The 'placebo effect' serves a more important purpose in healthcare than we thought

Psychologists and medical researchers have long known about the "placebo effect." Although its main purpose has historically had to do with testing drugs in clinical trials or identifying psychosomatic disorders, experts suggest embracing the placebo effect could have significantly positive impacts in hospitals, in both patient outcomes and satisfaction.

Essentially, a placebo effect is a beneficial outcome — produced by a drug without a therapeutic function — that is attributed to the patient's belief in that treatment rather than the treatment itself.

"In a lot of research studies when people improve but they've just been given, like, a sugar pill as opposed to the real medicine, it's dismissed as the placebo effect," Teri Gross, host of NPR's "Fresh Air" said in a Jan. 26 podcast. "Like, it was just a sugar pill. It didn't do anything, so the fact that you improved — we're just going to dismiss that and write it off to the placebo effect. But now some researchers are trying to harness the placebo effect, figuring, like, if a sugar pill could make some people feel better, what's going on and how can we use that to help them feel better?"

Ms. Gross' guest on the show was Jo Marchant, PhD, a British science journalist and author of the new book Cure: A Journey into the Science of Mind Over Body.

Dr. Marchant first pointed out that while many people experience positive effects from tricking the mind with a placebo, it is possible in some cases those people would have gotten better naturally on their own.

However, "what neuroscientists are finding is that taking a fake medicine, something that we believe to be something that's going to help us, really also has measurable biological effects on the brain and the body," said Dr. Marchant. 

The placebo effect works in a broader way than many people believe, according to Dr. Marchant. There is not just one placebo effect, but rather, "there are many depending on what we think a treatment is going to do for us," she said. For example, people who believe they are taking a pain killer will experience pain-related activity in the brain and a release of endorphins — the same chemicals that opioid painkillers are designed to mimic. A Parkinson's disease patient who takes a placebo will experience a flood of dopamine in the brain, which is what happens with the real drug.

There are many factors that contribute to these positive effects, according to Dr. Marchant.

"Some of it seems to have to do with stress and anxiety. You know, if we feel that we are in danger or under threat, the brain raises its sensitivity to symptoms like pain," she said. "[W]hereas, on the other hand, if we feel that we are safe and cared for and things are going to get better soon, we can kind of relax."

This innate awareness of our surroundings and how this impacts our stress or comfort level has a direct physiological effect on our bodies.

Going to the hospital is never a welcomed experience. However, if the physicians, nurses and administrators make the experience as comforting and pleasant as possible, patients will feel safe enough to relax, ultimately preventing stress from causing any harm.

Clinicians and other hospital workers can easily harness the placebo effect in their daily interactions with patients to help them relax. This does not entail dispensing fake medication. Rather, it requires the extra effort to smile, show empathy and demonstrate true care for the patient.

Positive effects of this approach have been proven in several studies. In one, according to Dr. Marchant, patients with irritable bowel syndrome were given fake acupuncture — the needles were placed in the incorrect places and didn't fully penetrate the skin. The patients were split into two groups, both believing they were receiving real acupuncture. The fake acupuncture was given to one group by a "sort of polite but cold" practitioner, and 44 percent of the patients said they had adequate relief from their symptoms. The fake acupuncture was given to the other group by a practitioner who was "extra empathetic and friendly and supportive," and 62 percent of them indicated adequate relief from symptoms.

"So just that element of the care that you're getting from the practitioner, just their sort of change in attitude, had a big benefit for the people that were going through that treatment," said Dr. Marchant. "That's nothing to do with the sort of physical effect of the treatment itself, just the way that that care is delivered." 

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