Beyond Abstinence

How to flourish in addiction recovery

New Research on Migraines Proves Power of Positive Thinking

'Stunning' research sheds light on the healing power of positive thinking.

Your head is throbbing, you shiver under heavy blankets and your throat is on fire. You're kicking yourself for not getting that flu shot.

And when the doctor says the only cure is to "let nature take its course," you feel worse still. But what if, instead, the doctor gave you a prescription that he said would have you feeling better in no time. A sense of relief sets in.

As it turns out, the doctor gave you a placebo, a dummy pill. But the funny thing is, you are feeling better. It worked wonders. Just like he said it would.

Is it possible that a patient can actually be "cured" by a placebo? New research on headaches has shed light on the healing power of positive thinking.

According to the findings of an innovative study on migraine headaches published in January in the journal Science Translational Medicine, what you're told when your doctor prescribes medication can influence how your body responds to it. Patients' reports of pain relief more than doubled when they were told the migraine drug they were prescribed was real than when they were told that exact same, real medicine, was a fake. 

In the study, researchers at Harvard Medical School and Beth Israel Deaconess Medical Center gave 66 migraine sufferers six envelopes, each containing a pill to be taken after their next six migraine attacks. Two envelopes were labeled Maxalt, a common migraine drug, to create positive expectations, two had no label, to generate neutral expectations, and two were labeled placebo, to create negative expectations. However, the researchers secretly switched the pills to see how a patient's pain relief differed as his or her expectations changed.  

As it turns out, the effect of the drug Maxalt was no different than the placebo labeled Maxalt.

These findings, called "stunning" by lead researcher Ted Kaptchuk, consistently showed that a positive mindset can boost the power and efficacy of drugs.

"Every word you [doctor] say counts, not only every gram of the medication," Kaptchuk noted.

The power of positivity and optimism has also been documented in the treatment of drug addiction. Researchers in a study on cocaine addicts discovered that expectations can actually change brain function.  

Using brain imagining technology, they examined the response of Ritalin, a prescription stimulant, in cocaine abusers under four distinct conditions of expectation and no expectation:

  1. Subjects expecting Ritalin and receiving Ritalin
  2. Subjects expecting Ritalin but receiving a placebo
  3. Subjects expecting a placebo but receiving Ritalin
  4. Subjects expecting placebo and receiving a placebo

In each of these four conditions, expectation of receiving the drug increased brain activity in addiction areas and addiction pathways. Self-reports of "drug high" were greater when Ritalin was expected, regardless of whether the study participants received the real drug.

Some Interesting Facts About the Placebo Response:

  • Colored pills relieve pain better than plain white ones.
  • Blue pills are more effective than red pills for insomnia.
  • Green pills are the best color for anxiety.
  • Larger pills are more effective than smaller pills.
  • Two pills are more effective than one pill.
  • Capsules are more effective than pills.
  • Injections are more effective than both pills and capsules.

Schmaltzy Care

The importance of doctors' messages to patients, both verbal and non-verbal, was borne out in a study of 262 adults with irritable bowel syndrome. The patients were put into three groups:

  1. a no treatment control wait list
  2. a sham acupuncture without much attention from a provider, or
  3. a group of sham acupuncture with lavished attention by a provider - at least 20 minutes of schmaltzy care, including touching the shoulder or knee of the patient for at least 20 seconds of silence lost in thoughtfulness, saying, "I'm so glad to meet you," "I know this is hard for you," "this treatment has excellent results," and so forth.

The results were not that surprising - those who got the best results were those who got the most care - in a dose-dependent response for a placebo. The more care people got, even if fake, the better they tended to fare.

Pygmalion Effect

Robert Rosenthal is believed to be the first one to use the term, "The Pygmalion Effect," which explains the magic of a self-fulfilling prophecy. This metaphor describes how our ideas and beliefs about other people come to life, just as Pygmalion, the Greek mythological character who fell in love with one of his sculptures, caused his sculpture, Galatea, to come to life.

Twenty-five years' worth of experimental research demonstrates that expectations can increase performance in hospitals, summer camp, banks, schools and armed forces.

To recap what Rosenthal says are behind the gains:

  1. Warm climate - when we expect people to do better, we are nicer to them.
  2. Input factor - we teach more to those we expect will excel.
  3. Response-opportunity factor - we give those people we expect will be successful more chances to contribute and we work with them more closely to shape their responses.
  4. Feedback - we offer more praise, reward and positive reinforcement to those we think will succeed.

Also, as clinicians, we must be aware of low or negative expectations of clients because those low or negative expectations will also negatively influence how clients proceed throughout the course of therapy and how they do after graduation. 

Expectations are powerful beliefs that have been proven to have the same effect as medication, so choose your thoughts wisely! Whether a patient is suffering from a migraine or fighting drug addiction, one's thoughts will determine how quickly and fully he or she recovers.

Since 2006, Dr. Jason Powers, MD, has served as chief medical officer for Right Step in Texas. Before coming to Right Step, Powers had a private medical practice, and worked as an assistant professor in the Department of Family and Community Medicine at Baylor College of Medicine in Houston. In 2003, Powers re-dedicated his career to helping addicts and their families after he personally faced addiction. Powers is board certified in family medicine and certified by the American Board of Addiction.

Jason Powers, M.D., is certified in addiction and family medicine and serves as chief medical officer at Right Step and Promises Austin.
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