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Placebo effect - explanation and examples
contents
- Explanation for the placebo effect?
- Sham operations and pill size
- The emotional brain
- Two phases of pain
- Placebo effect increases the effect of real medications
- Doctors and the placebo effect
- homeopathy
- An old story
- Placebos against phobias
- Religious ritual and placebo
- references
This placebo effect has been proven in various studies. Today we know that the organism supplies the patients with neurotransmitters and hormones in such situations - the belief in the effect of an ineffective treatment triggers the self-healing of the body.
The placebo effect has been shown to have an effect that is essentially due to the self-healing powers of human Oranism. (Image: Sashkin / fotolia.com) Conversely, there is also the nocebo effect: who is convinced that a treatment, a drug or an operation have bad effects, in which intensifies the pain, delayed healing or the symptoms even worse.
Explanation for the placebo effect?
Today, neuromedicine is a good way to explain how the placebo effect relieves pain: pain is not immediately felt in an injured area, but the peripheral nervous system and the spinal cord send the information "pain" to the brain. The brain has a memory of pain. In other words, depending on how we are conditioned, the brain allocates pain to be stronger, weaker, or not at all.
The body's own drugs release hormones and neurotransmitters in the brain that regulate the signal "pain". The opioids of the body are based on the same switching points as artificial painkillers. The happiness hormone dopamine can be triggered by the placebo effect, while cholecystokinin triggers anxiety and is released by the nocebo effect.
Normally, the pain at the wound comes about, and the information moves in no time to the brain, which responds to the pain. In placebo, on the other hand, the prefrontal cortex expects relief of the pain. Therefore, it sends signals to the areas of the brain where the opioids form and run through the spinal cord to the wound. The affected people do not displace the pain, but they actually alleviate it.
Sham operations and pill size
Even sham surgery works in some patients. With pseudo-drugs, many small pills work better than a large one. And the same rule applies as with branded products: the more expensive the ineffective pills are, the more effective people think of them.
In addition, placebos also have a negative effect. For example, patients choked their stomach contents after taking an alleged emetic.
The emotional brain
Neurologist David Servan-Schreiber believes that more than half of all doctor visits are caused by stress. And the majority of Western medicines are used to relieve stress related symptoms: antidepressants, tranquilizers, antacids for heartburn, high blood pressure and high cholesterol. Alcohol is also a means to deal with stress and depression.
At the same time the limbic brain regulates emotions, and with it an almonds kernel, from which fear reactions proceeded. This "emotional brain" controls heart function, blood pressure, hormones, the digestive and immune system, breathing, appetite, sleep and libido. The "killer cells" of the immune system are controlled by the emotional brain. So while positive emotions such as rest or well-being activated them, anxiety, stress and depression would inhibit them. This emotional brain has the ability to heal the body itself, and it can be "programmed," says Servan-Schreiber. For programming, old well-known methods can also serve: the stitches of acupuncture needles would deactivate the pain centers.
Neuroscientist Benedetti says, "The interaction with the doctor, the doctor's office environment or the clinic with their typical smells and sounds - all these are strong sensory stimuli that the patient associates with a therapeutic action."
Two phases of pain
The placebo effect takes place in two phases, first expectation and secondly learned reaction. First, the network comes into action, which prevents the pain stimulus from reaching the brain, then slows down the activity of pain-processing brain regions. There is not a placebo effect, but a variety, says Benedetti. And it depends on the previous conditioning, which biochemical mechanisms take place.
To place a placebo painkiller different neurotransmitters, depending on which analgesic patients had previously received - were affected by morphine habitants, the body launched opioids. In Parkinson's patients, up to 200% of free dopamine in the body increases when using placebos.
When drugs are significantly more noticeably injected, the placebo effect enhances their effectiveness, while an inconspicuous computer-guided injection does not. (Image: arcyto / fotolia.com) Placebo effect increases the effect of real medications
Benedetti also examined how the stimuli of medical treatment affect the effects of medication. Thus, patients with postoperative pain received their analgesics either openly by a physician or concealed via a computer-controlled injection pump. The result was clear: For all analgesics tested, the hidden injection had less effect. In the case of open injection, the expectation already releases messengers, and they occupy the same receptors as the analgesics, says Benedetti. The same was true in time: at the medical infection the pain eased immediately, with the concealed it took much longer. According to the researcher, Benedetti's experiments can be used to test when drugs are pharmacologically and psychologically effective.
Doctors and the placebo effect
Scientists at the Institute of Medical Psychology of the Ludwig Maximilians University (LMU) Munich use the placebo effect purposefully. The doctor working there, Karin Meissner, is aware, for example, as a scientist, that acupuncture is of little use objectively, but she still uses it successfully against symptoms such as hay fever.
Studies at the LMU institute showed that it does not matter if doctors place the needles after the "energy meridians" of Traditional Chinese Medicine or distribute them on the skin without any pattern. The result stunned: the needles worked in both cases. Meissner explains this with the placebo effect. Thus, the expectation of the patients and the circumstances, such as the confidence and reassuring words of the doctor.
US medical professor Ted Kaptchuk gave patients placebo pills for irritable bowel syndrome in 2010 and even told them beforehand that it was placebos. Nevertheless, the symptoms of placebo-treated patients improved significantly over subjects who did not receive treatment. Doctors, psychologists and neurobiologists therefore focus on involving and educating patients. The neurologist Ulrike Bingel says: "The patient has to understand the meaning of a therapy."
The placebo effect also plays a significant role at the doctor's visit and physicians should take advantage of this. (Picture: Picture-Factory / fotolia.com) So instead of giving patients placebo without knowing it, physicians should explain to the person concerned exactly that it is placebos, how the brain produces messengers and hormones, and why the patient's positive attitude affects the outcome. The American physician Jo Marchant considers such a self-healing to be all the more successful, the more accurately a person imagines his healing. He could, for example, literally imagine how a wound closes, how knee pain ends or how he can walk again. By the way, such precise healing pictures teach shamans worldwide.
Second, trust in the attending physician is crucial. Therefore, patients should rely on their "gut feeling". When friends trust a physician, it is transmitted to those affected, because the brain does not differentiate between their own experiences and other people's information. In addition, if friends support the patient, this promotes the placebo effect. The brain then spills oxytocin.
In placebo pills, but also in drugs that actually act chemically, the effect increases through rituals. This can mean to always take his "medicine" in the same place at the same time, to use a certain glass for rinsing or even to design a "solemn" act.
homeopathy
A well-cited example of the placebo effect is homeopathy. Here, substances are diluted so much that they are chemically no longer present. Successes in curing diseases are attributed to the placebo effect, especially by critics of homeopathy. An accusation energetically contradicts the practicing homoeopath, although a therapeutic application of the placebo effect may seem reasonable.
Homeopathy is considered one of the most controversial examples of the therapeutic use of the placebo effect. (Image: behewa / fotolia.com) Homeopaths take their time and respond to the individual complaints of their patients. So it's a special setting plus therapist-patient relationship. In addition, doctor and patient believe in the power of homeopathy. Critically formulated, the procedure consists of an unstructured talk therapy plus placebo. The question is, if the sugar globules do not only function as a symbolic medium, which brings the communication between doctor and patient, such as the release of hormones and neurotransmitters, into flux.
An old story
Even Hippocrates used placebos in antiquity, methods that he knew to be ineffective. And shamans stage a magical theater in which they conjure up foreign bodies that supposedly caused the disease in the patient's body and remove them with "mental surgery.".
Some abuse the faith of their fellow human beings to do charlatanry. However, the healers of traditional cultures are usually no different from today's doctors, who know how the white coat, a gentle voice and associations with the hospital helped to heal.
Military doctor Henry Beecher placed the placebos on a scientific foundation during World War II, after watching a nurse inject saline rather than morphine and still feel better.
Beecher also inspired the double-blind studies we use today to determine drug efficacy. The participants do not know whether they are getting a real remedy or pseudo-medicine.
The placebo effect is especially good for the treatment of phobias such as spider anxiety. (Image: pegbes / fotolia.com) Placebos against phobias
Placebos are excellent against phobias because they form in the brain and can be changed by positive suggestions. For example, 34 women with excessive fear of spiders underwent a study in which they allegedly received Angostura, a medicine from South America. In fact, they consumed pure silica. All subjects felt after the placebo much less disgust with spiders than without the dummy. Researchers now plan to use placebos as a first step in anti-phobia psychotherapy, especially to show patients how effective their self-healing is in defeating the condition.
Religious ritual and placebo
Hindus purify themselves ritually in the Ganges, which, chemically speaking, is a cloaca in "holy cities" such as Vahranassi, the city of the god Shiva, and whose water would rather lead to various infectious diseases instead of curing them.
The hope that prayer helps leads to the release of hormones and messengers, as well as the belief in the efficacy of a placebo pill. A study at Georgetown University showed that belief in supernatural help accelerated healing in 75% of patients.
This positive self-suggestion applies to many areas of life. If I believe that the woman of my heart loves me as well, that alone generates positive emotions, even if it is not true. This is true even if I believe that a benevolent God loves me and embraces me after my death.
This anti-realism in religions could be described as a placebo for everyday life: whether someone prays to the rain god, that the harvest does not wither, or means that God stands aside when he undergoes heart surgery. These are all self-suggestions that can cause the body to produce the corresponding opioids and hormones.
Religion can not be reduced to the suggestive relief of pain, but this plays a significant role. It is not without reason that Christians ask the Lord's Prayer "and deliver us from evil," and the goal of Buddhism is to overcome the suffering of life. A key lesson in Buddhism is accepting pain without sounding the alarm. This could be described as a loss of pain awareness, which in turn is a classic placebo.
Suffering is the core of Christianity. The crucified Savior took on the sins of mankind and their pains, and the Apostle Paul taught, "We suffer, but not as others do, who have no hope." Faith itself, and no supernatural power, relieves the pain. It can also be understood that people in bad phases of stress find faith, be it a 14-year-old believing in God while their mother is in hospital with cancer, or a drug addict in religion has his last chance looks.
Such placebo effects are obviously greater, the more fundamentalist a person practices his religion. Moderate Christians who accept scientific theories therefore produce fewer of the body's own pain dampers than fanatics who insist that miracles happen. Conversely, this spiritual excitement also leads to the deepest desperation when an expected miracle does not arrive.
Is there also a rational alternative to religion to use the power of placebo over physical and emotional pain? That should be difficult, because self-suggestions are the better, the less the affected people know that they are suggestions. (Dr. Utz Anhalt)
references
http://www.atheisten.org/forum/viewtopic.php?f=5&t=11547
http://www.scinexx.de/wissen-aktuell-16337-2013-06-28.html
Rick Heler: Science and religion. A painful reality. : Http: //freeminds.org/psych/science_religion.htm