Have you thought you might be coming down with COVID-19 lately? Well, you are not alone. A friend of mine called me last week telling me how anxious she was about getting it and told me that she felt a bit congested and a “tickle” in her throat. She asked if it could be psychosomatic. “It could be,” I told her, “but it could also be that you are just more aware of how you are feeling right now.” The reason I felt that is that the night before I woke up in the middle of the night with similar symptoms and came to that conclusion. It is only natural with all of the focus, attention, and anxiety about this SARS-Cov2 infection for people to pay attention to how their airways are functioning. It is a classic case of medical students’ disease. Often medical students will start to perceive themselves experiencing the symptoms of a disease that they are studying. And let’s face it, most of us are all studying COVID-19 right now.
To highlight the power of the mind and the placebo effect, I am going to report the results of a fascinating study done at McGill University in Canada where 61% of the recruited students in the study experienced psychedelic effects from a placebo. But first, let’s highlight the biggest secret the drug companies don’t want to tell you and most doctors underappreciate. That secret is one of the greatest powers to heal lies within us through the power of belief.
The “placebo response” is a complex phenomenon, initiated by the mind and leading to a cascade of real, measurable effects. In a few words, the placebo response is the activation of the healing centers of our being in a way that produces profound physiological changes. The body has two internal mechanisms to maintain health. The first is the inherent internal healing mechanism, the vital force, chi, or the primitive life support and repair mechanism that operate even in a person who is asleep, unconscious, or comatose. The second mechanism involves the power of the mind and emotions to intervene and affect the course of health and disease in a way that enhances or supersedes the body’s innate vital force. The placebo response seems to involve activation of the higher control center, but that is not to mean that its effects are solely in the mind.
Numerous studies have documented the pain-relieving effects of a placebo are mediated by endorphins – the body’s own morphine-like substances. Studies in severe pain have shown that roughly 56% will respond as well to a saline injection as morphine. But this pain relief can be completely nullified by adding naloxone, a drug that blocks the effects of morphine, to the saline. In other words the placebo effect in pain relief is only there if the body responds to that placebo by increasing its own morphine-like substances.
It is not all about endorphins though as a saline placebo can also reduce tremors and muscle stiffness in people with Parkinson’s disease via a different mechanism. The placebo only worked when individual brain cells in the subthalamic nucleus (a common target for surgical attempts to relieve Parkinson’s symptoms) began to fire less often and with fewer “bursts” of firing – a characteristic feature associated with Parkinson’s tremors. Somehow the saline placebo resulted in the processing of the information by healing centers in the brain to specifically target an effect that would reduce the dysfunction in the areas of the brain affected by Parkinson’s disease.
Other studies have shown demonstrable changes in brain activity through modern imaging techniques (e.g., CAT scans and MRIs) in other disease states with the placebo response as well as the experience of different emotions. For example, one study showed that expectation or hope is able to stimulate the part of the brain that is activated by pain medications and is associated with pain relief. In addition, numerous changes in chemical mediators of pain, inflammation, and mood have also been demonstrated with the placebo response.
The bottom line here is there is tremendous evidence that the placebo response is a highly specific and targeted healing effect that is triggered by conscious and unconscious centers in the brain. Rather than discounting and trying to avoid a placebo response, modern medicine should be more intent on developing techniques and practices designed to stimulate the same healing centers within patients as noted in these studies with placebos.
The development of the drug industry is based largely upon the perceived value of the double-blind, placebo-controlled trial. In order for a drug to be approved it must show a therapeutic effect greater than a placebo. Because a doctor as well as the patient’s belief in the value of a treatment can affect the outcome, most placebo-controlled trials are usually conducted in “double-blind” fashion: that is, not only are the patients made unaware when they are receiving a placebo, the doctors are made unaware too. Nearly all studies conducted this way show some benefit in the placebo group. It is generally thought the overall placebo response is about 32% there is evidence that in some conditions it may be as high as 80 to 90% percent in real-life clinical practice. The reason being is that, in the real world, the placebo response is enhanced by both the doctor’s and patient’s expectations.
To further evaluate the placebo effect as well as the power of expectation, researchers at McGill University in Canada constructed a very elaborate experiment. They recruited 33 students to take part in a study they were told was designed to examine the effects of the psychedelic drug iprocin on people’s creativity. This drug is a synthetic analog of psilocybin that is found in psychedelic mushrooms. However, in the study, the students were not given iprocin, they were given a placebo.
The title of the article says a lot of how the researchers amplified the effect of the placebo: “Tripping on nothing: placebo psychedelics and contextual factors.” What were the contextual factors? The environment was something akin to a flashback to something Timothy Leary would have designed. The “lab” where the placebo was given to the subjects was transformed into a drug-fueled party themed with psychedelic artwork, colored lights and black lights, bean bag chairs and mats arranged for comfort, arthouse films projected onto a screen, and a DJ playing background music on a turntable to complete the scene along with paid actors playing the part of tripped out partiers. As the party was taking place numerous researchers in white lab coats intermingled with the participants monitoring the experiment.
The main objective of the study was to determine a person’s perception of a psychedelic experience from nothing more than a placebo along with a powerful environment to amplify the power of suggestion.
The results were quite interesting. In questionnaires conducted during the experiment, 61% of the participants reported feeling psychedelic hallucinations and other symptoms such as light-headedness, visual distortions, feelings of relaxation, heightened senses, laughter, and nausea. Keep in mind that a little more than a third of the group felt nothing.
The authors concluded that “To our knowledge, these are the strongest alterations in consciousness reported in the literature following an inactive placebo psychedelic.” It proved what many people describe as a “contact highs,” in which people say they feel the effects of drugs or alcohol after being around people who have consumed either, even if they themselves haven’t. A contact high as the author’s explain is very “Similar to placebo effects, these highs may result from classical conditioning as well as the physical and social setting.”
As psychedelics like psilocybin are begging to be studied as antidepressant and in other mental disorders, the practical aspect of this study is the importance of the environment and “mood” to help facilitate the desired outcome.