How to benefit from the placebo effect

The word, placebo, is of Latin origin, meaning, “I shall please,” as in the prayer “I will please the Lord in the land of the living” from the Book of Psalms.

Finding its way into medicine, placebo has come to mean any inert substance given to a patient from which a beneficial effect might be achieved, but in the absence of a known specific effect on the condition to be treated. In the early history of medicine, physicians, having few really effective medicines, found that if they gave their patients what we now call “sugar pills,” along with hope and encouragement, sometimes these patients would recover from their illnesses.

In medical and psychological research, placebos are commonly used to evaluate the effectiveness of new treatments. The general principle is that for a treatment to be considered effective, it has to be at least as good as one already accepted treatment and it has to be more effective than a placebo, given to a similar group of people.

In trying to explain the effects of placebos we have found some unexpected results. Research has shown some connections between such “non-specific” factors as “bedside manner,” rapport, the “treatment alliance,” the perception and feeling of being liked and cared for by your healing professional, and subsequent outcomes such as symptom relief and treatment satisfaction.

In a study on the treatment of depression recently published in the American Journal of Psychiatry, UCLA Drs. Andrew F. Leuchter and Elise A. Witte found that placebos could actually alter brain activity in depressed patients, though in a manner somewhat different from the effects of the antidepressant medication studied. These and other findings suggest the potential for strategic uses of placebo substances and conditions in psychiatric treatment research. Dr. Leuchter expressed a caution to me that we should not mistake his findings to mean that placebos can be a substitute for real medications or treatments. Even when there is a placebo effect, such benefits are short-lived and most patients will not benefit from a non-active, placebo treatment.

Readers need not worry that their doctors might be giving them sugar pills instead of the real thing. A basic rule of health care is to ask for informed consent from patients before initiating a treatment – that pretty much precludes the giving of a placebo – unless you’re told in advance to expect one. Still, there’s much to be gained from this research to increase our understanding of the causes and ways of healing. One thing we know for sure is that there’s more to healing than what’s in the bottle and there’s a lot that we can do to promote each other’s well being.

The take home message is that our bodies and minds may already want and perhaps know how to heal, but that sometimes somebody has to jumpstart the mechanism with a dose of encouragement and positive expectation. Also, when we believe strongly in the care of our doctors, perhaps we better able to align ourselves in thought and deed with their healing intentions. We are then more likely to follow directions, think hopefully about getting well, and release some of the tension, conflicts and pains that can get in the way of our healing.

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