake, then it’s going to be tricked. It’s gonna be tricked.

David: That is, to me that is, I feel like I’ve been, a door’s been opened into an entire realm. It’s almost like a Schrodinger’s Cat kind of – like, in physics there’s that whole discussion of the microscopic world versus the macroscopic world, and how ridiculous it is to assume that big effects– There’s a whole thing there. And then this, to me, is like psychology’s side of that saying, “I don’t actually know what’s going on inside of my body.

Kristi: Absolutely.

David: I don’t even know – like you were saying – I don’t even know that peptides exist.

Kristi: Right.

David: But my belief in something can affect the peptides inside.

Kristi: Yeah.

David: That is out of this world to me.

Kristi: And it’s so cool. If you think about everything your brain does – I just got through teaching introductory psychology. And to me, the whole course is a myth debunking class, and it’s about how your brain is associated with all these interesting findings, and classical conditioning, and everything else. So, it’s really fun.

David: And it plays into – I’ve heard some neuroscientists talk about how you should think of what is the conscious part of the mind is not the entire organism.

Kristi: Oh no, no, no.

David: And in many ways, it’s only a small part of the organism. And the placebo effect sort of lends a lot of credit to that way of looking at things.

Kristi: Absolutely. And we’re not talking about, necessarily about, the Freudian version of the unconscious and stuff like that. But from a psychology perspective, there is a whole lot going on of which we are not aware in our own bodies, and in our own associations of things. And that really is now pervading, not just neuroscience, but social psychology as well. You look at new research about how we form associations with new words. Some – a test called the “Implicit Attitudes Test” – which is not non-controversial, but where it’s easier to form words that are consistent with our prejudices – or form associations between words that are consistent with our prejudices. Even though we say we don’t have any prejudices. So our conscious awareness of what’s going on in our body, and how we think about things, is not always accurate.

David: And for me, a lot of the problems often arise with the confidence, and the overconfidence –

Kristi: Yes, yes.

David: That, “No, actually, I do know everything that’s going on. And I know where my beliefs come from,” And all those sorts of things. Okay, so let’s talk about the sleep study.

Kristi: Yeah, confidence is rarely, rarely related to accuracy in psychology.

David: Let’s talk about this sleep study, because you’ve done what psychologists dream about doing. You’ve advanced our understanding of the natural world. So if you could just sort of explain, or give us an idea of what happened here in this study?

Kristi: Okay, first what I have to say is, I’m the second author on this project. I was the faculty advisor, and what your listeners might not know but they would probably wholly appreciate is that the first author, Christina Draganich was an undergraduate student who came up with this idea. And my job was to facilitate the idea. And so she graduated from Colorado Collage in 2012, and will be probably applying to medical school soon. But this project for her was, it started in introductory psychology. When we learned about these other – the exercise study that you mentioned, and everything else – she said, “Well isn’t that interesting?” And then did a literature review in our research design class, and then did this for her undergraduate thesis. So, this is not something that required a great deal of fancy footwork. This was hard, on the ground, work about what is next in this field. So she did this, and I facilitated this project – my role of course is making sure that it’s methodologically sound, and that other explanations can’t creep in. But that’s – the evolution of the project started from reading these other non-traditional applications of the placebo effect. And her interest, of course as a college student in sleep, and how sleep affects your cognition was very appropriate. And so we pursued this, and we figured out, this is how we worked together, “How can we set up some sort of machine to convince students that they had gotten an adequate amount of sleep, or below average, or above average?” And she didn’t have to be the big authority figure, which was interesting. She was, at the time, a 22 year old young woman, very bright, will a lot of fancy equipment – but still no lab coat, no doctor underneath her name. And she was able to convince students that they, hooked up to this machine, that they had gotten above average or below average sleep. And then therefore how, perhaps, they were going to perform on these cognitive tests.

David: First of all, that’s wonderful. That shows the – that’s a fantastic program you’ve got going there. And that science is a verb and a tool, which really is what, that demonstrates that so well.

Kristi: Yes. Utilized by anybody who has the capability, absolutely.

David: So let me see if I understand this: you have participants who are hooked up to what they believe is a machine that’s going to tell them whether or not they got a good night’s sleep.

Kristi: Right.

David: And some people are told they did get a good night’s sleep, and some are told that they did not get a good night’s sleep.

Kristi: Right, randomly assigned.

David: And then those randomly assigned people then take a test that measures their cognitive abilities.
Kristi: Yes.

David: That is normally done after a sleep study. And you found, what?

Kristi: This test, by the way, the PASAT, the Paste Auditory Serial Addition Test is actually really hard. If you or I were to do it, we would be struggling. So it’s not a test that would have a ceiling effect. You know, that our students would do all great on, and there would be no variability. So we wanted to pick a really difficult test, and has mental addition in it, and is prolonged. So there was a lot of variability in it. And we found that in the first experiment – the paper has two experiments in it – the first experiment we found that when people were told they had below average sleep, the preformed significantly worse on the PASAT then the group were told they had above average sleep. Now, the above average sleep folks performed at the norm of the test – the test norms. So we found the effect in the negative direction, in what we can the “nocebo direction”, that we messed with people, if you will, and they got worse. But we didn’t see, in that first experiment – that if you told them they got a good night’s sleep they got better. And this is where, when we sent the article for publication, the reviewers of the article said, “We want to see the extension of this; we want to see how far this can go. So we would like you to run another group of subjects.” We ran 100 more subjects, in fact, and added some more measures. And these measures were – some measures that we predicted would have no impact – like digit span, your digit span whether you sleep at all or not, seems to be very consistent. So we didn’t anticipate an effect on digit span. But then we added a couple of other tests, for which we did anticipate an effect of sleep – either in the good direction or the bad direction. And one of them, in fact, we did find – this is the controlled oral word association test, which is just basically saying, “How many words can you think of that begin with the letter, whatever, in a minute?” And that test showed that when you told people they got above average sleep, they actually performed better than the norms.

David: Wow.

Kristi: Yeah. Which was really cool for us, of course. And the PASAT also was replicated, by the way, in that second experiment. So we found that negative effect too.

David: And I don’t know if you realize this, but this is, a lot of people have written about this in the last few months – or last month or so. And what’s great about it is, it’s one of those studies that comes along that makes you go, “Huh, so, that’s something I should have known.” I mean, it’s incredible that the placebo effect is reaching out this far. I mean, your study suggests that if you’re trying to create a plan for yourself to get more sleep, to get better rest, that the belief in that plan and it’s efficacy is also an important part of that plan.

Kristi: Yeah.

David: Would you agree that it would also be important that it – we should be sure that we avoid getting into a state of mind where we may be believing that what we’re doing is detrimental to our sleep routine?

Kristi: Yeah, yeah, absolutely.

David: Regardless of whether or not it is or not.

Kristi: Yeah, I think what we showed in this study – and just to be clear, we did ask the participants how they felt they had slept the night before. And so we – that was a variable in the multiple regression equation, the statistical analysis that we used. But it didn’t predict anything. How we thought they had slept. What we told them, predicted everything.

David: Wow.

Kristi: And so, so here’s – here’s now the potential extrapolation. What you think matters – unless someone in authority tells you otherwise. So what you think absolutely matters on a day to day basis, ‘cause you’re not in these studies, you are not going to the doctor. You are not seeing other people who are telling you otherwise. So of course your own mindset matters about your sleep behaviors and patterns and your attitudes if you will, about how you sleep. But what was interesting to us of course, was how easily it was trumped by an authority figure with – in this case, a fancy machine telling you – in many cases the exact opposite of what you believed coming in. And that’s what predicted the day.

David: Wow. That is amazing. And that brings up an interesting point, that physicians need – have to understand and are trained to understand the – both the benefits and the drawbacks of the placebo effect in their bedside manner and in administering medication and treatment.

Kristi: Well I would argue that they’re definitely trained in the – in understanding it in the administration of medication, okay? I think, I’ll just go out on a limb and say that, I think psychologists, clinical psychologists particularly, have understood the placebo effect in terms of how it impacts psychotherapy results for decades and decades. And I think the physician patient relationship has lagged a little in it’s understanding of this. And I’m just going to say that, maybe because I know more of the research as a clinical psychologist myself. But I think that we have most certainly, as psychotherapists, understood that the placebo effect is an essential part of psychotherapy. It’s not the only part .There are of course active incredients in psychotherapy as well. But it’s an essential piece.

David: So – and I’m going to save that for a second, because it’s in one of the questions I’m going to ask you from Facebook.

Kristi: Oh sure.

David: But we’re going to go back into that a second. And I want to go ahead and get these questions to you. These are all questions that came from the You Are Not So Smart Facebook page. These are all people who are interested in this sort of stuff, and they are excited to have the opportunity to ask questions of an expert.

Kristi: Oh excellent.

David: So this first question comes from Rochester Jones, and he asks – does the placebo effect also counteract benefits if someone is tricked into believing they had no such benefits. For example if someone did not get a full night’s sleep, would their performance suffer if they believed they did not?

Kristi: Yeah I think, I think our data do actually speak to that question that – when, like I said before – when we asked them, our research participants how they slept the night before. This is before telling them anything. Before hooking them up to the machine. They walked in the door, and we asked them how they slept. That didn’t predict anything. And so, what then, after we hooked them up and told them a randomized lie, if you will – that predicted everything. So I think his question is – if someone did get a full night’s sleep, presumably we had many, many subjects who got fabulous night’s sleeps. And we told them they didn’t, and they performed like they didn’t. Yeah.

David: That still is making my brain hurt.

Kristi: Yeah, I can feel the existential crisis.

David: Oh that is amazing. Okay, so and that’s an example of nocebo, correct?

Kristi: Yes, yes.

David: Whenever you’re– Well explain if you will what nocebo is?

Kristi: Well it’s when – like in the alcohol research. When you give people fake alcohol, and then they perform a cognitively or behaviorally like they’ve had alcohol. That’s a nocebo. You’re decreasing their performance by something you’ve told them.

David: Alright, this is a question from Kenny Lim. And Kenny asks – how precise are placebos? In other words, can you give a 100 milligram placebo and expect twice the results of a 50 milligram placebo?

Kristi: Wow. That’s a great question I think – to be determined. But here’s how I would, I would frame it. It really matters in what the authority figure, if you will, the physician typically is saying. So if it’s the, “Oh let’s just start you out on this 50 milligrams, because this is a really potent drug, and I don’t want you to get any side effects. But I want you to get the full effect.” Then 50 milligrams should – if we were to do a study there, should have an effect with decreased side effects. And then you give this other group, “Well, I’m giving you the 100, but it might have side effects, but you’re definitely going to get relief. You’re probably going to get what you ask for in the placebo effect. So it really does matter how the experiment in that situation would be framed. What are the milligrams supposed to give to the person? Are there side effects? You can anticipate all of those things in an experimental protocol.

David: Okay, so–

Kristi: Not sure, I mean the question is great, I don’t–

David: It’s a great question, yeah. There’s an undergraduates [?] right there.

Kristi: Exactly.

David: And I do know that like the color of the pill in a placebo, the cost of the pill. The – if it has a brand name on it. Those things all have an effect. So, but those are things that are salient to the person who is about to receive that placebo.

Kristi: Right.

David: Okay, so Kyle Taylor asked, and I’m just going to paraphrase this. Kyle wants to know – we’ve discussed that authority is a powerful effect. It’s also in group, out group, group think, conformity. Do those things also play into the placebo effect?

Kristi: Yeah, I think they have to. The more people that are on board with what this authority figure is saying, the more likely you’re going to believe it too. I don’t think it’s necessary in many ways, because you go in, and if you believe the authority figure, then this all should work. But if other people do too, then it’s going to have a greater chance of working.

David: So, and we were talking earlier about this. That’s why I said… Rob Torel asks – what do you think is the ethical – what are the ethical issues of care givers giving out placebos? And sort of, I guess the question is asking – what is the most ethical and responsible way to administer placebos?

Kristi: Yeah that actually is a pretty serious question. And just so everyone knows, this study that we did went through our institutional review board here for ethics review. And because we had deceived our research participants, we needed to debrief them immediately upon – basically right after they had done their cognitive testing. We had to disabuse them of what we had told them, and answer any questions that they had. Which is really important in a research paradigm, when you’re not treating anyone for an actual disease or disorder. It’s very important to have your research participants as good as or better off when they leave your lab, than when they came in. So I do want the – your listeners to know that we – that we followed all of those protocols. And our research participants, like most research participants actually who are involved in deception studies are fascinated by what we were looking at, and felt like, “Oh yeah no, I completely believed this machine, and everything.” Now they didn’t know their cognitive testing score. They didn’t know whether they had tanked or not tanked or anything like that. So we were just debriefing them about the research protocol. And they were of course very interested in that. So then, that’s the long winded–

David: Right.

Kristi: Preamble to doing this in real life. I think your listeners probably are well aware that you can’t go into your physician and say, “Please give me a placebo so I feel better.” That kind of defeats the purpose. So it’s a very tricky protocol for physicians to be able to do something like this. Now, they’re not researchers per say, if they’re not in a research situation or institution. Just your general practitioner out in the community. They are not going to be able to, with all of the regulations about health care at this point, to give an inert substance, and may pretend necessarily that it’s going to help. I imagine physicians do all the time give substances that are not necessarily expected to help a lot, but they build them up in the patient’s minds. “Oh this should really help.” I imagine, I do not know have evidence for that, but I imagine that that happens all the time within the confines of their own ethical parameters. So the ethics piece for researchers is very circumscribed. We know what we have to do prior to connecting a study. We know what we have to do as soon as our research participants have finished in our study. And we know that we have to set things up so that our research participants are better off after – when they leave, than when they came in. But with doctors, psychiatrists – they’re in a different institutional setting. There are some different parameters, and while I’m not a physician or a psychiatrist, I can’t say how far they push the envelope to the benefit of their patients. I don’t know.

David: But I would, I also – and I will speculate with you, that doctors very often say, “Take this, you’ll feel better.” Knowing that saying it is the more important part of the equation. Interesting, that’s a fascinating thing.

Kristi: Well you think about how our country’s in a pretty bad situation with antibiotics. Because physicians, who presumably know that the antibiotics are not going to help this persons cold, have given them – unfortunately – to people who didn’t need them, because they really wanted them and they think that they would make them better.

David: Right.

Kristi: So I think, and we might have some evidence there that physicians have done this in the past to feed into the patient’s interests. And saying, “Oh sure, then this should work.” If you think it’s going to work, here I’ll give it to you. And unfortunately we’re in a – not a great situation because of that.

David: And we probably should, at this point, present the caveat that if you need serious medical attention, that the placebo is of course not a substitute for actually getting treatment. It just – feeling better – and in many situations is not all you want if you want to actually be better. I don’t want to give people that. I know that oftentimes people will say – of questionable practices – something like homeopathy for instance. They’ll say that, “Well it made me feel better, isn’t that all that really matters?” I’m like, “Well not – no, not if you have–”

Kristi: Depends, right.

David: Not if you have influenza.

Kristi: Right. If the body could fight it itself, and your mindset helped to fight this thing, then I am on board with that. But most of the time if you’re talking about, “I’m taking a fake substance to help this progressive cancer,” I’m like, “Ughh” That might not, it might no cut it. I mean, that’s the question: where are the limits of the placebo effect? And I don’t think we’ve reached them yet, but I think there are.

David: Yeah, and that’s exciting in every way to me, because, here we are again at the very edge of what we know. And scientists like yourself have the opportunity to push forward what it is we know about the natural world. That’s amazing; I love it. One last question to sort of end on a positive note, and that is from – Erin Oram asks – how can we use our knowledge of the placebo effect to just simply feel better and lead better lives?

Kristi: Well I don’t know that our data speaks to that directly. Our data suggests that the placebo effect is definitely – that we have not reached the limits yet. And the more non-traditional looks that we have at the placebo effect keep suggesting that the sky really is the limit. With that said, there are other parts of psychology that, perhaps, have addressed this in a broader way. If you think about just optimism, and the whole literature on optimism and health in health psychology suggests that optimists – with few exceptions – lead longer, healthier lives than pessimists. So mindset, in that sense, perhaps is a personality characteristic, is something that contribute more broadly. We cannot, like I said before, go into the doctor and say, “Give me a placebo,” or say to your husband or wife, “Will you tell me that I had a good night sleep last night?” I mean, I guess we could but that would get – we would figure it out pretty quickly.

David: Right.

Kristi: So the direct application of this study to making our lives better is not necessarily, that bridge hasn’t been built with every brick. But I think the extension of the placebo effect into these non-traditional areas, like sleep – there’s new things on sham acupuncture, and things like that. I think that suggests that: a) we haven’t reached the limits, and b) we’re connecting up with another literature in psychology that has been there also, but has been approaching from a macro perspective – how personality and the way you appraise your situations really also matters. So this optimism versus pessimism, and the manner in which you appraise your situation, and your coping strategies, and things like that. So it might be that these two literature’s are going to meet in the middle at some point. But I think those are 2 viable avenues to look at.

David: And just the very idea that belief, from a very reductionist and objective standpoint, belief is just sort of fairy dust and it just floats in the ether. And this research suggests, as lots of other research suggests, that belief directly translates to biological effects. And that’s an important thing to know about your brain.

Kristi: Yeah, absolutely. I think belief – and again, we’re not talking about fairy dust beliefs. We’re not talking, necessarily, about anything that we don’t feel that at some point we could measure. So beliefs are directly related to changes in the chemistry and electricity of your brain. And so–

David: Because beliefs are chemistry and electricity to begin with, right?

Kristi: Exactly. And so, therefore, those patterns of chemistry and electricity that have been associated with these other things in your life – your gut peptides, for instance, and your movement – then those are patterns that we can tap into, over the course of time. When I talk in introductory psychology to my students, I’ll draw a neuron up on the board, and I’ll say, “Well this is how it works at this point,” and then I’ll say, “times a billion.” Because that’s what is actually happening. We’re very, very complicated, but our brain is so fabulous in making connections without our conscious awareness of them. And then doing things without our conscious awareness, and making decisions without our conscious awareness. So in that sense, I think this belief is – to me from a very reductionistic perspective, is just translating to patterns of behaviors that affect other things in your body.

David: That is a great place to head out; I love it. Look, people are going to want to find you, keep up with you, learn more about what you’re up to. How can someone find you on the internet?

Kristi: Well I’m actually pretty easy to find, because I have somewhat of a unique name with a unique spelling; I think there’s only two Kristi Erdal’s in the United States. So the Kristi is K-R-I-S-T-I, the last name is Erdal: E-R-D-A-L, and I’m a professor at Colorado College. So if people do have questions, I’m happy to answer them. And it’s a fun conversation to have.

David: Yeah, and what are you working on next? What coming up next?

Kristi: Well next I do have another paper, in a completely different direction, with a student that’s in the pipeline right now. And she was looking at Post Traumatic Stress Disorder in Uganda. So a very different thesis that she did. But for my own interests, I’m a clinical neuropsychologist, and I’ve done research in sport related concussion, and things like that. And I’m really interested in – actually, for the first time, and maybe I could get your input on this – is writing a book about youth sports.

David: Oh yeah, we’ll talk about that. Sure.

Kristi: Everything we’re doing wrong in the United States, in contrast to the research. So that’s my next big project. The other interest in sport superstitions, that we’ve done with another student of mine did a paper on. It is, I think, connects the superstition research along with the placebo research in really interesting ways too.

David: Great, well I love that you’re doing all this work, and I really appreciate it. And I thank you so much for coming on the show.

Kristi: Hey thanks so much for having me, this is really fun.