The Placebo and Nocebo Effect

One of my favourite topics is the placebo effect and, on the down side, the nocebo effect. I feel very strongly that we should be leveraging the placebo effect more for our benefit, and be acutely aware not to be affected negatively by the nocebo effect. Today, I want to share a conversation I had with my colleague naturopathic doctor Felicia Assenza on this topic. You can also read her article below.

Join us for a 30 minute podcast episode about

the placebo and the nocebo effect.

 

The Placebo Effect

BY FELICIA ASSENZA, ND

What if it’s just placebo?’ Many of us have heard or asked this question before, especially in the healthcare field, but what if there’s something powerful and healing about the placebo effect that we might be missing by simply brushing it off?

WHAT EXACTLY IS A PLACEBO EFFECT?

A placebo effect can be defined as a beneficial effect from a substance or procedure that cannot be attributed to the specific properties of the substance or procedure itself. In other words, someone gets better from taking something that doesn’t, on its own, have any medicinal properties. For example, someone is given a new cutting edge pill for migraines (actually a plain old sugar pill) and the migraine disappears.

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HOW POWERFUL IS THE PLACEBO EFFECT?

Since its discovery in the 1700’s, the placebo effect has unfortunately been looked at as more of an annoyance or something that needed to be controlled for in studies of ‘real medicines’ or drugs or therapies being tested for their efficacy. For example, looking at whether or not Drug X is more effective than a placebo sugar pill. It wasn’t until the 1950’s that the placebo effect itself began to be investigated in more depth and we’re now realizing the incredible role it can have in very real healing1.

The placebo effect has been shown to play an important role in many ailments that our modern healthcare system has much difficulty with treating, such as pain, depression, anxiety, osteoarthritis, immune health, and ADHD. It has even been shown to be effective in the context of surgery! A fascinating 2002 study by Mosely and colleagues demonstrated that placebo knee surgery (where an incision was made but no actual surgery was performed) was just as effective at relieving symptoms of osteoarthritis as the commonly used arthroscopic debridement surgery2.

DO I HAVE TO BE TRICKED FOR IT TO WORK? 

No! It seems the most important part for a placebo to work is believing that it will work, believing that things will improve or that the outcome you are hoping for is possible. A 2010 study by Ted Kaptchuck and colleagues found that when patients with irritable bowel syndrome (IBS) were given a placebo, told they were given a placebo, and given up to date information on the placebo effect, their IBS symptoms still improved3.

THE NOCEBO EFFECT

By this point, it shouldn’t surprise you that when it comes to health (and I’d argue other areas of life as well, but that’s a discussion for another day) if you think something will help, chances are it will! Turns out the opposite seems to be true as well. If you think something will be harmful, chances are it will be. This has become known as the nocebo effect. In other words, the expectation that a harmful effect will happen actually leads to that harmful effect happening. For example, a couple of studies have shown that nebulized saline, which is just airborne salt water droplets, actually triggered asthma attacks in individuals who were told they were being exposed to something they were allergic to5,6. An earlier study even showed that people who thought they were being exposed to trees that they were allergic to triggered the same visible, itchy rash that actually being exposed to the trees caused7.

IT’S NOT QUITE THE SAME FOR EVERYONE

Like everything in medicine and healing, the placebo effect does not look the same for everyone. If you’ve been to one of my workshops or read any previous blog posts, you have probably heard me emphasize the importance of individualized medicine or, as I sometimes like to call it, personalized medicine. Everyone is different and I have yet to come across any therapeutic approach to healing that has exactly the same effect in everyone. The placebo effect is no exception. There has, however, been some interesting study into more specific individual variations in genetics, neurobiology, past experiences, and how they relate to the placebo effect and a person’s susceptibility to the placebo effect1,4.

SO WHAT DOES ALL THIS MEAN WHEN IT COMES TO MY HEALTH?

I think one of the most important things that the placebo effect shows us is our own healing abilities. One of the most powerful medicines is you! Realizing that your state of health ultimately falls on you is such an empowering way to approach your health but also quite a large responsibility. However, while you are the most important person on your healthcare team, you definitely don’t have to be the only person on your team. That’s where healthcare professionals come in to offer help and guidance to move you forward on your health journey, which brings me to my next point…

It is so so so IMPORTANT that you trust your healthcare professionals and have a positive therapeutic relationship with them. As we already talked about, the placebo effect can be a great asset to your healing but the nocebo effect can be quite the opposite. It is important that you feel comfortable enough with your healthcare providers to voice your thoughts or experiences with certain treatments and can collaborate on a treatment plan that you both believe is in your best interest.

What’s your experience with the placebo effect?

Do you have any experience with the nocebo effect?

We’d love to hear from you.

 

Want to work together on your health journey? Have more questions about the placebo effect? Let’s chat. Send us an email, give us a call, or book a free 15 minute consult.

Dr. Felicia Assenza can be reached by e-mail:

felicia.assenza@gmail.com

or through the

Awakening Health Clinic in Burlington

Leveraging the Placebo Effect

My friend’s husband has unknowingly been drinking caffeine-free coffee for the last three months. It worked just as well as regular coffee—until he found out that his wife and assistant had been conspiring for the sake of his health. The moment he found out it wasn’t “real” coffee and he shouldn’t be experiencing any stimulating effects, it stopped working.

Why did the caffeine-free substance work just as well for three whole months? That would be the placebo effect or the power of his mind. He expected it to work and hence experienced feeling more awake and less tired.

In the medical field, the placebo effect is defined as a measurable, observable, or felt improvement in health or behaviour that arises from the patient’s expectations concerning an inactive substance—like a sugar pill, distilled water, or saline solution—or a “fake” treatment rather than from the substance or treatment itself.

Different definitions speak about the expectation, or faith, or belief of the person as the defining factor for the placebo to work. Rob Williams, the founder of PSYCH-K®, a highly effective belief change system, suggests that it would be more fitting to refer to the placebo effect as the “perception effect”.

The western medical community has officially known about this phenomenon for 80 years. The American anaesthesiologist Henry Knowles Beecher discovered the placebo effect as a medic in World War II. After running out of pain-killing morphine, he replaced it with a simple saline solution but continued telling the wounded soldiers it was morphine to calm them.

If we have known about this for 80 years, why aren’t we leveraging the power of our mind more? The placebo effect should be a major topic of study in medical school. It gives doctors an efficient, side effect-free tool to treat disease. Instead it is often still regarded as something that is “all just in the person’s mind” and is linked to weak or suggestible patients.

We are all suggestible! Our world is full of suggestions, from the moment we wake up in the morning right up until we go to bed at night. The suggestions are on the radio, in the paper, on TV, and on the Internet. In fact, there are suggestions in this article that you are reading right now. Suggestions are littered throughout the media, whether they show up as supposedly objective news stories or commercials. They are on the bus and at work as we listen to other people sharing their beliefs. Beliefs are contagious. Suggestions are especially powerful when we enter the office of an authority like a doctor, a teacher or another person we admire and trust, like a Psychic we seek out for advice. And even when we are not listening to somebody outside ourselves, the suggestions are running in our own heads. We are constantly hypnotizing ourselves by repeating our current beliefs and stories.

Now, is that a problem? Not at all. We just need to harness the power of our subconscious mind and our beliefs and use them to our advantage. We need to be very aware of negative suggestions and we need to choose more supportive ones. We can literally change our biology and our health by what we believe to be true.

Bruce Lipton quote AUnfortunately, drug companies study patients who respond to the placebo effect with the goal of eliminating them from early clinical trials. (Greenberg, “Is it Prozac? Or Placebo?” 2003) An estimated one third of the population responds especially well to placebos. Those highly responsive people are eliminated before the drug is even tested. Drug companies obviously have no interest in researching the healing power we all have inside because we won’t need to buy drugs if we can actually heal from within. Knowing about the power of our beliefs and our ability to create our reality from those beliefs and perceptions, and to even change our biology, would open the door to a multitude of other possibilities for the human race. These potentialities would dramatically and completely change our consciousness level and affect the way we live. It would most likely be the end to many industries on the planet, the health industry being one of the foremost ones.

The Basic PSYCH-K® Training includes a documentary about different studies which illustrate that conventional medicine is often as effective as a placebo treatment. A Baylor School of Medicine study, published in 2002 in the New England Journal of Medicine, examined surgery for patients with severe and debilitating knee pain. The patients were divided into three groups. The surgeon, Dr. Bruce Moseley, shaved the damaged cartilage in the knee of one group. For the second group he flushed out the knee joint, removing all of the material believed to be causing inflammation. Both of these processes are the standard surgeries for severe arthritic knees. The third group only received a pretend surgery: the patients were sedated, the three standard incisions were made and then the surgeon talked and acted just as he would during surgery. All three groups were prescribed the same postoperative care which included an exercise program. The results were astonishing! The placebo group improved just as much as the other two groups who had surgery. The footage shows members of the placebo group walking and playing basketball.

Bruce Moseley quoteAnother area in which placebos have been proven to be highly affective is the antidepressant industry. A 2002 article published in the American Psychological Association’s prevention & treatment, by University of Connecticut psychology professor Irving Kirsch titled, “The Emperor’s New Drugs,” found that 80% of the effect of antidepressants, as measured in clinical trials, could be attributed to the placebo effect. Kirsch had to file a Freedom of Information Act request to even get his hands on the information on the clinical trials of the top six antidepressants on the market. In more than half of the clinical trials, the placebo worked as well as the drug. “The difference between the response of the drugs and the response of the placebo was less than two points on average on this clinical scale that goes from fifty to sixty points. That’s a very small difference, that difference is clinically meaningless.” (Kirsch)

Cell biologist Bruce Lipton also notes that the more antidepressants were talked about in the media and advertised for, the more effective they became. We are, as I mentioned earlier, all suggestible. We live in a culture where most people believe that anti-depressants work, and therefore they do.

A young man I know has recently been told that after taking a particular anti-depressant for six years his body had become accustomed to it and it would not work anymore. Guess what happened instantly after his doctor had given him this suggestion? Exactly! It stopped working for him. The one thing this young man can count on is that the doctor will next suggest this amazing new anti-depressant which will be all hyped up as working so much better. And it will indeed work. But not necessarily because the drug is all that it is made out to be, but rather because we believe it is. After all, anti-depressants are an $8.2 billion industry.

If we can heal by believing that a particular drug or treatment will cure us, what does this mean? It means that it is really our beliefs, thoughts, and feelings which are responsible for a change. We believe that the coffee will wake us up, or that the pain medication with a known brand name will reduce the discomfort, or that the anti-depressant will make us feel better. When it comes to depression, the general belief is that a chemical deficit in the brain is responsible. If our thoughts and emotions release different chemicals in the brain, wouldn’t it make more sense to work on a person’s thoughts and feelings to induce a different chemical state? Relaxation, meditation and belief change work are all a gift to claim our power to heal ourselves and to make any changes to our thoughts and experiences.

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The first thing which needs to change is for everybody to realize that we are constantly influenced and hypnotized to believe what the people around us believe. We have been brainwashed and programmed to believe that we need something outside ourselves to make changes to what we believe to be real, like our physical health. One of the hardest things to do is probably to go against our collective beliefs.

Somebody who has been diagnosed with a particular illness, whether that is cancer, MS, lupus, fibromyalgia, to just name a few of those big ones, has to not only defy any personal limiting beliefs but also the collective beliefs about what it means to have one of these diseases. Connie Kowalski, an amazing colleague of mine, has refused to play within the field of Lupus and has come back to perfect health after needing a wheelchair and everybody fearing she wouldn’t have long to live. She did deep healing work at a subconscious level. Another friend and colleague of mine, Allison Bastarache, has done the same for MS. She healed herself completely and has now stepped into her calling of being an energy worker and spiritual healer. As these two amazing women and their beautiful healing stories show, our potential healing power is truly limitless!

Are you ready to embrace your own power to change your reality?

PSYCH-K®, Hypnosis and NLP all give us tools to make changes.

Contact Angelika

905-286-9466

greendoorrelaxation@yahoo.ca

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What is the Nocebo Effect?

Most of us have heard of the placebo effect, but do you know what the nocebo effect is?

The power of the placebo effect has been repeatedly proven. Bruce Lipton, for example, sites in his book “Biology of Belief” a “New England Journal of Medicine” study from 2002 on surgery for osteoarthritis of the knee.

The patients were divided into three groups. One group received real knee surgery, one group received no surgery and the placebo group received “fake” surgery. These patients in the last group believed they had been operated on.

The fascinating outcome is that the placebo group improved just as much as the group that received real surgery.

The nocebo effect is the exact opposite of the placebo effect. The nocebo effect occurs when the mind is engaged in negative beliefs and self-suggestions than damage the health of the person.

Bruce Lipton mentions the example of a patient who was falsely diagnosed with cancer of the esophagus, which in 1974 was considered 100% fatal. The patient died believing he was terminally ill.

Both the placebo and the nocebo effects show that the power of our mind is our real healing power. That is were Rob Williams technique PSYCH-K® comes in.

If you want to know more about reprogramming negative beliefs about your health and replacing them with positive beliefs using PSYCH-K®, or hypnosis contact

Belief Change Coach Angelika

greendoorrelaxation@yahoo.ca

905-286-9466