Embodying the Placebo Effect: Shaping Your Biology with Thoughts
I want to help you consider medicine as a holistic experience of conscious healing through intentional biological experiencing. In other words, you can use your expectations and intentions to direct your biology. If that sounds daunting, don’t worry. It’s easy, free, and anyone can do it. To do this, you do not need a degree, a guru, to become one with the Force, or decades of meditation experience. And I’ll help you prove it to yourself that you already do it right now anyway, whether you are aware of it or not.
I am a holistic medical cannabis pharmacist with both conventional and natural medicine expertise, and also a 25+ year South Asian yoga and meditation practitioner and teacher. The work I do is the merging of my sciences, spiritual fascinations, and honoring of ancestral wisdom in a way that I hope will help you understand yourself better and practice feeling well. Take a deep breath, become aware of your body, and release some tension with a long exhale. I'm going to take you on a nerdy introspective journey into the power of using your thoughts to improve your well-being.
Let's start with a little placebo effect science, where expectations can make a fake pill or sham treatment work like real medicine. This is copiously documented in countless randomized double blind controlled trials, inarguable proof that our thoughts and intentions have the mysterious power to shape our biology.
It's kind of funny how magical thinking makes us uncomfortable, and yet we have to build magical thinking into scientific studies in order to get robust data. Let’s dive into the science behind this magic of placebos.
Drugs and other interventions are evaluated based on how much they create a change beyond the placebo effect, basically by subtracting the estimated difference and disregarding it as statistical fluff. Unbiased medical studies are designed to minimize the impact of human expectations and intentions on results. We tend to look past the placebo effect to create “real” drugs, rather than embracing intention AS real medicine. A new designer drug is profitable, because big pharma can’t sell us our own thoughts and feelings. Maybe that is why the placebo effect seems to be an invisible, ignorable, mysterious, possibly imaginary, probably irrelevant, "woo-woo" afterthought.
Placebos have the most impact on pain, nausea, asthma, and phobias. Other conditions include smoking, dementia, depression, obesity, hypertension, insomnia, and anxiety. Antidepressants have such a huge placebo effect, that it is very possible the effects are caused by our expectation more than the pharmaceutical drug itself! And it is not just mental health medication that shows this phenomenon in the data. It’s just about every medication. Expecting your blood pressure to drop because of taking a fake pill actually causes your blood pressure to drop, and not just a little bit. One review of beta blocker trials attributed 34% of diastolic blood pressure reduction and 47% of diastolic blood pressure reduction to the placebo effect. Disturbingly, even a review of sham surgeries found that they may not have much difference in outcomes versus real procedures!
We have known since the 1970s that our bodies secrete our own endogenous opioids when we are given a fake pain pill, reducing even dental surgery pain. Since placebos work so well for pain, some believe we have to consider sometimes prescribing fake pain pills as a pain treatment!
“Do No Harm” - Nocebos and Side Effects
Just as expectations create benefits, they can also cause real adverse side effects. Not imaginary ones, but serious issues that require medical treatment. This is called a nocebo, which is a substance without medical effects that worsens the health status of the person taking it through the negative beliefs and expectations of the patient. In other words, if you are told a fake pill is going to cause a particular side effect, you are more likely to experience that side effect. Side effects monitored in antidepressant trials, for example, closely follow side effects of placebos. Considering that adverse effects from medication are a leading cause of discomfort, illness, and need for medical intervention, we cannot ignore the harm done by the nocebo effect in any medication, especially when overall Americans are taking too much unnecessary medication.
Big Bad Pharma
I am a proudly anti-pharma pharmacist. My back in the day pharmacy school entrance essay was a rant about evil big pharma and how I would use my knowledge and education to dismantle it. I wanted to make sure they still let me into the doctorate program if I promised to burn big pharma down to the ground with the facts, in my freshly starched first year student white coat. I am really not sure if they read the essay, but they accepted me so here I am. I wanted to learn about drugs to protect people FROM medication, as much as help them WITH medication.
Big pharma marketing knows how to leverage the power of expectation, and they get their money’s worth. Ads suggest pharmaceutical solutions can make you salsa dance, run on a beach, have a picture perfect vacation with your grandchildren, and any other lifestyle imagery to distract us from the ballooning costs and spooky side effect lists of medication. Just ask your doctor about this new drug, and soon you too will soon slow motion laugh all day, with perfect teeth, on a yacht, with all your conventionally attractive friends!” Manipulating our power of intention is absolutely part of big pharma’s business plan, and it’s working quite well for them, but not for us.
Remarkably, as the big pharma monster has grown, the placebo effect itself is also growing. It is more of a problem in US drug trial participants versus other countries, correlating quite disturbingly with the way people in the US are overrun with direct-to consumer drug advertising, which other countries wisely do not allow. In the US this is literally thwarting new drug discovery studies, because new medications cannot keep up with the increasing placebo responses of US patients. People tend to associate larger and more expensive trials with more effective medicine, and the placebo effect grows within our cells, alongside our expectation for bigger and better health outcomes through technology.
“Stop Hitting Yourself” - Thoughts Create Illness
Intestinal churning in anticipation of the next shift at a dreaded job. Upper back pain that flares up with emotional distress after a family conflict. Itchy skin rashes that correspond with anxiety attacks. Aches and pains that flare when you remember a deadline. Your body does not exist separately from your thoughts and emotions.
The disease-causing effects of our intentions are vast and well documented. Anger becomes a heart attack, gut flora imbalance creates depression, trauma from adverse childhood experiences manifests as asthma, and loneliness turns to a stroke. It almost feels like the schoolyard bully saying “stop hitting yourself,” while making you hit yourself. Even faking a sad or angry facial expression with no context will have the same deleterious effects on biomarkers of health as genuine sadness and anger. Your personal mind-body connections are working all the time, whether you are aware of them or not. This is just biology, not woo-woo stuff.
And please note that this is not about blaming ourselves for being sick because of our thoughts, or to say the need for medication is all imaginary. If you need medication, obviously I think you should take it! Please be gentle with yourself, and remember that you are swimming in a sea of disease-causing systemic stress, pollution, processed food, and social disconnection. This is about collective healing, not just placing the blame on the individual for larger factors beyond individual control. Systemic oppression makes us sick, and we need collective solutions to decolonize medicine.
How to Practice Feeling Good
Fortunately it takes time, repetition, and practice for negative manifestations of thoughts to develop in the body. Anger, sadness, or any emotion must be practiced chronically over time to lead to these biological outcomes. You are practicing embodiment of your thoughts, emotions, and intentions, all the time as a function of being alive. It's never too late to change what you practice, and I don't know about you, but if I must have this body to live this life, I'd rather practice feeling good instead.
So now that we know thoughts can make us sick, how do you practice feeling well through your own inner placebo effect of intentions? You can easily focus your mind-body connection to shape and improve your well-being. Meditation reduces blood pressure, heart rate, and stress biomarkers like cortisol. Knowing the science behind your practices will strengthen the benefits because your expectations will translate into stronger biological changes during meditation. And meditation only has good side effects.
Mimic the expression of a smile, even with no context or reason, to produce the same beneficial physiological effects as a genuine smile. Laugh to balance everything from your endocannabinoid system to your immune system to your heart health. Practice gratitude to reduce inflammation. Breathing, moving, singing, dancing, nature, yoga, art, connecting with others… practicing feeling good is practicing healing. It sets up an expectation, more powerfully than feeling bad, and it is easy to practice because it feels good! This improves health more than a fake pill, especially when you know the science behind it. Just like with placebos, the more you know, the more you expect, and the more you will benefit from healing practices.
The placebo effect should be proof enough for any skeptic that our thoughts are shaping our health all the time. And this fundamental truth of holistic health is not a new discovery. Our bodies exist not as separate from consciousness, but as an expression OF consciousness. Qi or prana follows attention and intention. Ancestors and indigenous peoples have always understood the mystical forces connecting the seen and unseen as essential to medical science and healing practices. The age old wisdom that white supremacy and colonialism degrades and destroys, labels as savage, primitive, inferior, or illegal, is actually more accurate scientific understanding, versus reductionism of health to one profitable molecule to act at one receptor.
Collectively, we need to look to our roots if we want real healing and well-being. Mind-body holistic health shouldn’t be considered “alternative” medicine anymore. Consciousness itself is the medicine we need.