Your Brain Is a Pharmacy

The placebo effect yields real neurological results

| September-October 2008

  • Brain Belief

    image by Richard Borge

  • Brain Belief

For a long time, doctors and researchers believed, like most of us, that the placebo effect is the mental by-product of an overactive imagination, a case of reverse hypochondria. Now, armed with brain-scan technology, the scientific community is discovering that there’s more to placebos than the power of suggestion. It seems that sincere belief triggers bona fide reactions in the brain, and we’re only just beginning to harness the effect.

In one study, participants were given two glasses of wine. (No, vino isn’t quite the same as a sugar pill, but hold on—we’ll get there.) Both glasses contained the same cabernet sauvignon, explains Psychotherapy Networker (May-June 2008), but the would-be connoisseurs were told that one cup contained a more costly pour. Unsurprisingly, the participants gave the “pricier” wine higher marks. But this wasn’t just a case of slick marketing: Brain scans revealed that the areas of the mind associated with pleasure burned brighter even before participants tasted the “more expensive” wine. “They expected pleasure, and their brains delivered it,” the psychotherapists’ journal reports.

This finding jibes with the work of Tor Wager, a professor of psychology at Columbia University in New York. When Wager was interviewed on Radiolab, a documentary show produced by public radio station WNYC, he described an experiment in which he applies an uncomfortably hot heating pad to participants’ arms.

One by one, research subjects are loaded into an MRI scanner. After testing how their brains respond to pain, Wager offers his participants some Vaseline but calls it Lidocaine salve. “We say, ‘This is going to be really effective; this is going to block pain,’ ” he says. Then he takes another picture of what’s happening in their brains.

As soon as participants anticipate relief, their temple region lights up with activity, and then the commotion shifts inward to the midbrain, which is responsible for releasing pain-killing opioids. In every case, the heating-pad pain was gone after the Vaseline was administered. It’s a mind game, but the results are real. As Wager explains it, all the drugs in the world are already in our brains; that’s why we have receptors that are able to make sense of synthetic or artificially introduced versions. The real trick is figuring out how to prompt our brains to release the right stuff at the right time.

Unlocking those secrets could revolutionize how we treat physical pain, mental disorders, and other medical complications. Another scientist who appeared on Radiolab is experimenting with intermittent substitution of placebos in a morphine regimen. So far, he’s been able to administer 50 percent less morphine, with no reduction in pain relief—halving his patients’ exposure to the addictive, side effect–laden pharmaceutical.

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