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Heal thyself: Your personal placebo programme
COVER STORY
HEAL THYSELF A drug that we can all get for free has wide-ranging health benefits, with no side effects. It’s called the mind. Jo Marchant reveals six ways to raid your own built-in medicine cabinet
Fool yourself “I TALK to my pills,” says Dan Moerman, an anthropologist at the University of MichiganDearborn. “I say, ‘hey guys, I know you’re going to do a terrific job’.” That might sound eccentric, but based on what we’ve learned about the placebo effect, there is good reason to think that talking to your pills really can make them do a terrific job. The way we think and feel about medical treatments can dramatically influence how our bodies respond. Simply believing that a treatment will work may trigger the desired effect even if the treatment is inert – a sugar pill, say, or a saline injection. For a wide range of conditions, from depression to Parkinson’s, osteoarthritis and multiple sclerosis, it is clear that the placebo response is far from imaginary. Trials have shown measurable changes such as the release of natural painkillers, altered neuronal firing patterns, lowered blood pressure or heart rate and boosted immune response, all depending on the beliefs of the patient. There is even evidence that some drugs work by amplifying a placebo effect – when people are not aware that they have been given the drugs, they stop working. On the flip side, merely believing that a drug has harmful side effects can make you suffer them. The nocebo effect, as it’s known, can
even kill (New Scientist, 13 May 2009, p 30). It has always been assumed that the placebo effect only works if people are conned into believing that they are getting an actual active drug. But now it seems this may not be true. Belief in the placebo effect itself – rather than a particular drug – might be enough to encourage our bodies to heal. In a recent study, Ted Kaptchuk of Harvard Medical School in Boston and colleagues gave some people with irritable bowel syndrome an inert pill. They told them that the pills were “made of an inert substance, like sugar pills,
that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes”, which is perfectly true. Despite knowing the pills were inert, on average the volunteers rated their symptoms as moderately improved after taking them, whereas those given no pills said there was only a slight change (PLoS ONE, vol 5, e15591). “Everybody thought it wouldn’t happen,” says study co-author Irving Kirsch, a psychologist at the University of Hull, UK. He thinks that the key was giving patients something to believe in. “We didn’t just say ‘here’s a sugar pill’. We explained to the patients why it should work, in a way that was convincing to them.” As well as having implications for the medical profession, the study raises the possibility that we could all use the placebo effect to convince ourselves that sucking on a sweet or downing a glass of water, for example, will banish a headache, clear up a skin condition or boost the effectiveness of any drugs that we take. “Our study suggests that might indeed help,” says Kirsch. While Moerman talks to his pills, Kirsch recommends visualising the desired improvement and telling yourself that something is going to get better. > 27 August 2011 | NewScientist | 33
HEAL THYSELF A drug that we can all get for free has wide-ranging health benefits, with no side effects. It’s called the mind. Jo Marchant reveals six ways to raid your own built-in medicine cabinet
Fool yourself “I TALK to my pills,” says Dan Moerman, an anthropologist at the University of MichiganDearborn. “I say, ‘hey guys, I know you’re going to do a terrific job’.” That might sound eccentric, but based on what we’ve learned about the placebo effect, there is good reason to think that talking to your pills really can make them do a terrific job. The way we think and feel about medical treatments can dramatically influence how our bodies respond. Simply believing that a treatment will work may trigger the desired effect even if the treatment is inert – a sugar pill, say, or a saline injection. For a wide range of conditions, from depression to Parkinson’s, osteoarthritis and multiple sclerosis, it is clear that the placebo response is far from imaginary. Trials have shown measurable changes such as the release of natural painkillers, altered neuronal firing patterns, lowered blood pressure or heart rate and boosted immune response, all depending on the beliefs of the patient. There is even evidence that some drugs work by amplifying a placebo effect – when people are not aware that they have been given the drugs, they stop working. On the flip side, merely believing that a drug has harmful side effects can make you suffer them. The nocebo effect, as it’s known, can
even kill (New Scientist, 13 May 2009, p 30). It has always been assumed that the placebo effect only works if people are conned into believing that they are getting an actual active drug. But now it seems this may not be true. Belief in the placebo effect itself – rather than a particular drug – might be enough to encourage our bodies to heal. In a recent study, Ted Kaptchuk of Harvard Medical School in Boston and colleagues gave some people with irritable bowel syndrome an inert pill. They told them that the pills were “made of an inert substance, like sugar pills,
that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes”, which is perfectly true. Despite knowing the pills were inert, on average the volunteers rated their symptoms as moderately improved after taking them, whereas those given no pills said there was only a slight change (PLoS ONE, vol 5, e15591). “Everybody thought it wouldn’t happen,” says study co-author Irving Kirsch, a psychologist at the University of Hull, UK. He thinks that the key was giving patients something to believe in. “We didn’t just say ‘here’s a sugar pill’. We explained to the patients why it should work, in a way that was convincing to them.” As well as having implications for the medical profession, the study raises the possibility that we could all use the placebo effect to convince ourselves that sucking on a sweet or downing a glass of water, for example, will banish a headache, clear up a skin condition or boost the effectiveness of any drugs that we take. “Our study suggests that might indeed help,” says Kirsch. While Moerman talks to his pills, Kirsch recommends visualising the desired improvement and telling yourself that something is going to get better. > 27 August 2011 | NewScientist | 33