Saturday, January 26, 2013

Studying The Placebo Effect

Mind Over Matter

An article, by Cara Feinberg, in Harvard Magazine examines the placebo effect. For years, placebo treatments have proven somewhat effective among certain individuals, which raises the question among scientists of how can that be. Ted Kapttchuk, an associate professor of medicine at Harvard University, is among a small group of researchers who are looking into how perceptions can influence and alter a patient's health.
[Re]searchers have found that placebo treatments—interventions with no active drug ingredients—can stimulate real physiological responses, from changes in heart rate and blood pressure to chemical activity in the brain, in cases involving pain, depression, anxiety, fatigue, and even some symptoms of Parkinson’s.
The challenge now, says Kaptchuk, is to uncover the mechanisms behind these physiological responses—what is happening in our bodies, in our brains, in the method of placebo delivery (pill or needle, for example), even in the room where placebo treatments are administered (are the physical surroundings calming? is the doctor caring or curt?). The placebo effect is actually many effects woven together—some stronger than others—and that’s what Kaptchuk hopes his “pill versus needle” study shows. The experiment, among the first to tease apart the components of placebo response, shows that the methods of placebo administration are as important as the administration itself, he explains. It’s valuable insight for any caregiver: patients’ perceptions matter, and the ways physicians frame perceptions can have significant effects on their patients’ health.
For the last 15 years, Kaptchuk and fellow researchers have been dissecting placebo interventions—treatments that, prior to the 1990s, had been studied largely as foils to “real” drugs. To prove a medicine is effective, pharmaceutical companies must show not only that their drug has the desired effects, but that the effects are significantly greater than those of a placebo control group. Both groups often show healing results, Kaptchuk explains, yet for years, “We were struggling to increase drug effects while no one was trying to increase the placebo effect.”
Last year, he and colleagues from several Harvard-affiliated hospitals created the Program in Placebo Studies and the Therapeutic Encounter (PiPS), headquartered at Beth Israel Deaconess Medical Center—the only multidisciplinary institute dedicated solely to placebo study. It’s a nod to changing attitudes in Western medicine, and a direct result of the small but growing group of researchers like Kaptchuk who study not if, but how, placebo effects work.
Explanations for the phenomenon come from fields across the scientific map—clinical science, psychology, anthropology, biology, social economics, neuroscience. Disregarding the knowledge that placebo treatments can affect certain ailments, Kaptchuk says, “is like ignoring a huge chunk of healthcare.” As caregivers, “we should be using every tool in the box.”
This statement is undoubtedly true. And, yet, Kaptchuk is not using the tools of the supernatural but the tools of science to investigate the placebo phenomena, a good thing. For now this is considered the best way to go go about understanding our world. When something is considered a "mystery" it does not mean it is beyond our natural knowledge; it means that we have not yet understood its mechanisms. Such is the history of scientific investigation.

Kaptchuk's research might open up science to understanding more of how the human body, including the brain and our thoughts and perceptions, operates. Equally important, it might reveal that how we think about the treatment is as important as what the treatment is: this is not yet scientifically verifiable, but many individuals subscribe to such ideas. Perhaps science, led by Kaptchuk, will prove this as valid if not verifiable.


You can read the rest of the article at [Harvard Magazine]