The Power of Placebo

In this article you will learn:

What placebo is and how truly powerful it can be based on the research
What the "nocebo" effect is
Why placebo should be considered seriously and not just as a silly phenomenon

The Details:

Having been initially documented by a physician named John Haygarth in 1799, it’s only recently that this intriguing phenomenon has started to be researched as a legitimate effect rather than being dismissed as some anomalous, meaningless data inherent to the research process.

Perhaps we have avoided considering the impact of our intentions and expectations on reality because the implications would upend every aspect of how we do healthcare in the first place. Nevertheless, consider some of the following interesting findings in recent years regarding the notorious placebo effect:

1. The placebo effect can work, even if you know it’s a placebo.(1)

2. The more “convincing” the placebo treatment is for a particular situation, the more effective it is. An example are blue pills for pain relief compared to pink pills(2) or having a seemingly “stronger treatment” of more pills compared to just one.(3) Branding makes a huge difference as well,(4) and in one study looking at osteoarthritis, a placebo injection was even more effective than taking an actual drug by mouth.(5) If you think that sounds crazy — in another study with Parkinson’s disease patients, some were fooled into thinking they had undergone “placebo brain surgery,” when in fact they had actually received a stem cell injection. Compared to the control group who did not have the placebo surgery and just the injection, they actually had better results and healing from the therapy.(6)

3. Personality traits, like optimism and friendliness, play a large role in one’s susceptibility to placebo(7,8) and the condition being studied. Research looking at the effects of pain and stress for example, found that people who were more pessimistic and less empathetic were more likely to experience a placebo effect in their treatment.(9)

4. Being paired with a doctor who appears warm, caring and competent(10) or shares the same values as you(11) makes a big difference in the degree of placebo you are likely to experience.

5. The placebo effect can influence athletic performance(12,13) and even creativity and

learning.(14,15) If someone expects to perform better, apparently, they will. This even bizarrely extends to your sleep habits(16) and body weight. In one study, participants were fooled with fake metrics about their sleep (that they had gotten more than they actually did), and consequently performed better during the day.(17) Damn that Oura Ring, who knows what secrets its hiding?

In an even more fascinating study, hotel workers were split into a control group and one that was presented daily with positive reminders that their work equated to sufficient levels of exercise. At the end of this study, the workers being presented with information that they were fit showed statistically significant improvements in their health markers and body weight compared to the control group, despite no difference in activity or lifestyle changes like smoking, drinking or eating healthier.(18)

Other research has also explored the relationship between simply believing you are active enough, compared to other people, versus believing you are insufficiently inactive. Those who believed they were doing well, had significantly less mortality, despite no actual difference in exercise habits.(19)

6. Animals can experience placebo, too. Research on various medications given to animals has shown a placebo effect,(20,21) and although it could be biased by the handlers giving the medication or placebo to these animals, it still shows the impact of expectation and belief on the outcome regardless. More interesting animal research shows that the conditioned response may play a big role in our experience of placebo.

Lab rats conditioned to experience morphine according to a particular smell or taste for example, were able to experience these same numbing effects even when the morphine wasn’t present.(22) Now that’s what I call high on life.

7. The placebo effect has even been observed in cases with strong medications like antipsychotics,(23) anti-depressants(24) and analgesics.(25) Despite these drugs having powerful chemical reactions in the body, one’s beliefs alone seem to be able to reproduce, at least to some extent, the same exact effects.

The "Nocebo" Effect

There’s so much more to the placebo out there, and as our understanding of science and quantum physics expands, I believe we will come to rewrite much of what we know about health and medicine today, as a result of what we find. Some of these points are just purely mind-blowing, and they bring to light several significant questions. One of the first is this: if expecting a positive outcome can influence reality to create that positive outcome, could expecting a negative outcome do the same?

Interestingly, this phenomenon does exist and it’s called the “nocebo” effect.(26-31)

It’s the placebo’s dark twin, and just like its twin, it throws a giant ass wrench in our modern understanding of health and interventions. When you believe that something is going to get worse, guess what? It often does. So much so that even physical pain can ensue without an apparent reason or cause.

These findings are not only intriguing, but slightly worrisome. If we can indeed shape reality with our thoughts alone, what implication do these things have for research and treatment? Furthermore, if our expectations can determine, or at the very least, considerably influence a result, how do we use this quantum power for our benefit and not our demise?

These are all fascinating topics, many of which I’ve discussed on my podcast. Yet, the idea that something invisible and unexplainable is responsible for influencing reality is nothing new. In the words of legendary author Arthur C. Clarke, “Magic is just science we don’t understand yet.”

References

1. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015591

2. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(72)90996-8/fulltext

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014313/

4. https://digest.bps.org.uk/2015/11/26/does-it-matterwhether-or-not-pain-medication-is-branded/

5. https://www.acpjournals.org/doi/10.7326/M15-0623

6. https://pubmed.ncbi.nlm.nih.gov/15066900/

7. https://pubmed.ncbi.nlm.nih.gov/20627818/

8. https://www.nature.com/articles/npp2012227

9. https://www.sciencedirect.com/science/article/abs/pii/S0022399914000531#bb0035

10. https://psycnet.apa.org/record/2017-10534-001

11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590751/