Thinking so, makes it so
Posted by Henry Bauer on 2009/05/16
Talk about “placebo-controlled trials” is too easily taken to imply that “placebo” means “doing nothing”. That is far from true. In reality, placebo describes the phenomenon that unconscious and not-understood emotional or mental processes can produce powerful physical effects. A person given a dummy pill and told that it is a drug will often experience the feelings that the drug would induce. Someone given a drug that lowers blood pressure, say, who is told that it raises blood pressure, may actually experience a rise in blood pressure: “placebo” can actually be more powerful than physical medication.
Mainstream disciplines are beginning to recognize the power of the placebo response. The National Institues of Health held a workshop in 2000, “The Science of the Placebo: Toward an Interdisciplinary Research Agenda”. Several books by doctors, historians, and psychologists have reviewed what little is understood about the matter:
Arthur Shapiro & Elaine Shapiro, “The powerful placebo — from ancient priest to modern physician”, Johns Hopkins, 1997
Anne Harrington (ed.), “The placebo effect–an interdisciplinary exploration”, Harvard, 1997
Howard Brody with Daralyn Brody, “The placebo response: how you can release body’s inner pharmacy”, Cliff Street Books, 2000
Whereas the term “placebo” is widely recognized, its opposite, “nocebo” is not. Logically speaking, however, it seems likely that, if thinking one’s health will improve can tend to make that happen, thinking one’s health is declining can tend to make that happen.
Perhaps the best known such phenomena are in voodoo, where such rituals as sticking pins into an effigy representing an actual person can cause harm to that person, and in the Australian aboriginal ritual of bone-pointing, where a person waking to find a certain arrangement of bones in his vicinity recognizes it as death-causing and subsequently does die. Our culture tends to admit some efficacy for the placebo response but to consign nocebo as effective only among primitive people. Logically speaking, though, whatever mechanism can translate belief into physiological action can surely do it in both directions. A recent article in the New Scientist is a sensible discussion of nocebo with a few examples:
Helen Pilcher, “The science of voodoo: when mind attacks body”, 13 May 2009.
Nocebo is of clear pertinence to “HIV/AIDS”, given the psychological impact of a diagnosis of “HIV-positive” or of “AIDS”, as several AIDS Rethinkers have emphasized at various times — Michael Ellner, Charles Geshekter, Neville Hodgkinson, Michael Geiger, Casper Schmidt, among others. But while a few mainstream researchers are taking placebo seriously, that remains to happen with nocebo.