Thoughts on thought: how placebos and nocebos work

Colleagues have been blogging about the placebo effect, and I have woven their comments together with some of my own…

Firstly, a recent blog by Sharon Frey, Media Manager,The First Church of Christ, Scientist.

Why do placebos work?

Some scientists are digging into a fascinating question – why do sugar pills have an effect

Sugar by Uwe Hermann via Flickr

In a blog network that highlights diverse perspectives on science and medicine, Steve Silberman wrote an interesting piece called Meet the Ethical Placebo: A Story that Heals.  He discusses a study showing that some patients who take sugar pills, even when they are told they are taking sugar pills, get better.

Some of these scientists have decided that this effect should be studied, instead of just being thought of as a “statistical distraction,” as many pharmaceutical companies may have considered them.

So, back to the original question: why do placebos work? Silberman says, “The precise nature of the placebo effect is shaped largely by patients’ expectations.”

To me, it sounds like the mental nature of health is now being observed in these clinical trials. This is intriguing, and I’m interested to see that these scientists are drilling deeper into what’s behind cause and effect with placebos. Another finding is that the level of support and confidence a health care provider has with the patient and his or her situation has an effect on healing.

Why would a supportive environment matter if there wasn’t a mental nature to health? It wouldn’t. And why would patients’ expectations matter either? I’m looking forward to seeing what these scientists find next.

In a recent “Other Voices” column, my West Coast colleague Eric Nelson in Northern California tracked down an amazingly cool video on the placebo effect, that I share below.  He introduced it by saying:

Have a look at the video below (very entertaining, by the way!).  And for some insight into the Christian Science “take” on placebos, check out this “oldie but goodie” article from the Christian Science Sentinel.

At the same time an East Coast friend sent me notice of an article on nocebos – the darker twin of the positive placebo.  

The article, called Mind over meds – patients can weaken painkillers’ punch by negative thoughts – by Benjamin Carlson, in Rupert Murdoch’s iPad newspaper The Daily – starts out with the line:

Told that a powerful painkiller would not bring relief, subjects in a new study from Oxford University felt the “nocebo” effect – as much pain as if they hadn’t been given the drug at all.”  Lead researcher Irene Tracey was quoted as saying “We not only overrode all the goodness of the positive expectation, we overrode the goodness of the drug itself.

To which one might gently add the query…is it possible that such experiments are probing and proving whether all the effects that drugs appear to have might in fact be attributable to the impact that educated belief has on the body?

This kind of research is really important, and all kudos to Dr. Tracey and her team for pursuing this angle with an open mind and for frankly reporting the results that they got. Whether they know it or not, such scientists would find a kindred spirit in the “discoverer” of Christian Science, Mary Baker Eddy.  Back in the late nineteenth century she was experimenting with placebos and uncovered the effects of nocebos – even though she didn’t coin those names for the positive and negative effects of the beliefs which, respectively, she identified and warned against.

In a 2010 Associated Press article called Placebo treatments stronger than doctors thought by Maria Cheng – AP Medical Writer – psychologist Linda Blair, spokeswoman for the British Psychological Society, identified the power of belief on the body, when she said:

It’s not that placebos or inert substances help, it’s that people’s belief in inert substances help.

As Eric commented after watching the videos shared above, it reminded him of what Mary Baker Eddy concluded after her own experiments with what she referred to as “unmedicated pellets”:

The prescription which succeeds in one instance fails in another, and this is owing to the different mental states of the patient. These states are not comprehended, and they are left without explanation except in Christian Science.”(Science and Health with Key to the Scriptures, p. 149)’

That is, they require to be understood in the light of a divine Science which explains the different effects of matter-oriented and Spirit-oriented thought on minds and bodies. Such an explanation can be found in a chapter called Physiology in Eddy’s Science and Health.

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