Is it all in your head? Yes, and that's one of the secrets to getting well.
Scientists have known for decades that placebo treatments can actually help a patient to heal physically. The doctor prescribes a pill that is either inert, like a sugar pill, or something that he knows would have no effect on the patient’s ailment, such as a multivitamin. But he doesn’t tell them this — instead, he assures them that they should be feeling better soon, and some of the time, their symptoms clear up.
There was concern about the ethics of this, though. Is it be permissible for a doctor to lie to his patients, even if he’s trying to help them? Scientists got curious — could the placebo effect be powerful enough that it would still work, even if the patients were told they were getting a placebo?
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A study done on people suffering from Irritable Bowel Syndrome (IBS) proved that open-label placebos work just as well as deceptive ones. Patients were given pills labeled “Placebo pills, take 2 pills twice daily.” Across the board, the severity of their symptoms was significantly improved. It turns out, deception is not necessary for placebos to work.
It doesn’t just have to be pills, either. Knee surgeon, Bruce Mosely, found that “the knees of patients who received placebo surgery healed at the same rate as the knees of those who underwent actual surgery. The placebo patients continued to improve even after they were told that the surgery was a sham.”
Seems too good to be true, right? Here’s the kicker: There are a host of factors that influence a placebo’s possible effectiveness, including your genetic make-up, and the size, quantity and color of the placebo pills themselves, as Amanda Zieselman reports in the Dartmouth Undergraduate Journal of Science. But there’s one more factor that’s more important than all of that, she says. It’s the “empathy of the doctor involved.” You can’t just shove a bottle of pills at a patient and tell them, “Here, take these placebos and get out of my office.”
The director of the program in placebo studies at Beth Israel Hospital, Ted Kaptchuk, gave two groups of IBS patients “sham acupuncture.” One group was treated by “formal, business-like doctors,” and the other by empathetic ones. The group that was treated well showed by far the most improvement. Kaptchuk concluded that “connecting with the patient, rapport and empathy […and] that few extra minutes, is not just icing on the cake.” Zeiselman says, “Even though no group actually received therapy known to heal, the patients who were tended to by compassionate staff showed improvements analogous to those of patients receiving common active IBS drugs.”
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Why is compassionate treatment so powerful? Well, one of the physically measurable effects of placebos on the brain is that they “increase the circulation of endorphins, the body’s own natural painkillers, and of dopamine, a neurotransmitter associated both with pleasurable activities and perceptions of pain.” If placebos don’t work without an element of compassion, then in part, it is compassionate treatment that encourages the brain to produce those endorphins.
So are we to we make of all this? First of all, it’s clear that the mind and body are intricately interconnected — but it’s more than that. These studies as a whole show that the role of love in caretaking is not just a bonus; it’s essential. I don’t mean erotic love, of course, but brotherly love — the kind of normal, human love which gives rise to the fruits of empathy, respect, and trust. These elements are so powerful that they can be a true factor in helping the mind to actually, physically, heal a sick body.
You don’t have to be a medical practitioner to use this information. If you’re a parent, keep it in mind when your child scrapes his knee or gets a fever. Maybe you’re taking care of an aging parent, or even a hungover roommate. Whoever you are taking care of, remember that your gentleness, your love, your empathy and your respect for them are not just “icing on the cake.” Love is actually a force powerful enough to help the body heal, whether or not it’s accompanied by working medicine. It seems that it’s not just our souls that need love — our bodies do too.