The Mind’s Tremendous Influence Over The Body
24 years old female presents with several week history of progressive stomach pains, substernal chest discomfort, heart palpitations, loss of appetite, headache, insomnia, and growing lump sensation in her throat. Physical exam was essentially normal.
Can this previously healthy female have suddenly developed reflux, globus, paroxysmal supraventricular tachycardia, brain tumor, and throat cancer with possible overlying thyroid disorder? Or perhaps has she contracted some other horrific mystery disease?
Maybe…
But maybe none of the above…
What if I told you she will be giving a doctoral dissertation for her Master’s next week for which she is ill-prepared given a recent breakup with her boyfriend of 5 years and a growing distaste of her school classmates who have been less than supportive.
In other words, anxiety.
The point is that the mind has tremendous influence over the body and numerous physical maladies can be attributable to a patient’s mental state. People can die of a broken heart or out of extreme fear. Stress can age the body dramatically (look at a picture of a presidential candidate and then another after having served 2 terms as President of the United States).
A mind under stress CAN affect the body. Reassurance helps. Elimination of the stressor is even better. If the stresses can’t just go away, development of strong coping mechanisms will do much to help. After that, there are prescription drugs that help, but have addictive potential as the anxious patient will tend to take a pill rather than dealing with and learning coping skills.
But here’s where the power of the mind can be “manipulated” into helping rather than hurting the body.
In my last blog, I did ridicule therapeutic hands to manipulate human body energy as total bunk (or rather a 9 year old girl did)… BUT… if a person truly believes that it does help, it probably can help some individuals just from the idea/belief/faith that it can.
Faith, trust, and sharing with another human being who lends a sympathetic ear is where questionable “medical” practices and homeopathy may provide benefit… not because such quackery directly helps the individual, but more because the individual BELIEVES it can help.
I can totally make up a quack treatment like placing an ice cube over the heart and stating that this practice can “calm” the heart palpitation down by “cooling” it to a more natural state… and if the patient believes it to be true… then the mind can potentially make it so in a significant number of people. In fact, I can state with some confidence that it will help in as many as 20-40% of patients.
How can I state such a statistic knowing my treatment is total hogwash?
It’s because of the placebo affect.
Although I don’t support (and perhaps even discourage) such quack medicine, as long as it doesn’t harm the patient and there’s no danger if a patient decides to forgo more traditional and evidence-based medical treatment, then I don’t see any long-lasting harm in it.
Because as scientists and doctors know… the placebo effect is real and DOES lend improvement nearly 40% of the time! Who cares if the activation mechanism of the placebo effect is via “therapeutic hands” or “local honey” or some other “un-accepted” treatment.
After all… the patient is feeling better and that’s what really counts in the end.
AND… if it doesn’t work, then traditional medical treatments can be pursued.
What is evidence-based, scientifically proven medical treatment?
It’s when the treatment helps people way more than the placebo (or in other words, way more than 40%).
*This blog post was originally published at Fauquier ENT Blog*
Ah yes the power of “evidenced based” traditional medicine vs the healing power of attention and placebo
Lets take a look at the number one prescription in the US – anti-depressants – meta studies clearly show they are not any better then placebo for mild to moderate depression. Of course only the positive studies are published in the medical journals to keep providers from being confused by all of the FDA studies.. Even the underlying premise of a serotonin deficit has never been shown to be true.
Unfortunately despite the evidence 1 in 10 adult is now taking anti-depressants and a growing number of kids. Doctors are not also being evaluated on quality metrics for essentially giving their patients a sugar pill. Exercise in fact works even better then drugs but there aren’t billions to be made so you don’t hear about it.
Of course MDs giving out sugar pills comes at a very financial cost and does little or nothing to improve long term outcomes. What is odd is how quick we are to show that kindness and attention don’t work but placebo’s given by MD’s do.
So does your blog also riducule the “healing hands that write RX’s for sugar pills masquerading as anti-depressants?”
I am not sure why this should seem revelatory, but it does reflect the Western medical system ethos that continues to insist on separating mental from physical phenomena. Of equal, and one might argue, more interest and importance is the “nocebo” effect, by which negative consequences/responses occur secondary to treatment. This has been well-studied in anticipatory nausea related to chemotherapy
I agree that placebos “work” – especially with perception-mediated conditions like pain and anxiety. However, I have a problem with intentionally lying to a patient about the potential efficacy of a placebo treatment. And therein lies the rub – if I’m not willing to “sell” belief in a placebo, it’s less likely to work. So… I stick with talk-therapy, reassurance, supportiveness, kindness. If someone happens upon a placebo and asks me its mechanism of action – I’ll tell them the truth. That’s the decision I’ve made in my practice, though I can appreciate why some of my peers have chosen otherwise.