This is fascinating – well worth a 30 minute listen!
It seems that the research on the placebo effect is broadening and deepening.
“Over the last several years, doctors noticed a mystifying trend: Fewer and fewer new pain drugs were getting through double-blind placebo control trials, the gold standard for testing a drug’s effectiveness.”
This recent article, which includes some useful links for further reading, points to the degree in which the placebo effect (classified by the writer as a ‘family of overlapping psychological phenomena’) is being studied and considered. The family of placebo effects ranges ‘from the common sense to some head scratchers’, and include:
1) Regression to the mean
2) Confirmation bias
3) Expectations and learning
4) Pharmacological conditioning (‘This is where things get a little weird’)
5) Social learning
6) A human connection
Interestingly, it seems that at least in pain studies, ‘there’s evidence that placebos actually release opioids in the brain’.
In another article in Mother Jones, What the Heck Is a Placebo Anyway?, the authors propose ‘… we now know that they (placebos) often involve real chemicals produced by the body—real drugs from your “internal pharmacy.” Some of these chemicals are used by the brain to make sure that your expectation meets reality. When expectation doesn’t meet reality, the brain steps in and forces it to fit.’
Over at Fox News (of all people), quoting the Wall Street Journal, they’re suggesting ‘Placebo drugs really work, evidence suggests‘.
Placebo ‘drugs’? Come on, folks, that misses the point a bit!
Damien Finniss was working as a physiotherapist when, on a still winter’s afternoon in 2001, he set up his treatment table in a shed at the perimeter of a Sydney footy ground.
As players came off with sundry aches – a pulled hammy here, a calf strain there – Finniss ministered to them with therapeutic ultrasound, a device that applies sound waves to the injured area with a handheld probe.
“I treated in excess of five or six athletes during the training session. I’d treat them for five or 10 minutes and they’d say ‘I feel much better’ and run back on to the training field,” recalls Finniss, now a medical doctor and Associate Professor at the University of Sydney’s Pain Management and Research Institute.
“But, at the end of the session, I realised that I’d, basically, had the machine turned off.”
Read the whole article here.
Meanwhile, in Germany, researchers reveal some convincing evidence of the impact of the placebo effect, discovering that “a person’s expectations have a major influence on just how strenuous they perceive exercise to be.”
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.
Read the full article here.
A recent meta-study in the World Journal of Gastroenterology (March 28 2017) – Systematic review: The placebo effect of psychological interventions in the treatment of irritable bowel syndrome
Aim – “To determine the placebo response rate associated with different types of placebo interventions used in psychological intervention studies for irritable bowel syndrome.” (Six studies, with a total of 555 patients met the inclusion criteria.)
… and the placebo effect, unsurprisingly, figures significantly:
“Contrary to our expectations, the PRR (Placebo Response Rate) in studies on psychological interventions was comparable to that in studies on pharmacological, dietary and alternative medical interventions.”
Download the whole study in PDF here.
The research effort on the placebo effect deepens and widens.
“In a report published online Feb. 15 in The BMJ, researchers at Stanford call for more health care providers to place emphasis on the importance of individual mindsets and social context in healing … (and) to develop more studies that measure the physical effects of these psychosocial elements to understand and quantify patients’ subjective experiences of expectations, connection and trust.”
“We have long been mystified by the placebo effect,” Crum said. “But the placebo effect isn’t some mysterious response to a sugar pill. It is the robust and measurable effect of three components: the body’s natural ability to heal, the patient mindset and the social context. When we start to see the placebo effect for what it really is, we can stop discounting it as medically superfluous and can work to deliberately harness its underlying components to improve health care.”
Read the article here.
In his book, ‘Suggestible You: The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal’ author Erik Vance explores placebos, hypnosis, and how beliefs influence bodily responses to pain.
“Placebos and beliefs generally is so much a part of our lives,” he tells Kishore Hari on a recent episode of the Inquiring Minds podcast. “It has an amazing power to change our bodies.”
Read the article here, or listen to the Podcast!
“I was just amazed that you could change what price you were going to launch a product at, and you could change what brand it was, and people would have dramatically different impressions of that product. And they would tell you incredibly different things about the product: they thought it was made of different materials, they thought it weighed more or it weighed less. Really out-there stuff that, at the time, we joked about but we couldn’t explain.”
More here. And meanwhile, for your listening pleasure …
This question/comment/assumption comes up a lot when we talk to people about placebos and the placebo effect. ‘It works’ (is the assumption) ‘if people believe it’s something else’ …
Like the ‘real’ thing, perhaps …? We’ve posted on this before, and it seems the research is becoming more robust and rigorous.
Once more, courtesy of Professor Kaptchuk … read Knowingly Taking a Placebo Still Reduces Pain, Studies Find …
New research has shown that patient’s envisioning and expecting positive results from major surgery, including open heart surgery, will over time actually recover and heal more effectively.
“Optimizing patients’ expectations pre-surgery helps to improve outcome 6 months after treatment. This implies that making use of placebo mechanisms has the potential to improve long-term outcome of highly invasive medical interventions”