Wednesday, June 11, 2014

Placebo? Mind over Muscle at Harvard

Wisdom Quarterly; Alia Crum, Ellen Langer (Harvard), Psychological Science (18, 2: 165-171)
(Chauncey McDermott) Mind over matter: "You can do it, Duffy Moon!"

Mind-Set Matters: Exercise and the Placebo Effect
ABSTRACT—In a study testing whether the relationship between exercise and health is moderated by one’s mindset, 84 female room attendants working in seven different hotels were measured on physiological health variables affected by exercise. Those in the informed condition were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General’s recommendations for an active lifestyle. Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.

Shhhh. These are just sugar pills.
The placebo effect is any effect that is not attributed to an actual pharmaceutical drug or remedy, but rather is attributed to the individual’s mind-set (mindless beliefs and expectations).

The therapeutic benefit of the placebo effect is so widely accepted that accounting for it has become a standard in clinical drug trials to distinguish pharmaceutical effects from the placebo effect and the placebo effect from other possible confounding factors, including spontaneous remission and the natural history of the condition (Benson & McCallie, 1979; Brody, 1980; Nesbitt Shanor, 1999; Spiro, 1986). Kirsh and Sapirstein (1998), in a meta-analysis of 2,318 clinical drug trials for antidepressant medication, found that [only] a quarter (25.16%) of the patients’ responses were due to the actual drug effect, another quarter (23.87%) were due to the natural history of depression, and half (50.97%) were due to the placebo effect.

Scholar Shelly Brown: "Bridging science and religion" (
Powerful love medicine (glucose, FD&C red)
The placebo effect extends much further than medications or therapy: Subjects exposed to fake poison ivy developed real rashes (Blakeslee, 1998), people imbibing placebo caffeine experienced increased motor performance and heart rate (and other effects congruent with the subjects’ beliefs and not with the pharmacological effects of caffeine; Kirsch & Sapirstein, 1998), and patients given anesthesia and a fake knee operation experienced reduced pain and swelling in their ‘‘healed’’ tendons and ligaments (Blakeslee, 1998). More generally, studies suggest that 60 to 90% of drugs and other therapies prescribed by physicians depend on the placebo effect for their effectiveness (Benson & Freedman, 1996; Nesbitt Shanor, 1999).

The placebo effect does not have to involve inert pills or sham procedures. Symbols, beliefs, and expectations can elicit powerful physiological occurrences, both positive and negative (Hahn & Kleinman, 1983; Roberts, Kewman, & Mercie, 1993).

Prof. Ellen Langer, Harvard University
For example, the mere presence of a doctor increases patients’ blood pressure (the ‘‘white coat effect’’), reinterpreting pain in nonthreatening ways (e.g., as sensations) prompts patients to take fewer sedatives and leave the hospital sooner; and the health decline of cancer patients often has less to do with the actual course of the illness and more to do with their negative expectations regarding the disease (Langer, 1989).

As the most common health threats are now infectious rather than chronic, remedies have also changed. Doctors now prescribe behavioral changes such as exercise for chronic diseases like diabetes, heart disease, and even cancer. We wondered whether the well-known benefits of exercise are in whole or in part the result of the placebo effect. A positive finding would speak to the potentially powerful... More

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