Placebo and the power of mind over body
Recently, Time magazine published an article on the prevalence of the use of placebo prescriptions. While some might read this as a piece about medical fraudulence, I see it as a marker of an important positive shift in the thinking of the western medical community.
Often in the field of alternative medicine and wellness you will hear credence given to the importance of the mind in mending the body. While this is a common concept in the worlds of massage, acupuncture, guided imagery, energy work, etc., it’s something that’s only recently taken hold in western medicine.
Thirty years ago the idea began to surface in conversations around fighting cancer. Organizations like Commonweal formed around the belief that the most effective treatment for cancer had to include informed patients who had positive thinking tools to strive for improved quality of life.
While select fringe areas of medicine began embracing the power of the mind in healing, the majority of the American allopathic industry had a long way to go. As the Times article states;
In 1979, a similar survey of American doctors found that 60% of respondents believed that using placebos was a good way to deduce whether a patient had a “real” problem or was just faking it.
Over the last few decades, however, there has been a noticeable shift. More and more hospitals are instituting programs like California Pacific Medical Center’s Integrative Medicine Program that really emphasize the importance of recognizing the mind, body, and spirit as integral considerations in a treatment plan. Research is coming out that recognizes the value of empathetic support in a patient’s fight against disease.
And whereas in the past doctors saw the placebo effect as a sign of hypochondria, of the doctors in this recent study, “96% believed that dummy pills could have real therapeutic effects.”
This isn’t to say that we have arrived. There are still many in the medical field who are dismissive of things they don’t understand. Just this week, the New York Times published an article questioning the very existence of a very painful and growingly common condition, fibromyalgia.
Thankfully, the Times Magazine article gives me a bit more hope. Quotes like:
“Physicians in this survey believe the mind and the body are inherently interconnected, and that belief can challenge our approach to the healing process in new, innovative ways”
are clear signs of forward movement in the efforts to bring the whole person and all of their strengths and imbalances into consideration when treating patients.
For more information on the placebo effect, a friend recommended Understanding the Placebo Effect in Complimentary Medicine: Theory, Practice and Research, by David Peters. It’s definitely on my To Read list.
Good to see you writing. Interesting post too.
It’s something I’ve thought a lot about myself. This era of “hi. here are your pills. bye.” style of health care lacks the quality positive interaction that is necessary for positive placebo therapeutic effects. Of course, the promise of the pill itself has a bit of placebo action, but it looses this if the person’s prior pharma experiences are negative or if the experience with the doctor is negative.
For some things, like antibiotics for strep, the pills are really all that’s needed. However for abstruse conditions like fibromyalgia and CFS that positive human connection is important.
A lot of this comes down to the stigma attached to the term psychosomatic. Most if not all diseases have a psychosomatic component (some more so than others) and we need to recognize and treat this aspect as well rather then just disregard it. Recognizing this is important for both doctors and patients. There is really nothing wrong with seeking therapy that targets the mental stress of dealing with a disease that may be physical.
The best kind of therapy is therapy that teaches one to cope on their own. Pain-management psychology is obviously useful for this; however, I have a lot of respect for meditation, exercise/yoga, and massage therapy (especially when combined with self-massage, body awareness, or other stress-management instruction).
Other alternative medicine (such as acupuncture, rieki, chiropractics, unproven herbs, and radical nutritionalism) I have less respect for. Even if it works for someone, it’s just a placebo crutch that one has to keep sinking money into — there is no self-empowerment.
Comment by colin — January 18, 2008 @ 3:17 am
Well, this is an issue I’m a little bit ambivalent on.
There is no doubt that positive thinking through placebos can have an effect in the healing of patients. The concern is that there’s a fine razor between cultivating positive thought on one side and enabling snake-oil salesmen to dupe the public on the other. The even greater concern, which is already a steady problem, is that giving too much legitimacy to placebo products will give the public the mistaken idea that they can turn to those in lieu of legitimate medical treatment, thereby exacerbating their conditions.
There is a great deal of skepticism about Western medicine, and while I would be the first to admit that it is wrought with problems, there is something to be said about the screening process of the FDA; in order to be considered a medicine there must be a minimal success rate, and the product must advertise its side effects.
Placebo products don’t have that screening process. Therefore you get things like my favourite target; homeopathy. Homeopathy is bronze age nonsense, and is nothing but a mass-market placebo. We know that the ‘Law of Similars’ is ridiculous, and any child can tell you that a chemical does not get stronger the more that it’s diluted. At the same time, many people use homeopathy and claim that it works. Should it then be labeled as a medicine, therefore making it as legitimate as treatments with tested and consistent success rates?
Or what about Reiki, which states that if you aren’t healed, it’s because you subconsciously don’t want to get better. That can actually have an adverse effect of a person’s emotional well being.
The problem with many alternative medicines is that they want to have it both ways. They wish to be considered a form of treatment on the same level as conventional medicine, but they don’t want to have to be held to the same accountability as conventional medicines.
And yet I wouldn’t deny the fact that ‘self-healing’ can assist in healing; primarily in ailments that our immune system would take care of anyway, or ailments that are already being addressed by other treatments. And that’s the problem. We have to find a way to take placebo treatments into consideration, but not to let them overstate their role as supplemental treatments. We want to legitimizing them, but not legitimizing them too much – and that’s hard to do.
To clarify; while I appear to sound as though I am against alternative medicine as a whole, there are plenty of forms of alternative healing such as massage, yoga, meditation, etc that have shown to have effective and consistent health benefits that can be easily measured.
Ah, and I’m bringing you two brown fedoras tonight 😉
Comment by Dave Haaz-Baroque — January 19, 2008 @ 1:03 am
you can say that alternative medicine is cheaper too and usually comes from natural sources :’-
Comment by Transistor %0A — November 22, 2010 @ 11:38 am