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Tuesday, May 04, 2010

How may we encourage healing placebo effects?

The New York Times offers an opinion piece by Olivia Judson titled "Enhancing the Placebo" in which she considers medicine's use of this effect for healing. She writes:
"The problem is that humans are not machines, and emotions are not abstractions. Hope and expectation, anxiety and fear, trust and suspicion — these cause physiological changes in the brain that can interact with drugs, changing their effects.

This is even true for a drug like morphine. Yes, it’s a powerful painkiller. But it’s far more powerful if a doctor marches in, tells you he’s going to give you morphine, and injects you, than it is if it is administered secretly by a hidden machine.

Differences in hopes and fears, and the resulting physiological changes, may explain why the placebo effect varies so much: individual experiences matter. Some people are more anxious than others, or may find the thought of a particular disease especially alarming. Moreover, in different cultures, similar diseases may be treated with different degrees of gravity.

Expectations around medical rituals may also explain why placebos tend to be more powerful if the pills are expensive or you take them several times a day; why injections and exotic machines are more powerful than pills; and why surgery is more powerful than injections. (In placebo surgery, the patient is anaesthetized, cut, and sewn back up again, but no manipulation is done. For obvious reasons, there have been few tests of this. But when it has been done, it has often produced good results for the patients.) ...

One idea would be to deliberately increase the element of formal ritual in medicine. Studies of "alternative" therapies show that strong placebo effects can be induced by ritual. Indeed, in mainstream medicine, surgery is the treatment most surrounded by ritual; perhaps this is one reason it appears to be the most powerful placebo."
Thomas Moore writes about the power of rituals and images for healing in his new book, Care of the Soul in Medicine, published by Hay House.

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