The Evidence for the Power of Belief

the size illusion by saikofish (http://www.flickr.com/photos/lou/)We all like to think we are bright, intelligent people but in the end, we really aren’t.

With a tag like that, how can you not continue to read? Obviously it is a bit of hyperbole used to entice the reader further into the post and it is a form of trickery.  Tricks are usually a form of lie, a deception perpetrated on another in order to get him or her to do something against personal interest or outside the bounds of that person’s standard behavior.  Have you ever had someone stand on your left side, reach around your back and tap your right shoulder to get you to look in that direction?  Ever have someone look shocked, point across the room and shout, “Hey, it’s Elvis!”  Then you have been tricked.  We’ve all been tricked at one time or another.  No shame in it.  Now what if you were told before the trick takes place that you were going to be tricked.  Obviously you wouldn’t fall for it, would you?

If someone came up to you and said, “I’m going to point across the room and declare ‘I see Elvis’ in hopes of directing your attention to that location so I can steal your tater tots without you noticing” would you look when a second later he makes his delusional claim to see the now dead King of Rock and Roll?  Probably not, right?  I mean let’s face it, there are tots at stake.

When it comes to medicine, this isn’t true.  A new study released this month showed  people given a placebo, a fake inert medicine, experienced an improvement in their health.  This effect, the placebo effect, is well documented and part of an interesting view of the human brain and its power over the body.  In this recent study, eighty people who suffered from Irritable Bowel Syndrome were divided into two groups.  The first group suffered without medication while the second group were given a placebo.  Specifically, they were told, ‘this is a placebo’ and were made aware of what that meant.

The provider clearly explained that the placebo pill was an inactive (i.e., “inert”) substance like a sugar pill that contained no medication and then explained in an approximately fifteen minute a priori script the following “four discussion points:” 1) the placebo effect is powerful, 2) the body can automatically respond to taking placebo pills like Pavlov’s dogs who salivated when they heard a bell, 3) a positive attitude helps but is not necessary, and 4) taking the pills faithfully is critical. Patients were told that half would be assigned to an open-label placebo group and the other half to a no-treatment control group. Our rationale had a positive framing with the aim of optimizing placebo response.The provider clearly explained that the placebo pill was an inactive (i.e., “inert”) substance like a sugar pill that contained no medication and then explained in an approximately fifteen minute a priori script the following “four discussion points:” 1) the placebo effect is powerful, 2) the body can automatically respond to taking placebo pills like Pavlov’s dogs who salivated when they heard a bell, 3) a positive attitude helps but is not necessary, and 4) taking the pills faithfully is critical. Patients were told that half would be assigned to an open-label placebo group and the other half to a no-treatment control group. Our rationale had a positive framing with the aim of optimizing placebo response.

Patients who took the placebo saw an improvement in their health.  Let me rephrase that for maximum impact. Patients who knowingly took the inert substance that was not formulated to treat any sickness, disease, or condition saw an improvement in their health while those who took nothing felt the same at the end of the study.  Those people who were told they were being tricked, were still tricked, partially because they wanted to be tricked.

I’m not a doctor. I’m not a psychologist. I don’t have any specialized knowledge in these fields that give me any special insight. What I am is someone struggling to understand Truth and slowly realizing there isn’t Truth with a capital T that sits out there like  Platonic ideal.  Apparently one of the more intriguing and persistent power in this world is belief.  I believe this medicine will make me better so I get better.  I’m told that there is a placebo effect so when I’m given the placebo, I get better.

I had a similar reaction to this study as I did to the study about posture I wrote about recently.  How can this be true? It doesn’t make sense. Just how stupid are our bodies?  Apparently, pretty dang stupid. The mounting evidence clearly points to what we believe carries a lot of weight with our physiology.  Oddly enough, the act of believing isn’t enough, though.  At least in terms of the IBS study, it was determined that success of the placebo effect relied upon four elements: “1) an accurate description of what is known about placebo effects, 2) encouragement to suspend disbelief, 3) instructions that foster a positive but realistic expectancy, and 4) directions to adhere to the medical ritual of pill taking.” I personally can’t help but think about all those ancient rituals we modern folk scoffed at as mere superstition and how those rituals helped foster a belief.  A ritual for a good harvest, a ritual for a healthy baby, a ritual to cleanse the body of illness… you see where I’m going with this.

At this point I’m supposed to draw big dynamic amazing conclusions that weren’t proven in the study but push an agenda.  I can’t bring myself to do that. All I can do is reflect on my own beliefs and contemplate what effect they are having on my life.  How many times have I gone through the motions of something, following the ritual, but in the back of my mind telling myself how futile it was?

What do you believe that may be having a positive or negative effect on your life?