Aristotle believed that “men acquire a particular quality by constantly acting in a particular way.” Aristotle understood the mechanisms of humanity far too well. A typical interpretation of such an idea in the culture of today might assume a tie-in to classical conditioning. The practice of conditioning has been understood in psychological terms for many years and is slowly starting to entertain a connection between psychological conditioning and medicine. Such a connection can be verbalized with the practice of using placebos to treat illnesses of all types. New research is being done that seeks to determine the nature of the placebo effect. Some scientists are finding that subconscious decisions are helping to promote well-being and that the placebo, if talked about and if given credibility, can boost the morale of the individual and thus improve the patient’s health.
Placebos have been used since the beginning of the 18th century and have been a weapon in the arsenal of physicians ever since. The early physicians used the placebos when they did not possess a suitable drug in their armament. Instead of not giving them anything the doctor would prescribe the placebo for the patient and they would not know any different. The fact that the doctor was prescribing them a treatment for their own health was at the very least a better alternative to no medication whatsoever. Early physicians understood the complex nature of humans and knew that the key to longevity was not purely physical health but overall well-being. They recognized the power of the will in respect to a full and speedy recovery and that simply a positive attitude can be the difference between life and death. Peace of mind truly does go a long way. At the beginning of the 1900’s a shift in the way physicians responded to the patients needs took place. Doctors began to treat patients with the mentality of disease being a purely physical and chemical situation. Placebos began to take a backseat and the cognitive factors of healing were becoming overlooked. Modern day physicians find placebos to be merely a nuisance and nothing worth using or mentioning. Recently biologists and psychologists have begun to take a second look at placebos and the underlying mechanisms of the mind involved in their responses. Not only is there evidence that placebos can be effective in treating illness, but that the situation itself can be a catalyst for change. Placebos that are examined today are not merely the pills that are given but can essentially be the “placebo effect” of simply being in the doctor’s office. A term commonly used to describe the fear associated with being at a doctor’s office called “white-coat syndrome” is also gaining a new definition. The association of being at a hospital or doctor’s office and feeling better, combined with the smells and atmosphere of those specific places, provides the necessary mental stimulation for a full recovery. Studies have been done that seek to determine this medicinal conditioning and what the brain is doing in response to such stimuli.
Marion U. Goebel of the University of Duisburg-Essen performed multiple studies involving placebo effects in relation to immune therapy. The theory behind her studies was to pair a certain drug with a food or drink item and then replace the actual drug with a placebo yet still maintain the food or drink item paired with it and then gauge the effectiveness of the treatment. The idea for these studies that were performed on humans came after a few colleague of hers, Manfred Schedlowski from the University of Duisburg-Essen in Germany and Maj-Britt Niemi from the Swiss Federal Institute of Technology in Zurich, performed a few immune therapy studies on rats. The Schedlowski, Niemi and their team conditioned rats by injecting them with an immunosuppressive drug called cyclosporine A, which is often used to prevent the rejection of transplanted organs after surgery. Along with the injections of this immunosuppressive drug the rats were given water sweetened with saccharin. The scientists then discovered that if the rats were given the sweetened drink alone that their immune systems would weaken. This is a huge result, showing that the brain has associated this stimulus with the immune response and that the drug alone is not the only way to affect such a response. Also, the fact that rats do no possess the same sense of consciousness means that subconscious cues associated with improved health are very real and do indeed have an immense impact in terms of recovery. The associate learning in the rats demonstrates that a belief or hope in the drug is not necessary for it to have the full potential for improvement, that the brain records subtle subconscious cues and uses that for regulatory mechanisms. Subsequent experiments showed that there might possibly be clinical applications to such conditioning. Rats that were conditioned with the immunosuppressive drug cyclosporine A and a sweetened drink were then given organ transplants. The rats that were then given only a sweetened drink outlasted rats only given water. This shows that the brain responds well to behavioral conditioning and it can even affect hormonal regulation. The stimulus, or sweetened drink, invoked a neuronal response that inhibited the release of cytokines from the spleen, thereby preventing an immune response to the foreign organ. A study similar to the one first mentioned was done with Schedlowski and Goebel on human male subjects. They administered the immunosuppressive drug cyclosporine A along with a greenish strawberry milkshake smelling of lavender and as a control gave a dummy pill to another group of males also combining that with the milkshake. After a few days of conditioning both groups were given dummy pills with the unique milkshake and it was found that the group associated with the actual immunosuppressive drug had their immune systems weakened simply in response to the milkshake while the other group of men showed no change from their previous state of being. This study was the first time that humans in a double-blind, placebo-controlled study showed that behavioral conditioning can in fact mimic the immunological effects of an immunosuppressive drug like cyclosporine A.
As well as being a trigger to immune responses, behavioral conditioning can also function as a suppressor to immune responses. An example of such a response has been recorded in regards to allergies through the studies done by Goebel and her colleagues. The team of scientists recruited 30 volunteers that were allergic to dust mites and for five consecutive days they conditioned the test subjects with a combination of a unique drink followed by a tablet of the allergy treatment desloratadine. This drug is used to block the action of histamines, which is the main cause of allergic reactions. After the conditioning part of the study, 11 of the individuals were given a placebo and the unique drink while the rest were given a placebo and water. The individuals given the dummy pill and the unique drink showed a strong reduction in their allergy symptoms as opposed to the others who showed no signs of change. The simple presence of a substance at one point that the brain associated with an antihistamine was able to cause an immune response with only the presence of that substance. These subconscious cues have great applicability in the field of psychological medicine and will have a bigger impact as more about them is researched.
A possible place of application for this psychological medicine is competitive sports. An example of this has been discovered through the use of saline solution and morphine. The World Anti-Doping Agency prohibits the use of morphine in competitive sports, yet scientists and athletes may have found a medical loophole. If the previously mentioned method of medicinal conditioning were to take place and people were to train their bodies to associate a simple saline solution injection with a subsequent injection of morphine and then wait a few days to eliminate any trace of the banned substance, and then be injected on game day with a simple saline solution, it would provide the desired effects without actually using anything illegal. Whether this is a moral decision or not, it is a potential issue that the sports community is going to need to understand.
The Power Balance bracelets may be one of the most recent and widely publicized examples of psychological trickery. These bracelets, worn by many paid professional athletes, were once advertised to provide better balance and an overall performance boost. The fine folks at Power Balance managed to secure the naming rights to the Sacramento King’s basketball arena, coincidentally while a class action lawsuit was well under way regarding the inaccuracies of their claims about their product. Despite the fact that their marketing department has had to retract their claims being grounded in science, bracelet sales have been continuing at a steady rate. Placebo effect in this case has worked flawlessly, and if simply buying an overpriced, thick, rubber band is enough to convince people that they will function better, then, in an odd way it might just be worth it. The placebo effect is a scientifically proven observation and further research is needed to gain a better understanding of this topic, but for now, if you wish to see how deep the rabbit hole goes, perhaps it doesn’t matter which pill you take. Either one will do just fine.