The Placebo Effect Works Even When You Know You’re Taking a Placebo

Think the placebo effect only works if you don’t know that you’re taking a placebo? Think again.

A new study is the first to demonstrate a beneficial placebo effect for lower back pain sufferers who knew they were taking a placebo. Pain was reportedly “30 percent less” even though the patients in the study knew that the pills they were being given were fake.

The received wisdom on the placebo effect is that it relies on the patients’ belief that they are taking a real medication and that the effect would vanish if they knew the truth. Medical studies often base the efficacy of their drug based on comparison with a placebo – a comparison that may now be called into question.

A paper published in the journal “Pain” is the first to demonstrate that patients who knowingly took a placebo in conjunction with traditional treatment for lower back pain saw more improvement than those given traditional treatment alone.

“These findings turn our understanding of the placebo effect on its head,” said joint senior author Ted Kaptchuk, director of the Program for Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center and an associate professor of medicine at Harvard Medical School. “This new research demonstrates that the placebo effect is not necessarily elicited by patients’ conscious expectation that they are getting an active medicine, as long thought. Taking a pill in the context of a patient-clinician relationship — even if you know it’s a placebo — is a ritual that changes symptoms and probably activates regions of the brain that modulate symptoms.”

“It’s the benefit of being immersed in treatment: interacting with a physician or nurse, taking pills, all the rituals and symbols of our healthcare system,” Kaptchuk said. “The body responds to that.”

You can find out more about the study in this article or read the study itself.

As a hypnotherapist, the implications of this research are significant.

What difference does it make to hypnosis?

Have you ever heard of someone who “couldn’t” be hypnotised? Me too, but everything we know about hypnosis tells us that anyone can be hypnotised. How do we reconcile these two positions?

The truth is that although anyone can be hypnotised, some people have told themselves that they can’t (or won’t) be hypnotised with such conviction that they’ve actually hypnotised themselves into being un-hypnotisable!. This might seem a little counter-intuitive, but it’s the truth. Hypnosis isn’t something that someone does to you – it’s something you do for yourself..

The same would appear to be true of the placebo effect – there’s no deceit or trickery required, just belief and ritual. If you “buy in” to the process, it will work for you – just like hypnosis..

Can we use the placebo effect with Auto Suggestion?

One of my favourite types of hypnosis is Auto Suggestion – simply using the power of suggestion to someone who is a receptive state of mind without a trance or needing to “go to sleep”. Emil Coue, one of the foremost practitioners of Auto Suggestion, documented pain management techniques that used auto suggestion. In some instances, simply telling yourself that the pain was “going” could be enough according to Coue.

A little belief can go a long way

One of the best pieces of advice about hypnosis that I was ever given was that to be successful you had to “be the hypnotist”. It meant introducing yourself as the hypnotist – not someone who was “just a bit interested” in hypnotism or “liked to play about”, but someone who was 100% serious about it.

This plugs in very well to what this study reveals about the importance of rituals and symbols – these are all encoded into your subconscious mind and are an important part of triggering a response. I’ll certainly think twice about putting my pocket watch away now – it has such a strong association for many people with hypnosis that the thing works in a way that is far more powerful than a simple pendulum. And if it ain’t broke…