You are the placebo.
A nice title, which I honestly did not invent myself, but because I think it is so perfect, I don’t want to change it. The title comes from the book “You are the Placebo” by one of my favorite neuroscientists Dr. Joe Dispenza.
In my previous blog (which you can find HERE) you could read about nocebo, how our thoughts affect us and can cause damage or make you sick.
And what you might wonder after reading that blog is whether we also have the ability to make ourselves better with our thoughts?
You will discover that in this blog!
When a treatment only temporarily or slightly helps but your chronic pain just comes back, was the temporary improvement a placebo effect?
Are all treatments for chronic pain a placebo or perhaps a nocebo?
What exactly is a placebo?
Placebo is the Latin translation of “I shall please”.
A placebo is a fake medicine. A fake pill. A fake injection. A fake operation. Or a fake treatment. As long as it looks exactly like the real treatment.
When you believe that a particular drug or treatment is good for you, even if it is of no value to you, such as a sugar pill, your pain symptoms can be reduced or even completely heal.
That is the power of placebo. Or should I actually say; the power of your brain.
And the more you believe that a particular substance, treatment or surgery will work because you have been informed about its benefits, the more likely it will actually happen.
Because according to the placebo principle, it is your own thoughts, emotions and beliefs that generate chains of physiological events in your body. And there seem to be three concepts that all work together to create that placebo response.
I’m going to tell you more about that in a bit. But what is also interesting is that many studies have been done on placebo and, for example, on sugar pills. Read a few below!
For example, orthopedic surgeon Bruce Mosely published a pilot study in 1996 based on his experience with 10 ex-military suffering from knee osteoarthritis. (1) These men were suffering from it so much that many of them limped, walked with sticks, or needed other help to get around.
During the surgery, the doctor would scrape and rinse the joint to remove any particles of degenerated cartilage thought to be the cause of the inflammation and pain.
In this study by Dr. Mosely, 2 out of 10 men received the standard surgery also known as debridement (where the surgeon scrapes cartilage strands from the knee joint).
3 out of 10 men had a procedure called lavage (where high pressure water is injected through the knee joint, which flushes and washes away the decayed arthritic material).
And 5 out of 10 men had sham surgery, in which Dr. Mosely cut through their skin with a scalpel. Then, without performing any medical procedure, the skin was sutured closed again.
For those 5 men, there would be no arthroscope, no joint scraping, no bone removal, and no rinsing of the joint. Really just an incision and then stitches.
After surgery, all 10 patients on the study reported greater mobility and less pain. In fact, the men who had sham surgery did just as well as those who had debridement or lavage surgery. There was no difference in the result, not even 6 months later.
In 2002, the same Dr. Mosely published another study involving 180 patients. (2) These patients were followed for 2 years after they had surgery.
Again, all 3 groups had improvement where patients even immediately walked again after the operation without pain or without limping.
Again neither of the 2 groups that had undergone the real surgery had any more improvement than the patients who had undergone the placebo operation, even after 2 years.
Simply having the confidence and belief in getting better through the operation may have been enough for these people to heal from their symptoms. Simply holding on to the expectation that it will provide healing may have been sufficient for these people.
The body experiences what your mind believes. So if you believe that a damaged or defective tissue has been repaired during an operation, you will experience the same relief in complaints as patients who have really undergone a surgical correction.
So even only our thoughts and beliefs have the power to eliminate pain.
Another fairly well-known example is of Henry Beecher who was a surgeon in the second world war. (3) At the end of the war, morphine was very scarce in military hospitals. Before Henry Beecher operated on one of the soldiers, a nurse therefore gave the soldier a saline injection just as if she were giving him an injection of morphine. The soldier calmed down immediately. Beecher then simply performed the surgery on this soldier, cut him open, did what was necessary and stitched his skin back together. All without anesthesia. The soldier felt little pain and was not in shock.
After this successful case, Beecher did this more often when there was no morphine in stock. So he used an injection of saline instead of an injection of morphine.
When the war ended, he went to investigate this phenomenon.
In 1955, Beecher made history when he wrote a clinical review of 15 studies published by the Journal of the American Medical Association that not only discussed the tremendous significance of placebo, but also called for a new model of medical research that would randomly assign subjects to actively receive medications or placebo – what we now call randomized, controlled trials – so that this powerful placebo effect wouldn’t interfere with results.
And so many more studies have been done with placebos, too many to mention in this article. But I would say do your own research on it. For example, read the book “You are the placebo” by Joe Dispenza, many more studies are cited and the whole placebo principle and how it works in the body is explained in detail. It is really a very interesting educational book. It will give you a totally different view of the connection between your mind and your body!
But well, explained very briefly, how does that work in the brain when you take a placebo?
Through brain scans, they have seen that the same part of the brain lit up when taking a placebo as when taking the real medicine. This was proof that the brain produces the same substances completely independently. (4,5,6)
And how does such a placebo response arise? As I mentioned above, there seem to be three elements that all work together in creating that placebo response.
One way of creating a placebo effect has to do with conditioning. I will talk about that in another blog. And the other 2 are expectation and meaning;
Expectation, plays a role when we have reason to expect a different result. So, for example, if we have chronic pain from osteoarthritis and get a new drug from the doctor, who enthusiastically explains to us that it should alleviate our pain, we accept his suggestion and expect that when we take this new drug, something else will happen (we won’t be in pain anymore). Then our doctor actually influenced our susceptibility level.
And the more you will read about the treatment/medicine that is being recommended, you read what it does what the benefits are how it works etc and the more you read about it, the greater your belief that it works, the greater your expectation will be that you will indeed be pain free afterwards. And the greater the chance that this will happen.
Giving meaning, to a treatment or medicine helps it to work (or not to work), because when we give an action a new meaning, we have added intention to it. In other words, when we learn and understand something new, we put more of our conscious, purposeful energy into it.
So, for example, suppose you walk to work every day while you have osteoarthritis in your knee and you have learned (always heard), which I hope not by the way, that when you move your knee the joint wears out further. So you do walk to work but you don’t feel very good about it because every time you do that you think oh no oh no oh no this is really not good for my knee.
And suppose your new practitioner suddenly says “well I don’t know who told you that, but it is actually very good to keep moving with osteoarthritis because it ensures that the blood circulation in the tissues improves and also that the cartilage gets the necessary nutrients that way!”
When you assume that instead of your previous belief that walking is bad for you, your walk suddenly takes on a completely different meaning. Suddenly the walk is good for you, instead of not being good for you. If you assign meaning or conscious intention to an action, the result is amplified because you believe it is good for you.
So the placebo-effect is truly a real effect, and it works through our brain. And that also means that you can use your own brain to heal.
As I said in a previous blog, nothing works in the body without the brain, everything in our body is controlled by the brain and the nervous system, really EVERYTHING. The brain is the control center that controls everything and therefore also controls whether you feel pain or not.
And that is why I focus in my online treatment program on the brain, your thoughts and the nervous system for the permanent elimination of chronic pain complaints. So we really go to the origin of where the pain is generated.
Does that mean that my treatment is a placebo because I focus on the brain and nervous system?
To answer this question it is good to explain clearly the difference between placebo and placebo-effect. Placebo is as stated in the beginning of this blog a fake pill or fake treatment. Placebo-effect is the efficacy of a drug or treatment administered, which cannot be explained pathophysiologically or pharmacodynamically. The placebo-effect is attributed to other factors, such as the physician-patient relationship or the expectation – of patient, physician or investigator. A placebo-effect can therefore be both an effect of a placebo and a real treatment. I personally think that EVERY treatment and EVERY drug will have either a placebo-effect or a nocebo-effect and so your belief or disbelief will determine whether or not something works. The mind is that powerful.
So no my approach is not a placebo, no fake treatment is used. However, the placebo-effect could be an effect of ANY form of treatment with any potential practitioner. Because you have to believe in it to work and that is the same with my approach. And I think that the belief that something works is the most important thing for any treatment to be successful, no matter what treatment it is.
The attribute of my approach is cognition itself, so it’s hard to compare it to a pill.
The approach is mainly a process of learning how exactly the pain is caused, why it happens and how you can ensure that this pain generation from the nervous system stops.
No physical treatment takes place, so no placebo drug or physical placebo treatment is given. It is purely education and changing neurological patterns. So it really is addressing the roots of the problem.
It is the new knowledge of how mind and body are connected, it is the knowledge of exactly how the pain is generated that gets the job done.
The process is actually reversing the nocebo, not through a placebo drug or placebo treatment, but simply by using the power of the mind to heal the body.
Reversing the nocebo response from the diagnosis you have had about a structural defect with the thereby provided prognosis. Abnormalities such as a herniated disc, bulging intervertebral disc, spinal canal stenosis, osteoarthritis, whiplash, sciatica, RSI, carpal tunnel syndrome, fibromyalgia etc etc. These diagnoses are all characterized by actual physical pain, which is not imagination, there are very real physical changes that are taking place IN the body. And these physical changes cause you pain. But this physical reaction in your body is in most cases caused by chronic stress, tension, life pressure, self-imposed pressure and “negative” emotions that are so unacceptable that they are often suppressed in the subconscious mind. And so in most cases this physical pain is not caused by a structural defect as your doctor tells you. Structural abnormalities are normal and natural and do not necessarily equate to pain.
The fact that during my program physical pain literally disappears without the intervention of the physical body is the proof.
Believing that the pain is caused by a structural defect is the nocebo. When you maintain these thoughts, the pain will remain. Realizing that structural abnormalities in the human body are completely normal and in most cases do not need to cause pain and by taking this as a new truth, you reverse the nocebo you’ve been holding on to all along.
And therefore the result of my program is almost always permanent. No more placebo and no more symptom control, just tackle the deep core of the problem.
So changing what you believe in can make your complaints go away. So you are the placebo yourself.
I am very curious to hear what your thoughts are now; determines what you believe whether something works yes or no? Tell me in a comment below!
(1) J. B. Mosely, Jr., N. P. Wray, D. Kuykendall, et al., “Arthroscopic Treatment of Osteoarthritis of the knee: A Prospective, Randomized, Placebo-Controlled Trial. Results of a Pilot Study”, American Journal of Sports Medicine, vol. 24, no. 1: pp. 28-34 (1996).
(2) J. B. Mosely, Jr., K. O’Malley, N. J. Petersen, et al., “A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee”, New England Journal of Medicine, vol. 347, no. 2: pp. 81-88 (2002); also note, the following independent study showed similar results: A. Kirkley, T. B. Birmingham, R. B. Litchfield, et al., “A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee”, New England Journal of Medicine, vol. 359, no. 11: pp. 1097-1107 (2008).
(3) H. K. Beecher, “The Powerful Placebo”, Journal of the American Medical Association, vol. 159, no. 17: pp. 1602-1606 (1955).
(4) F. Benedetti, L. Colloca, E. Torre, et al., “Placebo-Responsive Parkinson Patients Show Decreased Acitivity in Single Neurons of the Subthalamic Nucleus,” Nature Neuroscience, vol. 7, no. 6: 587-588 (2004).
(5) F. Benedetti, A. Pollo, L. Lopiano, et al., “Conscious Expectation and Unconscious Conditioning in Analgesic, Motor, and Hormonal Placebo/Nocebo Responses,” Journal of Neuroscience, vol. 23, no. 10: pp. 4315-4323 (2003).
(6) F. Benedetti, H. S. Mayberg, T.D. Wager, et al., “Neurobiological Mechanisms of the Placebo Effect,” Journal of Neuroscience, vol. 25, no. 45: pp. 10390-10402 (2005).