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The Power of the Placebo Effect
The placebo effect is real. Why don't many people agree?

Over the last two weeks I’ve written articles questioning the efficacy of acupuncture and cupping. In both the placebo effect was mentioned. The response from fans of the above treatments was the same: it’s not placebo; it really works.
We have to question why we’re so opposed to the placebo effect when it has been shown to work more effectively than many therapies. As Ezra Klein recently stated, placebos have proven as important to our understanding of healing as many medical interventions.
Former doctor and Air Force flight surgeon Harriet Hall believes the term ‘placebo effect’ is unfortunate. As she notes, the term comes from Latin meaning, ‘I please,’ which she posits opposing ‘I benefit.’
What we really mean by “the placebo effect” is not some mysterious effect from giving an inert treatment, but the complex web of psychosocial effects surrounding medical treatment. Those effects occur with effective treatments too, not just with inert treatments.
The true culprit here might be our fascination with treating isolated therapies as potential silver bullets. If this drug works for this, it must work each time. For context, consider acupuncture: the low lights, ambient music, and relaxing for an hour are all part of the treatment.
I had several sessions in New York, a city not known for its calm pace. Taking an hour from my day to chill and essentially meditate, or nap, is therapeutic. Might that prove more effective than needles? Possibly.
Environment matters. A 1984 study on the effects of hospital window views found that patients staring out into nature had shorter postoperative stays, complained less, and took fewer and more moderate doses of drugs than patients whose windows faced a brick wall. Hospitals like the Dyson Centre for Neonatal Care in England took this into consideration when designing their building.
Deliberately distancing itself from the traditional hospital look, feel and smell, this and other places like it are drawing on a growing body of research that shows that buildings themselves can speed the recovery of patients, as well as boosting the health and happiness of the staff who work in them.
And while the exact mechanisms and results are not clear, it appears that having a positive attitude toward healing helps boost immunity, resulting in a cascade of beneficial effects. Again, this depends on what type of disease or injury is under discussion and what treatments are being provided. Yet it’s not controversial to say that a good attitude helps you feel better, which would obviously affect how your body functions.
The biggest pushback I received always came joined with a criticism of Western medicine. While I’m just as skeptical at the destroy and rebuild mentality of chemotherapy, for example, and the take a pill when anything slightly aches approach, the double blind study is one of the most reliable indicators of efficacy so far invented.
It’s a shame that pharmaceutical companies overstate effects and gauge prices, just as ridiculous mark-ups by hospitals ($36.78 for Tylenol? $14,000 outpatient knee surgery?) make patients cringe in disbelief as they watch life savings disappear.
Our psychology is complex. As reported by Shankar Vedantam, we are wildly influenced by the price on the bottle of wine. People tasting a $5 bottle that were told it’s a $45 bottle thought it better than a $90 bottle that they were told cost $10. Anticipation and expectation shape experience. Blame our dopamine receptors.
If we’re going in for a treatment with the idea that we’re going to be fixed, chances are our attitude will help the healing process along. This is a truer estimation of the placebo effect than something ‘fake’ tricking us. Showing just how much perception matters, Hall notes the following:
If your treatment works is there be a problem? Again, that needs to be addressed case by case. If you’re shelling out hundreds of dollars for a result that could be achieved with an hour of meditation or restorative yoga, you have to wonder. If it’s the only feasible way to procure an effect, it might be effective enough.
Just don’t discount the placebo. Its power is stronger than you might believe.
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Derek Beres is working on his new book, Whole Motion: Training Your Brain and Body For Optimal Health (Carrel/Skyhorse, Spring 2017). He is based in Los Angeles. Stay in touch on Facebook and Twitter.
Iron Age discoveries uncovered outside London, including a ‘murder’ victim
A man's skeleton, found facedown with his hands bound, was unearthed near an ancient ceremonial circle during a high speed rail excavation project.
- A skeleton representing a man who was tossed face down into a ditch nearly 2,500 years ago with his hands bound in front of his hips was dug up during an excavation outside of London.
- The discovery was made during a high speed rail project that has been a bonanza for archaeology, as the area is home to more than 60 ancient sites along the planned route.
- An ornate grave of a high status individual from the Roman period and an ancient ceremonial circle were also discovered during the excavations.
Foul play?
<p>A skeleton representing a man who was tossed face down into a ditch nearly 2,500 years ago with his hands bound in front of his hips was dug up during a high speed rail excavation.</p><p>The positioning of the remains have led archaeologists to suspect that the man may have been a victim of an ancient murder or execution. Though any bindings have since decomposed, his hands were positioned together and pinned under his pelvis. There was also no sign of a grave or coffin. </p><p>"He seems to have had his hands tied, and he was face-down in the bottom of the ditch," <a href="https://www.livescience.com/iron-age-murder-victim-england.html" target="_blank">said archaeologist Rachel Wood</a>, who led the excavation. "There are not many ways that you end up that way."</p><p>Currently, archaeologists are examining the skeleton to uncover more information about the circumstances of the man's death. Fragments of pottery found in the ditch may offer some clues as to exactly when the man died. </p><p>"If he was struck across the head with a heavy object, you could find a mark of that on the back of the skull," Wood said to <a href="https://www.livescience.com/iron-age-murder-victim-england.html" target="_blank">Live Science</a>. "If he was stabbed, you could find blade marks on the ribs. So we're hoping to find something like that, to tell us how he died."</p>Other discoveries at Wellwick Farm
<p>The grim discovery was made at Wellwick Farm near Wendover. That is about 15 miles north-west of the outskirts of London, where <a href="https://www.hs2.org.uk/building-hs2/hs2-green-corridor/" target="_blank">a tunnel</a> is going to be built as part of a HS2 high-speed rail project due to open between London and several northern cities sometime after 2028. The infrastructure project has been something of a bonanza for archaeology as the area is home to more than 60 ancient sites along the planned route that are now being excavated before construction begins. </p><p>The farm sits less than a mile away from the ancient highway <a href="http://web.stanford.edu/group/texttechnologies/cgi-bin/stanfordnottingham/places/?icknield" target="_blank">Icknield Way</a> that runs along the tops of the Chiltern Hills. The route (now mostly trails) has been used since prehistoric times. Evidence at Wellwick Farm indicates that from the Neolithic to the Medieval eras, humans have occupied the region for more than 4,000 years, making it a rich area for archaeological finds. </p><p>Wood and her colleagues found some evidence of an ancient village occupied from the late Bronze Age (more than 3,000 years ago) until the Roman Empire's invasion of southern England about 2,000 years ago. At the site were the remains of animal pens, pits for disposing food, and a roundhouse — a standard British dwelling during the Bronze Age constructed with a circular plan made of stone or wood topped with a conical thatched roof.</p>Ceremonial burial site
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzMTk0Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NDgwNTIyMX0.I49n1-j8WVhKjIZS_wVWZissnk3W1583yYXB7qaGtN8/img.jpg?width=1245&coordinates=0%2C82%2C0%2C83&height=700" id="44da7" class="rm-shortcode" data-rm-shortcode-id="46cfc8ca1c64fc404b32014542221275" data-rm-shortcode-name="rebelmouse-image" alt="top down view of coffin" data-width="1245" data-height="700" />A high status burial in a lead-lined coffin dating back to Roman times.
Photo Credit: HS2
<p>While these ancient people moved away from Wellwick Farm before the Romans invaded, a large portion of the area was still used for ritual burials for high-status members of society, Wood told Live Science. The ceremonial burial site included a circular ditch (about 60 feet across) at the center, and was a bit of a distance away from the ditch where the (suspected) murder victim was uncovered. Additionally, archaeologists found an ornately detailed grave near the sacred burial site that dates back to the Roman period, hundreds of years later when the original Bronze Age burial site would have been overgrown.</p><p>The newer grave from the Roman period encapsulated an adult skeleton contained in a lead-lined coffin. It's likely that the outer coffin had been made of wood that rotted away. Since it was clearly an ornate burial, the occupant of the grave was probably a person of high status who could afford such a lavish burial. However, according to Wood, no treasures or tokens had been discovered. </p>Sacred timber circle
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzMTk0Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MDAwOTQ4Mn0.eVJAUcD0uBUkVMFuMOPSgH8EssGkfLf_MjwUv0zGCI8/img.jpg?width=1245&coordinates=0%2C149%2C0%2C149&height=700" id="9de6a" class="rm-shortcode" data-rm-shortcode-id="ee66520d470b26f5c055eaef0b95ec06" data-rm-shortcode-name="rebelmouse-image" alt="An aerial view of the sacred circular monument." data-width="1245" data-height="700" />An aerial view of the sacred circular monument.
Photo Credit: HS2
<p>One of the most compelling archaeological discoveries at Wellwick Farm are the indications of a huge ceremonial circle once circumscribed by timber posts lying south of the Bronze Age burial site. Though the wooden posts have rotted away, signs of the post holes remain. It's thought to date from the Neolithic period to 5,000 years ago, according to Wood.</p><p>This circle would have had a diameter stretching 210 feet across and consisted of two rings of hundreds of posts. There would have been an entry gap to the south-west. Five posts in the very center of the circle aligned with that same gap, which, according to Wood, appeared to have been in the direction of the rising sun on the day of the midwinter solstice. </p><p>Similar Neolithic timber circles have been discovered around Great Britain, such as one near <a href="https://bigthink.com/culture-religion/stonehenge-sarsens" target="_blank">Stonehenge</a> that is considered to date back to around the same time. </p>Skepticism: Why critical thinking makes you smarter
Being skeptical isn't just about being contrarian. It's about asking the right questions of ourselves and others to gain understanding.
- It's not always easy to tell the difference between objective truth and what we believe to be true. Separating facts from opinions, according to skeptic Michael Shermer, theoretical physicist Lawrence Krauss, and others, requires research, self-reflection, and time.
- Recognizing your own biases and those of others, avoiding echo chambers, actively seeking out opposing voices, and asking smart, testable questions are a few of the ways that skepticism can be a useful tool for learning and growth.
- As Derren Brown points out, being "skeptical of skepticism" can also lead to interesting revelations and teach us new things about ourselves and our psychology.
New study suggests placebo might be as powerful as psychedelics
New study suggests the placebo effect can be as powerful as microdosing LSD.
- New research from Imperial College London investigated the psychological effects of microdosing LSD in 191 volunteers.
- While microdosers experienced beneficial mental health effects, the placebo group performed statistically similar to those who took LSD.
- Researchers believe the expectation of a trip could produce some of the same sensations as actually ingesting psychedelics.
Psychedelics: The scientific renaissance of mind-altering drugs
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="92360c805fe66c11de38a75b0967f417"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/5T0LmbWROKY?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>For the study published in eLife, the team recruited 191 citizen cosmonauts to microdose either LSD or a placebo over the course of several weeks and note the psychological effects. Volunteers were already microdosing LSD, so there was no true control. Each volunteer was given instructions on creating their own low-dose gel capsules, some containing LSD, others not. Then they mixed the capsules in envelopes so they didn't know if they were taking the real thing or not.</p><p>The trial design was ingenious: each capsule featured a QR code that was scanned after the addition of ingredients but before they were placed in the envelope so that researchers knew what they were ingesting.</p><p>The problem: volunteers sourced their own LSD. Lack of quality control could have had a profound effect on the results. </p><p>The results: LSD microdosers reported feeling more mindful, satisfied with life, and better overall; they also noticed a reduction in feelings of paranoia. </p><p>The catch: the control group felt the same thing, with no statistical difference between the groups. </p><p>Lead author Balázs Szigeti comments on the findings: "This suggests that the improvements may not be due to the pharmacological action of the drug but can instead be explained by the placebo effect." </p>Credit: Alexander / Adobe Stock
<p>Psychedelics are notoriously difficult to control for given the intensity of the experience. Yet there is precedent for the above findings. A <a href="https://link.springer.com/article/10.1007/s00213-020-05464-5" target="_blank">2019 study</a> found that 61 percent of volunteers that took a placebo instead of psilocybin felt some psychedelic effects, with a few volunteers experiencing full-on trips.</p><p style="margin-left: 20px;">"Several stated that they saw the paintings on the walls 'move' or 'reshape' themselves, others felt 'heavy. . . as if gravity [had] a stronger hold', and one had a 'come down' before another 'wave' hit her."</p><p>The Imperial team believes the expectation of a trip might have been enough to produce similar results. Senior author David Erritzoe is excited for future studies on the topic, believing they tapped into a new wave of citizen science that could push forward our knowledge of psychedelic substances.</p><p style="margin-left: 20px;">"Accounting for the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or users' expectations can lead to a strong placebo response. Self-blinding citizen science initiatives could be used as an inexpensive, initial screening tool before launching expensive clinical studies."</p><p>As investments into the psychedelics market explode, with one company <a href="https://www.bloomberg.com/news/articles/2021-03-03/thiel-backed-magic-mushroom-firm-atai-hits-2-billion-valuation" target="_blank">reaching a $2 billion valuation</a>, a recurring irony appears in the long arc of psychedelics and research: the power of our minds might be enough to feel greater life satisfaction and a deeper sense of mindfulness. If that's possible with a placebo, we have to question why the rush to create more pharmacology is necessary. </p><p>This is, mind you, a separate conversation over the role of psychedelics and rituals for group bonding. The function of group cohesion around consciousness-altering substances will continue to play an important role in many communities. </p><p>Of course, we should continue to explore the efficacy of psychedelics on anxiety, depression, suicidal ideation, PTSD, and addiction. <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">Pharmacological dependence</a> is a stain on the psychiatry industry. Whether or not psychedelics can be prescribed for daily use remains to be seen, but we know a moneyed interest is expecting a return on investment—the above company, ATAI Life Sciences, raised $157 million in its Series D round. </p><p>When it comes to wellbeing, some things money just can't buy. How we navigate the tricky terrain of mainstreaming psychedelics remains to be seen. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His most recent book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>Your genetics influence how resilient you are to the cold
What makes some people more likely to shiver than others?
