Sir William Osler, a luminary of internal medicine, rightly said that one should treat as many patients as possible with a new drug while it still has the power to heal. This is because there is wisdom in it since most of us would also believe that the medicine prescribed for a given illness will cure, or at least help us to manage, the condition.
This is the raison d’être of the placebo effect. We all know what it is — taking an inactive “dummy” pill or an injection of saline can bring about “healing” effects. This is how it works: When a patient in pain responds to the innocuous treatment, which they believe works, they feel relieved and healed after taking the “medicine,” although they would not know that it was just a placebo. It is a different thing if patients were malingering that they had pain while they never actually did. Well, if this wasn’t the case, the valid question is, How could their pain be relieved by a dormant placebo?
It was a given that in the good old days, the placebo effect approximated evidence enough of unreliable, shifty and changeable patients for most conventional physicians. This may, of course, not have been the only reality because nobody assigned such “healing” feelings to patients. In recent times, the verdict is that for patients who are in pain and perceive what they claim to feel, the placebo effect is something profound and real.
This is not all. It is implicit that the conventional medical establishment was just too disinclined to understand it, for obvious reasons. For far too long, it never gave its ear to the mind-body connection — the part of the whole and sum of the parts, which is so powerfully linked to the conviction that certain internal mechanisms can activate biochemical systems within the mind-brain-body apparatus and accomplish what the actual drug, if not placebo, was intended to do.
Research has fascinatingly, although reluctantly, found new-old, or old-new evidence of the eternal truth that has been known, for eons, by native or spiritual traditions — that our minds and advanced consciousness, or awareness, can impact not only our emotional, but also physical being. Interestingly, the opposite also holds true because certain events in our lives, when deduced by our minds as positive or negative, will have a substantial impact upon our body’s immune system or defense.
More recently, research in the rapidly-expanding area of psychoneuroimmunology (PNI) has provided scientific evidence for the mind-body nexus. This was paradoxically something that was for long denied by scientists — but not anymore. PNI offers something more intense too, namely that our bodies have evolved with the innate ability to calm and mitigate anxiety and depression, and provide pain relief or deep, sound sleep.
It is a scientific fact that we are all biologically programmed to heal our own fears, anxieties, depression or sleeplessness. It is a different thing altogether that pharma companies “engineered” the whole precept and percept of synthetic compounds that would “bind” with such natural receptor sites. On the upside, pharma researchers or companies did not, of course, “invent” such sites — all they did was to tweak the process and activate them. Just think of it: If only one masters the art of tapping one’s own production of peptides, our molecules of emotions, it could lead to a scary prospect. Pharma companies would go kaput.
What’s more, there are, in addition, a host of ways for us to up our feel-good factors or boost the levels of our own mood-altering peptides. Do you not feel good when you exercise, meditate or watch a hilarious, rip-roaring comedy? This is primarily because such healthy events boost the flow of endorphins, the feel-good chemicals in the body.
State of Mind
That placebos have the power to provoke healing and other effects has always been a major worry for big pharma. The reason is simple. For pharma to beat the placebo finesse at its own game calls for massive investment, not just in terms of research alone. They have to develop and prove that their drugs are more effective. This is sometimes easier said than done because research has presented that placebos can bring about “therapeutic” relief of symptoms in up to 50% of study subjects.
The evolution of mind-body medicine has amplified the placebo issue and turned it on its head. Several studies involving the ability of our body to fight infection, including illnesses as dangerous as cancer, have led to the establishment and potent validity of the mind-body connection. For example, factors like loss of employment or a terrorist threat heighten our stress. This empowers our bodies to quickly take position to fight, flee or defend against such infectious, perilous agents. On the downside, however, chronic or persistent stress is not only debilitating but also places a colossal load on our immune system, rendering it defenseless against infections and illnesses like diabetes, heart disease and cancer, among others.
How to Reboot an Infected Nervous System
The inference is obvious: Our state of mind determines the health of our immune system. This holds good for what is called the nocebo effect, the reverse mirror image of the placebo response. The nocebo effect highlights a contradictory element — that expecting hostile effects from a placebo can result in an intimidating, sometimes disastrous, response to it. In simple terms, it denotes an “exaggerated hypnotic” effect — what you believe can happen and, as expected, take place.
The premise is unpretentious, but also insightful. What we contemplate, sense, accept or believe about ourselves and how our bodies react actually make things happen, placebo or nocebo. This also leads us to an integrative paradigm shift: Taking responsibility for our own healing processes through the placebo effect is not such an implausible idea, and there is no reason why one should not investigate the power of our minds to alter our responses to illness in the physical sense.
When stress, depression and other psychological factors can alter our susceptibility to illnesses, including viral and bacterial infections — not to speak of heart disease, diabetes and cancer — there is ample reason to infer that the mind-body facet is not only potent, but also a defining factor in health and illness. The inference is obvious: The association between the mind and body may be construed to be connected, not only by our behavior, but also by the organic relationships that exist between our brain and immune systems. These connections work in either direction. The result is predictable: Our state of physical health can stage-manage our mental or emotional health, and vice versa.
Not long ago, most theories about human nature were founded on conscious experience. They were also proposed to be nothing short of prescientific scuttlebutt or folk psychology. But clinical and scientific justification for the causative patterns of our conscious mind in health and illness has only expanded today. It is not also without a purpose, therefore, that a whole new school of thought accepts the use of meditation, hypnosis, imagery, homeopathy and biofeedback as not merely placebo effect, but also as therapeutic for a range of medical conditions triggered by our emotions. What is most remarkable is the mounting of evidence-based results available — that, under certain conditions, such therapeutic interventions regulate and influence our autonomic bodily functions, such as heart rate, blood pressure and immune system function.
In this context, it would interesting to note that one of the most acknowledged validations for the upshot of our states of mind during medical treatment is, again, the placebo effect. Because just having faith in the therapy — or the therapist — and believing that it will work has by itself been found to be curative in a host of clinical situations, more so in certain functional disorders like irritable bowel syndrome.
This also makes it evident, again, that the mind-body interaction goes far beyond the placebo effect, although most researchers would assert that the outcome can “affect” only functional illness, not organic disease. On the contrary, however, yet another body of research submits to the fact that placebo may produce “organic” changes. Let us cull some common examples to place the idea in perspective. Healthy and loving relationships, as well as loneliness, can influence longevity and the resolve to live. Hippocrates, the father of medicine, articulately proposed that health was a balance of mind and body in the proper environment, not merely the absence of disease. What does this connote? That the mind has a powerful effect on our physical health and vice versa. This is also a reason why most happy people are less sick or are ill less often than others who are not cheerful.
People who get angry readily are thought to have more health problems. This is simply because stress, angst, antipathy, depression and loneliness suppress the immune system, overload the heart, elevate blood pressure, augment blood clotting, amplify bone loss and harden the arteries (atherosclerosis) while raising our cholesterol levels and fat in one’s waist — the longer the belt, the shorter the life. The outcome is anybody’s guess: allergies, asthma, joint disorders, diabetes, heart disease, stroke, cancer and so on.
The placebo effect takes credence in the fact that belief is the cornerstone of conviction. It signifies the brain’s ability to foresee the future and get ready for action. In other words, our brain crystal-gazes, not just evaluates, and forecasts the body’s future. This is how it works: When you sense seeing what you hope to see, or deal with, it typically happens. This is more than just happenstance, which you have learned to expect. The same principle holds good for our mind-body fusion music too. So, there it is. When our brain submits to the placebo effect as being curative, it stimulates the cells and releases chemicals that switch on the healing process in anticipation of getting well again.
The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy.