Placebo pill
Photo: Dan Saelinger
Q: Early in Mind Over Medicine, you admit that you used to be skeptical of the placebo effect. What changed your mind?

A: As an ob-gyn with conventional medical training, I was reluctant to buy into the idea that the mind can play such an important role in healing. But it's hard to dispute the fact that up to 70 percent of patients in clinical trials see their symptoms improve simply from a placebo. And doctors are observing these changes on a physiological level. For instance, in a report in the British Journal of Clinical Pharmacology, researchers found that when people with ulcers took a placebo four times a day, their ulcers healed at a greater rate than those given placebos only twice a day. The science proves that placebos don't just change how you feel; they can change your biochemistry.

Q: How does this happen?

A: When you're given a medicine—placebo or not—that you believe will help treat whatever is ailing you, your body's relaxation response can naturally turn on. You may think, "I'm doing something to help. My needs are being tended." These positive thoughts can set off the release of healing hormones and neurotransmitters—such as dopamine, nitric oxide, and endorphins—into your bloodstream. The effects of these chemicals can be powerful: Nitric oxide can increase blood flow to your organs, for instance, and endorphins can act like nature's morphine, dulling pain.

Q: Can negative thoughts have the opposite effect?

A: Yes. In some cases, negative thinking is the cause of the "nocebo effect"—in which patients feel worse after learning that a treatment may have negative side effects. In fact, in one study, asthmatics who inhaled a harmless solution that they had been told contained irritating allergens started wheezing. What's more, the researchers found that the subjects' bronchi actually constricted as a result. Our body's natural self-repair systems can't work properly if we're chronically stressed or pessimistic. They're more effective when the relaxation response is dominant.

Q: Besides positive thinking, what else helps the healing process?

A: You need a healthcare provider who can give you the time you deserve—not someone who's trying to see 40 patients in seven-minute visits. I used to be that kind of doctor, but hurrying through appointments doesn't put people at ease. Research suggests that nurturing care, specifically from those in the white coats, can have its own kind of placebo effect. The more face time a person gets with attentive, concerned doctors, the more likely that a placebo will work.

Q: Is it possible to harness the power of the placebo without a pill?

A: One of the most important questions I ask patients with chronic conditions is, what does your body need in order to heal? I hear all sorts of things, from "I need to fix my toxic marriage or leave" to "I need to quit my job." One woman said, "I need to move to my vacation home in Santa Fe. Whenever I go there, my symptoms disappear." I'm not saying medical care isn't necessary, but when you have a chronic condition, you owe it to yourself to do everything you can to activate your body's natural self-healing systems. Finding whatever it is that puts you in a state of neurologic relaxation can be just as important as going to the doctor.

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