The following post if from my counterpart in Michigan, Bob Cummings. Enjoy!
Explosive! That’s how correspondent Lesley Stahl described it.¹ And a study on the implications it raises for all drug-based therapy would be impossible – or would it?
In her recent 60 Minutes report on Placebos, Stahl interviewed Irving Kirsch, Associate Director of the Placebo Studies Program at Harvard Medical School. The explosive news: that placebos (inactive pills, such as sugar pills) have virtually the same effect as antidepressant drugs for those who are mildly or moderately depressed. This certainly would seem to shatter the conventional view about antidepressant drugs. (She wisely also mentioned that patients taking such drugs should not drop their use cold turkey but consult their doctor).
Even if you didn’t see Stahl’s 02/19/2012 60 Minutes segment, you’ve probably heard of the placebo effect in which an inert pill has a therapeutic benefit because the patient expects it to. And maybe you’ve heard of the negative version of this – the nocebo effect, in which a patient experiences an expected harmful effect.
In both of these situations, the patient’s thought arms the inert pill with an effect, good or bad, indicating a mental component in the medicinal process. In Stahl’s report, she pressed Kirsh, “But people are getting better taking antidepressants. I know them. We all know them.” Kirsch responded, “People get better when they take the drug, but it’s not the chemical ingredients of the drugs that are making them better. It’s largely the placebo effect.”
This begs the question of what this might imply about drug-based therapy in general. Is a drug’s effectiveness the result of thought rather than chemistry?
If it is, here’s how this might work. A pharmaceutical company produces a drug and as a result of a clinical study decides that it has a therapeutic effect, adding a layer of placebo effect to the drug. The Federal Drug Administration approves the drug, adding another layer. Physicians then accept this determination and prescribe the drug, adding another layer of the placebo effect. The public is educated about the drug through the media and by physicians and they add another layer.
“The chemist, the botanist, the druggist, the doctor, and the nurse equip the medicine with their faith, and the beliefs which are in the majority rule” is how Mary Baker Eddy, a pioneer in mental, spiritual healing back in the 1800?s, describes this in Science and Health with Key to the Scriptures (pg 155).
Now, if I wanted to do a clinical study to test this hypothesis, I would want to have each of these participants who create and use a drug to do so without adding a belief or expectation in a therapeutic benefit – without adding a layer of the placebo effect.
Of course, such a study would be impossible, wouldn’t it? A drug company is not going to invest the time and expense to develop and produce a drug they believe to have no chemical therapeutic benefit. The FDA would not approve such a drug, physicians would not prescribe it, and so on. You just couldn’t remove all layers of the placebo effect and then have our health care system utilize such a drug (not to mention the ethical issues involved).
But what if a study could be conducted that would address just one layer of the placebo effect? Hypothetically, if you could take a drug (an actual drug, not a placebo) and have physicians NOT add their layer of the placebo effect to the drug, what result would we expect to see? Wouldn’t we expect to see a decrease in the therapeutic effectiveness of the drug? And wouldn’t this decrease be a measure of the placebo effect layer added by physicians?
Consider this. In his book entitled, “Timeless Healing – The Power and Biology of Belief” (see page 30), Herbert Benson, M.D., a graduate of Harvard Medical School, shares what he learned from a 1979 study he and Dr. David P. McCallie Jr. made of therapies used to alleviate a condition called “angina pectoris” (chest pain). He explains that techniques used in years past that have since proved to be “misguided” nonetheless often worked even though there was “no physiologic reason” they should have.
He relates that when these therapies “were used and believed in, they were effective 70 to 90 percent of the time…” “Later, when physicians began to doubt whether these treatments worked, their effectiveness dropped to 30 to 40 percent.”
In this situation, the therapy lost over half of its effectiveness. Same therapy! What changed? Was this a result of the physicians’ layer of the placebo effect being removed as a more accurate assessment of the therapy surfaced over time? Was the higher rate of effectiveness early on the result of the physician’s layer of the placebo effect being included?
This all points to thought and the mental nature of the healing process. Stahl said her story involves “how the mind is so powerful over the body“¹. If this be the case, then how powerful would thought – influenced for the better by a single, all-good, infinite mind – an all-powerful, all-loving divine Mind – be to do the body good?