(Note: This article by David McMillin was originally published in True Health newsletter.)
For over thirty years sugar pills have been prescribed as a placebo treatment for almost every conceivable problem. Aside from the obvious ethical issue of misrepresentation, researchers and clinicians have used placebos with the full confidence provided by extensive medical research. Over the decades numerous studies have apparently established that using placebo treatments can produce positive outcomes in 30 – 40 percent of cases, especially for pain relief. Placebos were regarded as safe, economical, and ethical treatments that simply utilized the patient’s positive beliefs and expectations for healing.
However, recent research has called into question the validity of the placebo. Not surprisingly, the new interpretation of the placebo effect has sent a shock wave through the medical research community. Apart from research, understanding the placebo controversy has practical implications for your health and healing. Recognizing and utilizing the divine aspect of healing as the ultimate expression of the placebo effect is where we are headed with this article. But first, let’s define our terms.
Placebo is Latin, literally meaning “I will please.” As a medical intervention, a placebo is intended to produce healing, but not believed (by the researcher or clinician) to be a specific therapy for the illness. Thus it is used either for its psychological effect or to eliminate observer bias in a research setting. Or to put it another way, a placebo is a change in a patient’s illness attributed to the symbolic significance of a treatment rather than its medical properties. Sugar pills are not the only placebo treatment. Invasive treatments, such as surgery, can produce strong placebo effects. Andrew Weil believes that all medical treatments have an element of the placebo and that the “history of medicine is actually the history of the placebo response.” In his book Health and Healing, Weil echoed the insightful medical observation that “One should use a new remedy as much as possible while it still has the power to heal.”
In a clinical setting, placebo effects may be nonspecific. Physician attention; patient and physician expectations of treatment effects; the reputation, expense, and impressiveness of the treatment; and characteristics of the setting can all contribute to a positive placebo effect.
Thus, in essence, placebo effects have been regarded as a manifestation of the mind. In metaphysical terms, “mind is the builder.” Traditionally, placebos have been regarded as a manifestation of the mind’s power to heal.
In research, placebos are used to establish the “real” value of a particular treatment. Also called “sham” treatments because by definition the interventions are not supposed to have a “real” effect, placebos have become part of the gold standard for modern medical research. You can see why questioning the reality of the placebo can be unsettling for researchers.
At Meridian Institute we have researched and published papers on the concept of sham treatment in studies involving spinal manipulation. We have also conducted basic research on the physiological response of various techniques thought to be sham treatments. We have learned that understanding placebo effects is enormously complex and controversial.
The study that initiated the current placebo debate appeared in The New England Journal of Medicine (NEJM, May 24, 2001). Titled “Is the Placebo Powerless? An Analysis of Clinical Trials Comparing Placebo with No Treatment,” the article reported the findings of a “metaanalysis” (systematic review) of 114 clinical trials. The authors concluded that,“We found little evidence in general that placebos had powerful clinical effects.”
For alternative medicine advocates who have used the concept of placebo as an example of the power of mind/body healing, the placebo debate raises important issues about the psychological dimension of healing. Does the mind have the power to heal? If the consistent positive results that have been attributed to the placebo effect are not due to psychological factors, what can account for the undeniable healing that occurs when placebos are used?
The NEJM study suggests that the positive outcomes that are consistently attributed to placebos are not necessarily produced by the beliefs or expectations of the participants, but are essentially the result of natural cycles of health and illness. Remember that the study compared placebo treatment to no treatment. Many health problems resolve irrespective of treatment or lack thereof. When a physician tells a patient to “take two aspirin and call me in the morning,” the underlying assumption is that the body will often heal itself, even with little or no treatment. Maybe no treatment is sometimes clinically appropriate. Perhaps the placebo effect is more complex and mysterious than previously thought. Even if placebo effects result from natural cycles of healing, what does this really mean? After all, nature is an expression of the divine. Possibly the healing process itself may have a divine source.
Before discussing a deeper, spiritual aspect of the placebo phenomenon, let’s take a moment to reflect on the limitations of the scientific process. By its very nature science produces tentative results. Scientific findings can always be amended or completely disproved by future investigation. That is the nature of science. In other words, science cannot provide absolute truth or certainty. I point this out because I often cite scientific research in this newsletter, and I want to be clear about the limitations of scientific research.
With regard to the new interpretation of the placebo effect, I suspect that future studies will redefine the role of beliefs and expectations about healing. The path of scientific knowledge often reverses itself. Yes, mind is the builder. Future studies will likely elaborate the importance of the mind with regard to placebo effects. Perhaps mental processes cannot fully account for all of the positive placebo outcomes. Something more may be at work here – the spiritual (divine) aspect of healing may be recognized.
To understand placebo, we must understand the healing process itself. Edgar Cayce provided this explanation of healing: “Know that all strength, all healing of every nature is the changing of the vibrations from within – the attuning of the divine within the living tissue of a body to Creative Energies. This alone is healing. Whether it is accomplished by the use of drugs, the knife or what not, it is the attuning of the atomic structure of the living cellular force to its spiritual heritage.” (1967-1) The “Creative Energies” were described as electrical vibrations – as manifestations of the life force that has a divine origin.
Note that almost any therapy (including surgery and drugs) can assist with the “attuning of the divine” that is the true source of healing. In another instance Cayce noted that the divine healing energy is a natural expression of atomic and cellular processes. “For all healing, mental or material, is attuning each atom of the body, each reflex of the brain forces, to the awareness of the divine that lies within each atom, each cell of the body… These adjustments are merely to attune the centers of the body … and nature does the healing.” (3384-2)
The concept that “nature heals” is an old idea. It is the basis for many traditional systems of healing such as naturopathy, osteopathy, and chiropractic. The expression “innate healing” is also used when discussing the body’s natural tendency to heal itself. Most natural healing traditions are explicit in identifying innate healing as an expression of the divine within.
The linkage of innate or divine healing with the placebo effect is natural. If the body is constantly healing itself, the placebo effect may be an expression of its innate ability. This idea first entered my mind while I listened to Eric Mein lecture to a group attending a Meridian Institute research conference. Dr. Mein explained that placebo is fundamentally a spiritual manifestation – the divine within. The mind, through its beliefs and attitudes, can enhance the divine healing energy, as can many other therapeutic interventions.
Thus the controversy about whether placebo is real or simply an illusion produced by natural cycles of healing can be interpreted at a deeper level. Perhaps the innate healing that occurs as a natural process regardless of the type of intervention or lack thereof is actually a manifestation of the divine within. Or as Andrew Weil has observed, the real issue is not whether the placebo exists, but rather that “… all systems of medicine should regard the placebo response as a therapeutic ally and work to evoke it more of the time, no matter what methods they use …”
This controversy is more than a methodological argument among researchers. Here are some points to keep in mind as you apply the information in this article:
The underlying spiritual dimension of healing is poorly understood by medical science. Consequently, the body’s innate tendency to heal is often ignored. Perhaps the placebo debate will encourage further scientific exploration of the innate, divine aspects of healing. At a personal level, keep the faith.