On Views of Psychological Effects and the Placebo Effect

　　Often when encountering certain phenomena, someone will say with a skeptical tone: “Is this just psychological?” Or they will dismissively attack certain treatments: “This is merely the placebo effect.”

　　This kind of person is very superficial—yet they make up no small share of the population, so a word must be said.

　　Whether psychological effect or placebo effect, they have an irreplaceable role; one must not belittle a phenomenon merely because it is psychological.

　　In many situations they work better than drugs even for common illnesses.

　　Psychological effects can produce both positive and negative results. Typically, if a person long has no contact with others and is shut in a small room for years without sunlight, depression comes easily.

　　One factor in depression is the influence of hormone secretion in the body, and such secretion is currently beyond direct control—it can only be altered through emotional regulation.

　　Likewise, psychological effects may produce all kinds of strange illnesses, and once such illnesses arise they are often hard to reverse.

　　For example psoriasis: once one has it, if the patient is in a poor mood and receives many negative suggestions, naturally spirits are low and the disease grows more severe. Clinical medical surveys show: people with more negative emotions have a higher rate of psoriasis than ordinary people.

　　Psychological action has a harmful side; naturally it also has a good side. The good side makes people happier in mood and healthier in body.

　　As a matter of reality, though there is not yet sufficient evidence that cheerful cancer patients necessarily outlive unhappy ones, cheerful patients' quality of life is often far better than the unhappy.

　　And psychological effects often act on the body's own hormone secretion and regulation, which often has therapeutic effects on some illnesses.

　　There used to be a mistaken belief that the human body by itself is insufficient to solve certain disease problems. That belief is wrong.

　　For in this world there are clearly people who never suffer a major illness in life, and people who remain relatively healthy throughout. Though differences exist between people, for most these differences are not in fact large.

　　For instance, in a research paper recently published in the prestigious international journal Cell, researchers from the University of California discovered that bacteria in the human body may help us manufacture thousands of kinds of molecules. By developing new data-analysis software to study bacterial samples from the human body, they identified many bacterial gene clusters; by switching these clusters on, one can control the secretion of active molecules by the body's bacteria. The researchers identified 3,118 gene clusters in the human body; the proteins encoded by these clusters form a huge “molecular factory” that can produce special drug molecules to help treat human diseases.

　　This shows that at least humans possess the capacity for self-treatment against quite a few diseases—it is only that most people have not tapped this potential.

　　And if psychological effects merely cause changes in human hormone secretion, they can clearly also influence the living environment of certain bacteria; some positive effect is entirely foreseeable.

　　Those who dismissively say “placebo effect,” and often wave the double-blind experiment about, are also problematic—because at present there truly are situations where a genuinely effective drug does worse than a placebo.

　　Typical is an experiment at the University of Turin in Italy: using a pain-relief ointment that in fact does nothing, versus naloxone (a strong antagonist/anesthetic agent), in a double-blind experiment on subjects injected with capsaicin. Those given the ointment all said the pain eased; yet after naloxone was injected, subjects reported the pain had returned.

　　This is a typical example of a placebo working better than a drug. By ordinary judgment one should conclude the strong anesthetic agent is useless—but in fact that is not so.

　　An experiment at Harvard University is even more interesting: they took placebos, even wrote clearly on them that they were placebos, and gave them to patients with irritable bowel syndrome.

　　Irritable bowel syndrome is one of the most common functional disorders. Its feature is that there is no structural inflammatory pathological change in the intestinal wall, yet the whole intestine shows abnormal physiological responses to various stimuli. At the same time, this illness is very closely associated with mental factors.

　　They found that whether or not patients knew it was a placebo, it could act on the symptoms; more interestingly, the group who knew it was a placebo actually showed symptom improvement, while the other group who did not know whether it was a placebo had no effect at all.

　　This is as the ancients said: “Diseases of the mind need medicines of the mind.” Illnesses associated with mental factors do not mean the patient must have mental illness; at the same time, in reality a great many common illnesses correlate with mental factors. Such drugs often cannot solve them or work poorly, yet through the placebo effect they can work very well.

　　The key in the Harvard illness experiment is this: if the patient is uncertain whether the medicine is useful, then neither works; but if the patient clearly knows it is useful, or clearly knows it is useless, or guesses it is useful but is only told it is useless—in any of these, once the state shifts from uncertain to a state of certainty, and a fixed course of taking the medicine is carried out, then effect appears.

　　These are real cases of the enormous power of psychological factors. So do not belittle the role of psychological effects and the placebo effect.

　　To sum up in one line: curing the illness is always better than taking medicine that does not cure it.