Placebo Induction

“... the existence of placebo effects suggests that we must broaden our conception of the limits of endogenous human capability.... The study of placebo effect, at its core, is the study of how the context of beliefs and values shape brain processes related to perception and emotion and, ultimately, mental and physical health.” 1

A placebo response is often thought of as a faith-based response to a treatment modality that of itself has no proven therapeutic value. The belief, or belief system, causes what many now term a "meaning response."2 It has also become apparent that both conscious expectation and unconscious conditioning, as reflected in types of learning, can serve to initiate a placebo response and do so via distinct biopathways.3 It is further evident that there is not one response but many, as evidenced by multiple areas of the body being influenced by different types of placebo responses.4 In addition, similar dynamics may produce negative results, "nocebo" responses, whereby patients develop pathological reactions rather than those of healing.5

The various forms of meaning producing either response can result from the patient’s confidence in the practitioner, the device, the procedure, the pill, the injection, or can be an effect of the patient’s religiosity or other learning. Whatever the basis of a placebo response, that agent triggers a cascade of biochemical or biophysical events that results in the desired clinical outcome in spite of the absence of proven utility of the regimen.

It cannot be denied that the placebo response is real and powerful. That it is without adverse side effects contributes, in part, to it representing the perfect medicine. Since it is not reproducible in any but the smallest population of patients, it presents a frustration. Learning how to selectively induce it in patients suffering from a range of maladies and regardless of belief systems is the goal.

Our question is whether we can trigger that same sequence of events leading to the same response using an artificial inducer in place of faith. We also ask as to the nature of the inducer. If effective, whether the inducer is a drug or other formulation, a thought, belief, or practitioner, as it has been developed to deliberately and independently stimulate an active response it is now a therapy and not a placebo. The ultimate aim of the project is to enhance the ability of responders and to induce a controlled response in non-responders.

The objectives of the project are therefore:

  1. to determine the sequence of cellular and/or subcellular events initiated by a belief system plus a triggering agent (practitioner, device, technique, product) resulting in a healing response in the absence of a typical therapeutic substance;
  2. to initiate the same sequence of events in the absence of, or in the place of, a belief system or learned behavior;
  3. to study the effect of the successful completion of step 2 above on the patient’s belief system; and
  4. to determine if people can be taught to become responders or increase their ability to do so.

Contemporary placebo research has shifted from viewing the placebo response as a nuisance within clinical trials to recognizing it as a bona fide phenomenon in need of multi-disciplinary investigation. By accepting this challenge, we stand to reveal more of the intricacies of the human mind as well as "fundamental insights into human biology."6