“If the placebo effect operates by fooling the brain, why does it require deception if the brain can supposedly resolve the problem independently?”
In: Biology
Placebo effects can improve how you feel based on believing you’ll get better. It’s almost like the ‘amount of belief’ is like the ‘dosage’ of medicine for how much you’ll feel better. There are different ways to increase that ‘belief dosage’ but one of the strongest ways is through deception, by telling or somehow showing you that you are taking a powerful treatment. It doesn’t just have to be a medication: placebo surgery or injections can have quite a strong placebo effect because they ‘show’ us how strong the treatment must be.
However, the ‘dosage’ is not actually based on deception, that just happens to be a convenient way to get a strong belief, but you can also get that without deception, which is sometimes called ‘open placebo’. This involves telling people truthfully that they’re taking a placebo, but also telling them correct information about how incredibly strong placebo effects can be and explaining how they work in the mind and body, particularly if that’s supported by an expert person presenting real evidence of studies or videos from people explaining that it really does work. Don’t forget, the ‘dosage’ is the belief, it’s just that usually telling people they’re receiving a placebo reduces rather than increases belief. There’s evidence this works well for some situations (like IBS, pain, or other symptoms) and may not work so well in others (like wound healing) although more research of actually generating a strong belief without deception is needed (that’s quite hard to do, including for the scientists doing these studies).
There is another way to generate placebo effects that can be very strong too: ‘conditioning’, which means learning by association. For example, a study gave people a weird drink with a strong medicine and then measured their blood: as predicted, they had measurable immune changes when taking the drug, but they ALSO showed measurable changes in their blood after they did this for a while then had ONLY the weird drink without the actual drug.
Belief (whether deceptive or open) and conditioning are just two proposed mechanisms for placebos to work and there may be other reasons too. Also placebos are complex and it’s still unclear how much they lead to just feeling better vs measurable body changes, though there is certainly evidence of physical changes to the body in some specific situations.
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