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Placebo and Nocebo Effects

The placebo effect can be defined as the power of the mind and the unconscious to heal in response to something (whether sugar pills or just a suggestion) that the person believes will improve his or her condition.

Scientific studies on placebo focus on the effectiveness of new drugs or treatments, whereas they have confirmed the reality of a mysterious phenomenon – the possibility of thought influencing not only psychological but also physical states of people. The effects appear to be strongest and most reliable in the treatments of pain, where in both clinical and laboratory settings placebos of all kinds – sugar pills, cold creams, saline injections, fake ultrasound, even mere words, when convincingly presented as medical painkillers – have been found to bring significant relief (Humphrey 2002).

About 35% of all people who receive a placebo treatment will experience a significant effect. The conditions and illnesses that have proved sensitive to placebo treatment include angina, ‘migraine headaches, allergies, fever, the common cold, acne, asthma, warts, various kinds of pain, nausea and seasickness, peptic ulcers, psychiatric syndromes such as depression and anxiety, rheumatoid and degenerative arthritis, diabetes, radiation sickness, Parkinsonism, multiple sclerosis, and cancer’ (Talbot 1996). Humphrey notes that when people are unwell, they often start to recover as soon as they receive medical attention – whether the treatment has taken effect, or even if it is a sham. It is often the mere belief that recovery is coming that brings the recovery about.

Buckman & Sabbagh (1993) sum it up:

“Placebo… seem[s] to have some effect on almost every symptom known to mankind, and work in at least a third of patients and sometimes in up to 60%. They have no serious side effect and cannot be given in overdose. In short, they hold the prize for the most adaptable, protean, effective, safe and cheap drugs in the world’s pharmacopeia.”

Turner (1969) and Paul (1975) researched how healing ritual and symbols ‘work’ by operating on the self-image of the patient, creating a particular personality with particular emotional patterning (analogous to psychotherapy). There is some evidence from research (Laderman 1987) that the ritual influences body image and, indirectly, impacts on the physiology of the person. We still cannot explain how (and why) the placebo effect affects both body and mind but it does show that mere imagery (whether visual, verbal, etc.) can create real changes at the physiological level. However, this works only if the person believes it will work. (Prayer has similar effect on those who believe it.)

And here is the example of placebo response in absent of treatment in children with ASD:

Jones, R.M. et al. (2017)’s study simulated an eight-week clinical trial protocol for ASD for the purpose of testing the feasibility and validity of several outcome measures. Twenty caregivers answered questions about their child's behaviour each week and completed paper questionnaires during weeks one and eight. Though no treatment was administered, at least 80% of parents reported improvements in their children: a significant decrease (29%) in problem behaviours and 7% decrease in general ASD behaviours. The findings suggest that just participation in research can significantly influence parents’ responses.

The nocebo effect is the opposite – if a person believes he has been harmed (either by magic or the ‘evil eye’, for example), he will soon feel the consequences.

It makes you think, doesn’t it?

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