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. Thirty three percent of the response to antidepressants is attributed to the placebo effect.

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.
  • Nature taking 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 therapy sessions.
  • Lean slightly forward when addressing the client and asking questions.
  • Solicit the client’s beliefs and input when selecting treatment interventions.
  • Most importantly, instill HOPE and OPTIMISM when discussing the prognosis of the client’s presenting problem.
Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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