Interpersonal Expectancy Factors In Treatment Outcomes - Beyond the Placebo Effect

Author: Solfvin J
Conference/Journal: First World Symp on Self-Healing & Power of Consciousness
Date published: 2001
Other: Pages: 42 , Word Count: 616


PURPOSE:

The current paper examines the role of the healer/practitioner's beliefs and expectancies in treatment outcome studies, and the implications of this in clinical and research settings.

METHODS:

A review of selected studies from social psychology, medicine, pharmacology, and parapsychology is presented in which the belief or expectancy of the person administering treatment is either manipulated or assessed, and outcomes compared.

RESULTS:

In the 1950's social psychologist Robert Rosenthal proposed that in carefully designed, well controlled empirical studies involving human or animal subjects, the expectation, intent, or belief of the experimenter can slip through the controls and show up in the results. After many hundreds of studies, the evidence for Rosenthal's 'unintentional experimenter expectancy effect' is overwhelming and remarkably robust. Some of these studies involved animal learning models, such as rats running mazes. When this was extended into actual school classrooms, by suggesting to teachers that particular students (actually randomly selected) had been identified as 'late bloomers' who were expected to excel during the school year, these students not only got higher grades from the teacher, but also improved on standard IQ tests significantly more than their classmates.

I wondered how this might apply to medical outcomes and placebo effects. A few studies had already identified a physician's expectancy factor in medical outcomes. For example, in a classic review article, Benson and McCallie (1979) noted this pattern with various treatments for angina pectoris which are now known to be ineffective, even showing significant advantage over placebo in double-blind trials, when physician's believed it. A growing number of controlled studies have shown effects of non-local human intention, or DMILS (distant mental intention on living systems), such as prayer, healing intention, and remote staring, on the physiology of human subjects. Some of these have shown expectancy effects of handlers or experimenters. In a study with malarial mice injected with babesia rodhaini (Solfvin, 1982), veterinary student assistants were told that half of the mice had parasitaemia and half not, and that half of each group were receiving distant psychic healing. There was no healer and all of the mice had babesia, yet both these expectations played out in significant differences in red blood cell counts after 10 days of incubation. More recently, Schlitz and Wiseman have conducted a remarkable series of studies on this topic. Schlitz has previously conducted a number of successful studies of DMILS (distant mental intention on living systems), showing the effects of distant 'intention' on human physiology, compared with randomly interspersed control (nonintention) epochs. Wiseman, who is skeptical of this effect, has conducted similar experiments in England, but has shown overall null results. Schlitz and Wiseman decided to co-conduct an experiment together, at Wiseman's laboratory in England, with half of the trials conducted by each, with everything else being the same. Schlitz's half of the trials showed significant influence on the subjects' physiology, but Wiseman's half did not.

This was replicated by Schlitz and Wiseman, this time in Schlitz's laboratory in California, with the same results.

CONCLUSION:

These results suggest (but do not establish) that the physician's attitude or expectation may influence actual medical outcome in a patient, and that the experimenter's expectancy may influence the outcome of a clinical trial. Standard double-blind methodology may not be sufficient to rule this out. More research is needed. Researchers and clinicians may have 'blind spots' regarding the potential importance of their own expectancy in medical outcomes. It may be that physician's positive attitude towards a treatment may add, catalyze, or interact with patient's attitude in stimulating placebo effects, and may, in some cases, potentiate an effective treatment. In clinical trials with alternative and complementary medicine (CAM) treatments, culture, belief, and expectation should be considered in its application and testing.

BACK