If the placebo effect works by tricking the brain, why does it need to be tricked if it’s apparently able to solve the issue on its own?
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Because it doesn’t know that it can. Your brain focuses on the thing that’s the most important, and ignores everything else. You can see that when you’re riding in the car – you might remember some highlights of the drive, but you won’t remember every detail. If pressed, your brain might even fill in fake details, based on best guesses and context clues.
The placebo effect works because the brain is filling in information based on context clues – it knows that medicine makes whatever is causing the pain to go away, and you took medicine. Therefore the pain is no longer needed. The second you become aware that it’s a placebo, though, then the brain will correct for that new information – you didn’t really take medicine, so the pain is still needed until you solve the problem.
The thing is, the brain _can_ turn off the pain signals whenever it wants. It sends those signals because they’re important at the time. Sometimes when the pain is overwhelming, or something else seems more important (or even just more interesting), the brain will turn off the pain signals anyway. But as long as your brain thinks that the pain signals are important, they will be noticable.
The placebo effect works based on belief. The reason it works is because the brain believes it will work. If you eat a gummy bear and tell your brain to believe it’s aspirin, it won’t work because you know you’re lying to yourself. You don’t believe yourself. You can’t lie to yourself but others can
The placebo effect is complicated and difficult to study. Unfortunately, it’s not possible to make any absolute and certain statements, since this is an area of ongoing medical research. We can only say what seems currently likely.
Relatively recent research suggests that the placebo effect has been overestimated; some of the foundational studies that “established” the placebo effect failed to account for certain factors, such as regression to the mean.
“Regression to the mean”, in practice, is the really simple fact that most patients get better. Even if they have a disease that is permanent and the body can’t fix it, people have ups and downs within that context; and they tend to be going to get treatment when they’re in the “downs”.
There does appear to be some amount of small measurable effect. It’s strongest in subjective measures; in particular, in pain. This makes sense as the *experience* of pain is fundamentally a neural phenomenon, something that is happening in the brain. It is well known that mental state significantly affects pain – it’s why people can ignore pain during a fight, for example. Things like stress, comfort, etc. have a major effect on pain.
There’s little (but not zero) current, verified evidence that the placebo effect can significantly affect “physiological” issues.
I think there are a number of things going on and they are at the interface , if you like, of subjective experience and autonomic (involuntary) function. It’s worth bearing in mind (no pun intended) that consciousness is only one part of what makes us , us… how we experience ourselves – but we are our in fact our *whole* body and that body works sometimes with conscious choice and other times without with a very blurred line in between.
One of the things that placebo has the most effect on if how we consciously experience or interpret our pain – our emotional state can influence this. Secondly, we are not just our conscious experience we are our autonomic ( involuntary) systems that are not generally under voluntary *conscious* control but can still be stimulated to work involuntarily by things like expectations – even expectations or other signals we aren’t very aware of. In this way placebos may stimulate hormone production ( also connected to pain) or immune responses but it’s limited to what the body already can do under the right conditions rather than for example simply ‘cure’ cancer.
Im not sure I’m doing a great job of explaining simply but you have to realise that our consciousness is only one part of ‘us’ and our body can be prompted to internally produce certain biological effects without the conscious part being fully aware of what’s going on. Harnessing those ‘prompts’ , exploring the definite limits and the best way to use these processes is something we are studying.
The placebo effect is strongest for disorders that exist in the brain – depression, anxiety, chronic pain, etc. There’s zero placebo effect in advanced cancer.
When you do a clinical trial of a new drug for depression, you generally have a nurse tell all trial patients that they should exercise and get therapy. Those two things are pretty effective, even for the placebo group.
Humans are social creatures. Pain, crying, calling for help, we do these things when we need assistance.
When our brain is convinced we received that assistance, the pain has served part of it’s purpose, so it dials it down.
It doesn’t matter if that perceived assistance comes from the attention of a parent, a doctor, actual medicine, or “fake” medicine. We received help, that’s what counts.
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Because it doesn’t actually solve any issues, just how the patient/doctor reports. It has zero effect on anything that can be objectively measured. It’s a mirage.
One part of the placebo effect is how it affects the researchers. These scientists are observing the patients, taking the measurements, interpreting the measurements. As logical and methodical as they try to be, they too are affected by an expectation to see results when a treatment is given. This biases them towards reporting better results of treated patients.
This is why in a double-blind trial, no one knows who has received the treatment and who hasn’t until the results have been compiled into unambiguous numbers.
*There is no spoon*
Explain like you’re 5, ok.
The placebo effect won’t fix a broken arm.
The placebo effect might fix a problem created by your imagination.
Let’s say that you really really believe you’re allergic to electricity. Every time you go near electricity, you act as if it’s making you sick.
You’re training your brain that when you go near electricity, you’re supposed to feel sick, so eventually… you DO start to feel sick when you’re near electricity, because that’s what you’ve trained your brain to do when you’re near it. Then you TRULY start to believe that you’re allergic to electricity, because your body actually is reacting on its own.
But then your younger brother hides a cell phone in your pocket, you don’t know it’s there, you don’t feel sick until he tells you about it- because again, your brain isn’t making you sick because of the electricity, it’s making you sick because that’s what you’ve trained it to do when you *know* that you are near electricity.
If I gave you a vitamin and told you that it would remove the feelings of sickness when near electricity, and you believed me… you might take this vitamin, telling your brain “brain, when I eat this, it keeps me from getting sick around electricity”. Your brain goes “well, ok, I guess when you eat that vitamin, you won’t get sick near electricity”.
Even though the vitamin actually does nothing, YOU are giving your brain an exception to the rule YOU created for it.
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