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Placebo: A Healer In Disguise

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In the short documentary, “Fake Surgery”, it was evident that patients who thought they had undergone a surgery showed signs of healing, despite not undergoing a proper surgery. Doctors have used placebo effects in different experiments throughout the history of medicine to test not only the strength of medication but rather the idea of why placebo’s work and how the body and mind is powerful and to able cure itself. There has been an increase in the research of the placebos over the years and it is evident that the placebo effect is no longer a false phenomenon and does actually shows signs of healing in patients in various case studies and experiments. In this essay, one will discuss why patients showed signs of healing with reference to Moerman’s (2002) concept of the “meaning response”.

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A ‘placebo’ directly translated in Latin means “I shall please”. In modern day times, a placebo is an exact replication of pill that contains no ingredient to create a change. It may be called a “sugar pill” as it serves no chemical or biological use. A placebo was initially introduced within the medical field to test or trial the effectiveness of a medication to determine the change that medication creates as opposed to no medication. However, in studies and experiments it has shown that the Placebo relates to healing. Thus, it is called the “placebo effect”. The psychology fields have also used the placebo effect to display classical conditioning. There a few ethical issues behind the Placebo effect as well as the extent to which a placebo effect works. There are also many factors that contribute towards this healing process and may affect people differently in different situations.

The human body was created with its own immune system with the purpose of protecting the body from harm and fending off bad cells that may cause sickness or disease. Despite some people having a weak immune system whilst others may have a strong immune system, the body would be completely defenseless without an immune system. Therefore, the body is capable of naturally healing itself over time if fully functioning, not taking into regard diseases that weaken the immune system such as HIV or lupus. However, certain social factors may slow this natural healing process down such as stress or exhaustion which may account to why some people take longer to get better than others. If given the chance, the body may heal itself. Medication speeds up the process of natural healing so instead of staying in bed for 4 days with diarrhea, medication can stop the diarrhea immediately without disrupting our everyday lives.

In the August 24 issue of The Journal of Neuroscience, a neuroscience report, it was observed that a placebo generated activity in the endorphin system when participants were told that their pain would be reduced. Endorphins and dopamine are neurotransmitters that target specific areas in the brain to make you feel better. These endorphins stimulate the body to heal itself naturally or regulate pain. This chemical change produces self-healing. Despite there not being enough extended research in this field, one can believe that healing that takes place after taking a placebo is affected by both your psychological and physical being.

The mind is powerful, and perception is a strong force in our daily lives. The way people perceive things, can depict their emotional and mental state and reality. Our beliefs are a driving force and when we believe in something completely, with utmost faith, we may not be led astray by factors that may disprove our beliefs. Therefore, if we are led to believe that we are being healed by medication, we start believing it and feel like we are being healed. Azjan’s Theory of Planned Behavior (1991) in social psychology shows that our decisions made are based on behavioral, normative and control beliefs. These beliefs can have a positive or negative effect on the healing process relating to placebos as it affects your overall attitude on treatment.

We are shaped by our beliefs and values which may be passed down from generation to generation creating a culture. There are many different cultures in different parts of the world. People are brought up with the culture and strongly believe in it because it worked many generations before them and they want to belong to a community and enjoy familiarity with others, instead of being isolated and different from the rest. We are often taught not to question our elders because they are wiser and have experienced more than them. This notion can be carried over into many aspects of our lives. Such as when a doctor, who is a trusted doctor by many within the community and has studied at a reputable university with many qualifications to his name, directs a patient to take medication; the patient does so almost without questioning the doctor and his methods. In addition to this instruction, we believe that this doctor will heal us because he healed your father last week. Therefore, before we even step foot in the doctor’s rooms, we are already under the impression that we are healed or will get better as soon as possible. This shows that there is evidence of a meaning response. A placebo is used in different populations in different contexts. Thus, normative social behavior which is a social influence that promotes conformity plays a role in expectancies and behavior.

In social psychology, Kirsch (1994) suggested that hypnosis can be considered as a non-deceptive placebo. The healing process of the placebo may be maximized when three expectations are met during hypnosis. A patient does not undergo hypnosis with a dangling watch and needs to be snapped out of it but rather led to believe in the effectiveness of the treatment and healing process.

Expectations play a role because we expect a certain outcome and are pleased when our expectations are met more often than not. We are also inclined to act the way in which we expect, so if we expect to get better the body may adjust itself to working on getting better to anticipate and meet the expectation. If you constantly tell yourself, you eventually start to believe it because you do not consider factors that can disprove this. When given a placebo, the logic may be that “I am taking medicine, therefore, I am getting better” and because of this belief it may happen. This may be seen as a confirmation bias as patients work towards getting better. According to Moermann, “expectancies are the outcome of a complex play of meanings”, thus the placebo may work in a particular context with many different meanings.

The pharmaceutical business has flooded the market with an overflow of medication that is widely available almost anywhere, at any shop. This medication treats the faintest of ailments to the most life-threatening diseases. When one feels that they are coming down with a sickness, they know that they are able to run to the shop and drink a pill or spoonful of liquid to feel better within a few days. The idea that one has something to reduce the symptoms and continue with their everyday lives alone satisfies the mind and calms one down immediately. People may not even be fully aware of the ingredients that are in the actual medication but take it because it is offered by a reputable pharmaceutical company or the latest advertisement on the television guarantees that it works. Thus, the brand name of a pharmaceutical company has an effect on the active medication as well as the inert medication. Either one taken causes the individual taking the medication to believe that the medication is effective which stimulates healing. Placebos show that perhaps there are alternatives to pharmaceutical drugs which has cured people for centuries. As a result, pharmaceutical conditioning plays a role in why patients believe in the power of a placebo and show healing.

A placebo in itself cannot cure or heal a patient. However, there are many social factors that play a role in why people heal after taking a placebo. A medical practitioners’ approach to a patient may have an effect on how the patient heals. A despondent, negative practitioner may negatively affect the patient’s mood and will to get better. A hopeful, warm practitioner may increase the patient’s eagerness to take the medication and show signs of improvement. The actual physical environment in which the placebo is offered may also influence whether the placebo works or not. In line with Kirsch, a suitable environment will allow for the full maximization of hypnosis of the client. I think placebo may not always generate healing for every single illness or disease due to the nature of the illness as your body alone may not be able to heal cancer on its own and will need the help of other healing processes. I think patients show healing in certain conditions that are favorable for healing.

It is not about the inert substance. It is about the environment, the doctors. The meanings related to the Placebo. Moermann analyses the meaning related not to the placebo but rather to other factors that creates a system and atmosphere of meaning relating to a placebo. He provides an anthropological view of a placebo and perhaps to a certain extent he is correct. Patients may show signs of healing as a placebo pill may be perceived as symbolic. Despite not knowing that the pill is inert or that the procedure is not real, these medical images or medications may have a deeper symbolic meaning behind it. It may be a variety of symbolic meanings for different patients. It could symbolize culture or just health. For example, when we think of illness, we immediately associate it with medication and healing. Perhaps looking at a pill or undergoing a surgical operation universally symbolizes getting better, hope and healing. This symbol may create positive thinking which helps healing.

During these placebo experiments, patients are often show positive side effects and signs of healing. In contrast to this, patients may show negative side effects, yet the placebo has no active substance to cause any physical harm. This is known as a nocebo. This may be proof that expectations and the mind does play a role. It makes one think, how can a patient get sick if they are taking an inert substance and why it is one patient may show signs of healing, yet another patient has negative side effects. If a patient is told that a pill will cause negative side effects, he may start taking placebo with a negative mindset that he is going to get sick and he will get worse. This negative mindset may fester and cause negative side effects. A self-fulfilling prophecy may also cause this nocebo effect because are falsely informed of the negative side effects and it becomes true. The nocebo effect not only supports the idea that expectation affects healing but also acts to prove and disprove healing may stem from our physiological and psychological parts when comparing the two.

In light of the above, it is evident that many factors affect why patients who take placebos show signs of healing. Our bodies contain neurological chemicals that when released may induce pain relieving. Our psychological well-being is powerful and we are guided by our beliefs, expectations and society. There are social factors that when fully maximized to be favorable, it helps a patient believe in healing. Moermann’s healing response also shines a light on how different factors can bring out meaning and healing.

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