Extensive research on placebo effects and sham surgery provide invaluable data for optimizing conditions for healing.
“A placebo has no discernible pharmacological value, and yet research has shown that when patients take placebos, their symptoms improve."
“A placebo has no discernible pharmacological value, and yet research has shown that when patients take placebos, their symptoms improve”
A placebo has no discernible pharmacological value, and yet research has shown that when patients take placebos, their symptoms improve… To many, the idea that patients can find relief through the power of suggestion smacks of quackery—but the evidence of this phenomenon is undeniable… Despite all this evidence, most doctors or hospitals would never even consider using placebos on their patients… Why don’t we harness this mysterious (and no-cost) effect for direct healing?
Removing Barriers to the Body’s Self-Healing Ability
I’ve been ruminating upon the common principles of the complementary and alternative (“CAM”) healing modalities with which I’m familiar, like acupuncture and homeopathy. I believe CAM treatment strives to remove barriers to the body’s self-healing ability so it can be restored to its condition of “remembered wellness,” as Herbert Benson, MD, calls it in his book, Timeless Healing, The Power and Biology of Belief. He believes humans can heal themselves and discusses the placebo effect, where, for example, a patient’s condition improves when taking sugar pills because the patient believes he or she is taking medicine… Santa Barbara is blessed with a panoply of alternative healers. I seek them out with the confidence that they share my belief—my knowing—that they are facilitators, not creators, of my healing, and that love, self-love in particular, is the most powerful medicine of all.
Contents
Context: How Healing Happens
Optimizing Conditions for Healing
Placebo, Nocebo, Non-Deceptive Placebo
Research Findings
Why Placebo Effects Happen
More Details
Resources
Recent Newsletters
Context: How Healing Happens
The Body’s Intelligence Does the Healing.
Wound healing shows us that it’s the body’s innate intelligence that heals us. If a wound is significant, we may need to support the process by cleaning the wound or bandaging the sides together, but those actions don’t do the actual healing. Rather, they set the conditions for the body’s physiology to heal the wound.
When we consider how healing from any illness or imbalance occurs, we see that the same model applies. There may be a need to create more optimal conditions in order for healing to be more efficient or effective, but it’s the body’s physiology that ultimately heals.
For example, an ice pack, herbal supplement, pharmaceutical drug, or chiropractic adjustment may prompt the body to heal, but it is, in fact, the body’s intelligence that does the actual healing. In other words, all healing is self-healing.
Thinking This Through from Personal Experience
Everyone has had the experience of having scratches, cuts, and wounds that have healed. How did the healing happen?
If you’re walking in the woods and a sharp branch catches on your shirt, it may scratch the skin on your arm. You might see the scratch beginning to turn red but if it appears to have no blood, or only a small amount, you move on, knowing it will heal.
If you’re using a knife and it slips and slices your skin, it might bleed immediately and perhaps you run some water over it, pat it dry, and carry on again knowing it will heal. If the wound doesn’t stop bleeding, you’ll probably put a bandage on it to soak up the blood, and then carry on, knowing it will heal.
If you get a really deep cut, and the two sides of the wound are pulled quite a bit apart, it may appear that the skin will have a hard time re-connecting. As a result, you may therefore help the wound healing process by pulling the sides together and wrapping the arm in such a way that the separated skin stays tightly together. If you can’t do that, or it doesn’t appear to be working, you may go to a doctor who will stitch the sides together to hold them securely. And then, again, you move on, knowing it will heal.
Optimizing Conditions for Healing
Why Do We Need to Concern Ourselves with Optimizing Conditions?
If our planet had not been assaulted by more than 80,000 poisonous chemicals and was instead left unharmed, we’d be living in a healthy environment and the body would naturally have optimal conditions for healing. We’d co-exist with natural sunlight, organic electromagnetic frequencies, and pristine, life-giving air, soil, food and water. If we lived in a peaceful community, we’d be without excessive stress.
Since we don’t live in such an environment, we need to be aware and intentional to address the harmful effects of these factors.
Setting the Conditions to Activate Healing
What do we know about the conditions that the body needs in order to heal?
There’s an exorbitant amount of research and evidence showing us that, without a doubt, the state of our nervous system and immune system (including the all-important gut microbiome) are directly related to the body’s ability to conduct its natural processes of healing. Factors that affect those systems are chronic stress and toxins in air, soil, food, water, medicines, and personal products. These cause a dysregulated nervous system, chronic inflammation, and nutrient deficiencies, which then lead to chronic disease — the inability of the body to overcome the excessive challenges to heal.
Thus, we must address these factors — the root causes — that are serving as barriers to healing.
Part of the beauty of placebos is that they activate existing systems of healing within the mind and body.
Placebo, Nocebo, Non-Deceptive Placebo
Placebo
A placebo is a biologically inactive, inert substance.
In medical research, a placebo is often used as a control designed to measure effectiveness of a treatment.
However, in reality, biologically inert substances may also result in measurable changes — called “clinical improvement” in medical research and “healing” in common parlance. This has been called a “placebo effect”. [source]
Thus, biologically inactive substances have been shown to be effective cues to prompt the body to heal. Therefore, a placebo can also be defined as “the act of setting positive expectations and providing hope through psychosocial interactions” to enhance treatment. [source]
Placebo & Nocebo Effects, Non-Deceptive Placebo
Research demonstrates that placebo effects are genuine psychobiological phenomena attributable to the overall therapeutic context, and that placebo effects can be robust in both laboratory and clinical settings. Evidence has also emerged that placebo effects can exist in clinical practice, even if no placebo is given. The use of the word ‘placebo’ in a medical context, meaning innocuous treatment to make a patient comfortable, dates back to at least the end of the 18th century.
Placebo effects refer to positive biological and physiological changes that occur with a biologically inactive intervention, thus making the effects attributable to the therapeutic context as opposed to the intervention.
Nocebo effects refer to negative changes from a perceived negative experience, without a biologically active treatment. “A review of nocebo studies published in 2016 reports that ‘the verbal and nonverbal communications of physicians contain numerous unintentional negative suggestions that may trigger a nocebo response.'” [source]
A non-deceptive placebo refers to people knowing that they are receiving a biologically inactive substance. Positive healing effects occur with non-deceptive placebos as well. (See research findings below.)
Physiological effects from non-biological cues: positive expectations and interactions
Did you ever feel your own shoulders relax when you saw a friend receive a shoulder massage? For those of you who said yes… [you’re experiencing the] “placebo effect”… [Placebos] mobilize a person’s own ability to heal through multiple pathways, including those studied in the field of psychoneuroimmunology. This is the study of relationships between the immune system, hormones, and the nervous system. By defining a placebo as the act of setting positive expectations and providing hope through psychosocial interactions, it becomes clear that placebos can enhance traditional medical treatments.
Research Findings
See here for more detail on each of these findings, plus links to the original research.
“The group given opioids showed about the same level of pain relief as those in the placebo group.”
“Athletes falsely told they had been given anabolic steroids lifted heavier weights.”
Placebos alter the brain and decrease pain (as proven by MRI results).
Placebo effects are “robust in both laboratory and clinical settings.”
Placebo effects are “consistent across studies from different laboratories.”
Knowing the pill was a placebo (non-deceptive placebo) was more effective for migraine pain than no pill.
Non-deceptive placebos reduced perceived and measurable distress.
“A randomized control trial found that “placebo effects can also be elicited when prescribed transparently” (non-deceptive placebo).
“Even when people know they are receiving a placebo, the inactive treatment still has effects on the brain and reported levels of improvement.”
97% of UK doctors have used the principles of placebo in their work.”
“When athletes believe that they have been helped, even though the pills or injections are worthless, this psychological benefit helps them to work through pain and suffering.”
Harvard Medical School reported that placebo studies provide evidence of the non-biological elements that improve outcomes.
Sham surgery refers to a faked procedure, the surgical equivalent of a placebo. Findings from sham surgery include the following:
For knee pain: “The results were clear: the sham procedure was as good for pain and function” as arthroscopy, while being less invasive and risky.
For heart valve narrowing: An invasive procedure was not more effective than a placebo control.
“Sham-controlled studies have spared us some useless operations.”
Among 546 people who underwent sham procedures, they had “a significant decrease in anginal episodes… and increased quality of life and exercise time.”
The New England Journal of Medicine reported that torn meniscus surgery is no better than sham surgery.
“Orthopedic sham surgery often matches real surgery in outcomes—especially for knees and shoulders.”
“I think it’s unethical not to do them [sham surgery studies].” The alternative is exposing millions of people to unnecessarily risky and costly interventions that are no more effective.
In a review of 53 randomized control trials, “forty-five percent of the studies showed ‘no statistically significant benefit of the active surgical intervention over the placebo.’ ”
“Patient survival through 10 years was equivalent, indicating that in these patients there is no survival benefit to a pancreas transplant.”
“Placebo effect was observed in nearly half of the patients during the first 6 months following a sham spine procedure.”
“A majority [of surgeons who participated] felt that the improvement after some currently performed surgical procedures might be entirely explained by placebo effects (78%).”
Surgeons found that 80 to 95% of organ trauma patients fare best without surgery.
Four randomized control trials with 900 patients concluded that while appendicitis is often treated as a surgical emergency, “antibiotics are both effective and safe as primary treatment for patients with uncomplicated acute appendicitis.”
More Details
See the full lesson here.
Resources
The article above is an excerpt from WellnessResourceCenter.net (home of YogaTeacherCentral.com) where we consult hundreds of reference materials for each subject and organize the invaluable knowledge into more than 500 “lessons” — each organized with jump-to links for quickly getting to what you need.
Here are quick links to related resources:
Beyond Diagnosis: Healing — In this (free) lesson, we consider key issues that underlie most disease and healing principles that are consistently and verifiably effective.
Health Systems & Techniques — In this (free) curation, we bring together 20 systems of medicine + nearly 200 health and wellness techniques, structuring the material in an organized way for efficient research.
Root Cause Index — Verifiable root causes for more than 50 conditions.
Toxins — In this lesson, we explore the research and verifiable sources on the prevalence of toxins and their impact on the body.
Detoxification — In this lesson, we explore the body’s detoxification system and how to support it to remove toxins.
Chronic Inflammation — In this lesson, we explore the causes, symptoms and critical repercussions of chronic inflammation, and how to resolve it.
Vitamin D — In this lesson, we introduce and explore the essential functions of vitamin D and techniques for ensuring sufficient levels.
Good Stress & Chronic Stress — In this lesson, we examine the importance of “good” stress and the significant impacts of “bad” stress, the resolution of the stress cycle, and developing stress resilience.
Placebo & Nocebo Effects — In this lesson, we review extensive research on placebo effects and discuss practical implications for health and research decisions.
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