Recent insights into placebos have prompted not only a study by Harvard University, but possibly a whole new path in medicine.
It’s called Placebo Studies and the Therapeutic Encounter, and it’s based on the age old practice of giving patients a sugar pill or inert substance in place of an actual medication.
The placebo effect first gained notoriety with the publication of The Powerful Placebo by Henry K. Beecher in 1955, and has persisted despite studies done in 2010 that seemed to negate their effect.
Traditionally, placebos are given to patients without their knowing, expecting them to get better in a ‘mind over matter’ sort of way. In 2008 a study by the British Medical Journal indicated that as many as 50 percent of doctors have prescribed a placebo for patients without their knowing. This raises a moral question about whether this sort of medicine is dishonest.
Dr. Ted Kaptchuk, director of the Placebo Studies Program at Beth Israel Deaconess Medical Center, associated with Harvard University, has taken a different approach. He set out to quantify the effects of a placebo even when the recipients know that they are receiving one. This goes against the traditional notion that patients are “tricked” into getting better.
Surprisingly, the study found that patients that were in on the secret also benefited from a placebo. They are calling this the effect of the “clinical encounter.” It may be that just the ritual of going to the doctor causes people to heal faster and experience less symptoms.
In a recent interview with the popular podcast Science Friday, Dr. Kaptchuk explained the healing effects of the clinical experience. “An inert pill can not have an effect” he explains. “Our team… thinks that the placebo is hiding a very important phenomena – the the clinical encounter.”
The clinical encounter encompasses everything we know about going to the doctor — from the white lab coats to the effect of someone else showing empathy for your medical situation.
There is a flip side to the placebo coin: the concept of using a placebo may also be used to test the actual effectiveness of medications that are already on the market. It may be necessary to quantify the effect of the clinical experience, so that these factors can then be eliminated from studies of the actual medications.
Dr. Kaptchuk explained that the healing properties of placebo use are usually most noticeable in cases such as insomnia, anxiety, depression, and pain management, as well as functional bowel and urinary disorders. The effect is most noticeable in the subjective response of patients — they actually feel better.
Studies done by Dr. Kaptchuk and his group have been small and need to be repeated, but the results are promising.
“We think the placebo is about medical symbols” says Dr. Kaptchuk. “Ultimately we think the placebo is about the power of the imagination — trust and hope in the medical encounter.”