Beliefs and Placebo Response

The trick is not to be scared of our own power - defined as the ability to get things done.   I'm not saying to deny that you feel scared. I am saying don't be paralyzed or outdone by it.

We are stronger than the fears that arise. The fears may be triggered by our mistaken negative thoughts, internalized oppression, and negative core beliefs about ourselves, others and the world.

Somebody may have told us that we couldn't, or that we didn't matter or that it was impossible for us. But what if we refused to believe that? What would we accomplish then? What would that vivid and beautiful reality be like? What would be the picture in our minds eye if we believed that were true?

My mentor, Roberto Gutierrez, tells me all the time that 50% of the work is visualizing it. The rest is doing the work, overcoming obstacles and persisting through setbacks. The miracle is that it can be done. Can you see it? Are you willing to take what you imagine and make it real? What would that feel like? What would that be like when you take what you imagine and make it real? What would the people that you care about do in the service of your dream? What would they do to help you make your vision real?

So this might all just be cheese to the average cynical skeptic. But when I read about the powerful "nuisance" that the placebo response is causing to pharmaceutical companies, I smile and think that what they consider as "noise" or interference in their clinical drug trials may in fact be the power of our own beliefs to heal ourselves at work. Placebos are beating out new drugs, and established drugs for that matter, in clinical trials.

In light of what we are learning about the placebo response, I have all sorts of questions: What are the biological changes that occur as a result of feeling hopeful? What are the biological effects of fear, negativity and hopelessness? Do we fully know and understand the capacity and limits of our innate ability to heal ourselves?

     "In a study last year, Harvard Medical School researcher Ted Kaptchuk devised a clever strategy for testing his volunteers' response to varying levels of therapeutic ritual. The study focused on irritable bowel syndrome, a painful disorder that costs more than $40 billion a year worldwide to treat. First the volunteers were placed randomly in one of three groups. One group was simply put on a waiting list; researchers know that some patients get better just because they sign up for a trial. Another group received placebo treatment from a clinician who engaged in small talk. Volunteers in the third group got the same sham treatment from a clinician who asked them questions about symptoms, outlined the causes of IBS, and displayed optimism about their condition.
     Not surprisingly, the health of those in the third group improved most. In fact, just by participating in the trial, volunteers in this high-interaction group got as much relief as did people taking the two leading prescription drugs for IBS. And the benefits of their bogus treatment persisted for weeks afterward, contrary to the belief - widespread in the pharmaceutical industry - that the placebo response is short-lived."

I understand how some patients might "get better just because they sign up for a trial."  It reminds me of when my friends tell me they feel better about a stressful family or work-related problem just by making an appointment with an expert to address it.

I wouldn't call the third condition a "sham treatment" especially when some of the elements described sound like health education or psychoeducation.  Also, there may be a lot going on therapeutically when a clinician displays "optimism" about a patients condition - beliefs, mirror neurons, health effects of optimism, etc.?

I also imagine the thoughts, beliefs and expectations of patients coming to Harvard (!) for a clinical trial as compared to how they feel at their regular health care facility.  "I am going to get world-class treatment!"

So how do we harness the power of our own beliefs to heal ourselves?  Especially in light of their well researched power to best medications.  How do we infiltrate our modern culture with these age old practices of confidence, beliefs, credibility and hope?  How do we consciously and consistently pair these elements with evidence-based interventions and treatments?

When I fell and hurt myself as a kid, there was always someone near who would say to me, "sana, sana colita de rana, si no te alivias hoy, te aliviaras man~ana."  This nursery rhyme of healing words and their intention always helped a little.  How far can we push the limits and capacity of words and hope now?

Reference:  The Placebo Problem by Steve Silberman from Wired and published in The Best American Science Writing, 2010.