By Dr. Mercola
By definition, a placebo is an inert, innocuous substance that has no effect on your body. Placebos, such as sugar pills, are therefore used as controls against which the effects of modern-day medical treatments are measured.
However, the placebo-effect, in which a patient believes he or she is getting an actual drug and subsequently feels better, despite receiving no "active" treatment at all, has become a well-recognized phenomenon.
A number of studies have revealed that placebos can work just as well as potent drugs. Sham surgery has even been shown to produce results that are equal to actual surgery!
Indeed, mounting research suggests this "power of the mind," or power of belief, can be a very healing force. Studies into the placebo effect also show that many conventional treatments "work" because of the placebo effect and little else.
The idea that "perception is everything" certainly appears to hold true when it comes to medical treatment, and this includes perceptions about quality and price. Oftentimes, the more expensive the drug is the more effective it is believed to be—even if there's no evidence to support such a belief.
Cost is simply associated with quality in general. One recent study highlights this intriguing connection between perception of quality based on cost, belief in relief, and measurable recovery.
Parkinson's Patients Improve from Belief in Expensive Drug Treatment
The randomized, double-blind study1,2 was small, comprised of only a dozen patients diagnosed with Parkinson's disease, but the findings suggest that simply believing that you're receiving an expensive drug can produce beneficial effects, including actual biological changes.
As reported by MedicineNet.com:3
"On average, patients had bigger short-term improvements in symptoms like tremor and muscle stiffness when they were told they were getting the costlier of two drugs. In reality, both 'drugs' were nothing more than saline, given by injection.
But the study patients were told that one drug was a new medication priced at $1,500 a dose, while the other cost just $100 -- though, the researchers assured them, the medications were expected to have similar effects."
Not only did patients exhibit greater improvements in movement after receiving the pricier of the two placebos, MRI scans also revealed differences in brain activity between the two placebo groups. In those who thought they were receiving a pricey new drug, the brain activity was more similar to people receiving an actual drug for Parkinson's.
Neurologist Dr. Peter LeWitt noted that:4,5 "Even a condition with objectively measured signs and symptoms can improve because of the placebo effect," adding that this phenomenon is not exclusive to Parkinson's patients.
Juxtaposed to these latest findings is previous research in which the placebo effect was found to produce marked effects even when no deception was involved at all.
In one trial, nearly 60 percent of patients given a placebo pill, who were told they were receiving a placebo, reported adequate relief from irritable bowel syndrome (IBS) symptoms. Only 35 percent of those who received no treatment at all reported adequate relief.
What Makes the Placebo Effect Work?
The jury is still out on the exact mechanisms that make the placebo effect so effective. It does appear that simply going through the ritual of treatment is enough to cause a beneficial response...
Regardless of the mechanism, studies do show that if you think you're receiving a treatment, and you expect that treatment to work, it often will. A previous article in Scientific American6 noted that:
"Placebo effects can arise not only from a conscious belief in a drug but also from subconscious associations between recovery and the experience of being treated—from the pinch of a shot to a doctor's white coat.
Such subliminal conditioning can control bodily processes of which we are unaware, such as immune responses and the release of hormones."
In the case of Parkinson's, researchers have suggested that patients who believe they're receiving a drug may trigger their brains to release dopamine. As noted in the featured article:7
"Parkinson's disease arises when brain cells that produce dopamine become dysfunctional, leading to movement symptoms such as tremors, rigid muscles, and balance and coordination problems. And it so happens that the brain churns out more dopamine when a person is anticipating a reward -- like symptom relief from a drug.
To [lead author Dr. Alberto] Espay, the new findings are more evidence that 'expectations' play an important role in treatment results.'If you expect a lot, you're more likely to get a lot,' he said."
This was also demonstrated in another recent study,8 which found that people with back pain who believe that acupuncture might be helpful actually get more pain relief from it, compared to those who do not believe it will work.
According to study author Felicity Bishop, PhD: "People who started out with very low expectations of acupuncture, who thought it probably would not help them, were more likely to report less benefit as treatment went on."
Emotions Control Intensity of Pain
As reported by NPR,9 pain is in a sense "all in your head," as your "perception of pain is shaped by brain circuits that are constantly filtering the information coming from our sensory nerves." Research has also shown that your emotions and/or expectations can significantly influence the perceived intensity of pain. As noted by NPR:
"The brain also determines the emotion we attach to each painful experience, [professor of neuroscience David] Linden says. That's possible, he explains, because the brain uses two different systems to process pain information coming from our nerve endings. One system determines the pain's location, intensity and characteristics: stabbing, aching, burning, etc.
"And then," Linden says, "there is a completely separate system for the emotional aspect of pain — the part that makes us go, 'Ow! This is terrible.' Linden says positive emotions — like feeling calm and safe and connected to others — can minimize pain. But negative emotions tend to have the opposite effect. Torturers have exploited that aspect for centuries."
Mental focus also plays a role. By monitoring brain waves, and telling participants to place all of their focus on one specific body part, researchers have discovered that you can essentially "tell" your brain to ignore sensory input to parts of your body, thereby blocking information such as pain. This kind of focus also results in increased brain activity in a region that ignores distractions. As explained by Stephanie Jones, an assistant professor of neuroscience:10
"There's coordination between the front part of the brain, which is the executive control region of the brain, and the sensory part of the brain, which is filtering information from the environment. That suggests that at least some people can teach their brains how to filter out things like chronic pain, perhaps through meditation."
Knee Surgery—The $4 Billion Medical Hoax
Many are quick to say that the placebo effect is responsible for the benefits of alternative treatments and natural supplements—the implication being that the treatment doesn't really work, and any benefit is "all in your head."But few stop to consider the fact that many of the benefits of conventional drugs and other interventions are also due to the placebo effect. Drugs have an added downside, however, in that they may also cause very real and adverse side effects.One of the most dramatic examples of this was a knee surgery study11 published in the New England Journal of Medicine in 2002.
Not only does this double-blind, placebo-controlled, multi-center trial definitively prove the power of your mind in healing, it also reveals that most knee surgery for osteoarthritis is an utter waste of money. The results of this study show that it's not actually the surgery itself that is responsible for the improvement, but rather it's due to the placebo effect. More precisely, it's the ability of your brain to produce healing when you believe it should be happening (such as after you receive knee surgery). According to the authors:
"In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure."
This was followed by another study,12 published in 2013, which also found that arthroscopic knee surgery for degenerative meniscal tears had no more benefit than "sham surgery." Here, they even excluded people with knee arthritis, as they tend not to benefit as much from meniscus surgery anyway, and the researchers wanted to ascertain if the surgery helps under "ideal circumstances." Well, at the post-operative one-year mark, all patients, regardless of whether they had real or sham surgery, reported equal amounts of pain reduction, which led the researchers to conclude that real knee surgery offers no better outcome than sham surgery (placebo).
This is a significant concession, as arthroscopic surgery on the meniscus is the most common orthopedic procedure in the US. According to this study, it's performed about 700,000 times a year to the tune of $4 billion. But according to these findings, any surgeon who tells you this is "the best" or "only" option for your osteoarthritic knee pain will not have a leg to stand on when you show him or her the evidence to the contrary... It's also worth considering these kinds of findings when you're weighing your treatment options. Remembering that your mind is the real healer here may help you find a safer and less costly alternative.
Other Examples of the Medical Placebo Effect
Another excellent example of the placebo effect is that of antidepressants. Research13 published in 2010 suggests there is little evidence that antidepressants benefit people with mild to moderate depression, and they work no better than a placebo. An earlier meta-analysis14 published in PLoS Medicine concluded that the difference between antidepressants and placebo pills is very small – yet these drugs remain one of the most prescribed drugs in the United States.
Considering the long list of side effects associated with antidepressants, including worsening depression, it seems reasonable to conclude that a placebo would be a far preferable option to the real thing... A third example of research revealing the placebo effect at work in modern medicine is a study15 published just last year. Here, the researchers took advantage of the recurring nature of migraines to assess the effects of the migraine drug Maxalt (rizatriptan), compared to placebo. Among the results were the following findings:
- Patients receiving Maxalt reported greater relief when told they were getting an effective drug for the treatment of acute migraine
- When the pills were switched, patients reported similar pain reductions from placebo pills labeled as Maxalt as from Maxalt tablets labeled as placebo
- Subjects reported pain relief even when they knew the pill theywere receiving was a placebo, compared with no treatment at all
According to the authors, the placebo effect accounted for more than 50 percent of the therapeutic value of this drug. As explained by co-author Ted Kaptchuk, Director of the Program in Placebo Studies and Therapeutic Encounter at Harvard Medical School:16
"This study untangled and reassembled the clinical effects of placebo and medication in a unique manner. Very few, if any, experiments have compared the effectiveness of medication under different degrees of information in a naturally recurring disease. Our discovery showing that subjects' reports of pain were nearly identical when they were told that an active drug was a placebo as when they were told that a placebo was an active drug demonstrates that the placebo effect is an unacknowledged partner for powerful medications." [Emphasis mine]
How to Harness the Placebo Effect in Your Own Life
There may be cases in your own life where you can use your mind to help heal your body or reduce your reliance on conventional medical care, including medications. And when I say that, I mean that if you strongly believe you will benefit from something, you radically increase the chances that you will. But there is one caveat: you may need to resolve any emotional blocks that are standing in your way first.
Such a block could be the belief that the pain or illness cannot go away. Maybe a parent or relative had the same problem and they never recovered, so you probably "can't" get rid of it either. Another block could be resentment that you have the disease or the pain, or even an unconscious desire to keep your ailment because of the extra attention you gain from it.
The Emotional Freedom Technique (EFT) is an extremely powerful tool that you can use to get to the root of your emotional conflicts, and release them, to help open your mind to the power of the placebo effect. It's often possible to feel better just because your mind subconsciously believes it's time, or your subconscious alters body processes in response to the placebo treatment without you even being aware of it. As often as possible, try to use the placebo option first. This is a new way of thinking about healing for most people, but can be extremely potent, especially when combined with a healthy outlook and disease-preventive lifestyle.
EFT Offers Relief for a Number of Health Problems
This non-invasive technique can also provide more direct relief for certain problems. For example, EFT has been shown to cut the frequency of tension headaches down by half, as well as reducing the intensity of the headaches. If you look at it in terms of energy -- pain is energy and your mind is also energy -- you can see how one directly influences the other. EFT is actually a subject of intense research and has been studied in more than 10 countries, by more than 60 investigators, with results published in more than 20 different peer-reviewed journals.
In 2012, a critical review in the American Psychological Association's (APA) journal Review of General Psychology17 found that EFT "consistently demonstrated strong effect sizes and other positive statistical results that far exceed chance after relatively few treatment sessions." This brought EFT one step closer to meeting the criteria for evidence-based treatments proposed by the APA, an important step toward EFT's acceptance by the wider professional community, and one that will bring its benefits to a wider group of people. The review found statistically significant benefits in using EFT for the following conditions:
Anxiety Athletic Performance Depression Pain and Physical Symptoms Phobias Post Traumatic Stress Disorder (PTSD) Weight Loss Food Cravings
The Placebo Effect Is Real, and Can Be a Powerful Ally for Your Healing
While the exact mechanisms behind the placebo effect are still being explored, there's no denying that the effect is real. And, most likely, the placebo effect takes on many different forms, impacting brain mechanisms and chemicals involved in expectation, anxiety, and reward. In short, a placebo really does change your brain, in a number of different ways. Writing in the journal Neuropsychopharmacology18 in 2011, the researchers noted the following observations:
All of this is good news; it reveals that you hold a great deal of power of healing within yourself—a power that can be tapped through belief and positive expectations. The placebo effect also comes into play in epigenetics, which is another burgeoning field of study. This fascinating new field breaks you free from the misguided belief that your genes control you. In reality, your genes are merely storage facilities, and the all-important expression of your genes is actually ruled by environmental influences—including your thoughts and expectations.
- First, as the placebo effect is basically a psychosocial context effect, these data indicate that different social stimuli, such as words and rituals of the therapeutic act, may change the chemistry and circuitry of the patient's brain.
- Second, the mechanisms that are activated by placebos are the same as those activated by drugs, which suggests a cognitive/affective interference with drug action.
- Third, if prefrontal functioning is impaired, placebo responses are reduced or totally lacking, as occurs in dementia of the Alzheimer's type.