Placebo Effect


If you take a pill and expect it to reduce your headache pain, you have increased the odds that the pain will indeed subside. This effect can be so strong that even if the pill you take is simply an inert sugar pill, a placebo, and not a pain-killing medicine, your headache may still go away. This “placebo effect” shows how expectation can have powerful physical effects.

How about a psychological condition that is being treated by counseling? Can the placebo effect operate in this case?

Let’s create a hypothetical situation where two guys, Joe and Bill, live in parallel universes. They both suffer from social anxiety; put them in a room full of strangers and they fall apart, overwhelmed with insecurities, fear, and dread. They each have a friend who has a similar problem and is undergoing counseling for the problem.

In their respective universes, the friend says, “Why don’t you sign up for some sessions with my psychologist? She’s really helping me and might be able to help you.”

Joe says, “That sounds good. If it works for you I bet it’ll work for me. Give me her number. Thanks for the tip. I really feel good about this.”

Bill, in his parallel universe, says, “Just because she helps you doesn’t mean she will help me. But what the hell, just to get you off my back, give me her number and I’ll schedule an appointment. Believe me, though, it’s going to be a big waste of time.”

Note that right out of the gate Joe and Bill have different expectations about how well the counseling might help. Joe is optimistic, Bill is pessimistic.

In their separate universes, Joe and Bill go off to their respective sessions. Afterward, each is on a bus heading home and a stranger sits down in the next seat and starts reading his paper. Joe and Bill each think, “OK, the Dr. says I might try to give a casual greeting to a stranger, just to show myself I won’t drop dead from fear. Here goes.”

Optimist Joe turns to the guy reading the paper and says, “Really hot weather we’ve been having, isn’t it?” The guy turns to him and says, “Yep, sure is,” and goes back to his paper. Joe thinks, “Well I’ll be damned. I actually got a response. I started a conversation and got a reply. This counseling is really working!”

In pessimist Bill’s universe his action and result are identical. He turns to the guy reading the paper and says, “Really hot weather we’ve been having, isn’t it?” and the guy replies, “Yep, sure is,” and goes back to his paper. Bill, however, thinks, “Well I’ll be damned. I reached out and got a big three words from him. What a waste. I tried to start a conversation and basically was ignored. This counseling is nonsense!”

Joe and Bill have identical experiences, but their reactions are quite different. How come? Do we have a placebo effect here? Remember, Joe believed the counseling was going to work. Is it that belief that makes him give such a positive reaction to the three words the stranger gave him? By the same token, Bill never really did believe the counseling would work. Did his negativity dispose him to put the 3-word reply in such a negative light?

When it comes to increasing the likelihood of successful counseling, let’s note that several preconditions are important. First of all, the client must be willing to take an active role in counseling and work hard to produce needed changes in his/her behavior. The client must also trust the counselor and be willing to “open up” to the counselor, and follow recommendations made by the counselor. Perhaps most importantly, the effectiveness of counseling is helped enormously if the client truly believes it will be helpful.

Obviously, this last precondition brings us into placebo-effect territory; that is, believing counseling will work makes it more likely to work. However, I don’t mean to suggest that successful counseling is simply a placebo effect. Notice, for example, that if a client believes there will be a positive outcome, then the client will also be more willing to work hard, stay optimistic and confident, trust the counselor, and persevere when the going gets tough. It is those qualities and actions that result in successful counseling, not some sort of magical placebo effect.

The point here is simple: Counseling is not like taking an aspirin, lying down, and waiting for your headache to subside; counseling requires you to take an active role in your treatment. If you sincerely believe that it can bring you positive benefits, you will be more likely to engage in actions that will bring those benefits.

There is no magic wand when it comes to stabilizing yourself psychologically and coping with life more effectively. You are the agent of change; only you can control your thinking and actions; only you can decide to empower yourself and develop an effective coping strategy. Your success, however, will begin with the belief that you can change.


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