Placebo, Nocebo and Belief

Having been fascinated most of my life with things ‘of mind’, I find it intriguing that we are influenced by the placebo effect. Some of us more so than others. It has been shown that “volunteers with a strong placebo response are more emotionally self-aware, mindful of their environment, and sensitive to painful situations”.

A placebo effect refers to the real benefits of a medical intervention that has no therapeutic value. The placebo comes usually in the form of a pill, or an injection, or even surgery.

With the placebo effect the simple act of taking a tablet can make a person feel its benefits. Belief is a powerful thing indeed.

However, this is not just a psychological phenomenon (all in the mind or tricks or fakery); it has a biological basis. In other words, simply taking a sugar pill while thinking it’s a pain killer can lead to a release in endorphins, alleviating pain. In effect the mind/body interaction is gives a healing response.

Thousands of studies have been done on placebos and it has been demonstrated that it is very common in headache treatment and back pain.

m mosely pillsA placebo trial documented in a BBC Horizon programme (hosted by the informative Dr Michael Mosley) includes the following story of Jim Pearce:

Jim, a 71-year-old, was confined to a wheelchair and using morphine because of his back pain. But after he took part in the study, taking the convincingly-labelled blue-and-white-striped “new” painkillers, he seemed like a different person.

The only thing was that he’d been taking placebos; dummy pills – they contained nothing but ground rice. But they worked.

Jim said: “I just woke up one morning and I thought, hang about, I haven’t got a twinge in my back. And it’s been going from strength to strength.”

But which did he prefer, the placebo pills or the morphine? He replied: “I got rid of the morphine and kept taking your blue pills.”

In fact, nearly half of the volunteers in the study reported a medically significant improvement in their back pain.

A recent article in the British Medical Journal suggests that it can be ethical to prescribe placebos, as long as doctors are honest about what they are doing. And so bizarrely placebos can work even when patients know that they are taking them.

My mother swears by her homeopathy tablets and tinctures. I believe homeopathy has very strong placebo effects. As after all, diluting a substance to such a massive degree such that there is virtually no original substance left in the remedy, gives the placebo effect a whole new field of effectiveness.

Now this brings us to the nocebo effect. These are the unintended negative effects that can occur when people are administered placebos. They are not random but tend to arise in response to the side effect warnings of the drug or treatment that were not administered.


My extra note: Importantly from many studies into the placebo effect – time spent with a doctor has a substantial effect on the outcome, with people benefitting from having a longer consultation.

Explore James Wild products at Quiet Earth


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