Brooks, Placebo Article

Harness the Power of Suggestion for Your Happiness The placebo effect can’t cure disease, but it really can work for you. By Arthur C. Brooks December 7, 2023 I remember once, at summer camp in the 1970s, 3,000 miles from home, I came down with a nasty case of strep throat. Before I could call my parents or go to the nurse, the coolest kid in camp took me aside. “You know it’s all in your head, right?” he said. “Just decide you don’t have a sore throat, and you won’t.” He was very cool, so it made sense to my early-adolescent brain to take his medical advice. Two days of extreme willpower later, I had a fever of 103 and couldn’t swallow. “The problem is that you are mentally weak,” Cool Kid explained. Defeated, I went to the nurse, who took me to the doctor, who gave me penicillin, which relieved my symptoms within 24 hours. Cool Kid was undaunted. “That stuff is just a placebo,” he told me, referring to a phenomenon in which the mere mental suggestion derived from taking a drug that is actually inert has a therapeutic result. “You cured yourself.” Cool Kid’s medical advice, flawed as it was, nevertheless took inspiration from the popular belief that “biology is psychology,” and that we can harness the placebo effect to get better. This belief has not stood up well in recent years; where physical maladies are concerned, evidence has emerged that the placebo effect is as fake as the fake drug itself. [NOTE: this is a link to the study: https://www.nejm.org/doi/full/10.1056/nejm200105243442106 ] Even so, although placebos can’t kill bacteria, they can change your attitude toward your problems. And that means they deserve serious consideration in your pursuit of happiness. In fact, properly understood, the strategic use of placebos might be an indispensable tool in your well-being kit. The modern use of the word placebo originates from a mistake made by the fourth-century Catholic saint Eusebius Sophronius Hieronymus, better known as Jerome, an early translator of the Bible into Latin. In the ninth line of Psalm 116, Jerome erroneously translated the Hebrew for “I will walk before the Lord” as “I will please the Lord in the land of the living”—in Latin, Placebo Domino in regione vivorum.Subsequently, hired professional mourners at funerals chanted that line and became known as “placebos.” The placebo as a concept in medicine appeared in the 18th century, most famously in the case of the German physician Franz Anton Mesmer, who introduced the technique that took his name of mesmerizing patients, by means of gestures and special instruments, to relieve them of various physical ailments. His explanation for how this—what he called “animal magnetism”—worked was debunked by a commission including none other than Benjamin Franklin, who helped demonstrate that a substantial benefit of the technique relied simply on the patient’s imagination. Although animal magnetism was not real, the power of suggestion could be. The physician Benjamin Rush, another signer of the Declaration of Independence, was a pragmatist who decided that if there was an effect, he didn’t really care where it came from: “Let us avail ourselves of the handle which these powers of the mind present to us.” By the early 20th century, the therapeutic effects of suggestion on physical disease were widely believed to be genuine, and even the medical journal The Lancet reported on some apparent evidence of the phenomenon. Skeptics never quit the cause, however, and today, the placebo-doubters appear to have won out: A 2001 comprehensive analysis of well-designed studies showed that placebos of all types (whether drug tablets or supposedly therapeutic conversations) might affect our feelings of health, but they did not have a significant physical effect on diseases. [this is a link to the same 2001 study Brooks referenced above: https://www.nejm.org/doi/full/10.1056/nejm200105243442106 ] In other words, I wasn’t mentally weak for failing to cure my own strep, and the penicillin was not a placebo. (If the now-50-something Cool Kid is reading this, he will be feeling a little chastened, and less cool.) Before we dismiss placebos entirely as a legitimate form of treatment, however, we should note that no one claims they can’t have a psychological effect on people. As a result, they may still be beneficial when a malady is primarily psychological in nature. The same applies to happiness, for which placebos can work wonders. For example, researchers in 2005 showed their study participants a series of disagreeable photos. The participants were given an anti-anxiety medication, which muted activity in parts of the brain—the rostral anterior cingulate cortex and the lateral orbitofrontal cortex, to be exact—that govern perceptions of unpleasantness. The next day, the subjects were told they were getting the same medication when they viewed more photos but were given saline solution instead. The placebo affected the overlapping areas of the brain and lowered perceived unpleasantness. When it comes to well-being, placebos may work even when they are “open-label”—in other words, when people know they’re not a real medicine. In one 2022 experiment, participants were told they were getting either a placebo (in the form of a nasal spray) or no treatment at all. After they were asked to make self-deprecating statements (such as “I do not want to be the way I am”) and listen to melancholy music, the nasal-sprayers experienced less sadness. The most likely mechanism of a placebo’s action on happiness and unhappiness is that your expectation can stimulate unconscious behavioral conditioning, which leads to the release of neurotransmitters and neurohormones that change how you feel. So, say you have your “happiness nasal spray,” which you know is a placebo, but when you use it, it reminds you to smile, and think about people you love and the parts of your life for which you’re grateful. This effect might temporarily lower your production of cortisol and other stress hormones, giving you a sense of calm and peace. Nothing suggests that you can will away strep or treat it with a fake pill. You can get a lot happier using suggestion and placebo, however. Here are three practical ideas. 1. Invent your own unhappiness remedy. You can create an open-label placebo for yourself when you need relief from negative emotion or want a boost in joy and gratitude. Break a negative cycle of thought and feeling by walking a familiar circuit (for example, around the block). Write down a prayer or poem that you like to recite, to remind yourself that your life is a blessing and you will not be controlled by destructive emotions. You might even want to create a happiness medicine—your very own placebo pill. For a few years, I used menthol cough drops for this purpose, which I would pop into my mouth as part of my behavioral conditioning. I stopped that only when I took a job running a nonprofit, which was so stressful that I was eating 50 of them a day; I smelled like a chemical plant, which wasn’t great for fundraising, so I switched to sugarless gum. 2. Avoid human “nocebos.” If a placebo can have positive mental outcomes, then a “nocebo”—telling people that an intervention has unpleasant side effects, which increases the likelihood of experiencing the effects—tends to create negative mental results. Some evidence suggests that medical patients can do better in treatment with encouraging doctors, and worse with discouraging ones. Although no research to date has experimented on the unhappiness effects of discouraging words, we hardly need it to know that relentless negativity from others makes it hard for us to feel happy. Sometimes you need to hear the truth, but you don’t need more exposure to critics than necessary. While you’re at it, think about the places where you’re most likely to encounter these discouraging people who are all too ready to dispense their negative feedback, such as social media or cable television. If you notice that certain channels make you feel worse about yourself and the world, cut out those nocebos. 3. Dispense the placebo to others. The placebo effect of happiness works on others, not just you. Start prescribing them freely: Give others encouragement; take others on your happiness stroll; share your candy. You will quickly find that prescribing a positivity placebo to others is a secret to getting happier yourself. It also means developing the best identity and reputation you can have. Above all, strive never to be someone else’s nocebo. Cool Kid didn’t know science, and Saint Jerome’s Hebrew may have been a mess. But we can still benefit from placebos, perhaps not to alter our physical circumstances but to change our attitude toward them. And therein lies one of the great insights to living a better life. Adverse events are inevitable for everyone, and negative emotions are an appropriate response. We evolved this way to help us recognize and avoid adversity when we can. But a surplus of negativity in response to hard times can easily make things worse. Managing our own emotions can allow us to bear and accept life’s inescapable trials, and even learn from them. A homespun placebo now and again can help.