Mindset Matters: The Powerful Placebo Effect

Wander around any bookstore and you’ll come across a huge self-help section telling you that belief is the key to success and wellbeing. Some of the claims are far too good to be true. No matter how hard you think about it, that Ferrari is not going to spontaneously appear in your driveway. Yet, while beliefs are not the panacea to all our problems, increasing scientific evidence indicates that there are many circumstances in which our mindset – or the way we think about and approach the world – does powerfully shape our experiences. In this article, we explore the placebo effect, which is one of the most fascinating cases of mindset influencing our wellbeing.

What is the placebo effect?

The placebo effect is when our expectancies trigger improvement without us receiving any genuine treatment. In the famous example, after running out of morphine, a World War II doctor named Henry Beecher decided to administer saline – or salt water – to wounded soldiers while telling them it was morphine. Incredibly, the saline injection relieved many of the soldiers’ pain. That is, the simple belief that they had been given morphine triggered pain relief.

Some even more remarkable placebo effects have been observed since then. For example, patients undergoing surgery for debilitating conditions like osteoarthritis of the knee have been found to show just as much improvement when they are anaesthetised and then told they’ve had surgery compared with when they actually receive the surgery (Moseley et al., 2002).  Similarly, patients with Parkinson’s disease receiving highly invasive deep brain stimulation via electrodes surgically implanted into their brains experience equivalent symptom relief when they are simply told they are receiving stimulation compared with when they are genuinely receiving stimulation (Pollo et al., 2002).

Is the placebo effect only confined to medical walls?

Placebo effects are not confined to medicine, though. Recent research has uncovered placebo effects on critical cognitive abilities, including learning and memory, as well as on physical performance.  In one of my favourite examples, club-level endurance runners were led to believe they were in a trial of ‘recombinant human erythropoietin’ – a performance enhancer – but actually received a series of saline injections (Ross, 2015).

The belief that they were receiving a powerful performance enhancer allowed the athletes to improve their race times by an average of 10 seconds – a huge improvement considering that most competitive races are won by fractions of a second. The placebo was so effective in one participant that he reported feeling like Superman each time he took the injection.

How can I individually harness the placebo response?

While these types of placebo effects may seem somewhat miraculous, there are good biological explanations for why they occur. Harking back as far as Pavlov and his dogs in the early 1900’s, we know that basic biological processes can be conditioned to respond to stimuli that have been paired with salient events in the past – Pavlov’s dogs salivated when he rang a bell because he had previously paired that bell with food.

In the same way, our expectancies, formed by a combination of the information we receive about an intervention and prior conditioning (i.e. what has happened in the past), trigger activation of our central nervous systems and the release of neurotransmitters that drive the placebo effect. For example, expecting pain relief triggers the release of endogenous opioids – the body’s natural morphine – in the brain and spinal cord, which leads to pain relief even when we receive a placebo. Similarly, neuroimaging studies have found that patients with Parkinson’s who expect and experience improvement from a placebo treatment show a release of endogenous dopamine – the very neurochemical that these patients are typically depleted of.

How you think matters…

Together, the scientific evidence for the placebo effect and its biological underpinnings show us that how we think and what we experience are intricately related. While it is not always as simple as touted in the self-help aisles of bookstores, there are a number of ways we can develop our mindset to tap into our bodies own natural resources to place us in the best possible position to succeed professionally and personally. In the Mindset Matters Programme we aim to help individuals develop greater awareness of their existing mindset and to provide practical skills for developing a mindset to facilitate their own personal growth and fulfilment. We can’t promise to cure Parkinson’s disease, but we can promise to challenge some beliefs you may not even know you hold.

Written by Dr Ben Colagiuri

References

Mosely et al (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 347: 81-88.

Access here

Pollo et al (2002). Expectation modulates the response to subthalamic nucleus stimulation in Parkinsonian patients. Neuroreport, 13: 1383-1386.

Abstract here

Ross et al (2015). Effects of an injected placebo on endurance running performance. Medicine and Science in Sports and Exercise, 47: 1672-1681. 

Abstract here