Good News for the Placebo

h9The placebo effect is as old as the healing professions themselves. The idea that you will get better because you believe you will get better is a very powerful one, and one that doubtless the pharmaceutical companies would like to have suppressed if they had the chance. But there is powerful new research that seems to prove what we hypnotists knew all along, and that is; you are a mind with a body, not a body with a mind. Fine words indeed, words that virtually every alternative mind therapist will unhesitatingly agree with. Belief in the healing power of the mind has, it seems, very definite and traceable physiological responses, particularly within the brain itself, including immune responses and the release of hormones.

It has to be said that some medical experts (them again) have always viewed the prescribing of placebos as a nuisance. After all, in their view, disease has to be viewed strictly in physical and chemical terms. But they are missing the bigger picture. If a patient consciously (or unconsciously if it comes to that) believes that a substance is genuinely therapeutic, that it will reduce pain and negate unwanted symptoms, then surely this has to be a good and positive (not to mention inexpensive) step in the right direction. However, the effectiveness of this belief goes beyond the humble sugar pill. Even the sight of a stethoscope or a doctor in a clean white coat can trigger an unconscious reaction which then triggers a positive physiological reaction. Scientists are now coming to believe that placebos hold the key to understanding how the brain can control the body as a route to faster healing.

And where would we be without the humble rat? Heading a team at the University of Duisburg Essen in Germany and the Swiss Federal Institute of Technology in Zurich, psychologist Manfred Schedlowski has been very busy finding out how straightforward conditioning can mimic the pharmacological effects of drugs. First, they conditioned the rats by injecting them with the immunosuppressive drug Cyclosporine A which is used to prevent the rejection of transplanted organs. At the same time, they gave the rats sweetened water. Just as in the case of Pavlov’s dogs, the rats became conditioned to associate the sweet water that even without the drug, the rat’s immune systems were weakened. Subsequent experiments showed that after actual organs were transplanted, the rats lasted considerably longer having just the sweetened drink without the drug, than they did with the drug.

So, behavioural conditioning can mimic the effects of a particular drug. Good news for the mind therapists, bad news for the drug companies. Testing the theory on rats isn’t nearly so much fun as experimenting on humans though, so in 2003 neuroscientist Fabrizio Benedetti of the University of Turin Medical School tested the influence of Expectancy and Conditioning in 60 people who had volunteered to undergo extreme pain. In this case, both the placebo and the drug that increased pain were administered, and the results were the same. However, it turned out that merely the expectation of more pain was enough to increase the levels of pain experienced by the volunteers. Expectation of course is one of the key components of hypnotic suggestion and here is the proof. It also proves that scientists have all the fun. The bottom line however, is that unconscious cues and the suggestion inherent in placebos can alter responses created in the electro-chemical organ known as the brain and positively affect the level of discomfort suffered by sufferers of allergies for example.

Placebos can activate pain-killing [natural] opiates produced by the brain. The taking of the pain-killing drug morphine is banned in athletic competition, but not during training. Again, Benedetti has experimented by giving athletes in training morphine, and then an inert saline solution on the day of the big race. Levels of pain tolerance were significantly increased after the saline solution was administered.

You don’t have to be an award winning scientist though to share in the fun. The good old family doctor can radically improve a patient’s condition simply by radiating confidence or spending more time with the patient. This has to be because at an unconscious level, the patient will then have more confidence in the effectiveness of a particular therapy. It is well know that like designer clothes, patients seem to prefer the more expensive name-brand drugs than the cheap version.

It gets better. In 2004, psychologist Cynthia McRae and her friends and colleagues at the University of Denver performed several pretend brain surgeries on patients suffering from advanced Parkinson’s disease. The operations were a resounding success! Patients who underwent the sham surgery were doing just as well after a year as those who underwent the real surgery and who had their brains implanted with human embryonic dopamine neurons.

The practical benefits of this sort of foolery should not be underestimated. Doctors and scientists all over the world are just beginning to wake up to the reality of the power of the placebo. It doesn’t take much sophistication to make this work, as we are about to see…

Top of the list of placebo cures is Acupuncture. Researchers from the Centre for Complimentary Medicine Research at the Technical University of Munich led by Dr. Klaus Linde have affirmed what we all deep down knew to be the truth anyway… fake acupuncture treatment works just as well as the real thing! The placebo effect is at the root of one of the most popular treatments for a range of issues from migraine to blood pressure to you name it, we got it. An analysis of studies involving over 7,000 patients proved acupuncture to be more effective in treating migraines than tablets, which kind of proves my point. What is not clear is whether the patients involved in the study were particularly suggestible, but then a study of such magnitude is bound to include a good cross-section of high and low suggestibles. Nor is there any evidence pointing to whether the acupuncturists were properly trained or a bunch of amateurs having a laugh – that would have been a lot more revealing and a lot more fun. The bottom line however is that it did not matter one jot whether the needles were inserted in the correct places (along so called ‘meridians’ or ‘energy points’ or at random. The research also shows that acupuncture does nothing to improve fertility, which should come as no big surprise.

This essay would not be complete without a look at one of the new the buzz-words of the century: Brain Training. Jostling for position in the already packed marketplace, new machines, resembling hand-held Nintendo games and heavily publicised by Star Trek Captain Patrick Stewart (no doubt for a hefty fee) have sold over 100 million galaxywide. But is brain training just a gimmick, or is there some real value in it? Answer: yes, it’s just a gimmick, and no, it doesn’t train your brain any more than any other stimulating mental activity like Scrabble or Soduku or whatever it’s called. Again, we turn to the serious scientists for the answer. Professor Alain Lieury put the testers to the test at the University of Rennes (that’s in France by the way) by giving the consoles to a group of 10 year old children and found that normal run-of-the-mill activities such as doing their homework, watching documentaries, reading and playing games were not only just as effective but were more fun into the bargain (OK, maybe not homework.) Professor Lieury’s bugbear was the claim that brain trainers improved memory, a dubious claim not actually backed up by proper scientific research.

In Professor Lieury’s tests, those who were not exposed to the delights of the brain trainer, relying instead on more traditional paper and pencil exercises fared much better after a six week trial. Their memories improved by a remarkable 33% whereas the group whose brains had supposedly been trained by these infernal machines showed a significant decrease of 17% in performance. It just goes to show, if you want to remember something, write it down! That is why generations of schoolchildren and students make notes in class, or is that too obvious? When it came to more complex mathematical exercises, both groups fared reasonably well; both the scribblers and the brain trained improving by 19%. Those with no extra training whatsoever, also improved by 18%.
Makes you think doesn’t it? Or was that the point of the exercise anyway? Either way, there’s far too much charlatanism being peddled these days – this is just another example. Shame on you Captain, Mr. Spock could have told you the whole thing was illogical.

What is logical however is that research has proved that music lessons and musical training from an early age can improve spatial awareness, and this is no placebo. Research has shown that the motor cortex, the cerebellum and the corpus callosum, which connects the two sides of the brain, is more developed in musicians than in those who have never had the opportunity to play a musical instrument. I believe that children who grow up with the appreciation of good music as part of their experience really do end up smarter than those brought up on a diet of endless junk. Music lessons improve hand and eye coordination and pattern recognition. All those scales and arpeggios really do come in useful! And then there is the purely therapeutic effect of good music; the many and varied components of really great music: variations in mood, pitch, rhythm, speed, tone, etc. can be profoundly relaxing, even uplifting. The appreciation of great music can activate the brain’s reward centres and depress activity in the amygdala, reducing the effect of negative emotions such as depression and fear.

The placebo is not and cannot be a ‘one size fits all’ type of therapy. There are lots of conditions where a placebo would be inappropriate. These decisions are best left to the medical fraternity. My point is that it should become more part of mainstream medicine. In the third world, traditional healing has relied for thousands of years on the placebo effect, often without realising it. What we need is a greater and more universal understanding, and acceptance, of its dramatic effect.

Copyright Andrew Newton 2013. All rights reserved.