The placebo effect is one of the most dramatic demonstrations of the ‘mind-body connection’ in action. It is also one of the most well-known but least understood phenomena in modern medicine.
The placebo effect occurs when someone demonstrates measurable physical or psychological improvement in response to an inert medication or a treatment that actually has no therapeutic value whatsoever. Behind the placebo effect is what has been referred to as ‘the physiology of expectation’. This is when patients know the expected result of taking a particular medication and their physiology then behaves accordingly to produce that result.
This observation raises an important question. Is this improvement real or imagined? The answer to this question very much depends on one’s definition of ‘real’ in an experiential sense. If the improvement is perceived as real by the patient, then it is indeed real in the sense that our perceptions create our reality. As I say to my clients, ‘What you feel, is real’. If we perceive we have a pain, then we do indeed have a pain regardless of whether there is a clinical reason for the pain or not. Likewise, if we believe we’ve taken a medication to alleviate pain, then it should come as no surprise to experience relief from our pain. The medical community has recognised that ‘the expectation’ of therapeutic benefit from a drug is a significant factor in the effectiveness of that drug. It’s even been shown that the colour of certain pills and capsules can influence the efficacy of the medications.
For many years pharmaceutical companies have used placebos in controlled trials to ascertain whether the trial drug is effective enough to be approved by the Medicines and Healthcare Products Regulatory Agency (MHRA). Usually the trial drug has to perform significantly better than a placebo in two trials before it is allowed to be more widely tested. There have been many cases in which drug trials have been abandoned, not because the trial drug wasn’t effective, but because there wasn’t a significant enough difference in the results between the trial drug and the placebo.
Most significantly, through the use of sophisticated brain-imaging techniques such as MRI and PET scans, measurable physiological changes have been consistently observed that corroborate the effects of an expected positive outcome. The flip side of the placebo response is the ‘nocebo response’ and this demonstrates the power of negative suggestion. If someone is given a drug and told that it will exacerbate the experience of pain (hyperalgesia) even though the drug in question may be an analgesic, in many cases the perception of increased pain will be the result.
The power of the mind to affect both our emotional and physical well-being for good or ill cannot be understated. It’s encouraging that modern medicine recognises the important role the mind plays in the healing of the body, and it’s now widely accepted that a patient’s mental and emotional attitude towards recovery has a significant impact upon the recovery process.