Andrew Siegel MD 5/30/2020
Potent mind-body magic in action, this tool is commonly wielded by traditional doctors, “alternative medicine” practitioners, and even parents of young children.
PLACEBO EFFECT: The therapeutic, healing and beneficial action of an inert substance or treatment that is not attributed to the properties of the substance or treatment itself, due to the patient’s belief in that substance or treatment. This effect is often nurtured by the positive expectations and optimism of an “authority” that the substance or treatment will aid the healing process.
BOTTOM LINE: Expectations shape outcomes and if one thinks something will work, it likely will.
Image by Oberholster Venita from Pixabay
“A doctor who fails to have a placebo effect on his patients should be a pathologist.” –JN Blau
“The mind can make a heaven of hell and a hell of heaven.” –J Milton, Paradise Lost
NOCEBO EFFECT: As powerful as the placebo effect, this occurs when a patient receives an inert substance or treatment and experiences worsening of symptoms. This happens by virtue of negative expectations regarding the effectiveness of the substance or treatment provoked by the pessimism of the “authority” about its benefits and/or serious concern about side effects.
(Note: In the following words, I refer to the practitioner of placebo as the “authority”)
HOW TO FOSTER THE PLACEBO EFFECT
The key to effectively eliciting the placebo effect is the ritual forged by a caring authority figure in a comfortable environment that results in a positive therapeutic interaction. A good physician, alternative medicine practitioner or parent knows how to tap into and draw forth the placebo effect. It requires an enthusiastic and supporting attitude as well as a reassuring, competent, and confident manner. Positive energy is contagious and is of foremost importance. Style of dress and speech and proper phrasing of sentences can weigh heavily towards achieving the end result. A self-assured and positive statement, e.g., “You will be better soon” will induce the placebo effect much more readily than hesitant and hedging assertions, e.g., “I’m not sure this will help.” The more time spent with the recipient of the placebo effect, the better the chances of provoking a positive response.
If a physician prescribes a medication, the more expensive it is, the more effective it will often be. The more expensive medicine is perceived as more valuable, in line with cognitive dissonance theories.
ACUPUNCTURE AS AN EXAMPLE OF A TYPE OF ALTERNATIVE MEDICINE THAT DEPENDS ON THE PLACEBO EFFECT
The placebo effect may be triggered by any type of alternative medicine.
Acupuncture, although regarded as an integral part of traditional Chinese medicine, is a “pseudoscience” since the underlying premise is not based upon the scientific method. Although needles inserted into the body can be interpreted as a form of quackery, acupuncture does remains an effective form of treatment for many people. However, it is beneficial whether needles are inserted correctly or incorrectly into “acupuncture points” and whether or not standard or retractable needles are used. Although not based on valid scientific criteria and more sleight of hand than legitimate modulation of the peripheral nervous system, acupuncture can effectively manage a variety of conditions. Provided that the acupuncturist adheres to the key points reviewed above and as long as the patient has faith in the power of the needles, the results are likely to be positive. Furthermore, acupuncture is expensive, again prompting cognitive dissonance that likely contributes to its success.
A PARENT ELICITING THE PLACEBO EFFECT TO HELP THEIR CHILD
Parents can be master practitioners of placebo in their interactions with their children. Consider the child who scrapes their knee or elbow after a fall and is embraced in the comfortable hug of his or her mother in a calm, relaxing and familiar environment, being gently shushed and having the “boo-boo” cleaned, a band-aide applied, and love and reassurance abundantly administered.
PLACEBO PAIN RELIEF
Placebo pain relief is genuine and not simply “in one’s head.” The biochemical basis for the success of the placebo effect is the all-powerful mind-body connection. Whether traditional physician, alternative medicine practitioner or mom as placebo authority, the physiology is the same. The placebo effect elicits the release of endorphins (a contraction of the words endogenous and morphine). Endorphins are hormones secreted within the brain and nervous system that activate the body’s opiate receptors, having a pain-relieving effect. Endorphins are also released under a variety of other circumstances, including exercise, situations that can be considered thrilling or exhilarating and sexual climax.
Placebo responses can be inhibited or eliminated by the administration of naloxone, an opioid antagonist (often used to treat narcotic overdoses in emergency situations) that blocks endorphins.
Bottom Line: The placebo effect can be wielded to improve a variety of symptoms and complaints. When it comes to pain, the placebo effect is capable of tapping into the “pharmacy within,” causing the release of natural opioids synthesized in the brain that function to impede incoming pain signals from the body. Expectation is everything!
Wishing you the best of health,
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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery. He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States. His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families.
Video trailer for Prostate Cancer 20/20
Preview of Prostate Cancer 20/20
Andrew Siegel MD Amazon author page
Prostate Cancer 20/20 on Apple iBooks
PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours).
Dr. Siegel’s other books:
PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food
MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health
THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health
Tags: alternative medicine, Andrew Siegel MD, endorphins, mind-body connection, nocebo effect, placebo effect
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