Narrative medicine again – the placebo effect.
‘It took me a long time to notice, but many of my patients told me “We are feeling much better now, doctor.” And this was said at about the time that our first half-hour consultation was coming to an end. They had not yet taken the pills nor received the shots I was about to prescribe for them, but their faces were more relaxed, their voices less strained, their eyes brighter and their pain less severe. Clearly, they were starting to heal before I’d done anything remotely medical . I must have been launching my patients’ healing processes even before reaching for my prescription pad.
What I am talking about here is the placebo effect. To most of us, a placebo is a fake sugar pill that commands no respect and deceives only the naïve or the ignorant. But, thanks to new rigorous studies, researchers are learning fascinating things about how the brain works to heal the body through the measurable power of the placebo effect. Given an appropriate milieu generated by a kindly, knowledgeable and self-confident health-care professional, placebos can cure a variety of real but subjective symptoms. These include pain, nausea, fatigue, muscle weakness, abdominal cramps, sadness and despair. Sophisticated imaging techniques show that when a person trusts the therapy they are being given, the brain can reroute its signals and cause the body to heal itself – the placebo effect once again.
Added to this, the patient needs a kind word, empathy and reassurance as well as a firm but gentle touch. Add a touch of humor too. Physicians have been using these tools for a long time: since Hippocrates and his oath, in fact. One hundred years ago, it wasn’t the leeches doctors put on your skin that healed you. It was the idea of being cared for that switched your brain into healing mode. Thanks to the placebo effect, many of the treatments and medicines we inflict on our patients seem to work, even though there is little or no physical reason for them to do so. The history of medicine – surgery, physiotherapy, chiropractice, and homeopathy are littered with discarded treatments that seemed a good idea at the time. Many therapies did not work as designed, but triggered surprisingly powerful placebo effects on the human mind.
According to his colleagues, Dr. Pennie had learned to optimize the placebo effect when caring for his patients. He harnesses the reassuring smile, the soothing voice, the gentle touch in ways that show he cares for his patient while in the process of diagnosing and treating.
So, to feel assured that we will all be cared for during our illness/difficulty/predicament, is a powerful human need, one that opens the doorway to the placebo effect.
Now what I need to know is: will this work where psychiatry is concerned? I have a feeling that it might and am going to try and find Dr. Ross Pennie and get his opinion on that subject.