By Dr. Mercola
“The Power of the Placebo” is a documentary film about
exactly that: Placebos; how they work, and how you can harness
their healing power. The fact is “dummy pills” do indeed work,
and sometimes far better than anyone could have imagined.
For example, trials show people often react to a placebo in
nearly the identical manner as an actual drug. Placebos have
been shown to produce dopamine release and other chemical
responses, mimicking the effects of drugs without actually
taking an active ingredient.
By definition, a placebo is an inert substance that has no
effect on your body. In medical research, placebos such as sugar
pills are used as controls against which the effects of
experimental drugs (also in the form of pills) are measured.
However, the placebo-effect, in which a patient believes he
or she is getting an actual drug and subsequently improves
despite receiving no active substance at all, has become a
well-recognized phenomenon.
It also works with surgical procedures. Just like drugs,
placebo or sham surgery has been shown to produce results that
are equal to actual surgery, even though the physical problem is
in no way addressed!
The Power of Your Mind
Research suggests this
power of belief can be a potent healing force. Some studies
into the placebo effect have even concluded that many
conventional treatments “work” because of the placebo effect and
little else.
Interestingly, more recent investigations reveal the placebo
effect is growing in potency among Americans, and it’s having a
dramatic impact on the development of new painkillers.
Drug companies are finding it increasingly difficult to get
pain-reducing drugs through clinical trials, because as people’s
responses to placebos are getting stronger, it makes it more
difficult to prove that the drug actually works.1,2
An unusual experiment featured in the film involved
professional bicyclists. They were told they’d receive either a
standard performance enhancing supplement containing caffeine,
or a new supplement, expected to improve performance to a
greater degree than the standard pill.
However, there was a twist. Both pills were placebo,
containing nothing but corn flour. The racers were asked to
cycle at max capacity twice in one day. The first race was to
establish their baseline max, and the second to evaluate the
effect of the supplement.
Interestingly, even though the racers were tired and received
no active performance enhancer, half of them were faster in the
second race.
The placebo even made one cyclist break his own personal
speed record. After hundreds of similar experiments on athletes,
these kinds of results are actually typical.
In general, placebos enhance athletic performance by about 3
percent, which can translate into taking gold in the Olympics
versus failing to place in the top 10. So while 3 percent
doesn’t sound like much, it’s a very substantial improvement in
the world of professional sports.
Fake Surgery Works as Well as the Real Thing
Many are quick to conclude that the placebo effect is
responsible for the benefits of alternative treatments and
natural supplements — the implication being that the treatment
doesn’t really work, and any benefit is “all in your
head.”
Few stop to consider the fact that many of the benefits of
conventional drugs and other interventions are also
due to the placebo effect. And, unfortunately, drugs have
the added downside of causing very real and adverse side
effects.
One of the most dramatic examples of this was a now classic
knee surgery study3
published in 2002. Not only does this double-blind,
placebo-controlled, multi-center trial definitively prove the
power of your mind in healing, it also reveals that most knee
surgery for osteoarthritis is a waste of money.
The results of this study show that it’s not the surgery
itself that is responsible for the improvement; it’s all due to
the placebo effect. More precisely, it's the ability of your
brain to produce healing when you believe it should be
happening after receiving surgery.
As noted by the authors: “In this controlled trial involving
patients with osteoarthritis of the knee, the outcomes after
arthroscopic lavage or arthroscopic debridement were no
better than those after a placebo procedure.”
Improvement Following Knee Surgery Is Due to Placebo Effect
Another study4
published in 2013 also found that
arthroscopic knee surgery for degenerative meniscal tears
had no more benefit than “sham surgery.”
At the post-operative one-year mark, all patients, regardless
of whether they had real or sham surgery, reported equal amounts
of pain reduction, which led the researchers to conclude that
real knee surgery offers no better outcome than sham surgery
(placebo).
Arthroscopic surgery on the meniscus is the most common
orthopedic procedure in the US. According to this study, it’s
performed about 700,000 times a year to the tune of $4 billion.
But according to these findings, any claim that surgery is
“the best” or “only” option for osteoarthritic knee pain is
plainly false.
So, please do consider these kinds of findings when you’re
weighing your treatment options. Remembering that your mind
is the real healer may help you find a safer and less costly
alternative to going under the knife, which can have permanent
adverse consequences.
Placebo Surgery Even Works on Fractured Spines
A similar sham surgery trial is presented in the featured
film. Vertebroplasty is a procedure in which a fractured spine
is repaired by injecting surgical cement into the bone. However,
one doctor became aware of a strange anomaly.
Some patients, who for whatever reason received treatment on
the wrong vertebrae, still received pain relief. So he decided
to undertake a placebo trial. Some patients received the real
procedure, and others received sham surgery.
Bonnie, one of the elderly patients in the study who had
fractured her back during a fall, felt immediate pain relief
following her sham surgery. As noted in the film, “the procedure
transformed her life.” With the pain significantly reduced, she
became much more active. Within a week of the injection she was
back to her daily golf game.
And yet nothing, except numbing the area and
simulating the cement injection, had been done to her fractured
spine. Interestingly, Bonnie had real vertebroplasty done
before, putting her in the rare position of being able to
compare the outcome of both procedures. In her words, “they were
both so successful, I could go ahead and do whatever I wanted to
do without any problem.”
A total of 130 patients were included in this study. When the
results were tallied, there was no statistical difference in the
degree of pain relief between the real and the sham surgeries.
Even more importantly, there was no statistical difference in
the improvement of physical function between the two. More than
1 million Americans have received vertebroplasty over the past
couple of decades, yet it is no better than placebo.
Put another way, fake surgery works just as well.
Other Examples of the Medical Placebo Effect
Another excellent example of the placebo effect is that of
antidepressants. Research5
published in 2010 suggests antidepressants work no better than a
placebo for people with mild to moderate depression. An earlier
meta-analysis6
concluded that the difference between antidepressants and
placebo pills is very small — yet these drugs remain among the
most prescribed drugs in the U.S. That hardly falls within the
parameters of “science-based medicine.”
Considering the long list of
side effects associated with antidepressants, including
worsening depression, it seems reasonable to conclude that a
placebo would be a far preferable option to the real thing.
Placebos have also been found to work as well as the migraine
drug Maxalt (rizatriptan) for recurring migraines.7
Surprisingly, subjects reported pain relief even when they
knew the pill they were receiving was a placebo,
compared with no treatment at all. According to the authors, the
placebo effect accounted for more than 50 percent of
the therapeutic value of this drug.
As explained by co-author Ted Kaptchuk, director of the
Program in Placebo Studies and Therapeutic Encounter at Harvard
Medical School:8
"This study untangled and reassembled the clinical
effects of placebo and medication in a unique manner. Very
few, if any, experiments have compared the effectiveness of
medication under different degrees of information in a
naturally recurring disease.
Our discovery showing that subjects' reports of pain
were nearly identical when they were told that an active
drug was a placebo as when they were told that a placebo was
an active drug demonstrates that the placebo effect is an
unacknowledged partner for powerful medications."
How Does the Placebo Effect Work?
We now know the placebo effect is real. But what causes it?
How does it work? Writing in the journal Neuropsychopharmacology9
in 2011, the researchers noted the following observations:
- First, as the placebo effect is basically a
psychosocial context effect, these data indicate that
different social stimuli, such as words and
rituals of the therapeutic act, may change the chemistry and
circuitry of the patient's brain
- Second, the mechanisms that are
activated by placebos are the same as those activated by
drugs, which suggests a
cognitive/affective interference with drug action
- Third, if prefrontal functioning is impaired,
placebo responses are reduced or totally lacking, as occurs
in dementia of the Alzheimer's type.
By using brain imaging technology during placebo tests,
researchers have been able to show that even when a placebo is
used, your brain still responds according to expectations.
For example, in trials involving placebos for pain relief, the
participant's brains release natural opioids that provide
opioid-mediated pain control. So the placebo effect is tapping
into the same pain control centers as opioid drugs.
Placebos can also trigger the release of many other natural
brain chemicals, such as those involved in making us feel more
energized, or those that help us sleep better. As noted in the
film, "the placebo effect taps into our natural pharmacy."
Drugs work because we have the receptors for the drugs, and
that means we have brain chemicals that act on those receptors.
Receptors have evolved to react to those natural chemicals.” In
short, the placebo effect relies on chemicals — your own — which
appear to be released in response to or in accordance with your
mental or emotional expectations or beliefs.
So just how far can a placebo take you? Placebo trials on
patients with Parkinson’s disease have revealed that even this
serious condition can be ameliorated with a "dummy pill."
Lack of dopamine is one of the factors producing the symptoms
of Parkinson’s, and brain scans show that when Parkinson’s
patients are told they’re receiving an active medication, the
dopamine levels in their brains increase — even when there’s no
active ingredient in the pill.
As noted in the film, a placebo can release as much dopamine
as amphetamines in a person with a healthy dopamine system, so
it’s a dramatic response.
Mind Over Matter
Typically, for a placebo to work you have to believe it’s a
“real” drug. Why is that? Expectations, it turns out, play a
crucial role in recovery from illness. There’s a link between
your mind and your body, and when you expect a pill (or surgery)
to do something, your body yields to your expectation by
producing the requisite brain chemicals. Needless to say, the
stronger your belief or expectation, the more likely you are to
experience the desired result.
This was demonstrated in a study10
in which people with back pain who believed that
acupuncture would be helpful actually got more pain relief
from it, compared to those who were skeptical about the
treatment.
According to study author Felicity Bishop, Ph.D.: "People who
started out with very low expectations of acupuncture, who
thought it probably would not help them, were more likely to
report less benefit as treatment went on.” Factors that
influence a person’s expectations include the size, color and
price of the medication, whether it’s the real deal or a
placebo. For example:
- Capsules are more effective than tablets
- Large capsules are more effective than small capsules
- Expensive medications are more effective than cheap
medications
- Red pills are most effective for treating pain, while
blue pills are most effective when treating anxiety — except
if you’re an Italian male. Bright blue is the color of the
Italian soccer team, associated with “passion, excitement,
and heartache,” so for Italians, blue pills have the
converse effect, according to the researchers in this film.
Interestingly enough, there’s also evidence showing that the
placebo effect can work even if you know you’re receiving a
placebo.
However, in these cases, the effects tend not to last as
long. One woman suffering from irritable bowel syndrome was
asked if she’d be willing to try a placebo. While highly
skeptical, she agreed, and was astounded to discover she was no
longer in pain after three days of taking the sugar pills. But
as soon as she stopped taking the pills, the symptoms came back.
The study in question didn’t try to decipher why the placebos
worked, only whether they would work without deception, and in
63 percent of participants, they did provide relief despite the
fact that the patients knew they were taking chemically inactive
pills. One theory though, is that the mere act of seeing a
physician and taking a pill twice a day somehow makes your body
recognize that your intention is to get well.
How to Harness the Placebo Effect For Your Own Health and
Wellbeing
The film also reviews the use of hypnosis — another treatment
that has no “active influence” other than your own belief or
expectation. In a way, hypnosis can be viewed as “a procedure
that allows you to turn your own ability to produce a placebo
effect.” In the film, this is dramatically demonstrated by a man
who opts for hypnosis over anesthetic when getting a wisdom
tooth extracted.
At no point did he rate his pain over a four on a scale of 0
to 10. That’s the power of placebo, and nothing but words were
used to help him shift his expectations about what he was going
to feel, allowing his brain to release natural painkillers.
Chances are, there will be occasions in your life where you
can use your mind to help heal your body or reduce your reliance
on conventional medical care, including medications. And when I
say that, I mean that if you strongly believe you will benefit
from something, you radically increase the chances that you
will.
But there is one caveat: you may need to resolve any
emotional blocks that are standing in your way first. Such a
block could be the belief that the pain or illness cannot
go away. Maybe a parent or relative had the same problem
and they never recovered, so you probably “can’t” get rid of it
either. Another block could be resentment that you have the
disease or the pain, or even an unconscious desire to keep your
ailment because of the attention you gain from it.
The Emotional Freedom Techniques (EFT) is an extremely
powerful tool for getting to the root of emotional conflicts
such as these. By releasing them, it may be easier for you to
open your mind and harness the power of the placebo effect. It’s
often possible to feel better just because your mind
subconsciously believes it's time, or your subconscious alters
body processes in response to the placebo treatment without you
even being aware of it.
As often as possible, try to use the placebo option first.
This is a new way of thinking about healing for most people, but
can be extremely potent, especially when combined with a healthy
outlook and
disease-preventive lifestyle.