You Are the Placebo

by Joe Dispenza, Dr.

  Not surprisingly, Kirsch’s study caused quite an uproar, although many researchers seemed quite willing to throw the placebo baby out with the bathwater. While most of the fracas focused on the fact that these drugs weren’t any better than the placebo, the patients in the trials did, in fact, get better on antidepressants. The drugs did work. But the patients taking placebos got better, too. Instead of seeing Kirsch’s work as proof that antidepressants failed, some researchers chose to see the glass as half-full and pointed to the data as proof that placebos succeeded.

  After all, the trials provided stunning proof that thinking that you can get better from depression can actually heal depression just as well as taking a drug. The people in the study who got better on placebos were actually making their own natural antidepressants, just as Levine’s patients in the ’70s who had their wisdom teeth out made their own natural painkillers. What Kirsch had brought to light was more evidence that our bodies do have an innate intelligence that enables them to serve us with a chemical array of natural healing compounds. Interestingly enough, the percentage of people who improve while taking placebos in depression trials has gotten greater over time, as has the response to active medication; some researchers have suggested that this is because the public has greater expectations for the antidepressant drugs, which in turn makes the placebos more effective in these blind trials.17

  The Neurobiology of the Placebo

  It was only a matter of time before neuroscientists would start using sophisticated brain scans to take an intricate look at what happens neurochemically when a placebo is administered. An example is the 2001 study on Parkinson’s patients who regained motor skills after receiving only an injection of saline that they thought was medication (described in Chapter 1).18 Italian researcher Fabrizio Benedetti, M.D., Ph.D., a pioneer in placebo research, did a similar Parkinson’s study a few years later and, for the first time, was able to show a placebo’s effect on individual neurons.19

  His studies explored not only the neurobiology of expectation, as with the Parkinson’s patients, but also the neurobiology at work with classical conditioning—what Ader had been able to glimpse years previously with his nauseated lab rats. In one experiment, Benedetti gave study subjects the drug sumatriptan to stimulate growth hormone and inhibit cortisol secretion, and then without the patients’ knowledge, he replaced the drug with a placebo. He found that the patients’ brain scans continued to light up in the same places as when they were getting the sumatriptan; this was proof that the brain was indeed producing the same substance—in this case, growth hormone—on its own.20

  The same was seen to be true for other drug-placebo combinations as well; the chemicals made in the brain closely tracked those that the subjects initially received via drugs that were given to treat immune system disorders, motor disorders, and depression.21 In fact, Benedetti even showed that placebos caused the same side effects as the drugs. For example, in one placebo study using narcotics, the subjects suffered the same side effects of slow and shallow breathing when taking the placebo, because the placebo effect so closely mimicked the physiological effects of the drug.22

  If the truth be told, our bodies are indeed capable of creating a host of biological chemicals that can heal, protect us from pain, help us sleep deeply, enhance our immune systems, make us feel pleasure, and even encourage us to fall in love. Reason this for a moment: If a particular gene was already expressed so that we made those specific chemicals at one point in our lives, but then we stopped making them because of some type of stress or illness that turned off that gene, maybe it’s possible for us to turn the gene back on again, because our bodies already know how to do that from previous experience. (Stay tuned for research to prove this.)

  So let’s begin to look at how this happens. 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’s research also makes another point very clear: Different types of placebo treatments work best with different goals. For example, in the sumatriptan study, initial verbal suggestions that the placebo would work had no effect on the production of growth hormone. To use placebos to effect unconscious physiological responses by associative memory (such as to secrete hormones or alter the functioning of the immune system), conditioning gets results, whereas to use placebos to change more conscious responses (such as to relieve pain or lessen depression), a simple suggestion or an expectation works. So there isn’t just one placebo response, Benedetti insisted, but several.

  Taking Mind Over Matter into Your Own Hands

  An astonishing new twist to placebo research came in a 2010 pilot study led by Harvard’s Ted Kaptchuk, D.O.M., that showed that placebos worked even when people knew they were taking a placebo.23 In the study, Kaptchuk and his colleagues gave 40 patients with irritable bowel syndrome (IBS) a placebo. Each patient received a bottle clearly labeled “placebo pills” and was told it contained “placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body, self-healing processes.” A second group of 40 IBS patients, given no pills, served as a control group.

  After three weeks, the group taking the placebos reported twice as much symptom relief as the no-treatment group—a difference that Kaptchuk noted is comparable to the performance of the best real IBS drugs. These patients hadn’t been tricked into healing themselves. They knew full well that they weren’t getting any medication—and yet after hearing the suggestion that the placebos could relieve their symptoms and believing in an outcome independent of the cause, their bodies were influenced to make it happen.

  Meanwhile, a parallel track of studies that examines the effect of attitude, perceptions, and beliefs is leading the way in current mind-body research, showing that even something as seemingly concrete as the physical benefit of exercise can be affected by belief. A 2007 study at Harvard by psychologists Alia Crum, Ph.D., and Ellen Langer, Ph.D., involving 84 hotel maids is a perfect example.24

  At the start of the study, none of the maids knew that the routine work they performed in their jobs exceeded the Surgeon General’s recommendation for a healthy amount of daily exercise (30 minutes). In fact, 67 percent of the women told the researchers that they didn’t exercise regularly, and 37 percent said they didn’t get any exercise. After this initial assessment, Crum and Langer divided the maids into two groups. They explained to the first group how their activity related to the number of calories they burned and told the maids that just by doing their jobs, they got more than enough exercise. They didn’t give any such information to the second group (who worked in different hotels from the first group and so wouldn’t benefit from conversations with the other maids).

  One month later, the researchers found that the first group lost an average of two pounds, lowered their percentage of body fat, and lowered their systolic blood pressure by an average of 10 points—even though they hadn’t performed any additional exercise outside of work or changed their eating habits in any way. The other group, doing the same job as the first, remained virtually unchanged.

  This echoed similar research done earlier in Quebec, where a group of 48 young adults participated in a ten-week aerobic exercise program, attending three 90-minute exercise sessions per week.25 The group was divided into two. The instructors told th
e first half, the test subjects, that the study was specifically designed to improve both their aerobic capacity and their psychological well-being. They mentioned only the physical benefits of aerobics to the second half, who served as the control group. At the end of the ten weeks, the researchers found that both groups increased their aerobic capacity, but it was only the test subjects, not the controls, who also received a significant boost in self-esteem (a measure of well-being).

  As these studies show, our awareness alone can have an important physical effect on our bodies and our health. What we learn, the language that’s used to define what we’ll experience, and how we assign meaning to the explanations that are offered all affect our intention—and when we put greater intention behind what we’re doing, we naturally get better results.

  In short, the more you learn about the “what” and the “why,” the easier and more effective the “how” becomes. (My hope is that this book will do the same for you; the more you know what you’re doing and why you’re doing it, the better results you’re bound to get.)

  We also assign meaning to subtler factors, such as the color of the medicine we take and the quantity of pills we ingest, as shown in an older but classic study from the University of Cincinnati. In this study, researchers gave 57 medical students either one or two pink or blue capsules—all of them inert, although the students were told that the pink capsules were stimulants and the blue ones were sedatives.26 The researchers reported, “Two capsules produced more noticeable changes than one, and blue capsules were associated with more sedative effects than pink capsules.” Indeed, the students rated the blue pills as being two and a half times more effective as sedatives than the pink pills—even though all the pills were placebos.

  More recent research shows that beliefs and perceptions can also affect scores in mental performance on standardized tests. In a 2006 study from Canada, 220 female students read fake research reports claiming that men had a 5 percent advantage over women in math performance.27 The group was divided into two, with one group reading that the advantage was due to recently discovered genetic factors, while the other group read that the advantage resulted from the way teachers stereotype girls and boys in elementary school. Then the subjects were given a math test. The women who’d read that men had a genetic advantage scored lower than those who’d read that men had an advantage due to stereotyping. In other words, when they were primed to think that their disadvantage was inevitable, the women performed as if they truly had a disadvantage.

  A similar effect has been documented with African-American students, who have historically scored lower than whites on vocabulary, reading, and math tests, including the Scholastic Aptitude Test (SAT), even when socioeconomic class is not a factor. In fact, the average black student scores below 70 to 80 percent of the white students of the same age on most standardized tests.28 Stanford University social psychologist Claude Steele, Ph.D., explains that an effect called “stereotype threat” is to blame. His research shows that students who belong to groups that have been negatively stereotyped perform less well when they think their scores will be evaluated in light of that stereotype than they do when they feel no such pressure.29

  In Steele’s landmark study, conducted with Joshua Aronson, Ph.D., researchers gave a series of verbal reasoning tests to Stanford sophomores. Some of the students were given instructions that primed the stereotype that blacks score lower than whites by saying that the quiz they were about to take was designed to measure their cognitive ability, while the others were told that the test was merely an unimportant research tool. In the group where the stereotype was primed, blacks scored lower than whites who had similar SAT scores. When the stereotype was not primed, performance of blacks and whites whose SAT scores were similar was the same—proving that the priming made a critical difference.

  Priming is, basically, when someone, someplace, or something in our environment (for example, taking a test) triggers all sorts of associations that are hardwired into our brains (that people grading this test think black students score lower than whites), causing us to act in certain ways (not scoring as highly) without being conscious of what we’re doing. It’s called “priming,” because it works just as priming a pump does. You have to have water already in the pumping system in order to pump more water out of it. So in this example, the idea or belief that others expect black students to score lower than whites is like the water that’s already in the system—it’s just there all the time. When you do something to stimulate the system (grabbing the pump handle or taking the test), you’re stirring up all those related thoughts, behaviors, or emotions, and you produce exactly what was waiting to emerge from the system all along—be that water, in the case of a pump, or lower test scores, if it’s a test.

  Think about this for a moment. Most automatic behaviors that priming elicits are produced by unconscious or subconscious programming, which, for the most part, is happening behind the scenes of our awareness. Are we, then, primed to behave unconsciously all day long—without our even knowing it?

  Steele replicated this effect with other stereotyped groups as well. When Steele gave a math test to a group of white and Asian men who were strong in math, the white men in the group who were told that Asians do slightly better than whites on the test indeed didn’t do as well as the white men in the control group who weren’t told that. Steele’s experiments with strong female math students showed similar results. Again, when the students’ unconscious expectation was that they would score lower, they, in fact, did.

  The greater meaning behind Steele’s research, then, is quite profound: What we’re conditioned to believe about ourselves, and what we’re programmed to think other people think about us, affects our performance, including how successful we are. It’s the same with placebos: What we’re conditioned to believe will happen when we take a pill, and what we think that everyone around us (including our doctors) expects will happen when we do, affects how our bodies respond to the pill. Could it be that many drugs or even surgeries actually work better because we’re repeatedly primed, educated, and conditioned to believe in their effects—when if it weren’t for the placebo effect, those drugs might not work as well or at all?

  Can You Be Your Own Placebo?

  Two recent studies from the University of Toledo perhaps shed the best light on how the mind alone can determine what someone perceives and experiences.30 For each study, researchers divided a group of healthy volunteers into two categories—optimists and pessimists—according to how the volunteers answered questions on a diagnostic questionnaire. In the first study, they gave the subjects a placebo but told them it was a drug that would make them feel unwell. The pessimists had a stronger negative reaction to the pill than the optimists. In the second study, the researchers gave the subjects a placebo as well, but told them it would help them sleep better. The optimists reported much better sleep than the pessimists.

  So the optimists were more likely to respond positively to a suggestion that something would make them feel better, because they were primed to hope for the best future scenario. And the pessimists were more likely to respond negatively to a suggestion that something would make them feel worse, because they consciously or unconsciously expected the worst potential outcome. It’s as if the optimists were unconsciously making the specific chemicals to help them sleep, while the pessimists were unconsciously making a pharmacy of substances that made them feel unwell.

  In other words, in exactly the same environment, those with a positive mind-set tend to create positive situations, while those with a negative mind-set tend to create negative situations. This is the miracle of our own free-willed, individual, biological engineering.

  While we may not know exactly how many medical healings are due to the placebo effect (Beecher’s 1955 paper, mentioned earlier in this chapter, claimed the number was 35 percent, but modern-day research shows it can range anywhere from 10 to 100 percent31), the overall number is certainly extremely significant. Give
n that, we have to ask ourselves, What percentage of diseases and illnesses are due to the effects of negative thoughts in the nocebo? Considering that the latest scientific research in psychology estimates that about 70 percent of our thoughts are negative and redundant, the number of unconsciously created nocebo-like illnesses might be impressive indeed—certainly much higher than we realize.32 This idea makes a lot of sense, given that so many mental, physical, and emotional health conditions seem to arise from nowhere.

  Although it may seem incredible that your mind could actually be that powerful, the research of the past several decades clearly points to a few empowering truths: What you think is what you experience, and when it comes to your health, that’s made possible by the amazing pharmacopeia that you have within your body that automatically and exquisitely aligns with your thoughts. This miraculous dispensary activates naturally occurring healing molecules that already exist within your body—delivering different compounds designed to elicit different effects in any number of different circumstances. Of course, this raises the question: How do we do it?

  The chapters that follow will explain how this all unfolds on a biological level and thus how you can apply this innate ability to consciously and intentionally create the health—and the life—that you want to experience.

  Chapter Three

  The Placebo Effect in the Brain

  If you’ve read my previous book, Breaking the Habit of Being Yourself, you’ll find that this chapter reviews much of that material. If you feel that you already have a good command of that information, you may choose to either skip this chapter completely or skim it to brush up on those concepts as needed. If in doubt, I recommend that you read this chapter, because a thorough understanding of what is presented here will be necessary to fully understand the chapters that follow.