In Defense Of The Placebo Effect

What do you know about placeboes? Definition-wise, a placebo is an inert substance that will elicit a response in its consumer. Take a sugar pill and your pain goes away. The placebo effect is essentially a null effect – the pill didn’t do anything; brain is merely “tricking” the body into a reaction. Pharmaceutical companies test new drugs against placeboes all the time to see if their drug works – that is, that it does something.

But there’s another way to frame this whole situation, one without such a mind/body dichotomy. The placebo isn’t the sugar pill, the placebo is the act of taking the sugar pill, and this act creates the necessary internal environment for the reaction to take place. The placebo effect doesn’t mean that nothing happens. It means that whatever drug is being tested has no effect beyond that which the body does for itself.

Because, as it turns out, the body can do a lot for itself.

I’ve often heard people invoke the placebo effect in regards to massage – usually about specific massage styles that may not have the strongest scientific basis. They say that the massage is just fooling the client into thinking that it’s doing something. Ok, sure, the massage may not exactly be telling someone’s heart to pump slower or breaths to be deeper, but it provides the setting for the client’s mind and body to make this happen. When I work on someone’s jaw with craniosacral therapy, I’m not forcibly putting the jaw back into the right place. I’m loosening the surrounding muscles and relaxing the body, and this allows the bones to shift on their own. Indeed, many of my clients report that the biggest changes they feel in their jaw come several days following the massage. I didn’t move the jaw myself; all I did was create the right environment.

And placeboes can be more than specific actions – they also be something less concrete, like a belief that a treatment will work. Even when it comes to drugs that have been proven to work, believing that they work plays a huge part. Recent research found that when patients were told that a specific pain reliever was going to relieve pain, the effects nearly doubled (compared to when they were not told to expect anything). In contrast, when patients were told that the pain reliever would actually increase pain, this negative expectation completely abolished the effects of the (proven, tested) drug. What you believe about something can often be more important than the thing itself.

A client came to see me with extreme pain in his right shoulder. I started to work on that area and, no surprise, I discovered some trigger points… so I spent the entire hour working on them. He returned the next week absolutely elated – his pain was gone! – but I knew that the trigger points were still there. And indeed, when I massaged that same area again, he reported tenderness. How strange that the body was still experiencing something that the brain no longer noticed.

That didn’t mean that my client was wrong about his subjective experience, but it did illustrate the fact that pain relief is more than just releasing the trigger points and reducing inflammation. That first massage, coupled with his expectations of a positive outcome, had a greater-than-normal effect on his pain.

On a slightly different note, the placebo effect can take place even when people aren’t being “tricked”. A recent study showed that even when subjects are told explicitly that they’re just taking a sugar pill, that anything they may feel is placebo, the effect still takes place.

But I think there’s a line to draw here. Patients in the study were told that they’d be taking “placebo pills 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”. This is certainly different than saying, “this is a placebo pill, which won’t do anything in and of itself, but it has been shown to trick the body into thinking that it will”. It’s all a matter of framing.

As the title of this post would imply, I generally come down in favor of the placebo effect. The mind and the body are wonderful and amazing things, capable of more than we give them credit for. And if the body can heal itself – with only a slight nudge from outside factors – should we really argue against it? Or should we encourage it?

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  1. […] touches on research being done about the placebo effect and the power of one’s own body to heal, something I’ve written about before. It talks about how modern medicine has evolved since the 1960s to focus more on overall wellness, […]

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