Like the word dirge, placebo has its origin in the Office of the Dead, the cycle of prayers traditionally sung or recited for the repose of the souls of the dead. The traditional liturgical language of the Roman Catholic Church is Latin, and in Latin, the first word of the first antiphon of the vespers service is placebo, “I shall please.” This word is taken from a phrase in the psalm text that is recited after the antiphon, placebo Domino in regione vivorum, ”I shall please the Lord in the land of the living.” The vespers service of the Office of the Dead came to be called placebo in Middle English, and the expression ‘sing placebo’ came to mean “to flatter, be obsequious.” … Placebo eventually came to mean “flatterer” and “sycophant.”
The term entered medical history in the late 18th century, with a few British doctors that can claim to be the originator. For one, there is Alex Sutherland (born before 1730 – died after 1773) a doctor living and practicing in Bath, Summerset, who used the term to describe certain types of doctors keen to prescribe fashionable medicines such as waters with healing power, which he called “placebo” (doctors) in a popular book published in 1763. About the same time, William Cullen (1710 – 1790) from Edinburgh, Scotland, used it for the first time in a textbook, his Clinical Lectures: He gave a patient mustard powder as a remedy noting “… that I did not trust much to it, but I gave it because it is necessary to give a medicine, and as what I call a placebo,” summarizing today’s entire discussion in a single sentence: Placebos are to please the patient and improve symptoms because of that – what we call the placebo effect. And the third gentleman is John Coakley Lettsom (1744-1815), a doctor from London who resumed a similar position to Cullen; they used placebos of ineffective doses of what were popular medicines of their time.
More on this fascinating history, including the inclusion of placebo in the earliest forms of homeopathic practice, here.
In a report published in the National Institute for Health Research (NIHR) Journals Library, the researchers showed that there is significant evidence to demonstrate that acupuncture provides more than a placebo effect.
Professor of Acupuncture Research, Hugh MacPherson, working with a team of scientists from the UK and US, brought together the results of 29 high quality clinical trials focused on patients treated with acupuncture and standard medical care.
In the majority of these trials, patients with chronic pain treated with acupuncture and standard medical care were tested against those who were provided with standard medical care alone, such as anti-inflammatory drugs and physiotherapy. The trials involved approximately 18,000 patients diagnosed with chronic pain of the neck, lower back, head, and knee.
The report shows that the addition of acupuncture compared to standard medical care alone significantly reduced the number of headaches and migraine attacks and reduced the severity of neck and lower back pain. It also showed that acupuncture reduced the pain and disability of osteoarthritis, which led to patients being less reliant on anti-inflammatory tablets to control pain.
Here’s a fascinating story from a writer at the Smithsonian who experienced that the placebo effect is engaged even if you KNOW you’re taking a sugar pill.
“I was in grad school training as a psychotherapist,” (Kelley) told me once, “and I came across a study arguing that antidepressants work just as well as psychotherapy. I didn’t mind that so much, because I like psychotherapy and see its value. But later I found another study showing that antidepressants actually work no better than placebos, and that definitely bothered me. Did this mean that psychotherapy was nothing but a placebo? It took me quite a while to consider the reverse, that placebo is a form of psychotherapy. It’s a psychological mechanism that can be used to help people self-heal. That’s when I knew I wanted to learn more.”
It seems that here at Universal Placebos we’re selling ‘open label’ placebos, that is, placebos explicitly labeled as placebos. It’s so nice that science is catching up!
In his research, which includes a wonderful ‘one person experiment’ designed to use placebos in tackling writer’s block, the author interviews Kathryn Tayo Hall, a geneticist at Brigham and Women’s Hospital, and ‘sheepishly’ admits to the fact that placebos worked for him.
“Brilliant,” she said, and showed me a box of homeopathic pills she takes to help with pain in her arm from an old injury. “My placebo. The only thing that helps.”
“I don’t have to believe in you,” (the author says directly to his placebo pills), “because you’re going to work anyway.”
We note an interesting ‘counter narrative’ emerging – that is, scepticism about the commonly held view that drug treatments designed for mood disorders such as depression often engage the Placebo Effect. In this counter-narrative,
“Drug trials don’t show much in the way of classic placebo effects. The rise in placebo responses over the years is more likely due to the supportive factors in drug trials…and increasing problems with enrollment.”
The new finding—no upward trend in placebo responses—is unexpected and certain to be contested. Meanwhile, it stands as a rebuke to a popular narrative. By that account, drug effects had been hyped, expectations soared, and the inflated hopes were reflected in rising placebo response rates.”
This is fine, except the counter-narrative also resonates with challenges about the efficacy of conventional ‘gold-standard’ ‘blind’ ‘placebo controlled’ drug trials, where it has been shown that trials funded by drug companies (who by definition have a vested interest in their outcome) are 30% more likely to return ‘favourable’ results than trials which are not funded in this way. The ‘placebo effect’ might be the design and execution of the trial itself, not the actual function and efficacy of the placebo …!
“The placebo effect should be the subject of major, funded research efforts. If medical researchers could figure out how to leverage the placebo effect, they would hand doctors an efficient, energy-based, side effect-free tool to treat disease. Energy healers say they already have such tools, but I am a scientist, and I believe the more we know about science of the placebo, the better we’ll be able to use it in clinical settings.”
There’s so much attention right now given to Olympic atheletes’ use of ‘placebo’ rituals and objects, from favourite items of underwear to ancient Chinese ‘cupping’ techniques and herbal supplements.
“Judo gold medalist Kayla Harrison wears the lucky socks that were a gift from her grandmother. Hockey player Alex Danson spins her stick 15 times before each game. Tennis player Rafael Nadal takes alternating sips from two water bottles at every break between games.”
“In sports, it’s a little different in that in the vast majority of cases relying on the placebo effect probably won’t hurt, and in many cases might actually help because of the power of belief. Aside from some potential BO, is it really a problem that an athlete regularly wears the same t-shirt under his uniform to help with on-field success? In fact, savvy coaches regularly use various placebo approaches when trying to help their team with belief — and often these tactics work.”
“If drugs are effective and placebo responses small, this does not matter much. But people tend to turn to alternative medicine for subjective, stress-related conditions such as chronic pain, depression, nausea and fatigue (all problems that can affect cancer patients in treatment). Drugs for these conditions have significant downsides, such as unpleasant side effects and addiction, and placebo responses often account for most of the effect of the drug. So it becomes plausible that compared to popping a pill, a patient might get more relief — and fewer side effects — from an hour with a sympathetic therapist.”