The placebo effect, as doctors call it, is something that creates a real and positive change in a person's body but cannot be explained by the characteristics of the placebo itself. Something as simple as a father saying to a little girl who fell and bumped her knee, “I’ll kiss it and make it better,” can make the girl forget her pain.
With just a puff of air, a kiss, or a few kind words, a loving person can stop the pain of a child. Even though it should have no effect, a real change happens in the person’s body. That is why placebos are vital in medical research. In clinical trials, for example, a pill that contains no medicine but looks just like one with medicine is given to some participants. Researchers do this to show that people who are actually taking the medicine get better compared to those who really are not, therefore proving that a new medicine works.
“Placebos don’t do anything for bacteria,” Kathryn Hall, a medical researcher at Brigham and Women’s Hospital said. “Placebos can’t fight cancer. They can’t fight viruses.” What they can do, however, is affect how a person experiences pain or other symptoms.
Contrary to the placebo effect is the nocebo effect. The former is when a person expects the treatment to work, while the latter is when a person expects the treatment to fail. A person’s expectations can influence their outcome, with expecting failure having the possibility of treatments hurting or failing.
In a study published in May of 2021 in the journal Frontiers in Nutrition, athletes rinsed their mouths with either a pink or clear liquid solution. Both solutions were similar, having the same number of calories and sweeteners, but the athletes were told that the pink solution would increase their energy. It indeed did, with the athletes who rinsed their mouths with the pink solution having an “improved self-selected running speed, total distance covered, and feelings of pleasure obtained[…]when compared to an isocaloric and taste-matched clear solution.”
Researchers set up clinical trials in a way where no one involved—doctors and volunteers chosen at random—finds out who has taken what until the end of the trial, therefore ensuring that everyone expects the same outcome.
Ted Kaptchuk, director of the Program in Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center, began investigating open-label placebos in 2010 with pilot trials in which patients were given a placebo pill they knew would have no effect on their body. It was previously believed that patients had to be deceived in order for the placebo effect to succeed, but Kaptchuck’s trials proved that to be wrong. There was more improvement in the patients who took open-label placebos compared to the ones who did not.
Pain signals begin on nerves and travel up to the brain, with stronger signals being equal to greater pain. Different factors can change the way a person feels pain, however. Dangerous situations, for example, may cause a person to feel a lower amount of pain. Endorphins—pain-relieving chemicals—and dopamines are released by the brain during a placebo response to pain. The systems that control a person’s feeling of pain are the same systems that control the release of these chemicals.
A “therapeutic encounter,” as Kaptchuk calls it, occurs when a doctor and patient discuss how to treat the patient, building a strong sense of trust and ensuring the patient feels both heard and valued. A positive encounter can have the same positive effects on a patient as if they took a fake pill, while a negative encounter can have negative effects and result in the worsening of the patient’s disease.
Hall said negative encounters could factor into the reason why people of color in the United States many times have worse health compared to those who are White. More time is spent by doctors with individuals who are White than with people of color, with their also failing to look them in the eye and dismissing their symptoms.
“This is tremendously harmful,” Hall said. Any biases doctors may have need to be overcome. That is why doctors like Baruch Krauss, a pediatrician at Harvard Medical School, work on the best way to communicate with their patients, such as sending nonverbal cues to make patients feel comfortable.
A patient’s feelings towards their doctor and treatment can have an impact on the outcome. Positivity seems to attract positivity and negativity, negativity. The power our brains have to create change in our bodies is unimaginable.
[Sources: Science News for Students; Frontiers in Nutrition]