The Placebo Effect

The placebo effect is likely as old as the healing professions themselves. Three hundred years ago, doctors purposely used inactive substances when they had no suitable medications to treat certain medical maladies.

Placebos account for the successful treatment of depression, pain, asthma, arthritis, hypertension, insomnia and other conditions. In the classic placebo effect, a person consciously believes that a substance is therapeutic, and this belief generates a positive effect on medical or psychological symptom improvement.

For several decades however, scientists and researchers have known that placebo effects can also arise from subconscious associations as opposed to conscious beliefs. Any stimuli that a patient may link with symptom improvement – a physician’s white lab coat, a physical examination, the touch of the stethoscope to the chest, or the smell of alcohol in the examining room – may induce positive physiological responses, even if a patient has no explicit belief or faith in the treatment being administered.

The placebo effect probably accounts for most of the benefit associated with treatments such as acupuncture, aromatherapy, homeopathy and most other alternative treatments. Fifty percent of the response to antidepressants is attributed to the placebo effect, according to the American Psychological Association.

Conditions linked to significant psychological distress are most likely to respond to placebo.

Some possible mechanisms for this are as follows:

  • Psychological theory – psychology affects biology, beliefs affect biochemistry, the old “if you want to change the way you feel, change the way you think” adage.
  • Nature takes its course – we often get better by doing nothing at all.
  • Process of treatment – touching (when appropriate), displaying a caring attitude, being attentive and communicating effectively – may elicit a placebo response.

Using the placebo effect:

 

  • Inspire patient confidence by looking and dressing professionally.
  • Display symbols of comfort – soothing artwork, positive affirmations or the gentle sound of water tricking from a “mini-fountain” — in your office.
  • Discreetly take notes during meetings with the client/patient
  • Lean slightly forward when addressing the client and asking questions.
  • Solicit the patient’s beliefs and input when selecting treatment interventions.
  • Most importantly, instill hope and optimism when discussing the prognosis of the presenting problem.

And how about this: The color of a tablet can add a placebo boost to the physiological effects in real, legitimate drugs. For example, yellow pills tend to make the most effective antidepressants, like doses of drug-induced sunshine. Green tablets or capsules reduce anxiety – looking out over a plush landscape is soothing, and the dominant color scheme is obvious to us all. And red tablets are associated with a stimulating kick and “charged-up” sensation.

Fascinatingly, the placebo response could care less if the impetus for healing is due to pharmacological success, a caring therapist or an injection of saline. All it requires is that someone have a reasonable expectation of getting better. Now that’s powerful medicine.

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Joe Wegmann is a licensed clinical social worker and a clinical pharmacist with over 30 years of experience in counseling and medication treatment of depression and anxiety. Joe’s new book, www.thepharmatherapist.com, or e-mail him at joe@thepharmatherapist.com.