The placebo effect



I have been wondering about the placebo effect for the past few years.  Once you get into studying it, its oddities multiply.  I gave a couple of talks about it at the CTC recently (Nos 5 and 5a on the Talks page) and this follows on from those.  

The placebo effect tends to get a bad press.  Medical science certainly dislikes it. In most non-scientific people's view, describing a treatment as a placebo, especially in the expression a mere placebo,  is a major put-down. Any positive results from being treated with a placebo are frequently dismissed as being all in the mind. If you have friends who believe in homeopathy or a variety of alternative therapies, you need to be very cautious about comparing them with the placebo effect.  You will also tend to find a certain uneasiness if you try to discuss it with AT teachers.

But I think I have produced an account of the placebo effect which is medically credible and at the same supportive of the AT.  It is in the form of a quite long and fairly technical paper with full scientific references. You can access it from the sidebar.

Having put quite a lot of work into studying it, I think the placebo effect is a useful and fruitful topic for discussion.  I will be delighted to publish any  comments or feedback on the paper on this page. You can e-mail them to me here.  If you wish, comments will be published  without your full name or e-mail address.



From Sara Solnick    (www.fine-balance.com/)

Hi Gerry
I read your article on the placebo effect with interest - it is something I too have thought a lot about over the years.

One point maybe worth making is that when you talk about disease and infection, these too are examples of the body's workings. A disease does not invade the body any more than a treatment makes it well. Sometimes the body's ability to stabilise and self-repair is compromised, and then disease becomes manifest - either through exposure from without (a bacteria or virus is not dispatched by the body before it has been allowed to do damage, e.g. a cold to which we are all exposed, but not all of us succumb) or from within (the immune system works against itself, as in cancer or many less serious illnesses.) The relationship between the agents of disease and the disease itself are also complicated, and not strictly causal.

This is a bit brief, but do you see what I mean? It is hard to avoid getting caught back up in the same kind of thinking one has just extricated oneself from..........

Sara: I do see what you mean. It's a very good point indeed.

From M

Thanks, very interesting Gerry. The phenomenon of the placebo and nocebo effects are about beliefs and our reaction to the stimulus, outside of ourselves, of what doctors and other therapists or teachers give us. Unfortunately, nocebo effects are on the increase. In general medical advances are appreciated by everyone, which is a good thing, but peoples positive and negative beliefs in doctors and the industrial world are changing, they are more phobic about chemicals than before and prefer less interventions. Some experts' warnings affect people's beliefs and outcomes especially if they are perceived as scaremongering. Criticism about lifestyle choices, anxiety about the side effects of medicines, fear of toxicity from what may be in our food and air pollution are having widespread nocebo effects where peoples beliefs are making them ill. See article

Recent understanding about the placebo and nocebo effects show mind body unity at a biochemical level which affirms Alexander's, and other peoples views about our psychophysical selves being a complete interconnectedness. I wonder if you think that the Alexander technique in particular, compared to other approaches, optimises the placebo effect and that this is one of the reasons why it is so good for us. One problem is, if you tell someone they are receiving a placebo it is less effective.

M: I think you are right about the AT being particularly effective in optimising the placebo effect - more positively thought of as the self-healing mechanisms of the body. By focusing on how pupils are using themselves rather than having things done to them, they are placed much more in control of what is happening. Instead of having a pill, and carrying on as before, they are motivated to stop damaging themselves. And, of course, the interaction between the pupil and the teacher in itself automatically produces the conditions for optimising the placebo effect.

Regarding your last point, there is no need to pretend about anything when we are giving or having an AT lesson. There are sound psychophysical reasons for believing that it provides an effective therapeutic input.

Your points about the nocebo effect are well made, as are those of Sara about disease above. There is plenty of useful thinking to be done in this area.