Placebo Effects: More Than Medical
It’s “resolution reset” season already. At least that’s what an ad I received yesterday proclaimed. And it set me to thinking …
We recognize that change is difficult for many people even under the best of circumstances. It can also—and frustratingly perversely—seem that trying to change something for the better increases the difficulty factor. Some habits, such as smoking or drinking alcohol, can be hard to change because physical and/or psychological addiction is part of the context. But even there, reframing how one thinks about and approaches the desired change can be powerful. One reframing technique I like has pretty solid neuroscience behind it.
It’s common to think of a placebo in a medical context; after all, it’s generally defined as “a substance that has no pharmacological effect.” When I was a pharmacy technician administering meds to patients, we had a few placebos available in case a doctor ordered them. (One tablet looked very similar to a popular pink pain med.) Placebos are more commonly used in a variety of research areas, as a baseline to compare treatment levels of the independent variable(s) against. Not all of these areas are medical—and understanding that is key to maximizing their usefulness.
According to the Online Etymology Dictionary, “placebo” means “I shall please” in Latin. It was first used in the 13th century as part of the name of a religious rite; its medical meaning has been traced to the late 18th century.
Most important for our purposes is its adjectival role in the phrase “placebo effect,” which was first documented in 1900. It’s frequently been used and explored in the area of pain relief. But many things can be placebos. Anything that can help a person is said to have a placebo effect. In psychology, the placebo effect is defined as “the belief that something will help makes that outcome more likely.”1
As part of my massage therapy training in ethics, we discussed placebo effects and how to ethically encourage them in our clients. That was pretty easy for me, as in my pharm tech job, I routinely told patients that a pain medication would start to work in 5–20 minutes (shorter for injections, longer for oral meds). I thought I was just providing accurate information. A very clever 2019 experiment—nicely summarized for lay people in a Cosmos article titled “Placebo Effect Can Be a Social Thing”—documented how a “caregiver’s” beliefs, whether placebo or nocebo, could be communicated to the “patient.”2
So one person’s beliefs about whether something will help or not can be communicated to another. That’s pretty amazing. But what’s even more important is hidden in the details of the psychological definition I provided: the use of a physical thing to get a placebo effect isn’t necessary. Ideas by themselves can have this power.
In other words, thinking something like “today’s going to be a good day” in the morning can change a person’s view of how they characterize their day in the evening. So one’s thoughts can change how one’s brain functions! A quotation from journalist–author Jo Marchant in a post at The Marginalian titled “Rethinking the Placebo Effect: How Our Minds Actually Affect Our Bodies” deftly sums it up:
What researchers are now realizing is that positive beliefs don’t just work by quelling stress. They have a positive effect too — feeling safe and secure, or believing things will turn out fine, seems to help the body maintain and repair itself …
Optimism seems to reduce stress-induced inflammation and levels of stress hormones such as cortisol. It may also reduce susceptibility to disease by dampening sympathetic nervous system activity and stimulating the parasympathetic nervous system. The latter governs what’s called the “rest-and-digest” response — the opposite of fight-or-flight. [sic]
One’s mindset regarding their resolutions can thus have more of an effect on behavioral change than making or nor making a resolution at all. If the self-talk around a resolution is negative—”It’s going to be hard, but I’m going to give up alcohol all January”; “I hate new year’s resolutions, but here’s my list to try again this year”; etc.—nocebo effects are invoked. Reframing such statements to encourage placebo effects can be straightforward. “I’m drinking less this month as part of improving my health.” “This year I’m trying a new approach to make life improvements; it’s based in neuroscience and social neuroscience.”
Our self-talk can have wide-ranging effects on our attitudes and choices. Switching from negative to neutral–positive thoughts and statements shared with others can have placebo effects that cascade. And they don’t have to be falsely positive. I learned this when I started martial-arts training in my 40s. I repeated these two statements often during those years: “It’s hard and I’m enjoying every minute of it”; and “It’s hard and I’m learning so much.”3
I’ve been embracing this shift in my thinking for a few months now, and not only have I been more productive, I’m happier and less stressed, and I’m better company for my friends. Using placebo effects to reframe things is easier in some areas than others for me so far, yet I’ve noticed that in those stickier areas, I’m being kinder to myself as I work toward what I want. That’s a big win in itself. I’m not seeing any downside to changing my thoughts to improve how my mind functions.
1: It does have a counterpart: the nocebo effect. That’s defined as the belief that something will have no effect or will harm makes that outcome more likely. So yes: a medication could have a nocebo effect for a person, if one thinks it won’t help. (back to the paragraph)
2: “Caregiver” and “patient” are both in quotation marks because they were roles played by the participants in the experiment. Half of the “caregivers” had been primed for a placebo effect, while the other half hadn’t. (back to the paragraph)
3: It really was hard! Every class was physically, emotionally, and psychologically demanding; and every class taught me something important about myself. (back to the paragraph)