Placebo Effect Related Quotes

Our analyses of the FDA data showed relatively little difference between the effects of antidepressants and the effects of placebos. Indeed, the effects were so small that they did not qualify as clinically significant. The drug companies knew how small the effect of their medications were compared to placebos, and so did the FDA and other regulatory agencies. The companies found various ways to make the data seem more favorable to their products, and the FDA helped them keep their negative data secret. In fact, in some instances, the FDA urged the companies to keep negative data hidden, even when the companies wanted to reveal them. My colleagues and I hadn't really discovered anything new. We had merely revealed their 'dirty little secret'.

The neurological research shows something truly remarkable: If a person keeps taking the same substance, his or her brain keeps firing the same circuits in the same way—in effect, memorizing what the substance does. The person can easily become conditioned to the effect of a particular pill or injection from associating it with a familiar internal change from past experience. Because of this kind of conditioning, when the person then takes a placebo, the same hardwired circuits will fire as when he or she took the drug. An associative memory elicits a subconscious program that makes a connection between the pill or injection and the hormonal change in the body, and then the program automatically signals the body to make the related chemicals found in the drug. . . . Isn’t that amazing? Benedetti

If you’re like most people, a string of nerve-racking incidents keeps you in fight-or-flight response—and out of homeostasis—a large part of the time. Maybe the car cutting you off is the only actual life-threatening situation you encounter all day, but the traffic on the way to work, the pressure of preparing for a big presentation, the argument you had with your spouse, the credit-card bill that came in the mail, the crashing of your computer hard drive, and the new gray hair you noticed in the mirror keep the stress hormones circulating in your body on a near-constant basis. Between remembering stressful experiences from the past and anticipating stressful situations coming up in your future, all these repetitive short-term stresses blur together into long-term stress. Welcome to the 21st-century version of living in survival mode. In fight-or-flight mode, life-sustaining energy is mobilized so that the body can either run or fight. But when there isn’t a return to homeostasis (because you keep perceiving a threat), vital energy is lost in the system. You have less energy in your internal environment for cell growth and repair, long-term building projects on a cellular level, and healing when that energy is being channeled elsewhere. The cells shut down, they no longer communicate with one another, and they become “selfish.” It’s not time for routine maintenance (let alone for making improvements); it’s time for defense. It’s every cell for itself, so the collective community of cells working together becomes fractured. The immune and endocrine systems (among others) become weakened as genes in those related cells are compromised when informational signals from outside the cells are turned off. It’s like living in a country where 98 percent of the resources go toward defense, and nothing is left for schools, libraries, road building and repair, communication systems, growing of food, and so on. Roads develop potholes that aren’t fixed. Schools suffer budget cuts, so students wind up learning less. Social welfare programs that took care of the poor and the elderly have to close down. And there’s not enough food to feed the masses. Not surprisingly, then, long-term stress has been linked to anxiety, depression, digestive problems, memory loss, insomnia, hypertension, heart disease, strokes, cancer, ulcers, rheumatoid arthritis, colds, flu, aging acceleration, allergies, body pain, chronic fatigue, infertility, impotence, asthma, hormonal issues, skin rashes, hair loss, muscle spasms, and diabetes, to name just a few conditions (all of which, by the way, are the result of epigenetic changes). No organism in nature is designed to withstand the effects of long-term stress.

Many years later, research by Keiko Hayashi, Ph.D., of the University of Tsukuba in Japan showed the same thing. 12 In Hayashi’s study, diabetic patients watching an hour-long comedy program upregulated a total of 39 genes, 14 of which were related to natural killer cell activity. While none of these genes were directly involved in blood-glucose regulation, the patients’ blood-glucose levels were better controlled than after they listened to a diabetes health lecture on a different day. Researchers surmised that laughter influences many genes involved with immune response, which in turn contributed to the improved glucose control. The elevated emotion, triggered by the patients’ brains, turned on the genetic variations, which activated the natural killer cells and also somehow improved their glucose response—probably in addition to many other beneficial effects. As Cousins said of placebos back in 1979, “The process works not because of any magic in the tablet, but because the human body is its own best apothecary and because the most successful prescriptions are filled by the body itself.

Kirsch admits that placebos and hypnosis are not the same. But they both tap into a deep force in the brain: expectation. “When you are doing something that affects people’s expectations, you are changing things in the brain in a way that’s related to fundamental function of the brain,” he tells me. “That may in fact make placebo effects paradigmatic of how the brain produces experiences.” Remember, the brain is an expectation-prediction machine. Kirsch observes that hypnosis, like placebos, messes with the very purpose of your brain. Thus, while they are certainly separate phenomena, their differences probably aren’t as important as their similarities—which in turn gives us a glimpse of the very fundamentals of consciousness.

What people said about their pain tracked perfectly with the activation of several parts of the brain associated with pain, such as the anterior cingulate cortex (which plays a role in emotions, reward systems, and empathy), the thalamus (which handles sensory perception and alertness), and the insula (which is related to consciousness and perception). Those reporting less pain from the placebo effect showed less activity in key pain-related brain regions. And those who felt less of the placebo showed more. People were not imagining less pain; they were feeling it.