Placebos Work Even if You Know They’re Placebos!


♪♪♪ Despite not containing any actual medicine
whatsoever, studies have found that placebos can help people. They’ve been shown to alleviate symptoms
in a number of medical conditions, including depression, pain, and even Parkinson’s Disease. And that’s supposedly thanks to the power
of belief. Basically, if a person really believes that
they’re taking an effective drug, their brain is somehow tricked into making them
feel better, whether it’s by producing chemicals or activating key neural regions. But… it turns out that’s not the whole story. You see, scientists have discovered that even
when patients know they’re taking placebos, they still feel better. So somehow, they’re experiencing the placebo
effect even though they don’t believe they’re taking medicine. And figuring out why this happens will help
us understand what things our brains can and can’t fix all on their own. Placebos were first used to test the effectiveness
of treatments. The idea was simple: You give half of a test
group medicine and the other half something inert, and if the group taking the medicine
fares better, then the medicine works. But, in some cases, the placebo group got
better, too. So, instead of getting frustrated over a ruined
study—though I’m sure that happened as well—clinicians took advantage of these happy accidents and
started giving patients placebos as treatments. Anywhere from seventeen to ninety-seven percent
of doctors say they’ve done this at least once, though there’s a lot of debate about
whether it’s ok from an ethical standpoint. I mean, sure, if it works, you’re helping
the person. But you’re also lying to them about their
medical care. Of course, you can’t let them in on the
ruse, because then the placebo won’t work. Or… will it? See, this whole practice of actually prescribing
placebos made some medical professionals wonder if there was a way to use them without deception. And it turns out, there is. Open label placebos are ones where the patient
is informed that they are taking an inert medication. And like other placebos, they can be used
in one of two ways: either as a dose extender after a round of medicine to prolong its effects,
or just straight up as a treatment. Either way, clinical trials have demonstrated
that they work. For example, in a series of small studies,
one research team found that open label placebos were more effective than no treatment or the usual treatment for a variety of conditions, including cancer-related fatigue, migraines,
and test anxiety. They even worked for patients with irritable
bowel syndrome in a 2010 study. The participants either received no treatment
or a placebo that was carefully billed as such. They specifically told the patients it was
“like a sugar pill”, and the pills came in a bottle labeled “placebo”. Yet, after three weeks, fifty-nine percent
of patients in the placebo group reported adequate symptom relief, while only thirty-five
percent of the ones who received no treatment did. That’s on par with the best pharmaceuticals
for IBS, even though the participants knew they were taking a completely inactive pill. Weirdly enough, researchers think that these
open label placebos still manage to work for many of the same reasons the usual, deceptive
ones do. Like, they can tap into prior conditioning—the
automatic responses you associate with a specific, learned stimulus. I’m sure you’ve heard of Ivan Pavlov and his
dogs. That’s the most famous example of classical
conditioning. By pairing the click of a metronome with food,
Pavlov was able to get his pups to salivate from the sound alone. And something similar seems to happen with
medication. Say you take something to lower your blood
pressure every day. Your brain might learn to associate the ritual
of taking that pill with a drop in blood pressure so much so that it actually stops mattering what
pill you take. This is essentially the idea behind dose-extending
placebos. A round of medicine first trains the brain,
then the placebo maintains the response. For example, in one study, patients were given
an immune-suppressing drug along with green, strawberry-flavored milk. Afterwards, when they drank the weird milk
with a placebo, their immune function became suppressed, just like it did with the active
medication. And it only took four sessions over three
days to condition their brains. This kind of conditioning could also occur
subconsciously all the time, which might be why you don’t always need a training regimen
with real medicine to see results. Simply taking effective medicines may condition
your brain to associate pills, grossly-flavored liquids, or whatnot with the physiological
responses that make you feel better. It’s also possible the secret to open label
placebos is in fact the power of belief or, what psychologists would call an expectancy
effect. Even if patients don’t believe they’re
taking medicine, they could still believe that the treatment will work—and that might
be why it does. You see, studies have found that open label
placebos are more effective when a doctor explains the rationale behind them, especially
when they explicitly say things like “It is well known that placebos are very effective”. Still, whether it’s because of conditioning
or expectancy or a bit of both, it’s still pretty amazing that placebos work at all. And researchers are still trying to figure
out their limits. Since their effect comes from convincing your
brain to help you out, they seem to work best when symptoms are directly controlled by brain
activity—things like pain, nausea, and fatigue. So if larger studies continue to demonstrate
their potential, open label placeboes could eventually supplement or replace medicines
like opioids that have nasty side effects. But what’s really wild is that, when you
think about it, so much of what goes on in our bodies is ultimately controlled by our
brains. So someday, open label placebos could replace
all sorts of expensive drugs and reveal just how powerful the human mind can be. Aren’t brains just the best? I think so, anyway. And if you do, too, you’ll probably love
all the episodes we produce here on SciShow Psych. And to that end, I have some great news! By clicking that subscribe button, you can
make sure each and every episode is delivered straight to your YouTube feed! So you won’t miss a single one. ♪♪♪

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Comments

  1. The best and the worst. I'm endlessly fascinated by this quirk of the human mind. I wish we could harness this power without selling people magic crystals and homeopathic hogwash.

  2. also could this be why people feel worse when some take generics, because the pills or capsules are the 'wrong' color or size or taste?

  3. Ever since Anthony started hosting, it's been bugging me that something about his speech pattern is familiar and I haven't been able to figure it out until now. If you told me that he was the new host of a new Reading Rainbow I would totally believe you. He sounds like he could be Levar Burton's son. ♥️

  4. Hm, so assuming I take pill A to reduce my blood pressure and after a few days my doctor finds out that there's actually something else wrong with me so he gives me pill B, which may be a placebo. Assuming also that I am a well behaved pavlonian dog, will my brain still reduce my blood pressure despite me having swapped pills…

  5. Is it just me or does his diction and tone really call Levar Burton to mind? Anyway, it's lovely, I could listen to this guy tell me about science all day.

  6. Did the studies examine if the participants understood what "Placebo" is? What about the Hawthorn effect which is improvement from knowing you're in a study?

  7. My sickness often goes away tempirarily when i have to go to school.
    And terrible on days i dont have it.
    Just an observation.

  8. They've already got "open label" placebos. It's called homeopathy. I've used it for years, knowing it was only sugar pills and that any reaction I got was the placebo effect.

  9. Wait…. But doesn't this call in to question any medications? Because if patients can get that result from known placebos, then what does that say about prescribed medicines?

  10. patients are told that placebos are effective, and so that makes the placebo effective even tho they know it is
    WHICH MEANS THE PLACEBO EFFECT CAN BE ITS OWN PLACEBO EFFECT
    WHAT

  11. How many patients were in these studies? I'm not very surprised that placebos work on some people. Just look at how many believe homeopathic remedies work.

  12. Placebos are seriously underrated and demonized. If your body can trick itself into getting better, that's awesome! Of course it won't cure cancer or any other serious diseases, but it can definitely help cope.

  13. Very interesting how you can twist the explanation around placebo so that, while being straight forward with the patient, the positive effect still remains! I always found the placebo effect quite curious

  14. I don't understand why anyone would ever agree to take a pill they know has no active medicine in it. I know I wouldn't. Probably wouldn't work on me anyway. I'm too much of a skeptic.

  15. I've been doing this for years. None of the anxiety meds or dosages that I've tried have worked, but I kept taking them, hoping that I might get some benefit from the placebo effect (unfortunately it hasn't worked; I seem to be as immune to the placebo effect as the actual meds 😕).

  16. There's a big difference between telling someone:
    "Here's a pill. It's a placebo, but placebos work even if people know it's a placebo. Let us know how it goes for you."
    …vs…
    "Here's a pill. It's a placebo, but placebos only work if people don't know it's a placebo. Let us know how it goes for you."

  17. Anthony I’ve liked you so far as the new guy, but I can’t watch your videos if you’re going to say “supposebly”. The word is supposedly and I know you know that.

  18. a) Placebos don't work for all people. If you already believe your body can heal itself, then you're already getting the max placebo effect, but if you have more faith in medicine than your own immune system, then you need that external cue to relax about your condition enough to allow the body to go into its optimal healing state (eg, low adrenaline, low stress)
    b) For people who are susceptible to placebo, they just need something they believe will help, which can be a known placebo, because placebos are "magic", and magic is even better than medicine!
    c) It needs to be a condition that the body can fix by itself, but is being inhibited from doing so by over active "fight or flight" causing the body to reduce immune system, cell/muscle repair, even reduce blood flow to digestion, as these are all things considered a waste of energy when you need that energy to escape imminent danger, such as a predator. It's all about shutting down that emotional state of feeling in some kind of danger (even if it's not a physical threat, such as danger of not being able to pay bills etc)

  19. I always find placebos fascinating. Oh, the power of the brain! There's even a school of thought that it's not about the pill – the ritual of seeing a doctor who seems confident treatment will help is itself a placebo.

  20. I've heard that you can hypnotize a person. I've been unable to reproduce those results, or become in a state of hypnosis. So I kinda wonder, how much of it is conditioning,, and what else, and…like…suppose you did a study, with random people as control, and then a set of well…less educated, people, and a set of very well, highly intelligent people. what would those results of placebo vs none have then?

    My hypothesis, is that the people who KNOW what a placebo is, what it means on a deeper level, are less likely to be affected. It would be interesting if Intelligence, and education have a notable effect on placebo effect.

  21. This is also why the last stages of pharmaceutical research aren't blinded, because in the real world people would also know what they're taking and even if much of the effect of a drug is placebo; if it works, it works. This is called external validity, where the goal is to define the real world effects of a drug as best as possible, rather than elucidating the exact ways in which it works and how precisely the drug affects certain biomarkers compared to placebo or established treatment under blinding (which is called internal validity)

  22. When I couldn't fall asleep or I was having insomnia, I used to imagine I have a pill that helps me relax and sleep and slowly melts in my mouth. Worked every time.

  23. I have degenerative Osteoarthritis in my spine and knees. I take morphine twice a day to deal with the crippling pain. It also leaves me exceptionally tired so I have to sleep during the day.
    If I could get over the tiredness with a placebo or even replace my morphine with one, I would.
    But as I'm scientifically minded I wouldn't expect a placebo to have any effect if I knew it was such.

  24. At the school my Mom worked at as a secretary years ago. They were legally allowed to give the kids a dose of Pando syrup for headaches and fever. The kids would come to her often saying they had a headache. But like many of the teachers, she suspected a lot came to try get out of school. So what she used to do is, she had an empty Pando bottle and filled it with Soda Stream lemonade concentrate. It tasted exactly the same as the medicine. She would give them that. Most never came back. If they did then she gave them the actual medicine.

  25. Damn, I wish that was working on me; still waiting for my new medicine to kick in and I've been on it for 2 weeks.

  26. can this be explained because people take pills with water, and extra water is good?
    Can this be controlled by injection placebos instead?

  27. Perhaps placebos work for the same reason that I heal my body by telling it to heal. I used to pray to God for healing and now I just heal myself.

  28. Don't get me wrong I love Hank, but the way the gentleman in this video speaks in such an assuring and calm manner is refreshing.

  29. You didn't mention that open label placebos are not as effective as normal placebos.

    Research needs to be done on what conditions make an effective placebo effect most likely.

  30. That is great news! I clicked the button. Now it says "unsubscribed." Nobody has fed me a thing yet but I eagerly await the arrival of my food. Thanks!

  31. With the growing public denial of science, it doesn't surprise me that the effect is still there when the doc tells you its a placebo, after all, some mom in a blog said it really worked!…
    Although the other one said it was full of toxins!

  32. Every time they do an episode on placebos apparently being the best thing ever, I just think that we're probably a good ten years before that's ALL that they'll give poor or marginalized people as far as medicine goes. Like, active medicine is going to become the domain of the rich and so if you're poor and have some kind of condition, they're just going to give you a placebo with the word "placebo" on the bottle and if you don't get better from that it's because you didn't BELIEVE hard enough in it and you'll be blamed for not trying hard enough to make your own brain do something. Also, the placebo effect might wear off when people start having or continue to have symptoms because they needed real medicine and quickly associate the word "placebo" with "doesn't do anything" and "I'm still going to be in pain/have symptoms".

  33. I mean… my headaches sometimes feel better immediately after taking medication that I KNOW takes time to start working. I guess just telling your subconscious mind "There, I DID something about it! Medicine achieved! Things will be better any minute now; please stop bothering me!" can sometimes make you feel better.

  34. I have experienced this subjectively, so it's nice to know that there's actual evidence now to back it up. About as long as I've known the placebo effect was a thing, I've come up with dumb-but-harmless rituals to deal with all manner of maladies, trusting that my belief in the power of the placebo effect will invoke the placebo effect. Which sounds weird writing it down, but hey, it's worked for me for my entire adult life.

  35. According to hard science quantum physics experiments all the way back to 1925 perception literally Changes matter. To this day it can't be disproven and all have tried

  36. So if a placebo causes your body in a previously conditioned way wouldn't this also mean that the side effects will be the same as the actual medication as well. If I condition my body that taking the blue pill causes my blood pressure to drop but that it also makes me nauseated, wouldn't that continue on the placebo?

  37. I'm quite worried about the adequate disclosure there. Saying something is a placebo or "like a sugar pill" doesn't adequately explain the treatment if the patient doesn't know what "placebo" means and/or doesn't know that "like a sugar pill" means it's ineffective. The very fact a physician gives it to the patient suggests it is a medical treatment with potential medical benefits.
    Now… maybe we're okay with physicians lying to patients with regards to placebos, and not receiving genuine informed consent. But there's ambiguity in (at least) the descriptions of these disclosures, and that's troublesome.
    If a physician said to me "I'm prescribing this placebo to you; sometimes the routine of taking a medically inert placebo tricks the brain into getting better," then I know what I'm in for. But if the physician says "I'm prescribing X to you; we've found that some people who take X get better, though the numbers are small – indeed, comparable to that of a placebo," then that's misleading.

  38. “Anywhere from 17 to 97% of Doctors say they’ve done this at least once” Can I get a little bit of clarification on that statistic? 17 to 97 is a huge jump lmfao

  39. This is why I believe SSRIs work but don’t actually do anything beneficial, it that makes sense. (I have a long history of antidepressants use, no hate)

  40. I wonder if one can self – medicate successfully with placebos. I wonder if making people take placebos while they are taking a handful of Rx's already would backfire.

  41. More interestingly, expensive placebo is more effective than inexpensive placebo. This discovery also won the 2008 Ig Nobel Prize of Medicine

  42. Honestly this video makes me wonder if my cure-all for when I get sick or start feeling super down (a nice hot bowl of pho, which is a Vietnamese noodle soup) is a placebo or if it just genuinely helps, and, more importantly, if it even matters.

  43. I feel there's something else at hand. the body's natural ability to heal. When you do nothing, the body will still do everything it can to heals and take care of itself.

  44. Do a story on connecting to just the energy of something…..thru meditation….and healing thru that connection to just the energy.

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