Placebos and the Mind Body Relationship

When a product seems more enticing and more enjoyable because of a particular brand name, label or expectation, when an individual meditates, when a sugar pill has the capability of ailing a pain: these are all examples of a phenomenon called the placebo effect. The placebo effect is traditionally a deception of the mind, involving the application of a non-pharmacological drug or procedure that results in the improvement of ones health. Why this phenomenon occurs, is an unanswered question which is difficult to medically understand. What takes place in the body and what causes this phenomenon to occur? How deep is the connection between mind and body? To what extent can mind control body on internal, physical, involuntary levels?

The theory of the placebo effect is a relatively new concept, which the field of neuroscience has only come to except within the past 30 years. (3) Placebos were first introduced as an alteration of merely the psychological aspect of the mind with no physical side effects of the brain. (1) For example if a woman with depression were to take a sugar pill, believing it contained active medical properties, and began to feel better the phenomenon was explained by a change in her psychological state. The act of believing that she would feel better led her to recovery. Over the years studies were conducted surrounding the placebo effect where doctors and scientists found a plethora of viable evidence which upheld the notion that physical alterations can occur within the brain as well as a change in psychological state. (1) Between 30% and 75% of patients undergoing tests on placebo drugs are believed to feel the mental and physical benefits. (5) The mere act of believing that something will be true can both mentally and physically modify brain structure.

If a patient experiences pain, and then a fake pain reliever is administered, their perception of pain intensity can be reduced through the power of placebos. A study was conducted in 2005 by a team of researchers at Michigan University regarding pain analgesia and its effects involving placebos. A group of 14 male volunteers between the ages of 20 and 30 were subjected to induced pain. Then a solution was injected into the site of the pain. The patients were told the solution was an analgesic, when in actuality it was merely a saline solution with no known pharmacological effects. All the men were monitored through an fMRI and their brain activity was analyzed as the test was conducted. In addition to being monitored by the fMRI, the volunteers rated their pain on a scale of 0-100 every 15 seconds throughout the experiment. (2)(1)

9 of the 14 volunteers were reported as high placebo responders, meaning they felt a significant decrease in pain after the placebo was administered. Within this group of 9 high placebo responders, not only did they report a decrease in pain with the fake analgesic, but their brain activity changed. An increase in blood flow was reported in the regions of the brain which are associated with pain: the dorsal anterior cingulate and the right interior insula. These regions also displayed an activation of µ-opioid receptor-mediated neurotransmitters (endorphins), creating a chemical alternation that physically reduced pain by blocking impulse transmission between cells. (2)(1) The patients’ experience of pain decreased, correlating with the fMRI’s evidence of physical changes.

This study shows the relationship between the mind and body. How much of our body can our mind control? An expectation of pain relief led to a chemical alteration in the brain which physically altered pain receptors. An involuntary function was readily controlled by the power of the mind and the power of expectation.

The placebo effect also spans outside medicinal realms. Studies in social behavior show that when products are advertised in positive ways and when initial expectations are created the consumer’s experience of a product is enhanced. A study was conducted in 2005 which tested the prices of energy drinks and how consumers’ workouts were affected. Volunteers were split into two groups. One group was told that the energy drink was the company’s newest product and it cost $2.89. The second group was told that the energy drink was offered to them discounted from an outlet at $0.89 a bottle. After both test groups drank the product and worked out, they evaluated their workout. Overall, those in the first group experienced a more energetic and efficient work out, while participants in the second group were more fatigued and didn’t experience the same energy levels. All participants were asked if the price of the drink affected their work out and not one person said yes. (4)

Subconsciously, our minds and bodies expect a level of quality depending on the price that we are paying. This is a form of the placebo effect. Our expectation alters and often enhances our experience in the consumer world just as it does in the medical world.

Why and how this phenomenon occurs scientists are not fully aware, but several theories offer explanations. One explanation is based on practice. If a patient has taken a real medicinal pill before and experienced a positive outcome, or undergone surgery and recovered, then his mind is practiced or trained to believe and expect that a pill or a surgery will cure an ailment. In a sense, the mind is conditioned to be a high placebo responder. (5) Another explanation correlates with the analgesic experiment described above, where an expectation brings a patient to a specific state of mind that releases endorphins in the blood stream, much like what happens when you exercise. This release in endorphins causes the blocking of receptors in the brain, lessening pain. (5)(1)(2) A third theory is based on the release of stress. If a patient takes a pill the expectation of a positive outcome relieves stress on the body. The relief of stress has the power to relieve symptoms and cause chemical changes within the body. (5)

Even though the exact process of the placebo effect is unknown, there is one principle that weaves itself through each theory: expectation. In each case, it is the expectation of results that causes the placebo effect. Expectation has the ability to alter ones experience. In the case of the analgesia experiment, the expectation was the relief of pain. In the power drink experiment the expectation came from the amount of money spent on a product. If it is merely the expectation that triggers the minds power to control the involuntary systems of our bodies, then the more we expect the more positive results will be seen? The bundle of secrets that are wrapped tightly in the phenomenon of placebos is part of a larger discussion on the mind-body relationship. Placebos insinuate that we as humans have more control through our minds and bodies then currently believed.

Sources:

(1) Placebo Effects Mediated by Endogenous Opioid Activity on µ-Opioid Receptors

http://www.jneurosci.org/cgi/content/full/25/34/7754?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=or&andorexacttitleabs=and&fulltext=Placebo+&andorexactfulltext=or&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

(2) Turns Out Placebo Effect Is All in Your Head

http://pn.psychiatryonline.org/cgi/content/full/40/19/26

(3) Neurobiological Mechanisms of the Placebo Effect

http://www.jneurosci.org/cgi/content/full/25/45/10390

(4) Placebo Effects of Marketing Actions: Consumers May Get What They Pay For

http://web.mit.edu/ariely/www/Papers/Placebo1.pdf

(5) The Placebo Prescription

http://www.nytimes.com/library/magazine/home/20000109mag-talbot7.html