Holding a syringe can produce a placebo reaction if a patient has previously associated that scenario with feeling better. In such cases, the overall effect-improvement or even complete recovery-stems from a combination of the pharmacological action of the drug and the subconscious or conditioned response.
Investigators have been unable to identify personality traits that increase susceptibility to placebos. Personality, after all, has little effect on subconscious conditioning. For such subliminal responses, presentation matters more than personality does. Giving a medication a popular brand name or prescribing more frequent does can boost the efficacy of a placebo. Similarly a physician can maximize a placebo effect by reading confidence or spending more time with the patient. Such tactics may subconsciously build a patient’s trust in a therapy
A high price tag on the drug can apparently help, too. In one study, placebos reported to cost $0.10 worked considerably less well in relieving pain than did those priced at $2.50 per pill. Test subject evidently distrusted the less expensive medication. Patients are also liable to benefit more from placebos that involve elaborate medical procedures than from those requiring simple measures. Thus, the most effective sham treatments may extend beyond dispensing inactive pills to a simulation of a multistep therapeutic regimen.
As evidence of this idea, counseling psychologist Cynthia McRae of the University of Denver and her colleagues reported in 2004 the surprising success of a sham brain surgery in improving the quality of life of patients with advanced Parkinson’s disease. Surgeons performed the sham operation to compare its efficacy with that of implanting human embryonic dopamine neurons into the brains of Parkinson’s patients, who suffer from a lack of dopamine. In McRae’s follow-up study , which assessed the patient’s quality of life up to a year later, the researchers found that the patients who received the sham surgery were doing just as well physically, socially and emotionally as were the patients who had received the new cells. Well mattered was not the transplant itself but whether a patient thought he or she had received it.
In recent years, extensive research revealing the many medical application types and mechanisms of placebo effects has given credence to this once orphaned phenomenon. Doctors are now considering placebo pills and procedures as a way of enhancing the effectiveness of drugs and surgery. Such user may elicit new controversies and questions such as the use of placebos to boost athletic performance. In the meantime, sophisticated doctors might decide to manipulate the conscious and subconscious mind in ways that could cure or least, do no harm