LOS ALTOS, CA, March 16, 2012 – Irving Kirsch, associate director of the Program in Placebo Studies at Harvard, rocked the medical world a few weeks ago when he declared on CBS’ “60 Minutes” that in most cases antidepressants are no more effective than placebos – those pharmacologically inert “dummy pills” given to patients who think they’re getting the real McCoy.
This is not to say that people who take these drugs aren’t getting better. They are. But according to Dr. Kirsch, “it’s not the chemical ingredients of the drug that are making them better” but an expectation of healing so powerful that it alleviates all but the most severe symptoms of depression.
This phenomenon extends beyond just pills to include other medical procedures as well.
In one study, 180 patients with osteoarthritis were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. The placebo group simply had their knees opened and were then sewn right back up. As it turns out, those who received the legit surgery were no better than those who got the placebo. Similar results were found in a study dealing with “sham” acupuncture, published in January by the Canadian Medical Association.
Dr. Kirsch notes that it’s not just the patient’s confidence in the treatment they’re receiving but in the one who provides the treatment as well.
“A clinician who cares, who takes the time, who listens to you, who asks questions about your condition and pays attention to what you say, that’s the kind of care that can help facilitate a placebo effect.”
An acquaintance of mine, a retired medical doctor, would agree. A lot of his patients would respond only when he tended to them personally – even for the most basic procedures like giving shots and applying bandages.
It would appear, then – as Dr. Kirsch was saying earlier – that one of the key ingredients to recovery is faith.
The apparent downside of faith, of course, is that you’re dealing with a quality of thought and not a component of matter. As such, it’s pretty hard to administer – orally, intravenously, or otherwise. On the flip side, this could be a real plus, considering that it can be a lot easier to change your mind than to repair your body through purely physical means.
But the question remains as to what we put our faith in – doctors, drugs or (for a growing number of people) the divine?
Some believe the latter option is little more than a crapshoot, while for others it’s a reliable practice born of experience and an increased, albeit incremental, understanding that health is not the exception but the norm.
Perhaps once Dr. Kirsch wraps up his work at Harvard, he’ll want to explore further this new frontier of medicine that he and so many others involved in the study of placebos have inadvertently uncovered. No doubt it would rock the medical world even more and make for another great segment on “60 Minutes.”
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