Does Placebo Work When You Know It Is A Placebo? Is That Still A Placebo?
Last September, I wrote about why I firmly believed hypnotherapists should investigate and become aware of the placebo effect. (You can read the article on hypnotherapy and the placebo effect here)
There has been some discussion and further research findings recently that suggest the placebo effect is still viable even when the patient/client is aware that a placebo is being used. because I have mentioned Professor Irving Kirsch and his reference of clinical hypnosis being a “non-deceptive mega-placebo” this notion of knowing the placebo is being used piqued my interest greatly. (Plus Professor Kirsch was involved int he research I am citing today)
These days the majority of people know about the placebo effect. As I wrote in my previous article on the subject, it was (and still is) the discovery that a treatment or intervention of some kind that has no real relevant effect or benefit (e.g. sugar pill, or a behavioural equivalent) can make clients feel better. I have argued that the placebo effect is likely to enhance much that we do in the field of clinical hypnosis and hypnotherapy, and that learning to use it well can enhance the success of our work.
The placebo effect is responsible for the initiative that is in place for the approval of new drugs on to the market place: New drugs must go through rigorous double-blind placebo-controlled clinical trial before being approved for use. This is because it has to be shown that using the new medication, whatever it might be, is more beneficial to the individual than a non-active placebo even when the doctor (or whoever is prescribing the drug) and the patient have no idea which treatment the patients are being given. I mean, without such, companies could just keep on churning out placebos, show that they produce beneficial effects in the patients, and then rake in the cash!
Some cynics, and some healthy sceptics believe that there are some companies that are doing just that; from the wide variety of holistic and alternative treatments, psychotherapeutic interventions, remedies of all kinds as well as things like insoles, wristbands, and other kinds of similar stuff touted as having health benefits. Some deem the effects of much that is out there aimed at our well-being, as pure placebo.
This is all stuff I have written about before. However, up until very recently, it has continued to be inherent within placebo understanding, that inorder for the placebo to be effective, the clients or patients using them need to believe they are something else – that they are real medications that are going to help them. This leads to big ethical issues meaning that a doctor or therapst, for example, would have to lie about that which they are giving as a placebo.
Therefore, dealing out placebos has meant very few Doctors actually use them. Though whenever I was ill as a child, my Doctor would have me gargle on junior Disprin (those fluffy orange tablets that dissolved in water and tasted yummy) and it is thought that many doctors do offer up mild prescriptions that they perhaps do not deem wholly relevant to the reported issue, for some placebo effect.
Which brings me on to the point of todays blog entry… A very recent study by T. J. Kaptchuk, E. Friedlander, J. M. Kelley, M. N. Sanchez, E. Kokkotou, J. P. Singer, M. Kowalczykowski, F. G. Miller, I. Kirsch, A. J. Lembo (2010) entitled Placebos without deception: A randomized controlled trial in irritable bowel syndrome examined whether the placebo effect would still occur when ptients suffering from IBS were told that the pills they were being administered were inactive, it was like a sugar pill which had no medication in it.
Those in the study that were administered the placebo, were educated on the benefits of the placebo effect. They were advised that placebo helped with mind-body healing processes. Which does strike me as being suggestion, something us hypnotherapists know a bit about.
The results of the research showed that the placebo effect still occurred!
I’d recommend you go look at the research itself for more information on the results, because they are fascinating and are also encouraging. This is one of the first of these types of study, so we’ll need some more to clarify these findings and build upon them, as with any new research results.
It does mean that Doctors, and hypnotherapists too, for example, would not have to lie about anything they were using for placebo effect. The results suggested that as long as the person giving the placebo was trusted, the placebo will still be effective. Maybe at some point, it will be researched to see if the administrator of the drug/intervention even needs to be trusted! Though for now, evidence suggests trust is essential for good beneficial outcomes, particularly in hypnotherapy.
The results of this research could also mean that many of the drugs or interventions employed today for our well-being, may also just be down to placebo and not due to their own merit as was first tested.
Though before we go making sweeping demands of the government to introduce placeos into our health service, we do need more evidence to corroborate and enhance these findings, as exciting a premise as it is.
Those in the study group that were given no treatment, did also get some benefit from the interaction with the staff involved too… So the research may need some tweaks in future.
With this being explored further, with similar results, we might allow ourselves to consider implementing placebos ethically. It would also open up our minds to the notion that even when someone tells us a treatment or intervention or drug or remedy is good for us, it doesn’t necessarily mean it is!
I look forward to reading more about this in coming years!