Sunday, December 1, 2013

Placebos

It's interesting that 'placebo' is almost a dirty word in many medical and health circles. The reason medicines are tested relative to the placebo effect is because placebos WORK. Doctors, coaches, teachers should be looking for ways to reduce stress and improve their patients, athletes, and students' ability to heal, recover, and learn. Dismissing something as "all in your head" is nothing but ignorance.
...the placebo effect really is the brain's own healing process, and that's a long word, so it's probably easier to say the placebo effect. But the problem with the word placebo is it carries with it a lot of baggage. 
...when you look at placebo-controlled trials, the reason we have to do placebo-controlled trials to determine the "true biological effect of a drug or intervention" is we have to subtract out the placebo effect where people have an expectation that just taking a pill or having an injection or whatever the intervention is, they have an expectation that that will heal and, in fact, it does. It reduces pain, it can reduce inflammation to a certain degree, and it's hard to estimate and it differs with different conditions.But the percent of effect of the placebo effect in any given intervention has been estimated to be somewhere between 30 and 90 percent. Ninety is probably a little high and 30 may be a little low, so let's say 50 percent. A drug that has the ability to help reduce pain by 50 percent is a very powerful drug. So, you know, it's not a trick; it is your brain activating anti-pain pathways releasing those endorphin molecules, releasing those desire molecules, dopamine, to shift and reducing the stress response. 
...why not use this in a sort of a carefully titrated way and say, OK, why not put the individual who needs to heal into the most healing environment where the stress response is not activated and, to the extent that we can, it's reduced where you have positive emotional memories that flood you. Put them into a situation where they're likely to release these positive, these anti-pain molecules and these, you know, dopamine molecules of reward, and that will allow their body to heal or to receive the drugs that you are then giving them. 
So I'm not saying, you know, don't go to a desert island and don't take your cancer chemotherapy, but I'm saying don't fight against it by putting yourself in a stressful situation. Do the maximum that you can with things like meditation and yoga and prayer to help amplify these pathways in the brain that we know ultimately can help the immune system do its job to heal.
From the radio program On Being (October 24, 2013): The Science of Healing Places with Esther Sternberg

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