Menus Subscribe Search

Dr. Placebo — Half Quack and Half Savant

• November 28, 2011 • 8:25 AM

The placebo effect’s ability to influence human healing and human behavior is well documented, but we must be careful to make sure this fakery does no harm.

[Cue the drum roll] Ladies and gentlemen, introducing tonight, the magical, the amazing, the astounding, the one, the only [cue the cymbal] — DR. PLACEBO!! Performing sleights of hand that will amaze you, entice you, and lure you into miracle cures that will release you from your hard-earned cash. Come see never-before effects. Well, maybe always-seen effects. Step right this way …

OK, perhaps I’m more cynical than skeptical here, but given the successful selling of sham products such as balance bracelets and homeopathy, it’s important that we learn to think critically about one of the most powerful forces in medical research, the placebo effect.

Much has been written on the placebo effect — and an exciting new take is on the way from Miller-McCune — so our focus here is to critically investigate the role of these fake treatments and beliefs in our daily lives and how to use our skeptical skills in dealing with them. It’s important to realize that even when placebos have a positive impact, the effects can be short-term and end up masking more serious symptoms, preventing people from seeking reliable and effective treatments.

Simply stated, a placebo (Latin for “I will please”) is a substance or procedure given to a control group when used in scientific research designs to compare with an equivalent group receiving the real treatment or pill. In medical research, the look-alike treatment is often a sugar pill that does not have any real effect on the illness, allowing comparisons to be made between the actual medicine and the fake one.

It’s fairly common that about a third of people in the control group receiving the placebo report positive changes or lessening of symptoms. Sometimes recipients of the placebo claim negative side-effects (the “nocebo” effect), such as headaches or nausea. Surprisingly, some patients say they have positive outcomes even when told outright that they were receiving a fake treatment!

The power of the mind and its psychological impact has been a common explanation for how the placebo effect works. But continuing research also points to important physiological and neurological brain changes with placebo treatments. Indeed, with real treatment and medicines, some part of the cure can be attributed to patients’ expectations that the substance is working. Recent evidence suggests that placebo medicines are showing more effectiveness that the real pills, again illustrating some powerful physiological responses of patients to social, psychological, and biological expectations.

Headache relief seems to attract lots of placebo products, including one that simply required rolling on a wax-type substance and another by slowly moving a red light across your forehead. The red light should instead remind you to stop with these treatments and save your money, since in most cases, headaches will go away on their own with time and relaxation.

[class name="dont_print_this"]

Skeptic's Cafe

SKEPTIC'S CAFE
Peter Nardi discusses how to use our critical skills to avoid scams, respond to rumors and debunk questionable research.

[/class]

Consider too some non-medical situations where the mind has power over the reality. We know, for example, that people will often claim they are not as full after eating food labeled as healthy or low-fat, compared with foods labeled as an “indulgence” or high in calories. Here the placebo principles can result in people eating more unhealthy foods when they are not satisfied after finishing their better-for-you foods.

In an unusual study from New Zealand, university students who were told they were drinking vodka and tonic, but were really sipping a tonic-only placebo, not only acted drunk but also demonstrated worse eyewitness accounts and were more easily swayed by misleading information. Perhaps they would be willing to buy some fake red light treatment for their fake hangover and fake headaches!

Pricing can also have an impact on placebos, as Dan Ariely illustrated in Predictably Irrational. Researchers sold some students at a university gym a caffeinated soft drink at full price and another group bought it at a two-thirds discount. After finishing the beverage, and because of the caffeine, all students said they felt less tired after their workout. However, the group paying the higher price reported less fatigue than the discounted price group, even though they bought the exact same product. When tested with a problem set of anagrams to solve, those students who paid full price for the caffeine drink performed 28 percent better than the group who paid a discount for the drink. And all students performed even better when told the ads for the drink emphasized scientific studies showing the product improved mental functioning. Even in this experimental situation, the full-price group continued to outperform the students who received the discounted price.

Dr. Placebo, you’re amazing. Not only do you have power over fake medical treatments, you enhance the effect of real medicines, you contribute to our experiences when imbibing alcohol-based and caffeinated drinks, and you help people believe advertisers’ hype.

But do us critical thinkers a favor: because your name is a Latin word, remember the other Latin phrase that guides medical ethics and skeptical inquiry: Primum non nocere, “First, do no harm.” Save your effects and tricks for when it is helping people to feel better and to act more responsibly.

Sign up for the free Miller-McCune.com e-newsletter.

“Like” Miller-McCune on Facebook.

Follow Miller-McCune on Twitter.

Add Miller-McCune.com news to your site.

Subscribe to Miller-McCune

Peter M. Nardi
Peter M. Nardi, Ph.D, is an emeritus professor of sociology at Pitzer College, a member of the Claremont Colleges. He is the author of "Doing Survey Research: A Guide to Quantitative Methods.”

More From Peter M. Nardi

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

July 30 • 4:00 PM

Still the World’s Top Military Spender

Although declining in real terms, the United States’ military budget remains substantial and a huge drain on our public resources.



July 30 • 2:04 PM

The Rise of the Nuisance Flood

Minor floods are afflicting parts of Maryland nearly 10 times more often than was the case in the 1960s.


July 30 • 2:00 PM

The (Mostly Awful) Things You Learn After Investigating Unpaid Internships for a Year

Though the intern economy remains opaque, dialogue about the role of interns in the labor force—and protections they deserve—is beginning to take shape.


July 30 • 12:00 PM

Why Coffee Shortages Won’t Change the Price of Your Frappuccino

You’re so loyal to Starbucks—and the company knows it—that your daily serving of caffeine is already marked up beyond the reach of any fluctuations in supply.



July 30 • 10:00 AM

Having Difficult Conversations With Your Children

Why it’s necessary, and how to do it.


July 30 • 8:00 AM

How to Make a Convincing Sci-Fi Movie on a Tight Budget

Coherence is a good movie, and its initial shoot cost about the same amount of money as a used Prius.


July 30 • 6:00 AM

Are You Really as Happy as You Say You Are?

Researchers find a universal positivity bias in the way we talk, tweet, and write.


July 30 • 4:00 AM

The Declining Wage Gap for Gay Men

New research finds gay men in America are rapidly catching up with straight married men in terms of wages.


July 30 • 2:00 AM

LeBron James Migration: Big Chef Seeking Small Pond

The King’s return to Cleveland is a symbol for the dramatic shift in domestic as well as international migration.


July 29 • 4:00 PM

Are Children Seeking Refuge Turning More Americans Against Undocumented Immigrants?

A look at Pew Research Center survey data collected in February and July of this year.


July 29 • 2:00 PM

Under Water: The EPA’s Ongoing Struggle to Combat Pollution

Frustration and inaction color efforts to enforce the Clean Water Act.


July 29 • 12:40 PM

America’s Streams Are Awash With Pesticides Banned in Europe

You may have never heard of clothianidin, but it’s probably in your local river.


July 29 • 12:00 PM

Mining Your Genetic Data for Profit: The Dark Side of Biobanking

One woman’s personal story raises deep questions about the stark limits of current controls in a nascent industry at the very edge of the frontier of humans and technology.


July 29 • 11:23 AM

Where Should You Go to College?


July 29 • 10:29 AM

How Textbooks Have Changed the Face of War

War is more personal, less glorious, and more hellish in modern textbooks than in the past. But there’s still room for improvement.


July 29 • 10:00 AM

The Monolingual American: Why Are Those Outside of the U.S. Encouraging It?

If you are an American trying to learn German in a large German town or city, you will mostly hear English in return, even when you give sprechen your best shot.


July 29 • 8:00 AM

The Elusive Link Between Casinos and Crime

With a study of the impact of Philadelphia’s SugarHouse Casino, a heated debate gets fresh ammunition.


July 29 • 6:00 AM

What Are the Benefits of Locking Yourself in a Tank and Floating in Room-Temperature Saltwater?

After three sessions in an isolation tank, the answer’s still not quite clear.


July 29 • 4:00 AM

Harry Potter and the Battle Against Bigotry

Kids who identify with the hero of J.K. Rowling’s popular fantasy novels hold more open-minded attitudes toward immigrants and gays.


July 29 • 2:00 AM

Geographic Scale and Talent Migration: Washington, D.C.’s New Silver Line

Around the country, suburbs are fighting with the urban core over jobs and employees.


July 28 • 4:00 PM

Border Fences Make Unequal Neighbors and Enforce Social Inequality

What would it look like if you combined Israel, the West Bank, and Gaza, demographically speaking? What about the United States and Guatemala?


July 28 • 2:00 PM

Are Patient Privacy Laws Being Misused to Protect Medical Centers?

A 1996 law known as HIPAA has been cited to scold a mom taking a picture of her son in a hospital, to keep information away from police investigating a possible rape at a nursing home, and to threaten VA whistleblowers.


July 28 • 12:00 PM

Does Internet Addiction Excuse the Death of an Infant?

In Love Child, documentary filmmaker Valerie Veatch explores how virtual worlds encourage us to erase the boundary between digital and real, no matter the consequences.


Follow us


Subscribe Now

The Rise of the Nuisance Flood

Minor floods are afflicting parts of Maryland nearly 10 times more often than was the case in the 1960s.

America’s Streams Are Awash With Pesticides Banned in Europe

You may have never heard of clothianidin, but it's probably in your local river.

How Textbooks Have Changed the Face of War

War is more personal, less glorious, and more hellish in modern textbooks than in the past. But there’s still room for improvement.

NASA Could Build Entire Spacecrafts in Space Using 3-D Printers

This year NASA will experiment with 3-D printing small objects in space. That could mark the beginning of a gravity-free manufacturing revolution.

The Most Popular Ways to Share Good and Bad Personal News

Researchers rank the popularity of all of the different methods we have for telling people about our lives, from Facebook to face-to-face.

The Big One

One in two full-time American fast-food workers' families are enrolled in public assistance programs, at a cost of $7 billion per year. July/August 2014

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.