Placebo

Placebo and The Power of the Mind in Healing

 

The Placebo Effect: Your Thoughts Affect Your Health

Emotions, thoughts, and health are related. The Placebo Effect is real. Placebo is the mind's ability to help us heal. "Science has recognized that at least one-third of all healings including drugs, and surgery, and other allopathic interventions, one third of all healings has nothing to do with the process but has to do with the Placebo Effect." Dr. Bruce Lipton.

"The Placebo Effect is really another way of talking about the body's self healing capacity and anything that unleashes more of that is going to be a better system." Rupert Sheldrake, Ph.D.

What's Missing from Western Medicine: The Power of the Mind. What distinguishes Western medicine from all other healing traditions on the planet are several key concepts: the separation of mind and body, and the notion that all of nature can be explained via a materialistic world view. On the other hand, every single non-Western healing tradition recognizes the inextricable link between psyche and soma. “Dis-ease” is not limited to the physical body; thoughts and emotions are causative factors. And healing necessitates addressing these elements of our being. Getting well is not just about fixing the physical body.

Harnessing the Power of the Placebo Effect and Renaming It “Remembered Wellness”

The placebo effect yields beneficial clinical results in 60–90% of diseases that include angina pectoris, bronchial asthma, herpes simplex, and duodenal ulcer. Three components bring forth the placebo effect: (a) positive beliefs and expectations on the part of the patient; (b) positive beliefs and expectations on the part of the physician or health care professional; and (c) a good relationship between the two parties. Because of the heavily negative connotations of the very words “placebo effect,” the term should be replaced by “remembered wellness.” Remembered wellness has been one of medicine's most potent assets and it should not be belittled or ridiculed. Unlike most other treatments, it is safe and inexpensive and has withstood the test of time. Herbert Benson, M.D. Harvard Medical School. [PMID: 8712773] [Full PDF].

The Most Notable Medical Findings of 2015. The New Yorker Magazine.

The Power of a Placebo

I am fascinated by the placebo effect, for both personal and professional reasons. Having suffered a failed back surgery, I spent many years with lumbar pain. Part of my experience was to see how interactions with skilled rehabilitation professionals, even before any physical intervention, relieved some of my suffering. Ted Kaptchuk is a pioneer in elucidating the placebo effect, acting as a nodal point among researchers ranging from anthropology to genomics. This year, he and his colleagues published a paper that highlights how people may be genetically predisposed to, or resistant to, the placebo effect. The relevant genes govern molecules that shape our moods and goal-driven behaviors. Also this year, Kaptchuk published on the ethics of placebos, which physicians once prescribed routinely for diseases that had no remedy. He and his co-authors emphasize how the placebo effect arises not only from swallowing an inert pill from a bottle but also, as I experienced, from the intimate interaction between the sufferer and the healer. Reading these articles, I couldn't help but recall a headline that appeared in The Onion, in 2003: “FDA Approves Sale of Prescription Placebo.”

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The placebo phenomenon and the underlying mechanisms. Although mechanisms underlying placebo responses are not as yet completely elucidated, there is substantial evidence suggesting that placebo effects are indicative of healthy functioning of intact brain structures and occur through actual functional changes, and are not simply subjective symptom reports. [PMID: 32940864].

Can Insights From Placebo and Nocebo Mechanisms Studies Improve the Randomized Controlled Trial? By making approximations of expectations toward treatment effects it was possible to predict the magnitude of the placebo response in RCTs. The new approach of tapping into or directly asking patients about their perception and expectations toward a treatment, along with the account of the natural history of pain, has the potential to improve the information that can be obtained from RCTs [PMID: 32609651].

The neuroscience of placebo effects: connecting context, learning and health. We present an empirical review of the brain systems that are involved in placebo effects, focusing on placebo analgesia, and a conceptual framework linking these findings to the mind-brain processes that mediate them. This framework suggests that the neuropsychological processes that mediate placebo effects may be crucial for a wide array of therapeutic approaches, including many drugs [PMCID: PMC6013051].

Placebo and Nocebo Effects: A Complex Interplay Between Psychological Factors and Neurochemical Networks. The psychosocial context around the patient and the therapy, which represents the ritual of the therapeutic act, may change the biochemistry and the neuronal circuitry of the patient's brain. Furthermore, the mechanisms activated by placebos and nocebos have been found to be the same as those activated by drugs, which suggests a cognitive/affective interference with drug action [PMID: 25928679].

The placebo effect and its ramifications for clinical practice and research. There are many remaining knowledge gaps with regard to the placebo response. The evolving knowledge challenges the paradigm of the placebo controlled RCT as a gold standard for demonstrating benefit of treatments. There are a number of pointers towards alternative research designs and paradigms worthy of further exploration. The evolving knowledge can contribute to the further development of a 'meaning orientated' and patient centered healthcare system [PMID: 23497808].

Placebo Effect. Understanding how placebo responses form is vital for clinical practice as it can play a crucial role in determining the therapeutic outcome of the patient. Although placebo effects frequently occur in clinical practice, they often go underrecognized. The therapeutic rituals and the psychosocial context surrounding the patient can mediate a placebo effect. [NBK513296].

Study Sheds Light on the Placebo Effect of Medical Encounters. National Institutes of Health. National Center for Complementary and Alternative Medicine (NCCAM). Harvard Medical School researchers have found that a medical encounter—a patient’s visit to a provider—may produce its own placebo effects that can bring about significant symptom improvement. The part of the encounter that plays the greatest role in the placebo effect appears to be the physician-patient relationship.

Placebo Effects of Different Therapies Not Identical. Not all placebos are equal, and patients who respond to one placebo don't always respond to others.

Is there scientific proof that we can heal ourselves? Lissa Rankin, MD. TEDx

 

Lissa Rankin, MD explores the scientific literature, reviewing case studies of spontaneous remission, as well as placebo and nocebo effect data, to prove that our thoughts powerfully affect our physiology when we believe we can get well.

Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel SyndromePlacebo treatment can significantly influence subjective symptoms. However, it is widely believed that response to placebo requires concealment or deception. We tested whether open-label placebo (non-deceptive and non-concealed administration) is superior to a no-treatment control with matched patient-provider interactions in the treatment of irritable bowel syndrome (IBS). Placebos administered without deception were found to be significantly more effective than no treatment [PMCID: PMC3008733].

Pain and the Placebo (.pdf). Despite the recent blossoming of rigorous research into placebo mechanisms and the long-standing use of placebos in clinical trials, there remains wide- spread and profound misunderstanding of the placebo response among both practicing physicians and clinical researchers.This review identifies and clarifies areas of current confusion about the placebo response (including whether it exists at all), describes its phenomenology, and outlines recent advances in our knowledge of its underlying psy- chological and neural mechanisms.The focus of the review is the placebo analgesic response rather than placebo responses in general, because much of the best established clinical and experimental work to date has been done on this type of placebo response.

Placebo studies and ritual theory: a comparative analysis of Navajo, acupuncture and biomedical healing. Placebo effects are often described as 'non-specific'; the analysis presented here suggests that placebo effects are the 'specific' effects of healing rituals. One major healing ritual involves the doctor-patient relationship and interaction [PMCID: PMC3130398].

BBC Documentary - Placebo Effect As Good As Surgery For Outcome In Knee Pain.