Monday, January 17, 2011

More On The Placebo Effect

Don't laugh too hard because this has actually been done and golly gee about a third of would be surgery patients showed the exact same results as if they had really been operated on.

The first assumption one has to dump in order to understand how the placebo effect works, is the assumption--long held as a kind of biological dogma--that DNA controls our fate.  One also has to dump it's corollary that the cell nucleus is analogous to the brain of the cell.  Both of those assumptions are wrong.  The more accurate statement is that the cell membrane, with it's multitude of information receptors and effectors, is the brain, and DNA is a sort of semi hardwired software program. 

In this analogy DNA will not open a given 'window' (gene) unless it's told to by the keyboard of receptors residing in the cell wall.  The agents which press those 'keys' in the cell wall are either matter, in the form of specific chemicals, hormones, or amino acids; or they are energy waves like light and sound which is why we see and hear. Molecular biologists have calculated that energy signals are processed 100 times more efficiently than chemical signals. The instantaneous appearance of some healings may actually be relative to the cellular information being processed.

One of the tools used with some effect to trigger the placebo effect is hypnosis. The fact hypnosis works indicates that another one of those cellular energy wave triggers is generated by thoughts, both conscious and unconscious.  Those energetic thought waves can not only originate in the individual person, but can also come from other humans acting in the individual's environment. 

There is an interesting story about a young Britsh physician in the 50's, Dr Albert Mason,  who was using hypnosis to treat a young man for what he thought was a really bad case of warts. The young man's body was totally covered with wart like lesions except for his chest.  In Mason's first session with the boy he gave the suggestion the skin on one arm become healthy and pink and sure enough when the boy returned the following week, the arm looked very healthy. Mason then consulted with the boy's attending physician and found out the real diagnosis was not warts but congenital ichthyosis, a disease which is both genetic and lethal. Undaunted Mason continued with his hypnotic treatments because it worked,  and the boy continued to respond. 

This case was a sensation in the British medical community, but not for long. When Mason attempted to repeat these results on other patients with congenital ichthyosis he was not nearly as successful.  In later years he attributed this to his own lack of belief in his ability to repeat his success because he then knew what he was trying to treat was 'incurable' and he lost the cockiness and surety his ignorance had given him.  With this particular disease, Dr. Mason's belief structure had taken him from a powerful placebo catalyst to an inert and ineffective doctor exactly like all his peers.  Big Pharma to the rescue.

Along these same lines, I was watching an episode from the first season of the Tudors which dealt with a surge of plague running rampant through the British Isles.  Given what we know about the virulence of these plagues and the ineffectiveness of the standard treatments, it's not unreasonable to think a significant number of people survived because of the placebo effect.  Since the placebo effect triggers real cellular and genetic changes, it is also reasonable to speculate these changes in immunological ability were passed on to succeeding generations through the changed DNA of survivors.  The effect of measles in the European populations vs American Indigenous populations comes to mind. This would be different from immunizing generations of children because it would involve a change in the actual DNA of survivors, not an externally introduced capacity for the immune system to recognize a particular invader.  This could have significance for today because it is entirely possible there have been placebo effect healings in an occasional HIV sufferer who would then be a potential carrier while showing no identifiable effects from the disease, but the change in information in their genetic programming might be very interesting to know.

Placebo is a big subject with a multitude of variables, but it's effects are real and Big Pharma knows it.  In this post I've only scratched the surface of some of the relevant biological thinking and none of the research.  For those interested in more depth, Bruce Lipton's book 'The Biology of Belief' is a good place to start and his website lists numerous links to the most up to date research in cellular functioning, the new field of epigenetics, and the latest in human consciousness.

Tomorrow I want to get into the nocebo effect, which works exactly the same on a cellular level. Western culture is experiencing an explosion in cancer, auto immune, and mental health diseases.  I suspect it's not a coincidence that we are experiencing this in parallel with our recent communication advances like television, radio, and movies. It could very well be we have created a very toxic thought wave environment-- to go along with our toxic material environment--and our bodies are biologically acting this out for us in the form of disease.  Churches, historical Roman Catholicism in particular, have laid the groundwork for a lot of personal toxicity with their theologies of sin, guilt, and the irredeemable nature of humanity.  It is not surprising that very very few of our religious have demonstrated much of a capacity to be strong placebo enhancers other wise known as spiritual healersLike Dr Mason, eventually their belief structures ensure they will be as inert as the rest of their peers.


  1. Dear Coleen,

    First I want to thank p2p for his two very good references on your last topic. Your reference to Dr. Golomg's talk was one that I sent on to my daughter a newly minted allergist.

    I know Albert Mason personally, he is the only other Anesthesiologist that I know who also became a psychoanalyst. He now in his 90's practices 50 miles from where I live. Dr. Mason used hypnosis as an anesthesiologist on several patients with varying results, but decided that it did not work except on small behavior related problems and also could be used as an anesthetic or an additive of anesthesia.

    I personally used hypnosis as an anesthesiologist on many patients and was almost always successful. The first time was on a five yr. old strabismus patient. When we operated on these patients, we used muscle relaxants ( I don't mean valium or the like but drugs that would paralyze a person so they could not breathe or move a muscle without support.) The reason to use these drugs was so that there was no possibility of patient movement during a very delicate eye surgery. However for strabismus surgery it was necessary to have muscular contraction before the opthamologist tightened the last stitch. It necessitated the use of a second surgery the following day so that the child was kept breathing by inducing anesthesia with Halothane gas, the suture was tightened and the young patient was awakened. I used hypnosis on a series of 40 of these children. I would go to their room the evening before surgery and get there confidence and induce hypnotic trance by using a series of colored lights. The next morning in the operating room, I would do the same thing and the child would allow the surgeon to do his work, even though a little painful and disconcerting because I instructed the child to allow the doctor to finish. I could give you many more stories but will end with saying, hypnotic trance is a state of extreme concentration not sleep-fullness. People can put themselves in these states or allow others to do it for them. They can then concentrate to do something too difficult to do with out this state.

    I would like to make the suggestion that these two effects of the placebo and the nocebo are often accomplished by projections and projective identification. How these projections of ideas into another work on the cellular membrane or why is not part of my expertise.

    I do know that it does work. In the hands of a physician it might be called good (or bad) bedside manner. However, I can also remember using authoritarian hypnosis several times in our recovery room. I recall the first time. There was a woman in great pain and she had pulled out her IV. She was moving all over the bed and could not be reasoned with by anyone; it was extremely important for her survival that we got an IV reinserted. I first attempted to talk to her very kindly and she continued to scream obscenities as to how painful her surgery was. I went up to the side of the bed and used my right hand and pounded on the bed shouting as I pounded. “I can help you but you must let me help you.” I used a very loud and assured voice. She stopped and looked at me and grimacing in pain asked me what she needed to do and I told her to be still while I started her IV. After starting the IV, I put in some dilaudid to decrease her pain. She was very apologetic of her behavior. The hypnosis (her ability to concentrate was cause by my authoritarian induction approach.) I projected into her a way out of her situation and she went with it. Is this projection a part of plecbo effect sometimes? Hypnosis for short term use can work, but it may not come from the patient but is projected from without. Have a lot more to say but no time or space! dennis

  2. Thank you Dennis.

    My Mom was a physiotherapist until she retired. She tells of a patient who was making a great effort to recover use of his hand after a crush injury. "Look at that Miss. Doc told me they was all fractured. Can't believe how lucky I am than none of them was broken."

    Teachers know children live up or down to expectations. It has been proven in a number of studies.

    How about the twin study regarding optimism and pessimism? The pessimistic child was put in a room full of toys but wouldn't play with them for fear of breaking one. The optimist was placed in a room ankle deep in dung. "Yahoo!" he exclaimed, "with all this horse shit in here there's got to be a pony for me somewhere!" (OK, that's a joke not a journal report but I couldn't help but share it)

    Great coaches and leaders know how to change the lives of others. (On MLK Day, may I say how I have been and continue to be inspired by "I have a Dream")

    Olympic archers learn how to alter their heart rate so they can shoot between contractions. Herbert Benson wrote about the "relaxation response", a meditative state. Norman Cousins claims to have laughed himself back to health. Canadian sports psychologist Peter Jensen uses imagery, mental exercises and other techniques to help his athletes attain personal bests when they most count. We know some of these techniques are very, very powerful.

    Unqualified self-help coaches and outright charlatans can do great damage using slogans like Napoleon Hill's "Conceive, Believe, Achieve". Applied to the medical, psychological or religious fields one can be made to feel an enormous failure if the placebo effect cannot be achieved at will. Or one can be duped and robbed putting trust in the wrong people.

    Fascinating topic. Like Dennis I could go on for quite some time.


  3. As a therapist, we must always be careful of what we project into others. Good therapy comes from the truth that the patient works out from the depth of his mind (or soul). It does not come from what a therapist wants of his or her patient. As a qualified anesthesiologist, I was able to use projections into patients to help them tolerate a procedure. Non qualified self help authors often cause much more serious problems for the people who try out these projections. These "professionals" are the Sara Palin's of therapy. They know very little but make some money by seducing others with their non qualified ideas. I have a tremendous respect for expertise but there are many know nothings out there.

    On another topic if you are interested in projections and good therapy for fearful stuttering, see the movie "The Kings Speech." it is worth the money!

  4. Dennis

    Thanks for the movie recommendation.

    Mrs p2p and I enjoyed "The King's Speech" immensely. Fabulous acting, wonderful story. Interesting illustration of projection.


  5. I may have missed the previous post on the placebo effect (as this is "more" on it) but I wonder if you touched on how the placebo effect is related to the idea of faith and healing. Lately as I've studied the placebo effect I have become more and more disenchanted with the idea of the miraculous as the evidence points to the fact that if a person believes that a certain entity or medium with heal him/her, such a person will very likely receive healing. The object of faith has very little to do with the results. How is this reconciled to the idea that it is God who heals? Isn't the logical conclusion that prayer and faith in and of themselves are what heal a person, rather than the object of such faith and prayer? Any thoughts on this would be greatly appreciated, forgive me if this topic has been touched already.

  6. First here's the link to the previous discussion:

    In the first one I did get into some of the aspects of faith healing. If I had to give a short response, I would say God figures into it as a catalyst. It's the belief in God which triggers one's capacity to heal oneself. As I wrote in the linked article, Jesus said that all the time when he is repeatedly quoted as saying: "Your faith has healed you."

  7. Albert Mason would never be considered an inert and ineffective doctor. He is just not so good at curing congenital ichthyosis.