The placebo effect

Keen eyed readers are doubtless aware that I’ve written quite a bit on the topic of mind-body medicine over the past year, and that I’ve also been been interested to see some discussion of this topic drift into the mainstream media. The current New Yorker has an interesting article on the placebo effect e.g. the idea that a patient’s belief that they are going to feel better actually makes them feel better. The article goes in a lot of different directions and is tough to summarize, but in essence, it seems that in regards to pain there is an identifiable placebo effect. Most interesting is an anecdote told by the author of the article.

Three years ago, a week before Thanksgiving, while I was sitting in my office, my chest began to throb. It was a diffuse pain, but pain nonetheless. I am a middle-aged man with the usual amount of stress (too much) and I handle it in the usual way (denial). My cholesterol and blood pressure are normal, and I exercise regularly and try to eat sensibly. Still, I have read many obituaries of “healthy” men my age who ignore chest pain. So, somewhat sheepishly, I called my doctor and explained the situation, and he told me to come right over.

He conducted a thorough examination, and then we talked. He told me I was fine, that Thanksgiving is often a tense time, and that I should relax. My pain suddenly disappeared.

Now, one anecdote is hardly conclusive. But I’ve been struck by how common anecdotes like this one — stories which share themes of stress and tension causing physical symptoms — are. It’s the classic “I was feeling bad until I got to the hospital” story. It makes me think we are missing something in our attempts to explain pain and disease simply in structural (e.g. molecules, cells and organs etc.) terms.

The author’s anecdote reminds me of an experience I had. Over a decade ago, I was in a car accident that was fairly minor but did result in a painful rib contusion (essentially a bruise) where my ribs had pressed against the seat belt. It took about a month or so before I could laugh or sneeze without stinging pain. And over the years, I’ve occasionally found myself twisting my torso into some strange position and reactivating the pain. It’s as if if that strip of muscle never fully healed.

So, recently, I was lying in bed half awake, and I flopped over into a new sleeping position. This caused that old injury to start hurting, and I thought to myself, “oh boy, here it comes.” At that time, I had been doing a lot of reading the work of Dr. John Sarno, who fundamentally argues that muscles should heal within weeks or months, certainly not years. I actually had the thought, “but hold on… Sarno would argue that this pain isn’t real.” And right before I finished the mental recitation of the sentence, the pain seemingly magically disappeared. I’m not saying it slowly faded over the course of several minutes, I’m saying that within an instant it vanished.

One thought on “The placebo effect

  1. Pingback: Surgery and the placebo effect at My So-Called Penis

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