Henry Beecher is a US military doctor during World War II. In the hospital, where the supplies of morphine have long been exhausted, he sees a nurse injecting a wounded soldier with a simple saline solution. But the injection alleviates the patient’s suffering, because he believes he has received a strong painkiller. How can a placebo (Latin: “I will please”), i.e. a drug that has been proven to contain no active ingredient, still alleviate symptoms? Faith really does move mountains. We can observe this in many areas of life: in interpersonal relationships, in competitive sports – if you want to win, you can get a mental coach to get you in the mood for the competition – and also in medicine. Even in antiquity and the Middle Ages, healers used dummy medicines. But only after observing Dr. Beecher begins modern placebo research. The amazing thing: The effect is not based on imagination and does not only affect the feelings of those affected. Rather, researchers were able to demonstrate measurable, neurochemical changes in the brain and body. Those who take advantage of their own convictions open the drawers of their inner pharmacy. Green light for the self-healing powers!
Table of Contents
Placebo-Analgesie
Most research results are available on the influence on pain perception. If a supposedly highly effective ointment is applied to the skin of test persons, they perceive the subsequent stimulus as less painful. The technical term for this is placebo analgesia. Scientists at the Hamburg University Hospital were even able to make this visible: on MRI scans, they determined increased brain activity in the area responsible for the release of pain-relieving endorphins. Clever: The body’s own opiates are ready for action as soon as they expect a pain stimulus.
“There is no better remedy in sorrow than the encouragement of a noble friend”
(Euripides)
The American orthopedist Bruce Moseley provided the prime example of the placebo effect in 2002. For a study, he divided his arthrosis patients into two groups. In one, he only faked the planned knee surgery. However, he staged it with all the details, the patients could even follow the operation on a screen during the local anesthesia. Only they didn’t see their own knee. The surgeon only scratched the skin superficially, placed a typical stitch and applied a bandage. The knee joint itself remained untouched. The almost curious result: After the healing phase, the patients who had been operated on were just as satisfied with the treatment as those who actually had the operation.
Experts name two points as decisively responsible for the effect: expectation and conditioning. Every patient assumes that medication is given to alleviate symptoms or to heal illnesses . With this expectation, everyone goes to the doctor or to the hospital. In addition, the conditioning, i.e. the repeated experience that a certain preparation has the desired effect, does the rest. Babies who lack the experience that a drug will help them and people whose cognitive abilities are impaired, e.g. B. Alzheimer’s patients or severely depressed, the phenomenon does not work or only much less pronounced.
Placebo – The Miracle Cure
According to Prof. Dr. Manfred Schedlowski from the Institute for Medical Psychology and Behavioral Immunobiology at Essen University Hospital should not underestimate the behavior of the medical staff either: “The interaction between doctor and patient, the way the doctor talks to the patient, how he accepts and explains can have a huge impact on the success of a treatment or medication.” Because even a negative expectation or experience has consequences. This is where the “evil twin” of the placebo, called the nocebo, comes into play. When the dentist says, with good intentions, “You don’t have to be afraid, it only hurts for a short time”, the words “fear” and “it hurts” are in the air. The patient will sweat blood and water on the dental chair. “Even the side effects on package inserts can make patients downright ill,” explains one of the leading placebo researchers, Prof. Dr. Paul Enck from the University Clinic in Tübingen: “Studies show that if the side effect disappears from the package leaflet, it no longer appears in the patient.” An extreme example: In cultures with a firmly rooted belief in ghosts, doctors repeatedly report unexplained deaths after voodoo curses. The “cursed” are firmly convinced that they must die. And actually die, although medically there was no danger to life. In cultures with deep-seated beliefs in spirits, physicians consistently report unexplained deaths from voodoo curses. The “cursed” are firmly convinced that they must die. And actually die, although medically there was no danger to life. In cultures with deep-seated beliefs in spirits, physicians consistently report unexplained deaths from voodoo curses. The “cursed” are firmly convinced that they must die. And actually die, although medically there was no danger to life.
The exact mechanisms of action of the placebo phenomenon have not yet been fully researched. But there is no question that it exists. Similar to the perception of pain, the positive influence on sleep disorders, depression, movement disorders (especially in Parkinson’s disease) and on the immune system is well documented. The experts now also know many factors that increase the effect: Very small and very large tablets help better than medium-sized ones, red ones better than white ones. The same applies to medicines with complicated Latin names or very high prices.
So, in principle, are many surgeries and medication superfluous? No, they remain important. Because if the doctor uses his knowledge of the placebo effect, for example by giving his patients a little more time and attention, conventional medicine is by no means unnecessary. But more effective. Medicines may then help in lower doses or cause fewer side effects. Non-essential surgeries may be delayed for a while. Another question is a bit more difficult to answer: Is it even morally okay for a doctor to fool his patients? The doctor acts ethically if he informs the patient about the placebo administration. It’s just stupid that it would reduce the effect enormously. The Scientific Advisory Board of the German Medical Association still considers the use of placebos to be justifiable in everyday clinical practice – under the following conditions: the symptoms are relatively minor, there is no other tested and effective therapy available, the patient expressly requests a remedy and the treatment has prospects to success. Then the doctor is allowed to cheat. Completely official.
Placebo: the touchstone for drugs
Before newly developed medicines are approved by the health authorities, they have to prove their effectiveness in clinical studies. Researchers usually compare the drug with the previous standard therapy. If none exists, the drug to be tested (verum) competes against a drug-free drug (placebo). In these “placebo-controlled, double-blind, randomized” studies, one group of test persons receives the verum, the control group the placebo, which is identical in shape, color or taste. The study participants are assigned to the two groups by lottery (randomized), and neither patients nor doctors know who receives the verum and who receives the placebo (double-blind). This procedure should make it impossible to influence the study unconsciously. Various preparations did not come onto the market because they failed these studies, i.e. they did not show a significantly better effect than the placebo. Another task of placebo-controlled studies is to distinguish the drug effect from other effects, e.g. B. from a spontaneous healing.
Use of the placebo effect
How to use the placebo effect
Take your happiness and health into your own hands. You have more influence than you think. Because with a positive inner attitude you pave the way for your self-healing powers. A few easy-to-implement exercises will help you. If you also skilfully avoid unfavorable influences, you get the best out of every treatment.
BUILD YOUR OWN PLACEBO EFFECT
• When you go to the doctor, heed his advice. After all, that’s why you went to see him. No therapy will be successful without your help.
• Take medicines that have been prescribed for you, knowing that they are valuable and will help you.
• Don’t get stuck on one particular therapy, but be open to the options that are available to you. It doesn’t always have to be an operation lasting several hours, maybe a few hours of physiotherapy will work just as well. Give the treatment a chance.
• Relax as often as possible. In a relaxed mood – both physically and mentally – energy can flow much better. Ideal methods: autogenic training or yoga. Regular exercise also helps.
• Visualize a picture of your recovery in your mind’s eye. Imagine how it will feel to live symptom-free again. Think about what you are going to do then and paint the picture in great detail. Keep returning to this beautiful picture in your mind.
• Find a doctor you trust for each specialty you need. Who treats you and his employees politely and friendly, who takes the time and really listens to you.
PREVENTING THE UNWANTED OPPOSITE
• If you’re anxious or hypochondriac, don’t read the package insert too carefully. Be aware that the side effects mentioned there do not occur in the vast majority of cases.
• Don’t attach too much importance to lurid reports about new widespread diseases. And don’t listen when the “well-informed” neighbor squirts her disaster scenario poison.
• Stop thoughts like “that won’t help anyway”. If you catch yourself doing it, replace it with “this will work out.”
• Hands off dr. Google! On the net you will find a lot of hair-raising horror stories from laypeople. Sound knowledge will get you further, but you rarely find that in forums.
