20 February 2004

---Why the Placebo Effect and Kind Words Heal

I have always observed patients in pain who consult in the clinic and after spending sometime talking, leave smiling with an uplifted spirit and feeling less or none of the pain he/she came for.

In several studies involving double-blind trials, in which a particular new drug has to be tested, some patients are given a new drug, and others are given a placebo - but none know which they are getting. Technically speaking, a patient given placebo should not improve or note any significant symptom alleviation but in most cases, they do improve and even get well. This is known as the placebo effect, and is probably associated to the psychological boost a patient experiences if they believe - albeit mistakenly - that they are being treated with effective drugs.

I think that a similar effect takes place when a doctor talks sympathetically to a patient in pain.

A patient in pain is usually depressed, what with all the torment he/she has been feeling acutely or chronically. Prognosis of course, is worse in chronically-ill patients, but sometimes the placebo effect still manages to spring a welcome surprise.

Dr Gisele Chvetzoff, of the Centre Leon Berard in Lyon, France, and Dr Ian Tannock, of the Princess Margaret Hospital in Toronto, Canada, writing last month in the Journal of the National Cancer Institute, examined nearly 50 clinical trials that involved the use of placebos. In some trials as many as 21% of patients given a placebo reported a reduction in pain, or decreased use of pain medications. Up to 27% showed an improvement in appetite, and up to 17% actually gained weight.

What can possibly explain the improvement in well-being of these patients?

It is my opinion that all persons are born with an INNATE HEALING PROCESS. Constant pain in whatever form, diminishes this inherent capability to heal oneself. Fear and sadness add more to the cordon that prevents the individual to heal him/herself. But when something jolts or breaks that cordon (could be placebo or a friendly talk with a doctor), the person’s healing process kicks into high gear and he/she gets healed… sometimes instantly, other times, in a matter of days.

Dr Tor Wager, lead researcher of a study published in Science, has confirmed that a drug's effect can be enhanced if a patient believes it will work. So, the key word here is belief. I think it is the patient’s faith or belief that he can get well that fuels his innate healing process to work.

Controversy has surrounded this claim in the past, with suggestions that patients’ reports have been biased, but now the recent study done by Dr. Wager was able to map the area of the brain affected by pain. The researchers used functional magnetic resonance imaging (fMRI) on volunteers brains to map changes in blood flow. When an area of the brain is excited, blood and oxygen flow increases, allowing scientists to see which area of the brain is being used.

Volunteers were exposed to electric shocks and heat, and activity was noted to increase in the orbitofrontal cortex, an area which is also responsible for anxiety. When placebo was given, activity in this area was significantly reduced.

Dr Wager said this is proof that a placebo can alter the experience of pain.

To illustrate all these findings, I think this is what happens:

1.) Anticipation of Pain = Anxiety = Increased Pain Perception
2.) Belief or Anticipation of a Cure (Placebo or Kind Words) = Feeling of Contentment = Decreased Pain Perception or Alleviation of Symptoms

Further studies on this subject I think will point us to better ways and methods of combating pain and disease.



Finally it’s my first time to do a Friday Five, my own version. I’ve seen how this was done once or twice, and I’d like to give it a try. Here goes…

1.) What’s your existing state of mind?
Stressed out but feeling great. I feel like I have to be on constant vigilant mode. I have to be sharp and sensitive. I have to react wisely to the problems life is throwing in my court.

2.) What are your favorites currently?
CD: Norah Jones (Feels Like Home) and Josh Groban (Closer)
Book: Brian Greene (The Fabric of the Cosmos)
Scent: J.Chemie
Food: Salmon Teriyaki
Restaurant: Café Capreal
Dessert: Almond Torte
Drink: Pure Batangas Cacao and Columbian Coffee
Snack: Gardenia Raisin Bread

3.) What single best achievement can you claim the past year?
Acceptance of things I cannot change. My soulmate will disagree vehemently. But I think that is my greatest achievement. I have accepted my mother’s demise. I have not cried yet…but I’ll get there…may be next year that will be my greatest achievement.

4.) What proverb or quotation best fits your outlook for the future?
"A man should hear a little music, read a little poetry, and see a fine picture every day of his life, in order that worldly cares may not obliterate the sense of the beautiful which God has implanted in the human soul." - Johann Wolfgang von Goethe

5.) If an adolescent were to ask you for a single piece of advice to guide them through life, what would you say?
Love your parents. Hold them dear in your heart. Whether they have been good or bad to you is irrelevant, they were instrumental in your introduction to the world. Love them, hold them, hug them, and kiss them! When they leave for good, you’ll miss them terribly. Tell them you love them while they can still hear you and appreciate your care and love.

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