Why Do Placebos Work?

Several blog posts ago, I addressed the value and impact of the therapeutic relationship (VITR). Since writing that post, I read several supporting pieces on the topic. One is from a fascinating book, Hippocrates’ Shadow - Secrets from the House of Medicine – What Doctors Don’t Know, Don’t Tell You and How Truth Can Repair the Patient Doctor Breach by David H. Newman, M.D. and the other is from Newsweek column by Sharon Begley entitled: "Hooked on a Feeling – This is your brain on a placebo".

Both sources refer to credible research to support the idea that placebos, referred to as sugar pills, a sham treatment, or an inert compound, cure illness and engender health and well-being.

So how can sugar pills, sham treatments, and inert compounds do this? The answer is the there is something to the "tending ritual". The best answer is from Dr. Newman’s book:

"Studies indicate that the significance of the tending ritual of patient – doctor contact is real, and so is the response. The actions and interactions of the patient and doctor when acupuncture is performed, the shared experience of tending and communication, was more powerful than that of almost any pill science has produced. While hard science, the active ingredient, should be respected and given the credit it is due, we must also acknowledge and understand the simplest, and in some cases the most powerful, medicine of all: the contact between doctor and patient."

Sharon Begley’s column states "if neuroscientists have learned anything about placebos, it is that …high-level mental functions control the nitty-gritty of lower-level brain processes. In other words the brain responds to expectations when provided by a trusted care giver.

A basic tenant of integrative medicine, as practiced at the Marino Center, is to foster that trusting relationship and use the art of medicine as Hippocrates envisioned.