In an interview with CBS New York, Dr. Ted Kaptchuk, an associate professor of medicine at Harvard University who has been studying the placebo effect for most of his career, says there’s a reason why people feel better after ingesting a phony pill.
In this article appearing in Harvard Magazine a few years ago, he says that placebo treatments – which are interventions involving no active drug ingredients such as sugar pills or saline solutions, can stimulate real physiological responses, from changes in heart rate and blood pressure to chemical activity in the brain, in cases involving pain, depression, anxiety, fatigue, and even some symptoms of Parkinson’s.
These “sham” treatments can make people feel amazingly well – good enough to think they’ve been healed.
But they haven’t.
Several years ago, Kaptchuk conducted a randomized clinical drug trial on people who were experiencing severe arm pain from conditions such as carpal tunnel and tendinitis. Half of the subjects received pain-reducing pills; the others were given acupuncture treatments. In both cases people began to call in, complaining about the effects of the pills – which some said made them sluggish – and the needles which others said had left them sore. But the most astounding finding was that most of the other patients repeated real relief – both those who received the pain-relieving pills and those who received acupuncture. In fact, those who received acupuncture reported even more relief than those who took the painkillers. So did this prove, for the first time ever, that acupuncture works better than conventional medicine?
Not exactly. The reason is because, unknown to both groups, they each received shams. The patients given painkillers received pills made out of cornstarch and those who received acupuncture received a sham version where the needles never actually pierced the skin.
As it turns out, the study wasn’t designed to test two treatments – it was designed to test two shams.
So what gives?
That's what Kaptchuk and his team are continuing to study. They want to uncover the mechanisms behind these physiological responses – learn what is happening in our bodies, in our brains, in cases involving the placebo effect. He has found that even the method of placebo delivery (pill or needle, for example), where the treatment takes place, how kind or unkind is the doctor administering the treatment, etc., an impact the placebo effect.
“The placebo effect is actually many effects woven together—some stronger than others,” the article reports, and this is what Kaptchuk and his team are trying to figure out.
If anything, it’s valuable insight for any caregiver to know that patients’ perceptions matter and can have significant effects on their health.
It’s also valuable insight for consumers of alternative medicines who swear a bogus treatment is working in spite of clinical testing that says it’s a sham. It’s also why consumers are cautioned not to rely on “testimonials” when considering whether or not to use an alternative.
But even though placebos can cause a person to feel better, there’s a limit to the placebo effect.
“We’re not gonna shrink a tumor with a placebo pill,” Kaptchuk told CBS.
But for some conditions, it could fundamentally change the way patients are treated.
“Instead of putting people on drugs for long periods of time, if a placebo was going to work, that’s probably where you want to start,” Kaptchuk said.
More studies on the placebo effect will begin at Harvard later this spring.