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Wednesday, September 2, 2009

Placebo Part 2: Roots in Symbolism, Shamanism


Fabrizio Benedetti is one of the world’s leading researchers of how placebos work in the human brain, and he traces their effects back to ancient shamanism.

A physician, he also is a professor of physiology at the University of Turin Medical School, a consultant for the Placebo Project at the National Institute of Health in Bethesda, Maryland, and a member of the Mind-Brain-Behavior Initiative at Harvard University. He writes:
The placebo-nocebo effect represents an amazing example of how the mind-brain unit interacts with the body. Whereas placebos have to do with positive symbols that anticipate clinical benefit, nocebos are linked to negative symbols that induce expectations of clinical worsening. Positive symbols can range from empathic doctors and smiling nurses to trust-inducing complex medical machines and apparatuses. Likewise, there are a variety of negative symbols, ranging from shabby doctors to a pain-anticipating dentist’s drill.

From an evolutionary perspective, these symbols, and indeed their interpretations by the patients, have evolved from ancient shamanism to modern medicine, whereby the patient’s expectations and beliefs in the healing power of the doctor play a crucial role. By studying placebo and nocebo effects, today we are beginning to understand how medical symbols affect the patient’s brain or, in other words, how positive or negative psychosocial contexts can change the brain and body functioning of the patients.
According to the Wired article posted above, Benedetti, 53, first became interested in placebos in the mid-'90s, while researching pain. He was surprised that some of the test subjects in his placebo groups seemed to suffer less than those on active drugs. But scientific interest in this phenomenon, and the money to research it, were hard to come by.

"The placebo effect was considered little more than a nuisance," he recalls. "Drug companies, physicians, and clinicians were not interested in understanding its mechanisms. They were concerned only with figuring out whether their drugs worked better."

2 comments:

christopher said...

I have long been disappointed as to why the mainstream relegates the primary tool of this whole set of phenomena to a side street. Hypnosis is what I mean. If this tool were warmly welcomed instead of stigmatized and found in every venue with the full expectations of its success attendant on its presence, then miraculous outcomes would become routine. It would all be sourced in what we call the placebo effect. Of course that would also mean the nocebo effect could magnify too, but in actuality this happens anyway.

I have long been an advocate of bringing forward into contemporary society the shaman's successes. Hypnosis figures in most of them.

Gregory LeFever said...

That's a great point, Christopher. Too bad hypnosis today is found mostly in television commercials instead of some worthwhile use for it, as you suggest. I had not thought about the hypnosis-placebo link in quite this way before. Excellent!