By Eryn Slankster-Schmierer, PhD on October 7, 2021
The placebo effect: manifesting positive outcomes.
The placebo effect occurs when a person shows positive outcomes because they expect positive outcomes, usually due to some sort of intervention or special treatment. The presence of trusted authorities providing perceived valuable care can actually manifest positive results, whether there was a legitimate treatment performed, or not.
One might expect the psychosomatic placebo effect to only affect subjective scales: perception, pain, depression symptoms, etc. Alas, it can affect biologically quantifiable markers, as well.
While lost in another YouTube tunnel, I discovered a NutritionFacts.Org video on the power of placebo on prostate cancer. In one study, placebo successfully reduced prostate cancer growth even better than a leading drug (Smith et al., 2004). It didn’t just make people feel better, it measurably shrunk their tumors.
This got me thinking: What is the extent of placebos capabilities? How can we harness it to empower people’s health outcomes?
The nocebo effect: manifesting negative outcomes.
Similarly, a nocebo effect occurs when someone experiences negative outcomes due to anticipation or after a diagnosis. While traditionally, we think of the placebo and nocebo to be an inert pill, that is just symbolic. The “pill” is a “thing”- an action, thought, treatment, etc.- that manifests “an expected effect.”
A fictitious example: “Airborne,” is an episode of House that took place in an air plane. One passenger displayed symptoms that Dr. Cuddy decided is highly contagious bacterial meningococcus. She accidentally triggered the nocebo effect, spontaneously inducing fever, vomiting, and rashes on an entire plane full of victims, including herself. The episode concludes with Dr. House diagnosing the original patient with the bends, a condition developed from scuba diving too soon before his flight, only after theatrically prompting everyone on the plane to manifest another fake symptom inconsistent with meningitis.
Sure, that’s fiction though. If you aren’t familiar, the YouTube Channel Vsauce explores psychological phenomenon with experiments. An episode titled “Touch” illustrates the nocebo effect on real people. Michael, from Vsauce, set participants up in a very real looking exam room with a very technical looking device (it was a harmless laser pointer inside a fake machine). He plants the idea of negative outcome in the participant by prompting the person to alert him if they feel any pain. Among some of the participants, the expectation of pain manifested a perceived 9 out of 10 on a pain scale.
I suspect we are more susceptible to the nocebo effect than we think. In a similar way that a negative person seems to experience only negative things, I wonder how often we manifest negative side effects simply because we expected them.
Harnessing placebo to catalyze change.
There was a point in my graduate education that I offered good-luck charms to the “PCR gods” to solve an inexplicable, month-long inability to perform a successful PCR reaction (a genetic technique to amplify DNA fragments). It could be that a “higher power” acknowledged my submission and granted back my PCR abilities. Or it could be that an intentional change in mindset accompanied a change in the habitual behavior that led to my failures.
Surely the lucky charm wasn’t what fixed my PCR dry spell. Rather, a change was required. Silly ritualistic “gifts” were a tangible display of that mindset shift (along with an expensive one-by-one purge of every reagent I had ever used) that helped me manifest a positive outcome in a negative situation.
Call it what you want, but superficially, a placebo fixed my PCR. The logical part of you quickly identified the acts of throwing out old reagents as the key solution, but that’s only because I gave that to you as a known. Maybe shifting all behaviors that led us into an undesirable outcome (pain, injury, poor health, symptoms, negativity) requires an upheaval in what we know as normal.
Placebo, the power of suggestion, ritual, or intention: whatever word you want to use, it’s all the same phenomenon. While science can’t quite explain how it works yet, we know it’s real.
How far could the placebo effect heal us?
It may be tempting to brush off alternative therapies as cacophony, coincidence, scientifically unfounded, or homeopathic nonsense. I suspect asking any scientist or medical doctor their thoughts on Reiki, smudging, aromatherapy, or religious-based medical “miracles” will confirm this.
On the other hand, scientists know placebo works so effectively, it is mandatory in drug trials.
It is scientifically proven, and dare I say socially accepted, that when people are prompted to make plans, to set intentions, their productivity and follow-through improves (Rogers et al., 2015). At what point do the effects of intention, or placebo or ritual, transition from evidence-based behavioral phycology, to wacky alternative medicine?
Telling a patient, they can heal themselves is unethical, homeopathic, and unfounded, but inadvertently tricking them into it with a sugar pill (placebo) is called ethical science?
If you think I am suggesting you turn to essential oils to reset a broken bone, I’ve not made my sardonic personality apparent enough. But I do think what we put into our bodies, both into our mouths and into our minds, has a tremendous effect on our health and well-being. Moreover, almost no treatment works 100% of the time. I am suggesting maybe there is a place for ritual alongside modern medicine, positively affecting cancer treatment survival, disease prognosis, and overall well-being.
If we could placebo ourselves into “natural” healing, what negative harm is there?
We have a mystery power society calls placebo, intentions, rituals, the power of suggestion, etc. Its not about whether the placebo effect is real; evidence has supported it time and time again. We can disagree on the mechanism of the outcome, but that doesn’t invalidate the effects, nor the means in which they are achieved. Denying the therapeutic potential seems downright wasteful. While the “why” is interesting to think about, I am far more interested in how far it could work.
Perhaps it’s not the deception of the placebo we need as much as a faith in our ability to heal.
Disclaimer: While writing this, I was reminded of another VSauce Mind Field episode called The Power of Suggestion on this precise tropic, using placebo to treat clinically diagnosed disorders in patients. It was not the inspiration behind this essay, but it was so eerily similar that I feel obligated to credit it, because I can’t rule out subconscious inspiration.