Healing with the placebo effect

The placebo effect occurs in every treatment. In research, the placebo effect is usually seen as noise or nuisance: something that needs to be controlled for in order to discern the effect of a medical treatment. Professor in health psychology Jozien Bensing tries a different approach. She is using her Spinoza Prize for research on how the placebo effect can be used to promote patients’ healing. The first results about this research have been published in Patient Education and Counseling.

The underlying mechanisms of the placebo-effect are more or less known: learning (conditioning), patients’ expectations of a treatment and patients’ emotions have a leading role. An example of a learning effect could be a physician who places her hand on the forehead of a patient with fever. If the patient recovers soon after that, then next time, a cool hand on the forehead of the patient might speed recovery through the positive association that was made previously. Effects that are expected by patients are more likely to occur, this has been shown repeatedly in different scientific experiments. Stress and anxiety can cause or increase physical complaints, so lowering negative emotions might lead to an optimal placebo effect.

Communication as a drug
In 2006, Jozien Bensing won the NWO Spinoza Prize (the highest award in Dutch science), which she uses, among other goals, for research by NIVEL on the role of communication in the placebo effect: how communication can be used “as a drug”. “The placebo effect is not caused by the sugar pill or sham treatment, but is generated by how a treatment is offered. The communication in the consultation room plays a very important role in that process. The ritual of the treatment, the expectations and the emotions of a patient, and the way the physician is dealing with those factors, have an effect on the patient. Optimizing this process can aid patients’ recovery.”

The warm, empathic physician
The first simulation-experiment from Bensing’s project has been conducted and focused on manipulating patients’ expectancies and emotions. Placebo effect theory describes that raising positive expectations and diminishing stress and anxiety will enhance placebo effects. The experiment showed that targeted communication interventions are capable of influencing patients’ expectancies and emotions in order to attain a maximal placebo response. The warm empathic physician who raises positive expectations was most effective: patients were significantly less anxious after the consultation and had most positive expectations about the effect of the suggested treatment.