What Lies Behind the Placebo Effect?

Trivia question: What is the medication that helps with pain relief, shortness of breath, allergies, cough, peptic ulcer, heartburn, high blood pressure, acne, cold, rheumatism, migraine, obesity, cholesterol, anxiety, depression, and insomnia?

Indeed, a wonder drug - the placebo. If we examine it in a lab, we will find it is an "inert" medicine - it contains no active ingredient, nor any physiological effect. It can be a sugar pill, distilled water, flour with water, or any other inactive "medication" that resembles a regular drug.

So what is it about the placebo that manages to help with so many symptoms, to the point that there is no system in the body or symptom resistant to its effects?

Pharmaceutical companies know that to receive approval for a new drug, they must prove the drug is effective. It is standard in drug research to take two groups of testers: one group receives the medication, and another group receives a placebo - a pill that looks like the drug but contains no active ingredients. To avoid side effects on the results, the tester does not know what they are receiving, and neither does the doctor know what each patient received. Only in a coded computer system are testers labeled according to the drug they received, and treatment results are fed into it. In many studies, the group that received the placebo reports an average improvement of 30-50%. For the tested drug to be proven effective, it needs to show a significant result above the placebo group, say 70-80% improvement. From the pharmaceutical company's perspective, the placebo's effect is a nuisance to be bypassed. From the perspective of someone interested in health and healing, the fact that 30-50% improve just because they think they received a medication and expect improvement is significant.

In a classic placebo experiment on medical students, the students listened to a lecture about stimulant and sedative medications. The lecturer described in detail the effects these drugs have on the body, as well as the expected side effects. All students received a placebo.

Some students received an "orange" pill as a sedative, while others received a "blue" pill as a stimulant, and were asked to measure their blood pressure and heart rate. Additionally, they were to describe their feelings. The results were astounding: the students experienced a clear and definitive sensation matching the type of pill they took. Those who took the orange pills experienced a drop in blood pressure, a slowdown in heartbeat, fatigue, and dizziness. Those who took the blue pill experienced an increase in blood pressure, an accelerated heartbeat, increased alertness, etc.

What influenced their sensation was solely their expectations and belief in the activity of the medication.

If placebo pills have an effect, dramatic medical procedures, like surgery, even more so. In the mid-1950s, a surgical procedure to tie the chest artery was introduced to relieve chest pains in heart patients. Surgeons reported impressive results: 40% reported pain relief, most experienced significant improvement. Improvements were also measured in EKG and stress test (exercise treadmill test) results. Following the publication, a wave of surgeries ensued, but skeptical surgeons decided to test the results with a placebo trial. The operated patients were divided into two groups: one group underwent the full surgical procedure, and another group entered the surgery room, went through chest incisions and stitches, without anything being done. Surprisingly, the placebo group's improvement rates were identical to the treatment group! Apparently, just entering the surgery room, anesthesia, and waking up afterward, along with real stitches in the chest, convinced patients they could already heal (with or without chest artery tying). Following these findings, the chest artery tying surgery was stopped, but unfortunately, 10,000 people had already undergone it for no reason.

Today, it seems such an experiment would not be approved on ethical grounds, but sometimes even without deliberate trials, we witness dramatic placebo effects.

A story of healing and illness of a patient named Wright was reported in a professional journal by psychologist Bruno Klopfer. Wright suffered from advanced lymph node cancer. His neck, armpits, chest, diaphragm, and groin were filled with tumors the size of oranges. The liver and spleen were so enlarged they had to drain 2 liters of fluid from his chest daily, and he needed an oxygen mask to breathe. He did not respond to conventional treatments and seemed to have little time left, but Wright did not want to die. He heard about a new experimental drug called Krebiozen and begged the doctor to let him try it. The doctor refused, as the drug was only tested on patients with at least three months to live. Wright insisted, and the doctor finally relented and injected him with the drug on Friday. The doctor went home, not believing Wright would survive the weekend. To his surprise, on Monday he found him walking around the ward. The tumors were described as "melting like snowflakes on a hot griddle," and were half their previous size. This was a quicker regression rate than achievable through the strongest radiation therapy. Ten days later, Wright left the hospital cancer-free. He remained healthy for two months, until articles began to appear claiming Krebiozen had no effect on lymph cancer. Wright became depressed, the cancer resurged, and he was rehospitalized. This time, the doctor initiated an action. He told Wright he had a particularly concentrated version of Krebiozen, that the drug was indeed effective, and that the articles referred to damaged shipments during shipping.

The doctor took distilled water and subjected it to complex preparation processes before injecting him.

Again, the results were dramatic: the tumors melted rapidly, the chest fluids absorbed, and Wright got back on his feet and felt great. He was healthy for another two months, until the American Medical Association declared that it was finally proven the drug was useless in curing cancer. This time, Wright's faith took a fatal blow. The cancer developed rapidly, and he died two days later.

This tragic story carries a powerful message: When we can bypass our disbelief and activate our self-healing mechanisms, we can also dissolve malignant tumors overnight.

Let's give hope and belief the place they deserve in the healing process, and understand that no less than the doctor's efforts to heal us, we are acting through our belief in our ability to recover.