an actual therapeutic effect, causing the patient to feel better. This phenomenon is known as the placebo effect.
The placebo effect points to the importance of the perception and the brain’s role in physical health. This effect has been used not only with pills, but also with creams, inhalants, injections, and many other therapies. Medical devices such as ultrasound can act as placebos too.
The physicians (family doctors) have even been called placebos. A study found that patient recovery can be speeded up by words “You will be better in a few days,” or “The treatment would certainly make you better” rather than negative words such as “I am not sure that the treatment I am going to give you will have an effect.”
The placebo effect may be a component of pharmacological therapies: Pain-killing and anxiety-reducing drugs that are infused secretly without an individual’s knowledge are less effective than when a patient knows they are receiving them. Likewise, the effects of stimulation from implanted electrodes in the brains of those with advanced Parkinson’s disease are greater when they are aware they are receiving this stimulation. Sometimes administering or prescribing a placebo merges into fake medicine.
The word placebo came from Latin. It actually means “I shall please.” In 1811, it was defined as “medicine adapted more to please rather than to benefit the patient.” The placebo was first used in the eighteenth century. In 1785, it was defined as a “commonplace method or medicine.” Placebos were widespread in medicine until the twentieth century, and they were sometimes endorsed as “necessary lies.”
Placebos are produced by expectancy effect, where fake pills or substances are believed to be a drug. The expectancy effect can be enhanced through factors such as the enthusiasm of the doctor, differences in size and color of placebo pills, or the use of other inventions such as injections. In one study, the response to a placebo increased from 44% to 62% when the doctor gave them with “warmth, attention, and confidence.” Expectancy effects have been found to occur with a range of substances. Those who think a treatment will work display a stronger placebo effect than those who do not, as evidenced by a study of acupuncture.
Because the placebo effect is based upon expectations and conditioning, the effect disappears if the patient is told that their expectations are unrealistic or that the placebo intervention is ineffective. A conditioned pain reduction can be totally removed when its existence is explained. It has also been reported of subjects given placebos in a trial of antidepressants that “once the trial was over and the patients who had been given placebos were told as much, they quickly deteriorated.”
A placebo described as a muscle relaxant will cause muscle relaxation, and if described as the opposite—muscle tension. A placebo presented as a stimulant will have this effect on heart rhythm and blood pressure, but when administered as a depressant—the opposite effect. The consumption of caffeine has been reported to cause similar effects even when decaffeinated coffee is consumed. Perceived muscle stimulants such as fake creatine can increase endurance, speed, and weight-lifting ability. Placebos can help smokers quit. Perceived allergens which are not truly allergenic can cause allergies. Inventions such as psychotherapy can have placebo effects. The effect has been even observed in the transplantation of human embryonic neurons into the brains of those with advanced Parkinson’s disease.
Because placebos are dependent upon perception and expectation, various factors which change the perception can increase the magnitude of the placebo response. For example, studies have found that the color and size of the placebo pill makes a difference, with “hot colored” pills working better as stimulants while “cool colored” pills work better as depressants. Capsules rather than tablets seem to be more effective, and size can make a difference. One researcher has found that big pills increase the effect while another has argued that the effect is dependent upon cultural background. More pills, branding, past experience, and high price increase the effect of placebo pills. Injection and acupuncture have larger effect than pills. Proper adherence to placebos has been found to decrease mortality.
Motivation may contribute to the placebo effect. The active goals of an individual change their experience by altering expectation symptoms and by changing their behavior.
The placebo effect can work selectively. If an analgesic placebo cream is applied on one hand, it will reduce pain only in that hand and not elsewhere on the body. If a person is given a placebo under one name, and they respond, they will respond in the same way on a later occasion to that placebo under that name but not if under another.”
Nocebo effect
“In the opposite effect”, describes Wikipedia, “a patient who does not believe in a treatment may experience a worsening of symptoms. This effect is called nocebo. This word also has a Latin origin and means “I shall harm.” Nocebo effect can be measured in the same way as the placebo effect, e.g., when someone receives a fake pill, substance or sham treatment, results may report a worsening of symptoms. The recipients may nullify the treatment by simply having a negative attitude toward the effectiveness of the substance prescribed and the mentality toward the ability to get well”.
This is the same effect we experience when we disbelieve in our capabilities and in what we can achieve in life. If we concentrate our attention on our mistakes and failures, we will always be applying nocebo, and our life will be limited.
