The Placebo Effect is the improvement of a discomfort experienced after administration of a non-active substance (without therapeutic effect) or a treatment that has no utility over the ailment or problem.
There is an improvement or even a remission of symptoms (it can be pain, anxiety …). We are not simply talking about the suggestion or psychological conditioning: placebo has a biological, organic basis, so we would like to delve into the issue of what the placebo effect is and how it works.
Placebo Effect and Its Function: Not Just Pills
The first thing to note is that in the placebo they mediated substances like endorphins and dopamine, and they act brain circuits related to emotions and pain. Thus, we do not speak only of perceptions, of emotions … We speak on Biological basis, And we know biology & mind (beliefs, expectations …) are intimately linked.
We are familiar with the use of placebo, for example, in pharmacology: An empty capsule, or an injection of a non-active substance, is given to compare the effect with the treatment being tested (actual pill or injection), without the Whether they receive actual treatment or placebo. For a drug to be useful, it should be significantly better than placebo.
But placebo goes beyond pills or injections. That is why some researchers call it context effect as well. The environment, the way the placebo is applied, the phrases that are said … All this has repercussions in the placebo effect.
This placebo mechanism is well known to charlatans and smokers, who use the power of the situation to generate a placebo effect on their clients, as well says in this entry on the subject.
In ill Cure, we have commented that some fashion techniques, such as kinesiotaping, have quite a placebo effect. Placebos that do not have negative effects are well accepted (remember the famous “Bracelets of balance” that so many improvements promised, and none complied).
In sports, there are Many superstitions and placebos. We can also Remember Homeopathy, Which is Losing Strength in different Countries. When it is tested for its efficacy and found to be no more than placebo.
Placebo and Nocebo
We have described placebo as a beneficial effect that is obtained by applying a treatment or technique that, by itself, has no property to have the therapeutic effect. Let us remember that the situation and the way of applying it are key.
And Precisely There is The Nocebo Effect, which is Opposite: When We Believe That Something Will Hurt Us, and it really increases pain, discomfort and other negative symptoms, but it is a pill, injection or technique that has no effect Of itself (except for the power of the context in which they are applied).
A Study to Illustrate Placebo & Nocebo
There are some curious studies. For example, the one in which healthy subjects received a pill that was said to sleep , and experiencing relaxation and drowsiness, while other subjects in the same study received the same tablet but were told it was to be activated and experienced increased heart rate and alertness.
But let’s talk about an even more striking study (New York, 2011). In it, a powerful opioid analgesic (remifentanil) is applied under different conditions.
Subjects were subjected to painful stimulation (using a laser). An intravenous line was injected with saline or the drug. It also varied what they were told (they were told that medication was or was not). This generated four conditions:
1) Baseline. Application of saline.
2) The medication (Remifentanil) is applied without the subject expecting it.
3) The drug is still applied, but now the subject is expecting it because it has been told that it will receive.
4) The medication continues, but the subject is told not to receive it (negative expectation).
In the graph, extracted from that study, we can see the four conditions. In the baseline, there is a pain, almost 70 on a scale of 0 to 100. It is understandable since they are receiving saline, nothing more.
But, from there everything is striking. In the second phase, the subject already receives the medication, which is a potent opioid that provides strong and rapid analgesia (used in some surgical operations). but, the decrease of pain, although it exists, is not great (it happens to about 55 points).
In the third phase, the subject already receives the medication, but now he is told that, effectively, he will receive medication and will experience less pain. Although the medication is the same as in phase two, now the decrease in pain is more important thanks to the positive expectation (drop to about 40 points).
And in phase four, we see the nocebo effect: subjects receive medication, But are Told No. They are not getting anything that has an effect, they are going to experience pain. In effect, they experience pain, and the potent medication does not diminish anything the intensity perceived (70 points).
Logically the study is much more detailed. The study controls the variables & conditions. So that the effect of medication does not accumulate and does not influence the different conditions. I have summarized it quite a bit, but I think it is quite illustrative by the results it throws about the importance of expectations. And the context and potency of the Placebo / Nocebo Effect.