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Chapter
4
Evidence from the Placebo Effect
I. Introduction
The placebo effect itself is probably the best-documented way in which thoughts are known to affect health. A placebo is a chemically ineffective treatment, such as a sugar pill, given to patients who believe it works. The patient's belief itself becomes the healing agent. Historically, the placebo effect has often been regarded more as a hindrance than a help in medical research, misleading researchers into thinking an ineffective drug or remedy works. Outside the field of research, it has also given quacks and charlatans the anecdotal evidence they have needed to peddle their ineffective and often dangerous merchandise.
Researches have combated the problem with "blind" and even "double-blind" studies. In single-blind studies, the experimenters take care to ensure that the subjects do not know whether they are in the control group, i.e., the one receiving the placebo. The problem with single-blind studies is that sometimes the beliefs of the experimenters have contaminated the study. A doctor's enthusiastic endorsement of a cure is contagious. The patient takes advantage of the placebo effect indirectly -- by believing in the doctor or, in the case of medical research, the experimenter.
To counteract this effect of the placebo-by-proxy, researchers have resorted to the double-blind study, in which neither the subjects nor the experimenters know which subjects are receiving the placebo. However, according to Dr. Larry Dossey in Healing Words: The Power of Prayer and the Practice of Medicine, the placebo effect has contaminated even double-blind studies. For example, researcher Jerry Solfvin conducted three double-blind studies on the effectiveness of vitamin E on heart patients' angina pectoris, the chest pain associated with heart disease.
[A]n enthusiastic doctor who believed in vitamin E found it significantly more effective than a placebo, while two studies conducted by skeptics showed no effect.(12)
Dossey cites other studies dealing with meprobamate, an early tranquilizer of questionable effectiveness, which showed similar results:
Enthusiasts consistently found that it worked, while skeptics could find no effects beyond those of a placebo. To clarify this situation, researchers designed a double-blind study in which one of the physicians had a "skeptical, experimental" attitude toward the drug, while the other had an "enthusiastic, therapeutic" attitude toward it. They were totally unaware which pills were which, meprobamate or placebo. The patients also were in the dark; they did not even know they were involved in an experiment. The results: meprobamate proved significantly more powerful than the placebo -- but only for the physician who believed in it. There was no drug effect for the skeptical physician's patients.
This study was repeated, conducted simultaneously at three metropolitan psychiatric outpatient clinics. The results were replicated in two of the three clinics.... Thus Solfvin concludes,
"....As a general rule, the double-blind cannot any longer be assumed to guarantee the exclusion of the nonspecific effects of the treatment, especially when the actual treatment has a weak or variable effect." [Emphasis in the original study cited by Dossey.](13)
This suggests the existence of something truly extraordinary: Experimenters' and physicians' beliefs about a remedy can be communicated to their subjects or patients subliminally, if not telepathically.
In any case, the placebo effect points directly towards my first major thesis: that thoughts do in fact heal. The very existence of this effect, especially to the extent that researchers must take great pains to work around it, proves that some kinds of thoughts, namely the belief in the efficacy of a cure, can and do heal. Faith in the cure was one of the essential elements in healing in statements attributed to Jesus (Matt: 17:20, 13:58, and Mark 6:6).
II. The Power of the Placebo Effect
Michael Murphy, in The Future of the Body, a comprehensive treatise on extraordinary human abilities, devotes an entire chapter to the placebo effect. Some of the studies he cites are summarized below:
Angina Pectoris. This is a chest pain normally associated with heart disease. In the early 1950s, it was a common practice in the United States to perform a ligation of the internal mammary artery to relieve pain and improve coronary blood flow. In the late 1950s, two researchers performed a double-blind experiment. Each patient received a skin incision, but only in randomly selected cases was the ligation actually performed. The researchers found no significant difference in the improvement rates of those patients who received the ligation and those who received a simple skin incision. The ligation procedure was subsequently abandoned.(14)
Warts. The placebo effect, using some of the most outrageous remedies, has worked exceptionally well with warts. In 1934, a physician conducted a double-blind study showing that placebos worked almost as well as sulpharsphenamine, the drug commonly used to treat warts at the time. Another physician was able to cure 44% of his patients of one kind of wart, and 88% of those with another kind, using suggestion alone. Studies like these led psychiatrist Montague Ullman to conclude in the 1950s that suggestion, when compared against X-ray, drugs, and surgery, was the most important factor in curing warts.(15)
Asthma. One study showed that 19 out of 40 subjects developed asthmatic symptoms after inhaling a saline solution they believed to be allergenic. Twelve developed full-blown wheezing and bronchial spasms, which disappeared completely three minutes after receiving another saline solution placebo. The same researchers induced bronchospasms in 15 out of 29 subjects who were told that the saline solution they inhaled contained allergenic agents. The researchers concluded that suggestion played a significant role in precipitating asthmatic attacks.(16)
Pain Relief. In 11 double-blind studies conducted over a 15-year period, a researcher found that 36% of 908 subjects who received placebos achieved at least 50% reduction in various kinds of pain. The results match a 35% rate in another similar study.(17)
Arthritis. Arthritic patients who received placebos experienced the same levels of relief as those who took conventional antiarthritic drugs. Subjects noted improvement in eating, sleeping, elimination, and swelling.(18)
Medication Side Effects. In another study, published in 1955, researcher Henry Beecher showed that placebos could produce symptoms such as nausea, dry mouth, heaviness, headache, concentration difficulties, drowsiness, fatigue, and unwanted sleep.(19) In a study of the drug mephenesin, researchers found that placebos produced "combinations of weakness, palpitation, nausea, rash, epigastric pain, diarrhea, urticaria, and swelling of the lips that mimicked known side effects of the drug."(20) Mexican researchers found that placebos could induce some of the known side effects of contraceptives.
Cancer. Statistical studies of placebo treatments for cancer are also rare, which is understandable, considering the risks of belonging in the control group. However, in his book Meaning and Medicine, Dr. Larry Dossey gives an anecdotal account that strongly suggests that placebos can cure cancer in some cases:
A man with an advanced cancer was no longer responding to radiation treatment. He was given a single injection of an experimental drug, Krebiozen, considered by some at the time to be a "miracle cure." (It has since been discredited.) The results were shocking to the patient's physician, who stated that his tumors "melted like snowballs on a hot stove."
Later the man read studies suggesting the drug was ineffective, and his cancer began to spread once more. At this point his doctor, acting on a hunch, administered a placebo intravenously. The man was told the plain water was a "new, improved" form of Krebiozen. Again, his cancer shrank away dramatically. Then he read in the newspapers the American Medical Association's official pronouncement: Krebiozen was a worthless medication. The man's faith vanished, and he was dead within days.(21)
One of the most spectacular demonstrations of the placebo effect occurred during a high school football game. It is described by Norman Cousins in The Healing Heart as follows:
The item, which appeared on the front page [of the Los Angeles Times], concerned an episode that occurred at a Monterey Park, California, football game. What had happened was that four persons had to leave their seats during the game because of severe nausea and dizziness. Questioning on the spot by school officials established the fact that the ill persons had consumed soft drinks from a dispensing machine under the stands. Syrup had been mixed with water out of the local piping system. Was the culprit the syrup or the water? In the latter case, had copper sulfate from the pipes infiltrated the water? If the former, had bacteriological organisms contaminated the syrup?
The football stadium lacked loudspeaker facilities. The cheerleaders were therefore directed to make a public announcement requesting that no one consume any soft drinks from the beverage-dispensing machines until the precise cause of the sudden illness affecting several persons could be ascertained. The immediate effect of the announcement was that the stadium became an arena of fainting and retching people. One hundred and ninety-one persons had to be hospitalized. Local ambulances and private cars plied back and forth between the stadium and five hospitals in the area. Emergency-room physicians reported that the symptoms of food poisoning were genuine. No one knows how many persons at the game went to their own physicians.
Laboratory analysis showed there was nothing wrong with the water or the syrup. This fact no doubt figured in the subsequent and sudden improvement of all those who had become ill during the game.(22)
The incident was admittedly not a systematic experiment conducted by trained researchers, but it qualifies as one of those cases where common sense is sufficient to rule out chance or coincidence.
Placebos have their drawbacks. In addition to their capacity to work destructively, placebos almost necessarily involve an element of self-deceit, or at least some degree of ignorance. They all work via false beliefs.
Placebos also work best under proper social conditions, which Michael Murphy summarizes as follows:
Enlarging patient groups in which treatments are administered can improve responses to placebos, probably because the power of suggestion is increased by the greater number of participants.
A placebo's effectiveness depends to a large extent upon the physician's interest in the patient involved, interest in the treatment, and concern about the treatment's results.
A placebo's power is increased by experimental studies that impart a sense of interest and care to their subjects.
Placebo effects in most treatments are increased when the treatment has a good reputation.(23)
Relationships with others are an important element in reinforcing the beliefs.
III. Conclusion
The placebo effect offers some of the most convincing evidence there is for the existence of psychosomatic healing, and for two reasons:
Accordingly, it not only demonstrates the reality of psychosomatic healing, but it also demonstrates the extent of the mind's power in effecting it. Hence, it poses a very serious problem for anyone who would deny either the reality or the significance of the power of thought to heal.
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Notes on Chapter 4
12 Larry Dossey, Healing Words: The Power of Prayer and the Practice of Medicine (San Francisco: Harper San Francisco, 1993), 135. Return to text
13 Dossey, Healing Words, 135-6. Return to text
14 Michael Murphy, The Future of the Body (Los Angeles: Jeremy P. Tarcher, 1992), 249-50. Return to text
15 Murphy, 250. Return to text
16 Murphy, 251. Return to text
17 Murphy, 251. Return to text
18 Murphy, 251.Return to text
19 Murphy, 253. Return to text
20 Murphy, 253. Return to text
21 Dossey, Meaning and Medicine (New York: Bantam Books 1992), 203. The same incident is also discussed in Dr. Bernie Siegel's Love, Medicine, and Miracles, (New York: Harper Perennial, 1990), 34-5. Return to text
22 Norman Cousins, The Healing Heart (New York: Avon Books, 1983), 171-2. Return to text
23 Murphy, 254. Return to text