The Power of the Mind in Healing

The Power of the Mind in Healing

November 3, 2023

Joy Stepinski, MSN, RN-BC

In her book The Magic Feather Effect, author and journalist Melanie Warner investigates alternative healing [1]. She observes and interviews different patients and practitioners with respect to acupuncture, energy healing, chiropractors, and more. Warner raises the point that healing can happen in numerous ways. Symptoms of medical problems can resolve differently for various reasons. Sometimes healing can occur spontaneously. Often symptoms gradually disappear, like with a cold. Yet at other times, symptoms ebb and flow, such as experienced with pain and fatigue. People often seek help when symptoms are at their worst, and feel much better once treatment is received. One can wonder if the improvement may be due to the intervention or from the body’s ability to heal on its own. Perhaps expectation plays a role.

The author acknowledges that she does not fully support alternative medicine. However, she believes that these methods offer what “standard medicine” does not. She states, “By making us feel supported, by summoning the power of expectations and belief, by relaxing our bodies and reducing stress, mind-body therapies move molecules in our brains in a way that can reduce the ills we feel in our bodies…even though we’re far from a complete scientific understanding of how exactly they all do this” (p. 229). She chalks alternative medicine up to the placebo effect.

What exactly is the placebo effect?  Very simply, it is the positive result that occurs due to the expectation that a treatment will be of benefit [2]. The term appeared in 18th century medicine as a drug that was not meant to cure an ailment, but given to appease patients [3]. While historically given a negative connotation, the placebo effect has shown to be very powerful, and in today’s era is considered a positive response to any component of treatment or healing.

Research on the placebo effect has blossomed over the past 20 years. Even debilitating diseases like Parkinson’s have shown benefit. One small study (n = 6) found that the placebo effect was noticeable [2] among patients with Parkinson’s. The research design centered on two conditions. In one, patients were administered both the placebo and the active drug. A second scenario eliminated the use of the placebo. The researchers used positron emission tomography (PET) and discovered that patients experienced similar brain changes when given the placebo as the actual drug treatment. The researchers reported an endogenous release of dopamine in response to treatment, which was more heightened among participants who expected the placebo benefit.

Open-label placebos transpired in the late 20th century. The prior practice of giving placebos while withholding the fact that pills had no active ingredients was deemed unethical [3]. The concern was interference with patient autonomy. Instead, open-label placebos disclose this information. Patients are informed that the treatment may have a benefit, despite that the drug does not contain medicine.

Studies show that open-label placebos can be quite successful. For example, in a Portuguese randomized controlled trial on chronic back pain treatment [4], patients were followed for three weeks. Forty-one patients were given the placebo and 42 were given standard treatment. Findings showed a greater pain reduction with use of open-label placebos, versus treatment as usual. Notably, 17 participants asked for prescriptions at the research closing. The study concluded that open-label placebos can be effective for chronic low back pain. Other studies show benefits for depression, poor sleep [5], irritable bowel syndrome, and cancer-related fatigue [6].

One of the other ways to “harness” the placebo effect is the healthcare provider-patient relationship. When healthcare providers use encouragement, speak positively, reassure the patient, and discuss values, this type of communication can be profound [5]. If patients are not stressed or anxious, feel that they are supported and cared for, and trust their provider, the interaction can elicit a positive expectation. Other thoughts about the placebo as a “powerful antidote for illness” discussed in the literature [3] involves presence. Just by seeking care, patients find relief.

In Warner’s book, the author discusses that alternative medicine may provide the empathy that patients often seek when confronting medical issues. She states, “these therapies can also calm, empower, and inspire us, giving us more resilience than we imagine we have, and leading us down paths we wouldn’t otherwise find” (p. 229).

Whether standard or alternative medicine is used, the capability of these positive effects is important to note. Whether beneficial outcomes are referred to as “placebo” or a result of an “expectation,” our minds play an intricate part in healing and overall health. This is perhaps the key takeaway. As I have discussed in my blog, health is a dynamic journey of the whole being (mind, body, and spirit). Each choice we make affects the entire landscape of our health journey. Walking down paths that lead us to resilience, different opportunities, and overcoming challenges shows that the mind is an integral part of our being.  

References

1.    Warner, M. (2019). The magic feather effect: The science of alternative medicine and the surprising power of belief. Scribner.

2.    De la Fuente-Fernández, R., Ruth, T. J., Sossi, V., Schulzer, M., Calne, D. B., & Stoessl, A. J. (2001). Expectation and dopamine release: mechanism of the placebo effect in Parkinson's disease. Science, 293(5532), 1164-1166.

3.    Bernstein, H., & Brown, W. A. (2017). The placebo effect in psychiatric practice. Current Psychiatry, 16(11), 29 – 34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6003660/#R1

4.    Carvalho, C., Caetano, J. M., Cunha, L., Rebouta, P., Kaptchuk, T. J., & Kirsch, I. (2016). Open-label placebo treatment in chronic low back pain: a randomized controlled trial. Pain, 157(12), 2766. https://doi.org/10.1097/j.pain.0000000000000700 

5.    Bystad, M., Bystad, C., & Wynn, R. (2015). How can placebo effects best be applied in clinical practice? A narrative review. Psychology Research and Behavior Management, 8, 41-45.

6.    Kaptchuk, T. J., & Miller, F. G. (2018). Open label placebo: Can honestly prescribed placebos evoke meaningful therapeutic benefits?. British Medical Journal, 363. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889847/