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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Attitude Affects on Health

The role of attitude

For most common problems people bring to their physicians, much of the time one's attitude plays a more significant role than many people realize. Some people are just inherently more positive about things and other people look at the dark side no matter what. You can learn how to checking yourself for those negative messages and replace them with more positive messages. To access this "placebo response," one must embrace the power of expectancy -- that the person's expectation can produce a bodily effect under many different circumstances, not merely when the person is given a substance that is chemically inactive.

These positive messages help trigger the "inner pharmacy" you were born with. Essentially, this inner pharmacy consists of biochemical pathways in our bodies, natural healing pathways that can produce measurable bodily changes.

Studies show these pathways influence the health of the body, and we know they are sensitive to the emotional state and produce measurable body change. While scientists don't thoroughly understand how these pathways interconnect to produce a placebo response, that's where the research is heading.

However, "we don't have to wait for those studies to be done. We don't have to wait to find out how it works. When you've got something that's cheap, nontoxic, seems to work even though we don't know the mechanism, why not use it?" says Dr. Brody

To activate your placebo response, first expect that your health will improve. "Since illness is a threat to the organism, the brain may well have stored in its memory files certain pathways of healing: signals that can be sent to the inner pharmacy to stimulate the release of healing chemicals," Brody writes.

Next, reflect on past illnesses and how you have responded. What messages ran through your mind? What meaning did you give the illness? If you come down with a cold, is it an "Oh my God" response or did you take a more positive, pragmatic approach.

The meaning of an illness experience most likely changes in a positive direction when these three things happen, Brody says:

• The individual is listened to [by the healer] and receives an explanation for the illness that makes sense.
• The individual feels care and concern being expressed by the healer and others in the environment.
• The individual feels an enhanced sense of mastery or control over the illness or its symptoms.

Someone who attaches a more positive meaning to the illness will take control of the situation. If it's a common cold they are battling, they will take practical steps, get more fluids, more rest. They're giving the immune system a chance get into high gear, which may cut their down time to a couple of days rather than 10 days.

Brody admits that the placebo response has its limitations. "We can make two mistakes with this theory," he says. "We can't just 'think away' illness. But we also can't delude ourselves that because illness is real, we can do nothing about it. ... We can't make the illness go away completely, but we can affect our day-to-day functioning. That can make all the difference."

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