How I use the Placebo effect in practice

I'm a closeted crystal and colour therapy user. I don't really care much how they work, or even that it's been shown by science to be nothing more than placebo. All I care about is that I end up feeling better. If I was given the option between antibiotic and a placebo for a cold, I'd take the placebo anyday. In fact, I'd rather have a placebo than most medications and if I ever got a life-threatening sickness for which there is no known cure (god forbid); placebo please! Wanna know why?

Placebo's work and they don't have side effects!

I'd love to see an option on a GP registration form one day that said "are you happy to receive placebo's?". I'd certainly tick yes. The tricky thing about using placebos is informed consent but this would eradicate that problem. There are quite a few curious things about placebos and the way they work. One of them is that even when you KNOW you're getting a placebo, it still works! Crazy right? You don't even have to believe it will work for it to work. In fact, it's more important that your doctor thinks it will work than you do! (Benedetti, 2008)

How I use the Placebo effect

  • I don't use herbs or advice which I don't think will work
  • I ALWAYS try to finish consultations with some kind of positive affirmation of how effective the herbs will be (whilst trying to be realistic too)
  • Sometimes, when I stop making progress with a patient, I take their remedy and put it in a smaller bottle and say it's "strong" and should be careful not to exceed the dose I've mentioned. Often, the exact same herbs that weren't working before start to help (if it doesn't help it gets changed within the week).
  • I tell patients openly that I want to use placebos to strengthen their medicine, and it does, without necessarily having to change anything.
  • I work with each patients own beliefs of what makes their medicine stronger. So if they think tinctures are stronger than teas, I sure as heck give them a tincture if !

The nocebo effect.

Generally people haven't heard of this as much. It's the opposite of the placebo effect in the sense that when you DON'T believe something will work, you can stop it from working. So let's say your doctor hands you a medicine they've seen work countless times before but says to you "here's your medicine, I don't have high hopes it'll work, so come back in a week". Well, it wouldn't exactly fill you with optimism would it? It's not all too surprising when it turns out that it doesn't work. In fact, I actively avoid treating patients who think herbs don't work because they could possibly stop perfectly good herbs from working because of it! People who think it may or may not work and are open to possibilities is another matter of course.

The ethics of placebos

The most obvious problem with placebos, after informed consent, is that a placebo could be given INSTEAD OF a life saving treatment. I don't think this is how placebos should be used. It's my belief that they should be an option for last-resort treatment protocols after having received consent from the patient. I also believe that we should be aware of the way our beliefs and actions effect the effectiveness of treatments we supply as therapists and utilise this knowledge to our benefit without manipulating the patient. To ignore the information we've acquired of the placebo effect and its deeper connotations of how the healing dynamic works between therapist and patient is short sighted and cold hearted.

It seems placebos are often seen as a negative thing because a placebo is thought to do nothing. But we know that isn't the case. I hope with time we will see a shift towards utilising this incredible resource instead of pushing it aside.