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September 2014 | Read this issue and more at www.healthandwellnessmagazine.net |
All in the
Mind?
The Power of
the Placebo
By Fiona Young-Brown
A sugar pill.
Positive thinking.
Prayer.
Just three examples of placebos,
long dismissed by physicians as
“not real medicine”. Every drug
trial includes a placebo, a dummy
pill given to some of the participants as a form of control, allowing the researchers to measure the
actual effects of the drug on trial.
But research is now emerging that
suggests there may be more to the
so-called placebo effect than was first
thought. It may actually have some
healing potential, after all.
Ted Kaptchuk, of Harvard
University, has spent much of his
career studying human reactions to
sickness and treatment. He began
to wonder about the placebo effect
when a significant number of participants in a clinical drug trial complained of awful, debilitating side
effects. Yet those suffering additional
symptoms were from the group trying the pain pill being tested AND
those from the group trying acupuncture as an alternative therapy. At the
same time, an even larger number
reported that the acupuncture was
working wonders, more so than the
pain pill. What none of the participants knew was that the pills and the
acupuncture were both fakes – cornstarch pills and retractable needles.
Both of the “treatments” being tested
were falsehoods, so why should so
many claim to be
experiencing the
“side-effects”
they had been
pre-warned of?
And why were
even more experiencing relief?
Since that study,
researchers have often found that
placebos can bring out genuine physiological responses, and they are now
asking how this can be. Kaptchuk and
several colleagues went on to create
the Program in Placebo Studies and
the Therapeutic Encounter (PiPS),
an institute devoted to the study of
the placebo. Psychologists, biologists,
neuroscientists, and social scientists
all come together to share knowledge,
sharing the belief that the more they
learn about the placebo effect, the
more useful it might prove to be in
treating illness. Kaptchuk
still has
to fight
to be
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taken seriously, even more so since
he is not an M.D., nor does he have
a Ph.D. His doctorate in Chinese
medicine from a university in Macao
is not recognized in Massachusetts,
but his success as a researcher (he
has won several NIH grants) may
have been precisely because of that
“outsider” training. Another notable
study by Kaptchuk was in the field
of irritable bowel syndrome (IBS).
Splitting participants into three
groups, he found that those claiming
to have experienced the most relief
were those who received better personal care from the doctor (touching
their hand or shoulder while talking
to them, more time engaged in small
talk, etc.). Perhaps even more notable
was a study in which he told some
participants that they were receiving a
placebo. Despite this knowledge, the
patients still reported improvement,
at levels Kaptchuk claims rival those
of improvement through genuine IBS
treatments.
In 2011, one of his studies on the
placebo effect made national news
headlines (and you may remember
stories about it from local outlets),
when asthma patients reported feeling better after using a placebo, even
though testing of lung function found
improvement only after using a real
treatment, in this case an albuterol
inhaler. In other words, although
patients were not physically better,
they felt as if they were. The study
was praised for its high levels of
clinic control, but came under heavy
fire from medical professionals who
feared that asthma sufferers might
forego treatment until it was too late.
So what does cause the placebo
effect? Some scientists suggest it is a
rush of endorphins that numb pain.
Others believe that a strong desire to
improve and faith in one’s doctor or
treatment may spur short-term changes. More study is needed to find out
exactly how the placebo effect works,
and why it seems to work in some
situations and not others. Kaptchuk
and his medical colleagues certainly
do not advocate throwing away all
medicines; on the other hand, don’t
be too quick to dismiss something
we do not yet fully
understand.