The Magic of Belief

18.04.2017
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The Magic of Belief

1 The placebo effect refers to an improvement in symptoms as a result of medical treatment with an inactive substance like a sugar pill or even a staged medical procedure such as surgery. In other words, a patient recovers even though there has been no genuine medical intervention. Instead, the effect is generally attributed to the patient’s belief in the effectiveness of the treatment, which, in tum, mediates the healing of the relevant physical symptoms. Documented cases of the placebo effect have been reported since the early twentieth century. However, only recently has neuroscience been able to demonstrate observable evidence of real-time brain cbanges in relation to the administration of a placebo. (Question 1-2)

2 One of the most dramatic examples of the placebo effect involves a study of patients with acute arthritic knee pain. In an effort to determine which aspects of knee surgery were most effective, Dr Bruce Moseley, an American surgeon, conducted a controlled experiment involving three groups. In the first group, surgery included shaving off thin layers of the damaged cartilage; in the second group, the doctor flushed out the knee joint and disposed of the unhealthy tissue. In the third group, he simulated surgery by anesthetizing the patients and making the necessary incisions. However, no actual knee surgery was performed. In fact, the patients were not informed until a full two years afterwards that their operations were staged. (Question 3-4)

3 The results were staggering. (A) While knee pain for all three groups diminished
significantly, there was no difference in the level of pain decrease for any one group over another. (B) Rather, the uniform results seemed to be mediated by the placebo effect or the patient’s belief in the benefit of the surgical procedure. (C) As one of the placebo patients, Tim Perez, was later quoted as saying, ”In this world anything is possible when you put your mind to it. (D) I know that your mind can work miracles.” Perez, who previously could only get around with the aid of a cane, is now able to shoot baskets with his grandchildren. (Question 5-6)

4 Research on the placebo effect has been conducted for other diseases and afflictions including asthma, Parkinson’s djsease, pain, and depression. Depression, in particular, has been an area of major interest. This is due to both the recent rise in the use of antidepressants and the claim by critics that the $9.6-billion industry (in the US alone) is making a huge profit from pills that are no more effective than placebos. In one study. a University of Connecticut psychology professor used the Freedom of Information Act to obtain hard data regarding clinical trials of the six major antidepressants. He found that in over half of these trials the placebo was equally effective in treating the disease. Furthermore, he concluded that approximately 80 percent of the effectiveness of antidepressants was, in reality, due to the placebo effect. (Question 7)

5 Neuroscientists now have the technology to determine the brain mechanisms responsible for the placebo effect. Through brain-imaging techniques, they can record the series of events triggered by the anticipation of a specific result such as a relief of symptoms. In studies related to the alleviation of pain, scientists have discovered that when a placebo painkiller is administered, the body’s own innate pain relief center or endogenous opioid system releases brain chemicals that ease the pain. ln research related to Parkinson’s disease, in which dopamine deficiency is a major factor, patients release dopamine upon ingesting a placebo. While the placebo effect for depression is not entirely understood, there is noted brain activity in the form of electrical and metabolic changes in the same regions targeted by selective serotonin reuptake inhibitors (SSR!s), a type of antidepressant drug. (Question 8-9-10)

6 Based upon this neuroscientific evidence, a substantial number of researchers conclude that the body bas an innate healing capacity that can be invoked through presumed medical intervention. The placebo effect is strong medicine, which the medical community has only now begun to take seriously. Up until this point, doctors have invested much of their therapeutic effort in drugs and surgery. While this may be an effective way to increase income for medical practitioners and pharmaceutical companies, one has to question whether more energy should be allocated to exploring the clearly less-invasive biology of belief.  (Question 11-12-13)

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