PreFrontal Nudity

The brain exposed

In Defense of Placebos

Take advantage of faith in sugar pills.

People are always hatin' on the placebo effect. Don't be a placebo hater. What did placebo ever do to you except make your life more enjoyable and pain free? Placebos can help with a whole host of different problems including insomnia, aches and pains and depression. While there is a ton I could discuss about the placebo effect, I want to focus one simple fact: just because a treatment works by the placebo effect doesn't mean it's not good for you. Science has shown us the value of the placebo effect. I say take advantage of it.

People often equate the concept of the placebo effect with having no effect. In reality the placebo effect simply means that an improvement in symptoms is not attributable to a specific drug or therapy. While a pharmaceutical company trying to sell a drug might be very interested in the specific effects of that drug, the consumer doesn't always need to care. As long as something is safe, and the issue is one of quality of life, the only relevant metric in real life is "do you feel better?".

It's understandable that people like to trust science, and not, say, their friend's Hungarian grandmother's claims about her miraculous meatloaf. However, clinical trials base themselves on the significance of objective measurable effects for a group. But group statistics and objective facts do not necessarily improve your quality of life. What improves your quality of life is entirely subjective. If you have a headache and you think it's getting better isn't that good enough for you? Perhaps there is an objective way to measure it that will tell you you're not actually feeling better all, but so what? Do you need statistics to tell you if you should be feeling less depressed or not? What if your tennis elbow stopped hurting, but it wasn't supposed to?

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I try to utilize the placebo effect when I can - with a cold, for example, where there aren't any real treatments. Before I get a cold I almost always wake up in the morning with a tiny bit of a sore throat, so I start drinking a lot of orange juice (Tropicana Pure Premium works best) and taking Echinacea (definitely go with Nature's Way) with every meal. I also make sure to get enough sleep (see my earlier post) and eat lots of fruits and vegetables. And you know what? If I consistently do all those things I almost never get a cold (less than once a year), and even if I do, it is just a brief one.

The sleep, fruits and vegetables probably do something "real" to boost my immune system. In fact if I'd been sleeping and eating right all along I might not have gotten sick in the first place.

However, drinking lots of orange juice has no proven effect on colds. I do it for the vitamin C, even though that also has no proven effect on colds. But so what? Orange juice tastes good, isn't too expensive, is totally safe, and in my non-scientific study (n=1) it makes me feel better.

Similarly, Echinacea has not been shown to help either. But I mean a $7 bottle of pills of some weird sounding herb with printed claims about how it will help you: sure that's gotta be good for you. Plus when you burp afterwards it tastes like grass, so it's gotta be doing something. As long as a placebo is safe, and will make you happier than the money you spend on it, I say go for it. Would you rather have $7 or the belief that you're doing something to improve your sore throat?

Since I have a PhD after my name, and I like to tell people how smart I am, they often ask about the Echinacea. "Does it really work?" I tell them that I take it for the placebo effect. That usually elicits a laugh. And while I enjoy being clever, it's still true. They usually respond with, "Don't you have to believe it works?" That question really gets to the heart of the matter: I do believe it will make me feel better, and I also believe that the mechanism through which that will happen is the placebo effect. The placebo effect is still an effect after all. You still feel better than you did before. It's just caused by chemicals produced in your brain instead of chemicals produced in a lab.

Also I lied about the Tropicana Pure Premium and Nature's way. Since they're probably just placebos anyway, there's likely no real scientific difference between brands. But should I have told you that? The next time you got a cold you might have said to yourself, "That doctor guy on the internet suggested these brands, so they'll probably work best", and they probably would have made you feel better. This illustrates a problem with taking advantage of the placebo effect: scientists and doctors can't lie to you and still be ethical. Therefore you're probably gonna have to lie to yourself.

Interestingly though, even if scientists are honest about giving a placebo, it can still work. Some Harvard scientists conducted a beautiful experiment illustrating the effects of placebo without deception. In a study of Irritable Bowel Syndrome (IBS) scientists gave patients either a sugar pill (i.e. placebo) or nothing at all. On top of that they told the patients who received placebo pills that they were "inert or inactive ... without any medication in them." But they also told the patients that placebos had been shown in "rigorous clinical testing to produce significant mind-body self-healing processes." The patients who received a pill improved significantly more than those who received no pill.

If you believe they will work then they likely will. And guess what? If you don't believe they'll work then they probably won't. Placebos are like God; their power is faith-based. If you tell yourself, "This pill is a waste of my time and money, and it's not gonna help my headache." You'll be right, and you'll still have a headache. So you have to ask yourself: would you rather err on the side of being right or feeling better?

Faith and self-deception are powerful tools to help your quality of life, so long as you're not accidentally harming yourself. If the drug or procedure you're interested in is potentially dangerous or costs a lot of money, I'd say wait for the FDA to make a decision. But if your friend's Hungarian grandmother swears that her meatloaf will get rid of your tennis elbow, I say go for it.

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Alex Korb, Ph.D., is a postdoctoral researcher at UCLA and scientific consultant for BrainSonix Inc. 

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