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Placebo Isn't What You Think it is - Placebo Effect Myths Debunked

New age "gurus" often promote the placebo effect as evidence of psychological healing, or as a means to justify expensive placebo treatments, such as homeopathy, crystal healing, acupuncture, and even "dream healing". Unfortunately these claims stem from a deep misunderstanding of what the placebo effect actually is, namely non-specific effects and illusions.



The Placebo Effect isn't What You Think it Is

The placebo effect is one of the most widely misunderstood concepts. Myths regarding the nature of placebo abound. Sadly these are often promoted by well-meaning but misinformed professionals.


Most importantly, the placebo effect isn't a single effect at all. In reality it is an umbrella term used to categorize what is measured in the placebo arm of a clinical trial. In other words the placebo effect is the measurement of the combined influence of multiple factors that make up the difference between no treatment at all and a placebo treatment.



This difference can be made-up of multiple placebo effects, for example:

  • Self limiting illnesses - Many illnesses, such as the flu or common cold, will resolve themselves without treatment. In other words, you can do absolutely nothing at all and recover. In these circumstances, even a treatment with zero influence can give the illusion of benefit.


  • Regression to the mean - If the symptoms of an illness flare, it is highly probable that they will return to baseline without intervention. Again, any action considered as a treatment (even if entirely ineffective) undertaken during a symptomatic flare can give the impression of benefit due to the natural regression to baseline symptoms. Indeed, a common nocebo effect (the negative version of placebo) occurs when patients visit their doctor for a blood pressure reading. Results are often considerably higher on the first few readings due to a spike in stress. Fortunately, in this case, regression to the mean allows doctors to discard these initial readings and wait until blood pressure returns to baseline. Aka "White Coat Syndrome".

  • Optimism - A belief that one is working towards recovery can have a positive impact on a patients mood, this can lead to a subjective change in the patients interpretation of symptoms. In other words, while the symptoms may not change, a happy and hopeful patient is likely to experience them in a more positive light.

  • Bias in reporting - People want to recover and to believe that their treatment is beneficial. This can lead to misinterpretation, misreporting, and a bias in objectivity. Equally, doctors and researchers generally want their treatments to work, which can lead to a subtle social pressure on the patient to report favourably on their condition.



As you can see, none of the above placebo effects have any relationship to the mind's ability to heal the body. They are simply factors that may create the illusion of benefit for a treatment that offers none.


In other words it is the subjective PERCEPTION and REPORTING of "healing" and may have absolutely no basis in genuine physical healing.


These effects, among others, are collectively referred to as the placebo effect, and it is the influence of these effects, often in combination, that are measured as the placebo effect in clinical trials.


The placebo effect is not some mystical "mind over matter" healing process, but a combination of varied influences that can create the illusion of treatment efficacy where there is none.

Why is placebo used in medicine?



Placebos act as a fair and unbiased way of analysing whether symptoms are effected by medication or human bias.

When testing the efficacy of a medicine, it is important to remove bias from the equation.


Placebo is used to distinguish the genuine differences between no treatment at all and the treatment being tested.


A placebo offers the opportunity to establish what effects are the result of the belief that a treatment is underway, and the genuine effects of a treatment.


Of course, this cannot be established through a control group that receives no treatment at all, as subjects in that group are aware that they are not being treated.



Placebo isn't "Mind Magic"


New age thinkers often like to claim that placebo is evidence that the mind is capable of healing the body, but as we have seen this is not the case at all.


The placebo effect is not something that can be used to heal, but only to create the illusion of an influence.


Some new age practitioners even admit that their methods are nothing more than placebo, but then double-down on their deceptive approach by making irrational claims that they are able to "maximise the placebo effect", a nonsensical statement that demonstrates a disregard or misunderstanding of the concept of placebo.



Positive Thinking


Looking beyond the placebo effect, the role of positive thinking on health outcomes is relevant.


While it is obvious that positive thinking alone will not directly heal the body, as magical thinking is simply not relevant to the immune system, it is clear is that there is a link between positivity and health.



The mechanisms behind the connection between positivity and health remain poorly understood, but researchers suspect that hormonal changes triggered from a positive attitude may help protect against the inflammatory damage of stress or, perhaps, those with a positive mindset are more likely to make better life and health choices. Many studies also find that negative emotions can weaken the immune response.


However, it is important to remain sensible when considering the role of positive thinking.


It is common sense to understand that one cannot "smile your way to the re-growth of a lost limb" or "laugh your way out of tooth decay".


Equally, the invisible, yet still entirely physical, issues that can plague the inner-workings of our body (tumours, cancers, viral or bacterial infections, etc.) work by the very same rules. Just because you cannot see your insides, does not mean that the same physical and biological rules do not apply. Trying to wish away a virus through "positive thinking" or "manifestation" is as illogical and ridiculous as trying to wish-back an extracted tooth.


Positivity may offer an small but tangible improvement to the hormonal and chemical environment in which our immune system and any medical treatments will operate, but it must not be mistaken for a panacea.


It is true that positivity can occasionally help to improve healing outcomes, but only as an addition to genuine evidence based medicine, and definitely not as a replacement.


One thing is certain, on a subjective level alone, it's preferable to accept sickness as an inevitable part of human life, and to face it with a smile and the optimism to carry you through the ordeal.


Even if we cannot think or wish our way out of sickness, we can choose to make every moment of our life as happy and as positive as the circumstances allow. It's certainly better than the alternative!



 





 









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