So you want to get well. Are you sure? Okay, I’m going to give you a pill for that. What’s in it? Oh, a little sugar and glucose. Who cares, exactly? You can see the name on the pill, Placebo. Maybe you’ve heard of that? It means something that will help you get well not because it’s packed with wonder drugs but because it’s loaded with wonder. All you have to do is believe it will help.
Would you rather I had concealed what we’re playing at here, and let you believe this sugar pill was an experimental drug? We decided not to deceive you because we know this is going to work if you let it work. Here’s a file of what we know about how placebos help to heal. Yes, there’s a lot of reading material here. You can just read the executive summary if you want. When you’re ready to believe that the placebo can help make you well because it pleases you to believe that, take the pill.
I doubt that this is quite how physicians talked to patients who participated in a most interesting recent controlled trial of how placebos work even without deception. But I think it’s in the spirit of the undertaking, and of larger possibilities for healing.
The National Center for Complementary and Alternative Medicine (NCCAM) has released a study that suggests that the placebo effect may work without deception. The patient knows that she’s being given a sugar pill, not a real drug, with the suggestion that this could help anyway – and it does help. Her attitude shifts (maybe because she’s entering into a spirit of play) and the body responds, as it always responds to feelings and suggestions.
The study emerged from r
andomized controlled trials of people suffering from irritable bowel syndrome [IBS]. Patients knew they were taking a placebo and the control was a group that had no medication at all. 80 adults participated. The participants receiving the placebo were given instructions that permitted them to forecast a positive result.
The study found that concealment was unnecessary so long as patients were provided instructions weighed toward positive outcomes. “
Placebos administered without deception may be an effective treatment for IBS. Further research is warranted in IBS, and perhaps other conditions, to elucidate whether physicians can benefit patients using placebos consistent with informed consent.” {See
Kaptchuk TJ, Friedlander E, Kelley JM, et al., “Placebos without deception”]
For many years, the evidence has been growing that placebos work, especially in pain relief and as antidepressants. Back in
2002, one study reevalauated FDA data for six top antidepressants and found that 80 percent of their effect was duplicated in placebo control groups. French psychiatrist Patrick Lemoine, author of Le Mystère du placebo, maintains that 35-40 percent of official prescriptions are “impure placebos” – “pharmacologically inactive substances contaminated with a tiny amount of active ingredient” that is “not enough to have a clinical effect, but enough for doctors to claim that it does.” There is an impressive body of data on how placebos change the working of the brain. Given a placebo, the brain produces opiates that may be effective self-manufactured medication. Beliefs induce a chemical response in the brain, and the chemicals produced can combine with prescribed medications to generate better results – or better yet, substitute for those meds..
Placebo is borrowed from the Latin. It means “I shall please”. The evidence that a placebo will work even if we know we are being given nothing more than an inducement to shift o
ur attitudes and expectations is very exciting. It confirms that the mind can help to heal the body, if we please.
ur attitudes and expectations is very exciting. It confirms that the mind can help to heal the body, if we please.
It invites us to recognize the simple truth expressed by Mark Twain in visionary mode: “The power which a man’s imagination has over
his body to heal it or make it sick is a force which none of us is born
without. The first man had it; the last one will possess it.”
his body to heal it or make it sick is a force which none of us is born
without. The first man had it; the last one will possess it.”
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