Health Guide

Placebo Effect

Medicine often works from the outside in -- we take drugs to treat what ails us. But what if medicine could work inside out, if we could tap an "inner pharmacy" for treatment? Many people, seemingly more everyday, believe this is a strong possibility.

How it works

Take Anil, for instance. Anil was fighting weekly migraines, the kind that drags on for days. He lost one job because of them; his boss said he called in sick just too often. Anil tried all the usual treatments and preventives. He thought he was unemployable because of them. Yet, Anil had a family to support. Anil's stress level wasn't making things any better.

In talking with Anil, Dr. Brody, the latest doctor he went to, found that his patient had two problems: He had migraines, but he also had a terror of getting them. "He made the headaches that much worse by panicking over them," Brody says. "What panicked him the most was the possibility of a migraine starting up when he absolutely had to do something." If he took his migraine medication which included the medicine for vomiting he would be too drowsy to function properly.

With Brody's help, Anil put into motion a "placebo response," an expectation that he could heal himself. The process began when Anil changed the story he told himself. He gave it a more positive focus. He developed a mantra of sorts -- a positive message that pushed him to do whatever needed to be done, and then take his medication.

Since then, Anil has taken a job -- and only missed one day of work in one year's time. And he has reduced his use of medications.

How effective is this method?

In scientific clinical trials, this mind-over-illness response is known as a placebo effect. Patients in a controlled study are given a sugar pill instead of medication, and quite often, those given sugar pills do just as well as those receiving medication. The placebo response is unpredictable, says Brody, varying widely among trials, ranging from 80 to 0%.

However, the sheer numbers of patients who have experienced this response -- as well as the anecdotal evidence that many researchers have collected -- tells researchers that there's something to it. The sum total shows that the placebo response is something meaningful. The search is opening a window to a much bigger phenomenon, the connection between the mind and the body in health and illness, and this connection occurs independent of any trickery or any deception.

The notion of the sugar pill vastly understates the therapeutic power of a placebo. When administered with sensitivity and care, with the expectation of benefit, the placebo itself becomes a formidable tool.

What causes the response?

"By studying the science of the placebo, we can learn what kinds of messages or what kinds of emotional or mental states appear to cause the response. The physician and the patient can both learn how to send these messages to the patient ... and move this into the self-help area. This is what's new, the idea that patients can do this for themselves," Brody says.

Researchers have shown that simple exercises can dramatically lower catecholamine levels in anxious and normal people to reduce risk of heart disease, high blood pressure, and ulcers. Building on this theory, it has been shown that it is possible to prevent further heart attacks in people with serious coronary artery disease -- and even open up their blocked coronary arteries -- without the use of drugs. Elements like low-fat diet, moderate exercise, yoga and meditation, and social support have a positive effect on the stress pathway.

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