A placebo has no active ingredient. It maybe a pill, liquid, injection or indeed a treatment that looks like a real medical treatment. It’s usually used as a control in an experiment or test to determine the effectiveness of a medicinal drug.
The placebo effect is the positive health consequence (sometimes even ‘cure’) of taking a placebo . They are considered by some as miracle wonder of the capacity of the mind and by others as ‘dummies’ something of no intrinsic remedial value that is used in clinical trials and/or to appease or reassure another.
However, the fact is that no matter what label one puts on it, the placebo effect exists.
Placebo Response: Some call it the placebo response because it’s the human body responding in a positive way to a placebo.
It has been documented in a variety of books in the past and my current favorite account of the placebo is the Horizon episode 8. The Power of the Placebo first broadcast on BBC Two, 9pm on 17th February 2014. Mainly because it shows the physiological benefits of the placebo. Indeed Irvin Kirsch, Associate Director of the Program in Placebo Studies and a lecturer in medicine at the Harvard Medical School, is on there saying:
“It’s real and quantifiable, in fact you are doing quite well in active therapy if you’re getting a response as good as a placebo response”
It also highlights that deception is not necessary however the quality of the relationship between the practitioner and patient is. Bottom line is they have shown that the placebo taps into our natural pharmacy, our brains ability to create chemicals.
The key elements (Placebo Response Elements) as explained on the show, other books as indeed other areas are below:
- Transparency: many believe deception is required for it to work, is is not so, a placebo response still happens when the participant knows they are being given a placebo. There have been a number of experiments that have shown this is not so, including Ernest Lawrence Rossi, PhD, in his book The Psychobiology of Mind-Body Healing and Prof Ted Kaptchuk, Harvard Medical School.
- Improved Performance: Dr Chris Beadie has done over a decade of experiments on athletes discovering a 2-3 % improvement in performance through placebo. It may seem small to us but in professional cycling it’s a substantial difference: it can be difference between first place and not being in the top ten. He likens it to a car going faster without using more petrol.
- Neurobiological Effect: Prof. Fabrizio Benedetti, University of Turin, research shows real chemical changes in the body because of the placebo. (Pod casts of his work can be found on this link: Brain Science PodCast website)
- Natural Pharmacy: Prof Tor Wager’s research, University of Colorado shows how the Placebo taps into our natural pharmacy, the brains ability to create the chemicals it needs.
- Expectation is key: different research has shown that because it’s all about expectations even size, shape and color of a placebo tablet can affect how well it works: capsules are more effective than tablets; large capsule better than smaller capsule; more expensive is more effective than cheaper medication; color makes a difference: red better for pain; blue better for anxiety (unless you’re Italian male – Italian football colours and the effect that has!)
- Hypnosis: Prof Irving Kirsch, Harvard Medical School suggests there is a lot of overlap between hypnoses and placebo they are based on: belief, expectation and suggestion.
- Relationship: Proff Ted Kafchukti’s research suggest a 20% increase (42 %->62%) in the results where practitioners are caring, warm, supportive as possible: asking about life, the effect on life expressing empathy, touching the patient, silences showing thoughtfulness, show confidence in treatment.
- Tip of the Iceberg: the American Cancer Society description of the placebo effect was the best I had found (to date of the cancer charities, or indeed the web) because of its scope, accuracy, thoroughness and ease of understanding. Included in there is a very interesting fact which suggests that what we have yet discovered could be the tip of the iceberg of our potential to heal ourselves: in The Expectation Effect section, it shares findings of a study of people with Alzheimer’s disease: that they required higher doses of medicine than others to relieve pain! One can’t help but wonder: Could it be that all clinical trials (in the placebo trial or otherwise) are subject to the placebo response? How can it not? We take our expectations and past experiences everywhere we go, unless we have brain damage!
Additional to the placebo response there are other skills humans have that have yet to be understood how they work…and are likely to be connected to the placebo response and/or our deeper understanding of these areas could perhaps shed light as to how the placebo effect works.
Nocebo response: the opposite to the placebo response, it’s the negative response to an inert substance and/or procedure. There is some very interesting information about it of which my personal favourite is Worried Sick by Megan Scudellari on The Scientist website.
Pygmalion/Rosenthal Effect: the greater the expectation placed upon people the better their performance.
Hawthorne Effect: knowledge of being studied/measured on a behaviour has subjects improve/modify it. Productivity is effected only while being measured.
Experimenter Effect (Observer Effect): researcher(s) unconsciously influencing the participants of an experiment. Controlled by double bind experimental design.
Mind to Muscle: a scientific study which concluded “…mental training employed by this study enhances the cortical output signal, which drives the muscles to a higher activation level and increases strength.”
Recently I decided to expand the research to everything that involved influence and/or unexplainable behaviour, of course one of these was obviously Spontaneous Remission. “Spontaneous remission of cancer has been reported in almost every type of cancer.” What a find!
Well that was until I discovered the Spontaneous Remission: An Annotated Bibliography by Caryle Hirschberg and Brendan O’Regan. A book with the largest database of medically reported cases of spontaneous remission in the world, with more than 3,500 references from more than 800 journals in 20 different languages. . An abundant pot of gold for humanity!
I am now in the process of collating all that expanded research (and trying to put it into a meaningful, and easily digestible, structure). So that it can be practically useful…and I had to share The Institute of Noetic Sciences and Spontaneous Remission straight away…because sometimes we just need to know something is truly possible to make it happen.
The mind is an amazing thing. The secret of unlocking our natural ability to heal ourselves is still just that, a secret, at the moment. However I am sure that if we can identify the variables of the Performance Equation then we will uncovering the recipe for the placebo effect.
