Posted 18/01/2021 in Category 1

The Placebo Effect: What is it? And how does it work?

The Placebo Effect: What is it? And how does it work?


You might have heard of the term ‘placebo' effect, but do you know what it means? Kaptchuk and Miller (2015) examined the placebo effects in medicine. In their article, they described placebo effects as improvements in patients’ symptoms because they took part in a therapeutic encounter, with its rituals, symbols, and interactions. These signs and behaviours include health care paraphernalia and settings, interactions with clinicians, empathy and the laying of hands. In simple terms, we see improvements (in a condition, for example) with no substantial active ingredient). 


So if there is no active ingredient to bring about the change, what’s happening? Placebo effects involve neurotransmitters (chemicals in the brain) and specific regions of the brain. This is the pathway for common mediations. According to Kaptchuck and Miller, we might gain relief but not a cure. What we see is a change in subjective and self-appraised symptoms. While the placebos are not shrinking the tumours, the side effects of a cancer treatment, for example, fatigue, nausea, hot flashes and pain respond to placebo treatments. One study on patients with asthma show that placebos do not affect the patients’ forced explore volume in 1 second (how much air we can expel from their lungs) but there was a dramatic effect on perceived symptoms. Physically, we have not changed our condition, but psychologically and emotionally we have changed our condition. 


Many people who know a little about the placebo effect might think it’s just about dummy pills. But we need to consider the interpersonal and contextual factors here. Who is administering the pill and under which conditions? We believe in names (e.g., of a drug), the doctor’s approach, the pill colour and so forth. When we consider the psychosocial factors that promote therapeutic placebo effects, they can also have unintended negative effects called nocebo effect. The nocebo effect describes a circumstance where a negative outcome occurs because of a belief that the intervention will be harmful. 


Despite the challenges and drawbacks, there is a kernel of truth to unfurl for people who work in medicine and other settings to help others. Many, according to Kaptchuk and Miller, see placebo effects as unworthy and illegitimate caused by bias and prejudice. But what if a cure is not possible, but it is possible to relieve symptoms and provide comfort? When we think about sport, endurance events and recovering from injury, we want the best viable treatment and support for athletes, but it is not always possible to achieve this ideal. We want to relieve unnecessary pain and suffering. As the authors of the research explained, empathetic healthcare creates the conditions to tap into conscious and nonconscious mechanisms to help patients and to help patients to help themselves. 


So what’s best in sport? Care, concern, and support will always be forefront of our mind. Using placebo in sport ought to be for the best health and care for the athlete, team, and squad. Relieving pain and suffering helps those in endurance events (e.g., running, cycling, triathlon) and that remains foremost in our mind. 


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References

Kaptchuk, M. (2015). Placebo effects in medicine. The New England Journal of Medicine, 373(1), 8–9. https://doi.org/10.1056/NEJMp1504023

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