06/19/98

Placebo Effect

"May I take your order from the bar?"

"A Shirley Temple, please," I replied in my most sophisticated voice, hoping I wouldn't have to show the fake ID I had borrowed from an upper classman.

"And you, sir?"

"Scotch on the rocks, please."

The waiter returned with our drinks. "Our specials tonight are ..."

Distracted, I ordered something for dinner and reached for the tall bubbly liquid, topped with a maraschino cherry.

"Here's to decadence," I laughed. We clinked glasses. I sipped hesitantly, expecting unfamiliar flavors, but the drink tasted surprisingly sweet, like a carbonated fruit punch. During dinner I ordered two more Shirley Temples, becoming more talkative and silly with each one. When we rose to leave I felt so light-headed, I clung to my date's arm to steady myself.

"You punchy dame," he jibed. "You're teetering! What's wrong with you?"

"Nothing's wrong," I insisted. "Watch this." I let go of his arm and tried to walk an imaginary line, heel to toe, heel to toe, but I nearly toppled over. "Whoa," I giggled. "Guess I can't hold my liquor very well."

"What liquor?" He shook his head. "There's no liquor in a Shirley Temple!"

"There isn't?" Flushed with embarrassment, I sobered up fast, appalled that the power of suggestion had literally intoxicated me.

In medicine this power is called the "placebo effect," long recognized among doctors as a powerful ingredient in the healing process. As reported in the Scientific American, January 1998, carefully controlled research studies have shown that 30-40% of people diagnosed with depression, chronic pain, high blood pressure or asthma benefit from taking a placebo.

Walter Brown, M.D., states in the same publication that, "a patient's expectation of improvement is crucial." For example, when research participants were told that a non-alcoholic drink contained alcohol, they often felt and acted intoxicated. Some even showed physiological signs of intoxication. (How well I know!)

One study, Brown says, conducted by the U.S. Office of Technology Assessments, suggests that "only 20% of modern medical remedies in common use have been scientifically proven to be effective ... It is not that these treatments do not offer benefits: most of them do. But the benefits may come from the placebo effect, in which the very act of undergoing treatment helps the patient recover."

Despite negative connotations associated with placebos, such as the notion that one's symptoms are "all in the mind," their impact is real and should, therefore, be embraced by medical practitioners.

"The healing environment itself can be a powerful antidote for illness," Brown says. A thorough examination, attention from nurses and other medical staff, explanations of symptoms and assurance of a favorable prognosis reduce anxiety, which frequently leads to symptom reduction.

When doctors take the time to find out what a patient thinks will help, it often does. A diagnosis, prescription (even for an over-the-counter cough syrup) and a prognosis which defines the course of the ailment gives the patient a sense of control over it. When several treatment options are available, patients do better when they make the choice themselves, after the doctor has provided sufficient information about possible side effects and treatment outcomes. Harnessing the placebo effect and using it to contribute to the healing process can help doctors and patients avoid common pitfalls, such as demanding and prescribing pills or procedures that have no intrinsic value for the condition being treated (like antibiotics for colds.) Alternative remedies such as massage, herbs and multi-vitamins belong in the treatment mix, too, not only for proven benefits, but also because consumers believe in their effectiveness.

The healing power of the mind may be one of modern medicine's most powerful allies in the art of healing the body.

Please send questions or comments to bbruno@snet.net.