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Placebo effect explanation and application
When people believe that a therapy will cure their illness and their condition improves, even though the treatment has no effect medically, for example because tablets contain no drugs, we are talking about placebo effect.
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.
Conversely, there is also the nocebo effect: anyone who is convinced that a treatment, a drug or an operation has bad effects, in which intensifies the pain, delayed healing or the symptoms even worse.
contents
- How does the placebo effect work??
- 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 and placebo effect
- An old story
- Placebos against phobias
- Religious ritual and placebo
How does the placebo effect work??
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.
Typical placebo agent that can activate self-healing. Image: alimyakubov - fotolia 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 keep them.
In addition, placebos also have a negative effect. For example, patients choked their stomach contents after taking an alleged emetic.
The emotional brain
Neuroscientist David Servan-Schreiber suggests that more than half of all doctor visits are caused by stress, and the majority of Western medicines have been used to remedy stress-related symptoms: antidepressants, tranquilizers, antacids in heartburn, antihypertensive and too 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.
The brain controls the immune cells. Image: sdecoret - fotolia 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 goes into action that 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 diverse, says Benedetti, and it depends on the previous conditioning, which biochemical mechanisms were running.
For example, a placebo analgesic releases different neurotransmitters, depending on which analgesic the patient had previously received - if the sufferers were used to morphine, the body would release opioids.
In Parkinson's patients, up to 200% of free dopamine in the body increases when using placebos.
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 analgesics either openly by a physician or concealed via a computer-controlled injection pump.
The result was clear: the injected injection was less effective on all tested painkillers. In the case of open injection, the expectation already releases messengers, according to Benedetti, and they occupy the same receptors as the analgesics.
The same was true in time: at the medical infection the pain eased immediately, with the concealed it took much longer.
Benedetti's experiments could be used to test when drugs are pharmacological and when they are psychologically active.
Doctors and the placebo effect
Scientists at the Institute of Medical Psychology are deliberately using the placebo effect. The doctor working there Karin Meissner, for example, is aware as a scientist that acupuncture is objectively of little use, but still uses it successfully against symptoms such as hay fever.
Studies at the institute showed that it does not matter if doctors placed the needles on the "energy meridians" of Traditional Chinese Medicine or distributed them without pattern on the skin. The result stunned: the needles worked in both cases. Meissner explains this with the placebo effect. So did 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."
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 releases oxytocin, a binding hormone.
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 and placebo effect
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.
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 whether the globuli not only function as a symbolic medium, which brings the communication between doctor and patient, such as the release of hormones and neurotransmitters only in flow.
An old story
Even in antiquity, Hippocrates used placebos, methods that he knew were ineffective, and shamans stage a magical drama that conjures up foreign bodies that were supposed to cause the disease in the patient's body and that "mental surgery." " remove.
Some abuse the faith of their fellow human beings to run charlatanry, but most of the healers of traditional cultures are no different from today's doctors, who know how the white coat, a gentle voice and associations with the hospital co-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.
Placebos against phobias
Placebos are excellent against phobias because they form in the brain and can be changed by positive suggestions. Thus, 34 women subjected themselves to an abhorrence of spinning a study in which they allegedly got 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.
Placebos can help with therapy to overcome phobias. Picture: lucato - fotolia 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 in chemical "holy cities" such as Vahranassi, the city of the god Shiwa, represents a cloaca, 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 that God is standing by him when undergoing heart surgery, if there is a positive meaning in life , 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 bore 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, whether a 14-year-old begins to believe in God, while her mother with cancer in the clinic, or sees a drug addict in religion his last chance.
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)