We left off the last post pointing out the ethical quandary around using the placebo effect for therapeutic purposes. Consider the fact that as NDs, “Do no Harm” is a fundamental tenet of our practice. Everything else aside, if the results are similar whether or not we prescribe drugs, by not prescribing we at least would be sparing the patient from the side effects often associated with drug use.
If the benefit to the patient is really the primary issue, then we could even explore practices that claim to have high case study empirical success and analyze whether there is merit for the modality used or whether it was just the context of the practitioner-patient relationship that was able to create a placebo effect.
Simmonds says, “… conditioning appears to be complemented by expectancies, and it is difficult to tease out the relative contributions of each. Placebo effects are influenced by context and suggestion, as well as by the conditioning effect of a specific treatment.” (Price, 1999)
Unfortunately, any treatment that is not well understood but which works gets grouped into the simple explanation that it was “just the placebo” effect. Research investigating the positive therapeutic incomes effects is what’s required though.
I am not advocating that natural therapies be free of statistical standards applied to drug therapies. However, do we really understand the mechanisms and the factors involved in the placebo effect, and what specific influences the doctor-patient relationship, as well the patient’s mindset have on the treatment outcome?
Viewing the “placebo” as the trigger to a self-generated and “supported” (i.e. doctor-facilitated) initiative of the patient to take charge and get better, what is the next step on the path which doesn’t lead to a self-effacing and disempowered feeling, and possibly to a nocebo effect, when the patient finds out that they got better on “nothing?”
For many, getting better on “nothing” means they had “nothing” to begin with, and that it was all in their head. The problem with that interpretation of the process is evident. Placebo is not “nothing”; the process of taking the “placebo” empowers the body with the necessary tools to start the healing process. The body is primed for self-healing.