Image: AARON GOODMAN
In Brief
Something behind Nothing
- Dummy treatments can be surprisingly powerful. Placebos for depression can reproduce more than 80 percent of the positive effects of antidepressants.
- In the brain, placebos tap circuits governing expectation, attention and emotion.
- Doctors may someday routinely use placebos to augment and, in some cases, replace approved drugs and therapies.
Back in the 18th century, German physician Franz Mesmer peddled a concept called animal magnetism. Creatures contain a universal fluid, he asserted, that when blocked in flow, caused sickness. Mesmer used magnetized objects to redirect that flow in patients, initiating unusual body sensations, fainting, vomiting or violent convulsions that ended in profound salubrious effects.
Skeptical, Benjamin Franklin and French chemist Antoine-Laurent Lavoisier simulated one of Mesmer's typical sessions in 1784. They asked people suffering from ailments ranging from asthma to epilepsy to hug “magnetized” trees. The people swooned and shook, as expected. But then the researchers divulged that the trees were never magnetized. And everyone realized that something else was inducing the reactions to the trees. That something was later dubbed the placebo effect.
This article was originally published with the title When Pretending Is the Remedy.
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15 Comments
Add CommentDear Trisha,
Reply | Report Abuse | Link to thisI haven’t yet read full article, so forgive me if my assumption is not entirely correct.
We often grossly underestimate cultural dimension in both, placebo and nocebo effects. Since 1948 in Framingham (Massachusetts, United States) doctors are collecting data on physiological (emotional) factors that may cause cardiovascular and other diseases. The volume of collected data now allows for statistical analyses that are going far beyond initial intention.
In short, we now have strong indications that emotions (physiology) spread very much like viral diseases. There is also a strong indication that emotions (physiology) may hinder or facilitate spreading actual viral diseases.
In my opinion, we are grossly overemphasising chemistry and grossly underestimating psychology influenced by psychology of people who surround us. In simple terms, GP’s conviction alone might be more helpful than the drug he prescribes. The subsequent use of the drug by the patient might be only reinforcing the influence of GP’s conviction.
There is probably no drug factory that could match the one in our own body.
Have a nice day,
Damir Ibrisimovic
http://home.pacific.net.au/~damir-dsl/
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Reply | Report Abuse | Link to thishttp://www.scientificamerican.com/article.cfm?id=hard-to-swallow
Since the more expensive the placebo is the better it works that may explaint the increasing cost of medical treatments.
Reply | Report Abuse | Link to thisThe power of the placebo is very effective in helping people with psycho-somatic disorders and saving them time and much trouble from tranquilisers and other drugs that may possibly have undesirable side effects. Using the placebo effect, however, presents doctors with acute ethical problems. We have to tell the truth all the time, and explain to patients exactly what we are doing to them. You see, using the placebo effect involves a bit of confidence trick. People who have psycho-somatic disorders often get angry if you suggest that they can snap themselves out of it. They would be even angrier if you suggest the use of a placebo, which of course would be stupid. Is lying under these circumstances acceptable behaviour?
Reply | Report Abuse | Link to thisDear Shimagyoh,
Reply | Report Abuse | Link to thisIf you are practicing physician, I do not recommend lying to patients under any circumstances. You must honestly believe that drugs you prescribe will help your patients.
That said, many drugs that passed previous clinical trials have been shown later not to be better than placebos. This raised a lot of dust and increased interest into how placebos work.
In my opinion, what counts is your conviction and ability to transfer it to your patients. Unfortunately, this involves a very deep understanding of each of your patients. And that is almost impossible ask in this fast-paced world.
I will also add a suggestion that may seem (but only seem) ridiculous. However, if you need to act convincingly towards your patients (for their benefit) --- a good stage acting course will not sound as ridiculous idea as it might seem. Have a look at Framingham study and how emotions spread...
Have a nice day,
Damir Ibrisimovic
http://home.pacific.net.au/~damir-dsl/
Placebos are an intentional deception. Deception is never a good means towrd an end. It's more harmful to the foundation of science than good for the patient.
Reply | Report Abuse | Link to thisI also beleive placebos are being put on the table as a simple solution to our failed healthcare system. Placebos mean medicines are too expensive and patients are not worth the doctors time treating.
Reply | Report Abuse | Link to thisI do believe that the placebo effect is real, but I don't think they're universally applicable.
Reply | Report Abuse | Link to thisI have a severe problem with a sort of dizziness (not vertigo), and I have undergone many allopathic tests and some therapies. All test results are normal and the therapies did not help.
Any suggestions for placebos?
Take a placebo you are certain will work.
Reply | Report Abuse | Link to thisIf placebos are reproducing results in 80% of depressed patients, then that reveals that controlling thought processes is more effective than the "chemical imbalance" treatment theory. Cognitive therapy attempts to address this through focus on positive thoughts for endorphins, and to minimize negative thoughts that spawn cortisol. Marijuana is often used by depressed persons as a means to relieve their stress, and it is effective because people can "feel" it working (which may be the placebo effect), diverting their thoughts toward humor, calm, or introspection.
Reply | Report Abuse | Link to thisFinancially harmful, probably. Customers should not pay the same price for a sugar pill as opposed to a patented medicine. It's theft.
Reply | Report Abuse | Link to this@vapur - I take a good point from your comment. That is, instead of supporting the use of placebo treatments, science should find out 'why' placebo works for any particular condition. Then we can get to the root of the solution. For example, placebo research could help prove that talk therapy is more effective than chemical therapy (I think that was your point, and I agree). My fear is that placebo research will lead to passing out fake treatments and moving onto the next patient without a true understanding of what is occurring.
Reply | Report Abuse | Link to thisResearchers have been known to use mannitol in their sugar pills , so one might wonder whether the 'placebo'
Reply | Report Abuse | Link to thisis actually inert at all , therefore skewing any placebo research ?
"Researchers from Tel Aviv University describe
experiments that could lead to a new approach for treating Parkinson's disease (PD) using a common sweetener, mannitol"
I have given myself a placebo a few times and they seemed to work. Here's a possible explanation. Just the process of taking some new pill, fish oil, B6, asperin, etc., gives one a daily jolt of awareness and reinforcement of a common notion that one can heal thyself. Anyone heard of study on this?
Reply | Report Abuse | Link to thisHeal thy self? You don't need a study there is evidence everywhere. The scientists on the fringe know this but are banished for knowing so. Can't touch the money making machines of medicines ;-)
Reply | Report Abuse | Link to thisBruce Lipton may be of interest to you.