Monday, 2 January 2012

The Placebo Effect

The placebo effect is most interesting in the world of psychology because it proves our minds have a strong control over physical responses in the body as well as psychological ones. We hear the phrase 'it's all in your mind' frequently, and to a large extent that could well be true.

A placebo is a 'dummy' treatment used in experiments for control groups to test the different outcome of one drug against another, say drug 'A' against the placebo - an inert solution such as saline or a sugar. Scientists once believed that the inert solution would have no effect on the test patient but they soon began to discover that often it did, especially if patients were told that the solution would have an effect on them. For example, I could give a harmless mint to someone and tell them it was a strong laxative and so long as they believed me (the critical factor here) they would likely experience a trip to the toilet soon enough. This is what is known as the Placebo effect.

Why is this interesting? Placebos show that if a person believes they are being treated there is a strong likelihood they will perceive a change in their condition, and if this change is positive, i.e. a medicine that will certainly improve their condition, then that perceived positive change can lead to the condition actually improving. This has been seen in cases as serious as cancer with tumours reducing in size by use of placebos alone. On the other hand if a patient has no confidence in their doctor or the medicine they are taking then their condition is less likely to improve. A key factor here is how the mind perceives the situation, not necessarily just how the body reacts to different medicines.

Alternative medicines have been described as placebos, especially practices like faith healing - where somewhat ironically if the patient has faith in the treatment administered it could well work. Hypnotherapy can also been seen along the same lines, the patient has to have a belief in it being able to work as well as a wish for a change to occur - if those two vital ingredients do not exist then there is little chance in the therapy working no matter how many sessions are had. If someone comes to me asking to quit smoking for the only reason that their partner is giving them a hard time about it I would see no use in treating them for this very reason.

So why are placebos not used to treat more conditions in everyday life? The answer to that is that the brain is subjective and so people might not react the same way to the same treatments, and while placebos can be effective with treating certain problems such as pain or depression for example, for other aggressive diseases they would be far less useful.  Administering placebos also requires doctors to lie to their patients, as if patients were made aware of the real medicine they were taking the effect would not be there (although results have surprisingly still been found when the patient has been openly told they were taking a placebo). This would break the ethics of doctor-patient honesty and cause several problems especially legally if treatment did not work as hoped.

Instead we see placebos used in everyday life around us without most of us knowing they are there. Buttons to shut elevator doors or to make traffic light turn red so pedestrians can cross the road have been known to be placebos themselves, sometimes having absolutely no effect other than to make the person pressing the button feel better and less impatient.