Placebo, Coping, and Counseling

There is no magic wand when it comes to stabilizing yourself psychologically and coping with life effectively. Are you one of those who believes that psychology provides such a “magic-wand moment,” when a counselor is able make you better with little effort on your part? The truth is, successful counseling depends on several conditions: You must trust the counselor, be willing to “open up” and answer questions honestly, and follow recommendations; you must be willing to take an active role in treatment and work hard to produce needed changes in your behavior; most importantly, you must truly believe the process will help you.

That last condition sounds like a placebo-effect. That is, you believe counseling will work, and that makes it more likely to work. However, successful counseling is more than just a placebo effect. Notice, for example, that if you believe there will be a positive outcome, then you 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. 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 are other intriguing aspects of the placebo effect that can provide insight into improving your ability to cope with stress. Consider medical research using an “honest placebo.” Imagine you’re in a study to investigate a drug for back pain. One group receives the drug, one group gets no treatment and is told nothing, and a third group gets the honest placebo. This last group is told, straight up, that they will receive a placebo. No deception; no fake pill that leaves you wondering if it’s real or not; just complete honesty from the researcher – you’re in the placebo group! Of course, this honest placebo should have no effect on pain levels, right? After all, you know you’re taking a “fake” drug. Initial studies, however, have shown that the honest placebo significantly reduces pain compared to the no treatment group.

How can that be? If you know you’re taking a sugar pill, and not real medicine, why would your pain subside? Here’s a possible answer. You go to the physician with back pain; she gives you a bottle of pills and tells you they are placebos, fake inert compounds. You take the pills and bingo, your pain subsides. Some professionals theorize that what is going on here is pretty straightforward: Even though you know the pills are fake, you receive them in a larger context of treatment that includes a trained, caring, and attentive physician. These stimuli may very well activate memories associated with medical care throughout your life, care that has more often than not resulted in relief from what ails you. That global context may very well trigger brain systems that lessen your pain. Your body shows a conditioned response to the global stimuli of a physician attending to your problem.

The ultimate answer to honest placebos may be more complex, but let’s ask what this honest placebo finding can teach us about counseling and coping. If you enter counseling with a well-trained, competent, and supportive therapist, those characteristics increase your odds of success. Your success, however, will begin with the belief that you can improve, and an acceptance of the role you must play in producing that recovery: You are the agent of change; only you can control your thinking and actions; only you can decide to embolden yourself to develop and carry out an effective coping strategy. Notice how we are describing beliefs that empower you, require you to be accountable for the role you play in your therapy, and require you to work with your counselor, not passively wait for benefits to magically arise. So, the question of therapy being a placebo is irrelevant. What matters is that the counseling context spurs you into action, activating behaviors that embody the principles of effective coping – accepting the realities facing you, being accountable for what you do, and devising a coping plan that involves humility and empathy. Remember, it is not the magic of the counselor that brings you favorable outcomes; it is the consequences of appropriate actions on your part that produce coping benefits for you.

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