Great Expectations

When CBS’s 60 Minutes did a story about placebos being as effective as antidepressants, I thought viewers probably raised an eyebrow and listened a little more attentively, because this wasn’t someone’s personal opinion but mainstream media sharing cutting-edge research information from Irving Kirsch, an Associate Director of the Program in Placebo Studies at Harvard.

The airing of this story, along with an article that I read in the Wall Street Journal by Shirley Wang about the effect placebos have on issues like weight loss, dementia, fertility, and depression – real life issues that I know people face every day – really got my attention. Wang states, “…more and more research suggests there is more than a fleeting boost to be gained from placebos. A particular mind-set or belief about one’s body or health may lead to improvements in disease symptoms as well as changes in appetite, brain chemicals, and even vision, several recent studies have found, highlighting how fundamentally the mind and body are connected.”

It’s interesting to note that Kirsch also commented on the connection between the body and the mind when he found that the expectation of healing was so powerful that it alleviated all but the most severe symptoms of depression.

I also found expectations affecting the body in a study published in Psychological Science in 2007. Hotel attendants who were told they were getting a good workout at their jobs showed a significant decrease in weight, blood pressure, and body fat after four weeks on the job. This was in contrast to employees who did the same work but weren’t informed of any exercise benefit. They showed no change in weight although neither group reported changes in physical activity or diet during this same period.

So what’s new in this discussion about placebos? For one thing, I’ve seen more scientific research to support the effect of placebos, and researchers continue to study how the placebo effect works. Why the underlying interest in this effect? To me, the answer is that individuals may have better control of their own health by understanding how mind affects the body.

Research findings as reported in the national media (such as the WSJ and 60 Minutes) can seriously change the treatment and health habits of a nation and restructure the general use of western medicine. Dr. Kirch noted that there are two aspects involved with the placebo effect. One is having confidence or an expectation in the treatment, and the other is having confidence in the person administering the treatment. This means to me that faith – a quality of mind – enters into the equation for a successful recovery. The question then becomes where we place our faith – in the person administering the drug, or in the spiritual qualities of self?

There are a surprising number of individuals looking at alternative medicines, which include aspects of faith (prayer). Are we receptive to the repeated calls for the consideration of alternative medicines? A 2002 NIH study says at least a portion of the population is using alternatives, with the most used alternative medicine being prayer.

Do placebos work only through deception? I was interested to read that Ted Kaptchuk, Director of Harvard’s Program in Placebo Studies and the Therapeutic Encounter, demonstrated that deception isn’t necessary for the placebo effect to work. Dr. Kaptchuk found in a study he conducted that patients reported feeling just as good whether they were knowingly taking a placebo or the active treatment. According to Dr. Kaptchuk, a person’s perception and how the placebo affects the brain are two very important aspects in determining the future use of placebos.

I can see that all of these studies and reports are opening thought in a new direction. The most effective medicine for the future may be quite different from the medicine being used today. But consideration of an individual’s perception seems vital in any health treatments.

photo by Marie-Chantale Turgeon