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THE PLACEBO EFFECT THE TRIUMPH OF MIND OVER BODY THE PLACEBO EFFECT THE TRIUMPH MIND OVER BobDy A growing body of research reveals not just psychological and perceptual components to the placebo effect but also a biochemical substrate to the mechanism. ne of the most commonly used terms in medical language is the word placebo. The placebo effect is used as a scale for evaluating the effectiveness of new drugs. But what exactly is the placebo effect and what are its consequences in the deterministic structure of Western medicine? The placebo effect has been frequently abused by health professionals to denote and stigmatise a fraud or fallacy. Alternative therapies have often been characterised as merely placebos. But the placebo effect is not a fraudulent, useless or malevolent phenomenon. It occurs independently of the intentions of charlatans or health professionals. It is a spontaneous, authentic and very factual phenomenon that refers to well-observed but uninterpreted and contingent therapies or health improvements that occur in the absence of an active chemical/pharmacological substance. Make-believe drugs—drugs that carry no active chemical substances—often act as the real drugs and provoke therapeutic effects when administered to patients. In many drug trials, the manufacturers of the drug sadly discover that their product is in no way superior to the effect of a placebo. But that does not mean that a placebo equates to a null response of the human organism. On the contrary, a placebo denotes non- chemical stimuli that strongly motivate the organism towards a therapeutic course. That is, the placebo effect is dependent not on the drug's effectiveness but solely on therapeutic intention and expectation. Effects of positive and negative thinking The placebo effect has been often misunderstood as a solely psychological and highly subjective phenomenon. The patient, convinced of the therapy's effectiveness, ignores his symptoms or perceives them faintly without any substantial improvement of his health; that is, the patient feels better but is not healthier. But can the subjective psychological aspect of the placebo effect account for all of its therapeutic properties? The answer is definite: the placebo effect refers to an alternative curative mechanism that is inherent in the human entity, is motivated by therapeutic intention or belief in the therapeutic potential of a treatment, and implies biochemical responses and reactions to the stimulus of therapeutic intention or belief. But placebos are not always beneficial: they can also have adverse effects. For example, administering a pharmacologically inactive substance to some patients can sometimes bring about unexpected health deteriorations. A review of 109 double-blind studies estimated that 19 per cent of placebo recipients manifested the nocebo effect: unexpected deteriorations of health.' In a related experiment, researchers falsely declared to the volunteers that a weak electrical current would pass through their head; although there was no electrical current, 70 per cent of the volunteers (who were medical students) complained of a headache after the experiment.’ In a group of patients suffering from carotid atherosclerosis, prognosis and progression of the disease were burdened when their psychological health was bad (i.e., they were affected by hopelessness or depression). In another group of carotid atherosclerosis patients, prognosis and progression were burdened not only by hopelessness but also by hostility.* In patients with coronary heart disease, hopelessness was a determinative risk factor.* Social isolation, work stress and hostility comprised additional risk factors.* Positive or negative thinking seems to be a decisive risk factor for every treatment, perhaps even more important than medical intervention. Email: petrosarguriou@hotmail.com JUNE — JULY 2007 NEXUS + 27 A neglected phenomenon by Peter Arguriou © 2007 www.nexusmagazine.com