The True Healer ?
Placebo is a Latin word, which translates as “I shall please.” If something pleases you, it automatically triggers the release of pleasure hormones in your body, which means that in the event of an illness, you are likely to experience a healing response. In the field of medicine, the placebo effect is a phenomenon described as a measure for testing the efficacy of new drugs or therapies. There are three possible explanations why and how healing takes place (I want to mention at this point that shutting down or suppressing a symptom of disease has nothing to do with healing it).
1. A particular non-suppressive treatment has a curative value.
2. The healing power of nature is at work. This includes especially the immune system's natural response to stop and eliminate disease-causing factors. While this principle (of the body healing itself) applies to the majority of all medical cures, this “secret ally” of all doctors is hardly ever Introduced to the patients. The human organism rarely receives praise for the extraordinary abilities it displays when dealing with infections and physical injury. The body's own remarkable healing ability is behind every success in the healing profession. In many instances, healing may even occur despite the side effects that so often arise from the use of medical drugs or invasive procedures. If the body’s healing response remains absent, no medical technology or expertise will have any value.
3. The placebo effect triggers the healing response.
Orthodox medicine originally defined the placebo as an inert substance that, for psychological reasons only, is administered to satisfy or please a patient. However, this definition is no longer considered quite accurate or sufficient. The placebo effect can occur as a result of administering substances that are not inert, just as much as it can be triggered by procedures or pills that do not include medication. The placebo effect implies that the patient's belief in a "drug," which may just be a sugar pill or snake oil, has the power to stop pain and even cure a disease. A basic feeling of trust in a particular treatment or even the doctor can also act like a placebo. A research study is not considered valid or scientific unless it includes a placebo that is applied to a control group.
When the success rate of the drug or treatment is higher than the success rate of the placebo, then the drug has passed the test for effectiveness. In the past, the placebo has even been used to study coronary bypass techniques and cancer radiation treatments. In the case of bypass studies, the surgeons open the chests of the heart patients in the placebo group and immediately stitch them back together again, without actually performing a bypass operation. After surgery, all the patients are informed that their operation was a success. Some of the placebo group patients confirm that they have relief of chest pain. A number of the heart patients who received the actual bypass surgery also report relief of pain. If the number of “successes” in the group actually having had the bypass procedure is higher than that of the placebo group, then the bypass operation is considered to be an effective method to relieve chest pain.
An early carefully controlled study with patients suffering from Angina pectoris showed that 5 out of 8 patients, who had genuine surgery, and 5 out of 9 patients, who only received a sham operation, felt much better afterwards. Two of the patients with sham operations even experienced a remarkable increase in physical stamina and endurance. A group of highly skeptical researchers repeated the same experiment with another group of 18 patients. Neither the patients nor the examining cardiologist knew who actually received the surgery. The results were that 10 out 13 patients with real surgery and 5 out of 5 patients with the sham operation had improved significantly. This experiment demonstrated that the placebo together with the body's healing system might actually be the real power behind successful surgery. Surgery, just like every other treatment, can work as a placebo for the patient; and it seems to have no significant advantage over the placebo. It would, however, be very unwise to have a sham operation and continue with a detrimental lifestyle. The survival rate with sham operations is not more than two years, and with a normal operation not much longer either, unless the patient makes major changes in his diet, lifestyle, etc.
When the Placebo Becomes Medicine
The mechanics of placebo healing is centered in the belief of the patient that a drug, an operation, or a treatment program is going to relieve his pain or cure his illness. Deep trust or a sure feeling of recovery is all that the patient has at his disposal to initiate a healing response. Utilizing the previously described powerful mind/body connection, the patient may release natural opioids (morphine-type painkillers) from areas of the brain that are activated by certain thought processes. The corresponding neurotransmitters for pain relief are known as endorphins. Endorphins are about forty thousand times more powerful than the strongest heroin.
A patient who suffers from a cancerous growth may produce extra amounts of Interleukin II and Interferon to destroy malignant tumor cells. Being products of the DNA, the body can make anti-cancer drugs in every cell and eradicate cancer in a moment (spontaneous remission), provided the patient knows how to trigger their release. The triggers are trust, confidence and happiness, and are the same triggers that can cause a placebo response. To buy these drugs on the pharmaceutical market, you may have to spend up to $40,000 per course of treatment. The “success” rate with these drugs is less than 15 percent and their side effects are so severe that they can destroy the immune system and sow the seeds for future diseases
Your body is capable of manufacturing every drug that could possibly be produced by the pharmaceutical industry. Synthetically derived drugs only “work” because the cells of the body have receptors for some of the chemicals contained in the drugs. This also means that the body is capable of making these chemicals, too, otherwise these receptors wouldn’t exist. However, the body makes them with the utmost precision, in the correct dosage, and perfectly timed. The body’s own drugs cost us nothing and they have no harmful side effects. Pharmaceutical drugs, on the other hand, are very expensive and much less specific and accurate. It is estimated that 35-45% of all prescriptions have no specific effect on the disease for which they are prescribed. The majority of positive results are directly caused by the body's own healing response or triggered by the placebo effect and have nothing to do with the treatment itself.
The Placebo in Action
Medical doctors have the status and power to infuse in their patients the confidence to believe that, for their condition, they are receiving the most suitable and best treatment available. The hope to find relief and to get better may be the main motivation behind a patient’s visit to the doctor. Also, the doctor is likely to believe that his prescription will produce the desired effect, that is, relieve his patient’s symptoms. The belief of the doctor in his treatment and the trust of the patient in his doctor combined can produce a “medicine” that is capable of transforming even a useless treatment or a non-specific drug into a dynamo of healing. This can very well lead to a definite improvement of the treated condition, and in some cases, to a complete cure. This medicine is nothing more than the placebo effect.
If the doctor himself is completely convinced that the treatment he recommends to his patient will be successful, the patient’s perception of the doctor’s confidence is much more likely to produce a placebo response than if the doctor were doubtful about his approach. Dr. K. B. Thomas from Southampton, England has shown that a doctor doesn’t even need a prescription to help his patients. Dr. Thomas selected 200 patients who were suffering from such various symptoms as headaches, stomach pains, back pains, sore throats, cough and fatigue. First he divided the patients into two groups. The patients of group one received a clear diagnosis and a “positive” consultation during which he assured them that they would soon recover. He told the second group that he wasn’t completely sure what was wrong with them and asked them to come back again in case there was no improvement. Then he divided each group into two subgroups of which one received a prescription, which was a placebo. After two weeks, 64% of the
patients with the “positive consultation” had improved considerably compared to 39% of the patients who received uncertain advice. Of those patients who received a prescription (placebo), 53 percent had improved, whereas among those without a prescription, 50 percent had improved. This experiment demonstrates that a medical doctor can have a more powerful healing effect on his patient than a prescription drug.
This may also explain the phenomenon of why doctors who really believe what they do is best for their patients -- even though it may defy the logic of scientific understanding -- achieve much better results and their patients do well. If a doctor can inspire a patient to believe that he is going to improve, he has done a much better job than any sophisticated treatment may be able to accomplish. A leading article in the medical journal Lancet asked why it should be wrong to give a placebo when the essential modern therapeutic means have no better effects than placebos. It should be the primary aim of medical training to produce a warm-hearted, honest and optimistic doctor who listens to his intuition and who feels both compassion and love for his fellow human beings. The medical students should be tested for these basic human characteristics. Those students who are unable to pass this test should be prohibited from practicing medicine. The doctor’s very presence can work as medicine. What kind of therapy he uses may, indeed, be of secondary or complementary value. Thus, the doctor as a living placebo can be more powerful than his treatment, and there won’t even be any harmful side effects.
The current trend by large proportions of the population to seek alternative practitioners is not so much based on what they offer to a patient but how they make the patient feel. The very fact that alternative therapists use natural methods and compounds for their treatment modalities makes natural therapies more acceptable to the patient than medical treatments. It also makes them more humane and potentially more powerful as placebos.
We all have a pre-programmed natural instinct, although subdued in many people. This gut feeling senses a healing effect from pure, fresh foods, healing herbs and other natural remedies. A herb from the Himalayan mountains or a piece of ginger are more likely to trigger a placebo response in us than the synthetic fat “Olestra” or a chemical drug used to reduce blood pressure. Natural things are naturally pleasing to the body and mind. A naturopath has become a symbol for natural healing. Even if his methods may not be very effective, the symbol may still be a powerful enough trigger for a good placebo response.
The placebo is known to be directly responsible for a considerable amount of success in every medical treatment. This is being confirmed by the results of every controlled study. If there were any other treatment in the system of conventional medicine just as effective and consistent as the placebo effect, it would have most certainly been heralded as one of the biggest medical breakthroughs of all times. However, the placebo effect is not at all or only rarely mentioned in the medical textbooks. This is unfortunate because the placebo plays at least as an important a role in the process of healing and recovery as an expensive drug or sophisticated medical machinery.
A typical example for this is the drug digitalis, which has been used by doctors for over 200 years to treat heart disease, despite the fact that its long-term benefits and safety have never been proven. A major three-year double-blind control study (1997, New England Journal of Medicine) conducted by The Digitalis Investigation Group showed that out of 3,397 heart patients who received digitalis, 1,181 patients had died by the end of the study period compared with 1,194 out of 3,403 patients who had received a placebo. The study makes digitalis no better than a sugar pill in preventing death through heart disease, yet it is the preferred treatment (over the placebo).
During medical training, every would-be doctor has to face the unpleasant fact that drugs themselves cannot induce a healing response. A drug may work in only 35% of the people who receive it. The rest of them may either have no results or become worse because of the drug’s side effects. Doctors also know that a patient has a much greater chance of improving with a certain drug if they guarantee an improvement. They have learned that a patient can get better by merely looking at a medicine. However, this effect depends more on the imaginative power and the trusting nature of the patient than it does on the medicine itself.
The Miracle of Spontaneous Healing
Although modern medicine has virtually stumbled over the healing mechanism of the body, it still has not recognized it as such. Almost all of the scientific research conducted on the thousands of drugs and therapies applied by medical doctors throughout the world has included the “placebo effect.” Placebos have somewhat made it possible for medical research to be considered objective and reliable. It is not the placebo effect or healing mechanism, though, that has been the subject of research. All the attention has been on testing drugs or medical procedures as potential candidates for the treatment of disease. Drugs by themselves cannot inspire true healing without acting as a placebo and can, therefore, only be of secondary value, if any at all (considering the fact that suppression of symptoms has nothing to do with cure).
Moreover, it is erroneous to assume that the positive change of symptoms following a particular treatment must necessarily be the result of that particular therapy. Treatments have no healing powers of their own and remain ineffective unless they are able to work as triggers for the placebo effect or healing response. In addition, treatments that are geared toward merely getting rid of the symptoms of disease with disregard to its causes have nothing to do with real healing. Bringing temporary relief to the symptoms may be very desirable for the patient, but in the long term, such an approach makes it increasingly difficult for the body to heal itself. If true healing does take place, it is due to the existing mind/body connection and the body's own inner healing power.
The body's powerful healing mechanism was clearly revealed by a study on three groups of patients, all of whom suffered from bleeding ulcers in their stomachs. The patients in each group were informed that they would be testing a new drug that could stop the bleeding of their ulcers. One group received the new drug, the second group was given a drug that increases bleeding, and the third group was given inert placebo pills. Most of the patients were desperate individuals who hoped that the new drug would help them get rid of their agonizing problem. The results astonished the researchers. The bleeding stopped in patients from all the groups, even in those who received the drug that was supposed to increase the bleeding. Could the belief in the new wonder drug have been powerful enough to override the high toxicity of a bleed-inducing drug?
Obviously, in response to their thoughts and feelings of hope and trust, the patients' bodies did not only produce special drugs that could effectively stop the bleeding of their ulcers, but also neutralize the poisonous substances contained in the drug that was meant to trigger bleeding.
There are thousands of different studies that tell of the amazing effects of the placebo response. In one classic study conducted in 1950, pregnant women who were suffering from severe morning sickness were given syrup of ipecac, which is an effective compound to induce vomiting. The women were told ipecac was a powerful new cure for nausea. To the amazement of the researchers, the women ceased vomiting.
Another intriguing experiment was conducted with the help of medical students. Fifty-six students received either a pink or a blue sugar pill and they were told that the pills were either tranquillizers or stimulants. Only 3 out of the 56 students reported that the pills had no effects on them. Most of the students who received the blue pills assumed that they were tranquillizers and 72% of them felt sleepy. Furthermore, the students who took two blue pills felt sleepier than did those who took only one pill. By contrast, 32% of the students who ingested the pink placebo pills reported that they were less tired and one third of the students stated that they had side effects ranging from headaches, numbness, watery eyes to stomach cramps, intestinal pains, itching in the extremities and staggering walk. All responses by the students, except for three of them, were caused by their imaginative beliefs.
The implications of these and similar experiments could have revolutionized the entire medical approach to disease. Unfortunately, the law prohibits the sale of “drugs” that contain nothing but inert substances. Without such a law, many people could have become their own best healers, using only their trust in a drug that in reality isn’t one. On the other hand, if placebo sales were made legal, anyone could make a dummy drug and sell it as a real one. But then who is to decide which one is more effective? A former president of the Royal College of Physicians in London once estimated that only 10% of all diseases could be manipulated effectively by modern methods of treatment, including the administration of drugs. Disease manipulation does not necessarily mean that drugs have a curative effect. Actually, most of them merely suppress symptoms, and they are costly. By contrast, a placebo is very cheap or even cost-free. And it has no harmful side effects.
Healing Depends On the Patient
Most medical researchers know that depression, anxiety, negative stress, trauma, emotional crisis, etc., can make the crucial difference whether an administered drug or treatment program is effective or not. This fact may explain why drugs have only such small success rates, on average 35%. The majority of people find no improvement with drugs, and many report strong negative side effects. Any drug experiment that tests a drug against a placebo, or anyone taking such a drug should, therefore, incorporate or consider the following four crucial points:
1. Are there fewer subjects who suffer from depression, anxiety or trauma in the experimental group than there are in the placebo group?
2. Would the experiment have ended differently if the control group had received the drug and the experimental group the placebo?
3. Would the results of the experiment be the same if the researchers, who were assigned to administer the drug to the different groups, were asked to switch groups?
4. Would any pharmaceutical company risk repeating the same experiment, but with different subjects, if this could lead to significantly altered or even contrary results?
It is important to emphasize at this point that a particular drug or treatment may produce different results in different people and can, therefore, not be considered objectively testable for efficacy. A drug may not work for a particular patient unless he allows it to work. The patient’s state of mind, his subconscious acceptance or resistance, and his emotions play the main role in determining how successful a therapy is for him. The type of therapy he receives may, in fact, be secondary. The renowned researcher Dr. Herbert Benson from Harvard University stated once, “Most of the history of medicine is the history of the placebo effect”. The ability to cure a disease remains solely with the patient.
An existing or past trauma, sadness, depression and anger can all lead to unconscious programming of the patient's cells to shut down their receptor sites to both internal and external drugs. This may render any medical intervention useless, if not harmful. It is well known that if a patient is in shock, for example, he cannot be treated or undergo surgery. The same principle applies, although to a lesser degree, to a patient’s subjective condition when he receives a particular treatment. With a general drug failure rate of 65% it is obvious that drugs don’t do the trick. Rather, is the recipient of the drugs who determines whether healing takes place or not. True healing requires hope, trust and a profound belief that one “deserves” to be healed. Once the body receives the go-ahead signal from his host, which I would like to call “body/mind,” it will trigger a healing response and take care of the necessary details.
The dissimilar levels of trust and belief that different patients place in the potency of a drug can trigger a wide range of responses. A higher degree of trust can actually increase the placebo effect from 25% to 75%! For example, the healing rate for duodenal ulcers among the placebo groups in controlled clinical studies range from 20% to 70%. It is very unpredictable who will respond to a placebo positively. Some patients report relief of pain after they have been injected with sterile water. An average 3 to 4 out of 10 surgery patients with serious wounds (caused by ulcers) experience significant pain reduction after they have been injected with a salt solution. There are no reliable methods in modern medicine that can determine or guarantee which ones of the patients will or will not respond to a placebo. It is equally impossible to predict how well a patient will respond to a real drug treatment or surgery. The subjective state of the patient plays indeed a major, if not the most determinant, role in curing an illness.
It is well known that wounds may or may not produce pain, depending on whether the wounded considers it a “good” or “bad” wound. Soldiers who were injured during the war often did not even require painkillers when they felt that their wound would help them get into the safety of a hospital and then back home. On the other hand, a serious wound acquired in civil life through an accident can cause tremendous pain and trauma if it is associated with a loss of health, mobility and financial resources.