Why does the placebo effect appear in people who know 'this is a placebo'?
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Why placebo pills work even when you know they're a placebo | Psyche Ideas
https://psyche.co/ideas/why-placebo-pills-work-even-when-you-know-theyre-a-placebo
American football player Marshawn Lynch was anxious before the game in high school and sometimes suffered from a rather severe stomach upset. Lynch tried various treatments but it didn't work, but one day his mother, Delisa, said, 'Eating skittles (fruit-flavored candy) calms my stomach and makes me play better.' After being recommended, he started eating skittles before the game. Then, strangely, the anxiety and upset stomach that came before the game were alleviated, and the play improved.
Of course, Skittles are just candies and have no special physiological effects. However, Lynch loved Skittles throughout his career and always ate Skittles before the match. Psyche commented on Lynch's actions: 'Skittles for Lynch may seem like a crappy pre-match ritual, but eating skittles and believing that it will improve your performance. By the way, Lynch was taking advantage of a very realistic phenomenon: the placebo effect. '
Clinical trials have shown that the placebo effect is effective against a variety of illnesses and symptoms, including depression , pain , asthma , Parkinson's disease , and arthritis . According to Psyche, many of the reasons why new drugs are difficult to pass pre-approval clinical trials are not because they are ineffective, but because the placebo effect is too strong for them to outperform.
Although the placebo effect has been confirmed to be clinically effective, there is an ethical dilemma associated with giving patients a fake drug by lying 'this is a real drug' when used in actual treatment. Placebo prescriptions are not common, as most medical authorities around the world say it is not best to lie to a patient, even for good reason.
However, as in the case of Lynch, who knew that Skittles was just a candy, there are cases where 'the placebo effect appears even if you know that you are a placebo.' Such cases are called 'unblinded placebo' or 'non-deceptive placebo' and have been the subject of new research in recent years.
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The results showed that subjects had fewer symptoms of IBS than the untreated group, even though they knew that they were taking a placebo that did not contain the active ingredient. .. Subjects also reported an improvement in overall quality of life. Similar results are reproduced in a 2021 study, also in patients with IBS.
In addition, research results have shown that open-label placebo is effective for patients with ADHD and hay fever . In the 'Use' experiment , subjects who used nasal sprays reported relief of pain. This effect was supported not only by self-reporting but also by the electrical activity of the brain.
There are several hypotheses as to why open-label placebo works. The first hypothesis that Psyche cites is that 'the feelings of the subject who believe the treatment is beneficial actually have a positive effect on the body.' Although some experiments have stated that 'it is not necessary to believe in the placebo effect', it is encouraged to maintain an open mind, and
The second hypothesis is that the body associates certain actions and rituals with beneficial effects. People take headache medicine when they have a headache and cold medicine when they have a cold, and they repeatedly learn the relationship between 'taking medicine' and 'improving symptoms'. Therefore, Psyche explains that the body may remember this conditioning in the case of an open-label placebo as well, and the symptoms may have improved.
The third hypothesis is that 'a mechanism that is not well known is influential.' For example, it is possible that the act of 'getting treatment' itself raises the subject's attention to the mind and body, making it easier to notice that the symptoms have improved over time.
As research results show that open-label placebo is effective, researchers and clinicians are beginning to think about how to apply it to real-life treatments. It is expected that this can be applied not only to specific diseases such as IBS, but also to coping with stress and anxiety like Mr. Lynch, and to reducing drugs with side effects such as analgesics and ADHD treatments. Psyche pointed out that the next 10 years of research could have a significant impact, citing 'the pharmaceutical industry cannot make money with open-label placebo' and 'still in the early stages of research on open-label placebo.' I am.
It's unclear if open-label placebo will actually be the mainstream medical practice, but as Lynch loves Skittles, it's immediately possible to adopt open-label placebo methods at the individual level. is. Psyche says, 'For small problems that don't require medical intervention, such as pain, stress, anxiety, insomnia, and mild stomach upset, consider using your own unblinded placebo. (Remember that many herbal teas actually contain effective healing ingredients), take a hot bath (which also has medical benefits), and perform other rituals. By doing so, you can improve your mood while focusing on its healing effects. '
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