This piece, “Placebo: The Power of the Mind", appeared on page 26 of the Holiday 2024 issue of Chicago Life Magazine.
Medical science can take credit for innumerable amazing advances in managing and curing a wide range of human afflictions. But science accounts for only a part of healing. There’s a whole toolkit of other things that can make people better, one of which is the placebo.
It can be viewed using this link: Chicago Life Magazine - Placebo: The Power of the Mind
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Here's a small demonstration of the power of the mind. I once cured the stubborn warts on a kid's fingers with Magic Tape. Not tape that was magic, just plain old Scotch Magic Tape. I told him the product had special medicine in it that would make the ugly little things on his digits go away. I wrapped it around the fingers with the warts. He was to keep the tape on for 24 hours, then remove it. The warts were much improved in a week and, before long, totally gone. Verrucae (the fancy medical term for warts) are caused by the human papillomavirus (HPV).
The usual treatments for warts--burning with electricity or chemicals or freezing them--do not actually make the virus go away. Nor does the vaccine recommended for pre-adolescents that induces resistance to strains of HPV that cause cervical cancer. All of these interventions don't kill the virus themselves. They call the immune system's attention to the infection. This boy's immune response was invoked by Magic Tape, via his belief in its power. We are only beginning to explore the vast and subtle interconnections between the nervous and immune system, and the endocrine system and microbiome too.
Doctors tend to lump much of those things we don't understand scientifically under the term “placebo,” a Latin word that literally means “I shall please,” a lovely way, I think, to invoke the power of the mind.
The gold standard for clinical research is a blinded study that compares an intervention with a placebo control group. For example, half the participants in the study of a new drug receive the real medication and the other half, called the control group, take a substitute, like a sugar pill, without anyone knowing who's getting what. Then the researchers measure the outcomes of the two groups to see if the participants who got the treatment did better than those who unknowingly received the placebo. This research procedure is supposed to filter out participants' expectations of getting better from the actual effect of the drug being tested. There's also double blinding, which avoids researchers biasing results by keeping them too in the dark about who's getting the drug and who the placebo; and triple blinding, where even the statisticians who process the data don't know what results the study is anticipating.
Science, including medical science, is all about excluding as much subjective human influence as possible from an objective search for the truth. But human beings are rife with subjectivity. It's how we experience ourselves in the world, including wellbeing and illness. A doctor who addresses only the objective facts about a patient is missing out on a large chunk of human reality as well as on a whole set of powerful tools for healing.
Placebo effects are far more than wishful thinking. Those warts really did go away. Neither I nor the Magic Tape were what healed the lesions on that boy's fingers. Rather, the whole procedure induced belief that the verrucae would disappear. My words were picked up by his ears and processed by his nervous system which somehow talked his immune system into kicking out the papillomavirus that was causing the warts on his fingers. And so he was healed.
Because placebo effects have traditionally been framed as evidence against validity of a medical intervention, doctors, trained as we are to be medical scientists, tend to ignore their power. At its worst, when a placebo works on a particular patient that may be taken as evidence that the problem is not “real,” that it is “all in their head.” Similarly, a clinician employing a placebo like I did the Magic Tape may be accused of manipulating the patient with lies.
I learned early in my career never to hand a prescription to a patient, shrugging and saying, “I don't know. Maybe this will help.” Instead, I look them in the eye and say something like, “This is just what you need for this problem. You can expect to feel better soon.” My intention is to take full advantage of the faith the patient has in me as a doctor so as to maximize the placebo effect, on top of the biological power of the drug itself. I've seen articles claiming that, on average, more than half of the impact of drugs is related to the patient's expectation that they'll get better. (Frankly, I don't know how they measure this.) Whatever that fraction is, I call it “healing.”
In fact it's all healing. I'm a healer by profession, which doesn't mean that I heal patients myself. Next to the scientifically validated pills and procedures in my (virtual) doctor's bag is the faith my patient has in me and my remedies and the expectation that they'll feel better. All of these things help them to heal themselves. Loved ones, families, spiritual guides and communities can also play a large role on the path to mending.
You may ask yourself, “How do I know when what my doctor is prescribing is really the scientifically sound best choice and when they're just blowing smoke?” You can't know for sure. You're not a doctor. But you can ask questions, see if you understand the answers, and just as importantly, see if you trust the person who gives them. A trusting relationship between a patient and the professional caring for them supercharges healing. Though we don't really understand how it works, numerous scientific studies have demonstrated that trust is a powerful placebo. I think it's kind of magic.
