Human suffering can be reduced considerably but temporarily by the initiation of any intervention that the sufferer believes in. This is the ‘placebo’ effect. This is why the tooth immediately hurts a lot less as soon as the dentist appointment is made and one hangs up the phone. I have mentioned before how the placebo effect interferes with the study of Reich and Lowen therapy. I now come to see how it also interferes with the delivery of it.
There are two problems with the placebo effect: 1) it decays over time, and 2) it cannot work synergistically with growth strategies to relieve suffering.
There are two seductions (or assets, depending on one’s point of view) of the placebo effect: 1) It is immediate (unlike growth) and, 2) it is considerably stronger in effect initially than true growth effects.
The placebo effect is based on dissociation. Real growth is based on association (or re-association) In research, if another dissociative method (say a drug) is employed as the experimental condition, then the effects of that and the placebo may be additive. When the control group (which only has the placebo effect) is compared, the placebo effect subtracts out and demonstrates a treatment effect. Associative effects, however, are not additive to the placebo effect, in fact they may undermine it. Therefore, in testing something that leads to growth, when the experimental and the control group are compared, the shared placebo effect is like tall grass that hides what is happening on the surface, and no treatment effect is demonstrated. This is particularly true since studies tend to last less than 6 months, and the effects of growth in this arena usually take several years to manifest. This why effective ‘alternative’ treatments cannot be distinguished from ineffective alternative treatments by present day random-controlled trials—the subtle balancing and regulating effects (or their absence) are all hidden under the tall grass of the placebo effect.
In emotional well-being, the placebo effect is synonymous with what Alexander Lowen described as elation or illusion. As he often pointed out in his writings, the therapist’s ‘window of opportunity’ for change is often to prevent the client from ‘climbing back onto’ the illusion (and the placebo effect,) after a collapse.
Placebo effects are in fact part of healthy human adaptation for causes of suffering that 1) will pass on their own, or 2) cannot be addressed immediately but which will be effectively addressed in the near future (such as the tooth example above.) Where the cause of suffering is persistent, placebo effects support an increasing dissociation that covers a slowly depleting work and pleasure function.
Placebo effects have to be renewed periodically, by finding some ‘great new thing.’ This leads to a very disorderly approach to health where the sufferer travels from one type of practitioner to another, never really committing to the practices. The immediate positive placebo effects are mistaken for the treatment effects, but as the novelty wears off, the practices seem to stop working, and something new becomes overwhelmingly attractive. This is placebo abuse. In my practice as a therapist, it greatly interferes with forming a working relationship because new clients compare the subtle differences I am pointing out to the strong if temporary morale-boosting available through starting ‘something new.’