The Placebo Effect
WHAT IS THE PLACEBO EFFECT
A placebo is an inert substance or 'fake' surgery or therapy
used as a control in a experiment or given to a patient for its
possible or probable beneficial effect.
35% to 45% of all current prescriptions are for substances
that are incapable of having an effect on the condition for which
they are prescribed. Bok (1974)
Why an inert substance, a so-called 'sugar pill' or fake surgery
or therapy would be effective is not completely known.
BELIEFS OF WHY PLACEBO ARE EFFECTIVE
PSYCHOLOGICAL THEORY
Many people believe that the placebo effect is psychological
due to either a real effect caused by belief or to a subjective
delusion.
If I believe the pill will help, it will help, or my physical
condition does not change but I
feel like it has.
NATURE - TAKING ITS COURSE THEORY
Some people believe that at least part of the placebo effect
is due to an illness or injury taking its natural course, the
body is healing itself. Thus the placebo effect is mistakenly
thought to be effective, when in fact, the body is healing itself.
SOCIAL THEORY
Another theory is that a process of treatment involves showing
attention, care, affection, enthusiasm etc to the patient may
itself trigger physical changes in the body which promote healing
through the release of chemicals such as endorphin.
HOW EFFECTIVE ARE PLACEBO EFFECTS?
There have been a great deal of studies developed to try to
answer this question. The following are various studies that
have been carried out.
After reviewing 15 studies, Beecher (1959) concluded that
placebo medication successfully reduced pain in approximately
35% of the patients studied.
Evens (1974) reviewed 13 studies and concluded that on average
36% of the patients achieved relief from pain after ingesting
a placebo.
A negative view of the placebo phenomena has at its basis
the mistaken belief that placebo effects are 'unreal'. The assumption
is that if a patient improves simply by 'wanting to' or by following
a psychological suggestion, this is evidence that he or she was
not ill in the first place.
WHAT FACTORS EFFECT THEIR EFFICIENCY?
The effectiveness of the placebo depends on the confidence
of the patient in the medications powers of suggestion, the empathy
and charismatic personality of the healer and the doctor patient
relationship.
"Anxious people are more suggestible and accordingly more
responsive to the far-from-inert 'placebo' power of the doctor-patient
relationship." Winefield and Peay (1980 pp57)
THE PLACEBO EFFECT AND ALTERNATIVE MEDICINE
The placebo effect can be seen as an essential element of
any approach to therapy which claim to be holistic. Many of the
most positive and valuable aspects of the therapeutic encounter
contribute to the placebo effect. The rapport between the patient
and practitoner, the belief of the patient, the enthusiasm of
the doctor, although of great importance are all in a sense incidental
to the specific action of a drug, needle or homeopathic remedy.
The placebo can thus be seen as a simple form of psychotherapy.
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