Placebo Effect: when mind conquers matter
“Let’s do a thought experiment. Round up three hundred harried commuters with headaches—not hard to do on the New York subway any workday rush hour. Of course, they are shouting and whining strident protests, which only worsen their headaches, which is precisely what you want. You reassure them that you’ll get their names listed on the society pages of the New York Times in recognition of their public service (you can’t afford to pay them), and that settles them down long enough for you to herd them into three soundproof rooms, one hundred headaches per room.
Now the fun begins. You do nothing with the first one hundred. They get to glare at one another Big-Apple-style and ruminate on their throbbing temples. You make an eloquent speech to the second group, informing them that they are the lucky recipients of a newly developed and powerful painkilling miracle drug. (It’s actually aspirin with codeine, a proven pain reliever.) Then you leave them, too, alone with each other and their pain, contemplating their lawsuits against you. You make the same speech to the third one hundred, but you are lying to them. They think you are giving them a pain-relieving drug. In truth, they get a sugar pill.
After a half hour, you ask your three hundred captives to report on their headaches. In the “do nothing” group, twenty say their headaches are gone. Eighty are still suffering. In the second group, ninety report the complete disappearance of pain; that drug is certainly a miracle potion, the people say, and they wonder where they can purchase it. In the third group, the ones you deceived, forty-five still have headaches, but fifty-five do not. That pill did the trick, they say, happily reboarding the subway pain-free. Your experiment was a success and you are off the hook, unless one of your subjects is a liability lawyer.
But forget the legal ramifications for now. Look at what the experiment revealed. A sugar pill has no physiological action that will cure a headache, but thirty-five of your headache-free subjects in the third group provide evidence to the contrary. (Why thirty-five and not fifty-five? Because the results from the “do nothing” group show headache pain will cease in 20 percent of your subjects after one-half hour regardless.) Thus, for 35 percent of the subjects in our thought experiment, the sugar pill was just as much a miracle drug as the painkiller the members of the “real drug” group received. This “cure” in the absence of any truly therapeutic agent is the placebo effect, and it’s more than a curiosity. It’s a direct result of brain action. But how?”
Example from Faith Brynie (Psychology today), The Placebo Effect: How it works
What is the placebo effect
The term Placebo comes from the Latin word Placebo (I shall please), and it is actually a treatment or a process with no real effects. (Source: Wikipedia)
Sometimes when administering a fake treatment or putting someone in an unreal situation, this might change this person’s condition, i.e. make them feel whatever illness they have been suffering from was cured or alter their perception about said situation without changing the situation itself. In the previous example, when the third group people took the fake pill, some of them stated they started feeling better. In the same way, giving a glass of water laced with nothing but sugar and lemon to a runner and presenting it as a super drink that can increase the athlete’s performance can actually have this effect.
The result that stems from a person taking a placebo is called the Placebo Effect.
So if the placebo is something made-up, how is it possible that taking a fake pill (practically nothing) can actually affect our health? Can this happen with our decision making in everyday life? Let’s first answer the first part.
How the placebo works
How does the placebo work? This is something not clearly figured out yet, even though there are two major theories.
The first one is that this is merely a reflexive action of the human body. Throughout life, we are used to feeling better when we take a medicine or a kind of treatment. This process creates a “memory” to our body. So when we receive the fake treatment (the placebo), the human body reacts to that.
“There are many experiments showing that man’s functions are as conditionable as those of animals. For instance: patients suffering intense pains, caused by a disease called arachnoiditis, were relieved and slept after they received intravenous injections of novocaine (an anesthetic). After some time, the patients still experienced pain relief and slept, although weak saline injections, instead of novocaine, were applied.” (Source Julio Rocha do Amaral, MD e Renato M. E. Sabbatini, Placebo Effect: The Power of the Sugar Pill )
The second theory states that the placebo effect is some sort of an expectancy effect. The application of the expectancy effect here is that the person that received the placebo expects it to have results on him/her and this actually can have consequences. In this case, the change in the person’s condition does not result from the placebo itself, but rather from the belief of the person that his/her situation will change.
This belief can cause some changes in brain chemistry. Some research suggests that the intake of a placebo releases endorphins, which is a natural pain reliever of our body. (Source: Putting the Placebo Effect to work, Harvard Medical School)
Researchers have been able to demonstrate the placebo effect in action using brain scans. In one study, participants had a hot, painful piece of metal placed on their hand and then received either a pain-killing drug or a placebo injection. In both cases, the subject reported that the injection helped reduce the pain. The researchers used positron emission tomography (PET) scans to look at each person’s brain and found that areas of the anterior cingulate cortex, the area of the brain that contains many opiate receptors, were activated in both the placebo and treatment groups. (Source: Placebo Effect Experiments, Studies, and Causes)
As far as this expectancy effect is concerned, some people might even be affected just by visiting their doctor or doing something they believe that directly affects them. This whole process again works a little bit like a self-fulfilling effect.
Interesting Facts and placebo characteristics.
There are some fascinating things about the work of the placebo effect.
Research has shown that the placebo actually works even if the person receiving it knows that the treatment is fake. In a study conducted by Harvard Professor Ted Kaptchuk to people suffering from IBS disease, a group of people were informed that they are taking fake inert drugs from bottles labeled placebo pills. Well, the patients described that they had real improvement describing fewer symptoms from their decease. (Source: The Placebo Phenomenon, Harvard Magazine) In a similar study from Barry S. Oken (Placebo effects clinical aspects and neurobiology source ) it was shown that several people who suffered from migraines reported improvements in their symptoms after taking placebo and not actual pills.
Another interesting fact is that the dose and the form of the placebo plays a role to the extend placebo effect.
Studies have shown that the larger the pill, the stronger the effect it will have. Also, a placebo injection works better than a tablet. Even the colour of placebos might affect you. Intense colours and in general coloured pills work better than plain white pills. (Source: Antidepressants versus placebo in major depression: an overview Kahn A, Brown WA, 2015)
Another element to be factored in when studying the placebo effect is faith. If you believe that something will affect you, then the placebo has a stronger effect. In Preliminary Evidence Based on Participants’ Perceived Assignments in Two Placebo-Controlled Trials from (R. Barker Basel, Lixing Lao, Stewart Bergman, Wen-Lin Lee, Brian M. Berman 2005) it was shown that those who believed that the placebo treatment would work were affected more than those who didn’t.
But take a break and think about that a little bit. A big fake pill affects you more than a small fake pill! A colorful fake pill can affect you more than a fake white pill!
Imagine that the color of a fake pill, or the dose of it affects you. Now let’s see what happens in everyday life.
Where can we find placebo effects in everyday life? (Examples)
A fine example of the placebo effect is (in some cases) the buttons on pedestrian crosses at busy intersections. A lot of the times these buttons actually do not work (Source: For exercise in New York Futility, Push Button, New Yok Times) . Imagine if in the most traffic-congested roads every person could push that button and stop the traffic whenever they wanted; they would create a permanent traffic jam. On a busy day, when you are in a hurry, waiting for the light to turn green can make you anxious and nervous. But somehow, feeling that they have control over the time when the light becomes green makes people feel better.
The same thing goes in lots of elevators with the close-the-door buttons. (Although the open-the-doors buttons work). You can check it yourself with a timer: whether you press the close button or not, the door will close at the exact same time.
Another excellent example is the electronic cigarette. With 0% nicotine, this cannot cover the smokers’ dependence. The electronic cigarette is like a real one: you can smoke it, see it, feel it. But you do not get the nicotine dose that you are used to, so normally you’d still wish for a real cigarette. However, the electronic substitute, shaped like an original cigarette, with smoke puffing out, succeeds in creating for you the illusion that you are smoking. So, even though your dependence on nicotine remains, you have managed to trick your mind into thinking you are smoking, thus diminishing your wish for a real cigarette.
The Bathini Good Brothers case
The Goud family in India claim to have been entrusted with the secret cure to asthma. It involves patients swallowing raw the “Bathini Mrugasira Psaradam,” a small fish that has been previously kept into the mouth of live murrel fish, dipped into a yellow mixture of herbs, created according to the family’s 170-year-old undisclosed recipe. The cure, administered only by the Bathini Goud brothers, is offered free of charge on the day of “Mrigasira Karti” (i.e., on June 7th or 8th), in Hyderabad, India. This annual gathering attracts thousands of people, who flock to Hyderabad in hopes of finding relief from severe breathing disorders. Although there is no scientific evidence about the existence of an ingredient that could cure Asthma, many patients claim that they were cured or felt better after receiving the Bathini Good treatment.
Negative effects of placebo: the Nocebo
The Nocebo effect is the opposite of the placebo effect. Like the Placebo, the word comes from the Latin Nocebo, meaning “I will harm”. This is what happens when the substances consumed cause harmful effects to the individual, so that the individual’s situation worsens because of the negative side effects of a treatment. Imagine taking a real pill that eventually cures your illness but also causes you some minor nausea or a headache. If you had received a placebo, you might have had the same results, even though you would have taken a fake pill.
What you can do about it
We are not fully aware of how the placebo effect applies. Still, as most biases do, it works in both positive and negative ways. So there are some things that you can do to use it to your advantage and avoid being deceived. As another Ted Kaptchuk research indicates, when therapists spend more time and express more interest for their patients, this makes the patients actually feel better. So when you feel the need to visit a therapist, it is essential that you look for someone who, other than the mandatory education and training requirements, also possess those additional characteristics. Although this might not really cut the root of your possible problem, it might really affect you, perhaps by making you more open and trusting towards your therapist, thus facilitating your sessions.
Try to find things that you believe in. When you believe in something, those expectations can actually affect you and increase the chances that things will go your way. But beware: there are a lot of scoundrels and charlatans that are particularly familiar with the placebo effect and can take advantage of you, selling you things that have no value or making you believe in things that have no value. This could have a great impact on your pocket or, more importantly, your health.
For example, alternative medicine methods can perhaps make you feel better when you are ill. But when things get serious, you should be open-minded and also seek a more conventional medical treatment. Sometimes things can turn bad. (Check the following link from what’s the harm http://whatstheharm.net/homeopathy.html)
Once again, it’s all about belief and perception; all about the human mind and its tremendous power over the human body. So you might want to be careful what you believe in.