What is the placebo effect?

Welcome to Philosophy is not boring by Kadopoly.com. I'm Mira. And I'm Finn. Before we start, a massive hello to nine-year-old Vera and seven-year-old Eric, who listen together nearly every night in Giggleswick, North Yorkshire.

This episode is for both of you.

If you haven't already, tap follow wherever you're listening so you never miss an episode.

So, Mira, I need to ask you about something weird that happened yesterday. I was running in the park and I completely tripped and scraped my knee.

Oh no, did it hurt?

Yeah, loads. It was stinging and aching, and I was holding it, just feeling terrible. But then Dad came over. He looked at it, washed it with some water, and put a completely regular plaster on it. And it actually stopped hurting so much. Wait, did he give you any pain medicine? No, just a plaster. Even though he didn't give me any medicine at all, my knee felt so much better just a few minutes later.

Have you ever wondered why that happens? Why does just having a grown-up look at a graze or put a simple plaster on it actually make it hurt less?

I thought maybe it was magic. Or maybe Dad's just really, really good at putting on plasters. Or maybe I just distracted myself.

It's not magic, but it is one of the most mysterious and fascinating things about being human. Today we're asking a really big question. Can your brain actually change how your body feels just by expecting to feel better? Wait, so my brain can heal me? We are going to explore exactly that. We're looking at why a pill with absolutely no medicine in it, like a sugar pill, can make people feel better, and what that tells us about how our minds and our bodies are connected.

Wait, a pill with just sugar? Why would anyone ever take that? Doesn't medicine have to taste bad and have confusing scientific names?

Well, imagine this thought experiment. Picture yourself with a terrible headache. I'm wearing a white doctor's coat and I hand you a round white pill. I tell you it's a super strong, brand new painkiller that works incredibly fast. You swallow it with a glass of water. Twenty minutes later, your headache is completely gone.

Okay, so the medicine definitely worked. But here is the twist. What if I told you there was no medicine in that pill at all? It was just a little bit of sugar pressed into a circle.

I'd say, you tricked me. But wait. If my headache is gone, then how did it go away? The sugar couldn't have fixed my head.

Exactly! That is the mind-bending puzzle we are looking at today. It is called the placebo effect. A placebo is something that looks and feels exactly like a real medical treatment, but it actually has no active medicine in it.

And people have just been wondering about this. Did they trick a lot of people to find out?

People have known about the power of belief for thousands of years, but doctors only started really studying it recently. A doctor named Henry Beecher really put it on the map. He was an anaesthetist at Harvard University in America.

An anesthet what? That is a very long word.

An anaesthetist. It's a highly trained doctor who specialises in blocking pain when people need surgery. They are the ones who give you medicine, so you sleep through an operation and don't feel anything. During the 1940s and 1950s, Beecher was thinking deeply about how human beings experience pain.

That makes sense. If your whole job is stopping pain, you'd want to know absolutely everything about how pain works.

Right. And he started noticing that pain wasn't always a simple math equation. It wasn't just big injury equals big pain. He noticed that sometimes, if people just thought they were getting a powerful painkiller, they felt a lot better, even if they only got salt water. So the thought was as strong as the medicine.

Yes, so Henry Beecher decided he needed to investigate this properly. In 1955, he published a very famous and influential paper. He gathered up 15 different medical studies where patients have been given placebos. Like the sugar pills or the salt water. Exactly. He looked at all these different patients who had been given something fake but who believed it was real.

And Beecher reported something absolutely wild. He said that about a third of the patients, around 35%, actually felt better after getting a placebo, as long as they believed it was medicine.

What? A third of them? But there was nothing in it. Does that mean they were just making it up? Like they were never really hurt or sick in the first place?

No, that is the most important part to understand, Finn. They were not imagining it. The pain was completely real. The sickness was real. We must never think that a placebo working means the illness was fake.

But if the medicine was fake and the pain was real, how did the pain go away? That feels like it breaks the rules of science.

It doesn't break the rules. It just shows us that the rules are more complicated than we thought. Because the relief was real. Expecting to feel better is actually a huge part of feeling better.

Wait, huh? How can expecting something make it happen in my physical body?

It turns out, when you believe you are getting medicine and you feel safe and cared for by a doctor, your brain actually sends out its own natural pain-relieving chemicals. It's like your brain has its own built-in medicine cabinet, just waiting for the right signal to open up.

That is kind of amazing, actually. So the sugar pill doesn't cure you, but it acts like a secret key that unlocks your brain's own pain blockers.

Exactly. It is especially strong for things like pain and feeling sick to your stomach, which we call nausea. The brain can send signals down to your body to say, hey, help is on the way. You can turn down the alarm bells now.

So Henry Beecher proved that a third of all people can be fixed with just sugar. That's incredible! Well, hold on.

This is where we have to look closely at how science works. Science is all about testing claims. Later researchers went back and looked very carefully at Beecher's math and the 15 studies he used. Oh no. Did he get it wrong? Did he make a mistake? They found his sums were a bit too generous. He overstated his numbers, meaning he kind of accidentally grouped some things together that made the placebo effect look even bigger than it was.

It wasn't really a full third of people for every single condition.

Oh man. So it's not real. It was just bad math.

Oh, it is real. The later researchers proved that the placebo effect definitely exists, especially for pain and nausea. Beecher was right about the big idea, even if his exact numbers were a bit too high. He changed medicine forever.

How did he change medicine? What do doctors do now? Do they just give people sugar pills all the time and hope for the best?

Not exactly. But the placebo effect is so powerful and so real that it completely changed how we test real medicine today. What do you mean? How do we test real medicine? Today, if a scientist invents a brand new medicine, they have to prove it actually works. So they do something called a clinical trial.

They give half the people the new real medicine, and they give the other half of the people a placebo. And they don't tell them which one they got. Exactly, because they know the people taking the placebo will feel a little bit better just from the expectation and the hope. The real medicine has to beat the placebo effect to be approved.

If it's not better than a sugar pill, it doesn't get to be a real medicine.

That's crazy! The fake medicine is so good that real medicine actually has to fight it to win. It really is.

And this brings us right back to your Grey's Nefin and the plaster your dad put on it.

Oh right. Because the plaster didn't have any painkillers in it. It was just a normal piece of sticky fabric. Exactly.

But your dad was looking after you. You felt cared for. You expected that getting a plaster would make things better, because that's what grown-ups do when you get hurt.

And because I expected it, and because I trusted my dad, my brain unlocked the medicine cabinet and turned down the pain volume.

Yes, being cared for by someone you trust is a real physical part of healing. The way a doctor talks to you, the routine of taking a pill, or a parent washing a scraped knee. Your body actually responds to that care. Expecting to feel better is part of feeling better.

So next time I fall over, I'm still gonna ask for a plaster. Not because it's magic, but because feeling safe actually helps my body do its job.

That's a brilliant way to think about it. The mind and the body aren't two totally separate things. They are constantly talking to each other.

Do you have any fun facts about this? Because my brain is already pretty blown.

I do! Here's a great one. The word placebo comes from an old Latin word that means I shall please.

So it literally means it's just trying to make you feel nice.

Yes, and here is the weirdest, most mind-bending fact of all. Modern studies have found that sometimes placebos work even if the doctor tells you it's a placebo.

Wait, what? If they say, here is a sugar pill, it has no medicine, it still works.

Sometimes, yes. It's called an open label placebo. Because just the ritual of taking a pill and the fact that a doctor is trying to help you is enough to trigger that relief in your brain. Alright, Finn, time for the quiz. Are you ready?

Okay, I'm ready. I think I remember all the tricky parts.

Okay, first question. Who was the Harvard doctor we talked about today? Next one, this is tricky. What year did he publish his famous paper looking at 15 studies? Question 3. What is the exact word for a pill with no medicine in it, like a sugar pill? Alright, here's number four. True or false? Later researchers found Beach's numbers were a bit too generous.

Last question. What does every new real medicine have to do before it's approved today? Great job! Let's go through the answers and see how you did. The answer to question one is it was Henry Beecher. For question two, he published his famous paper in 1955. Number three, the answer is it's called a placebo.

Question four, that is true. The placebo effect is real, but his math was a bit high. And the final answer is it has to be the placebo effect in a clinical trial.

You know, Mira, I used to think a sugar pill was just a silly trick. But it's actually showing us how amazingly powerful our brains are and how much we need each other.

I really love that way of looking at it, Finn. The connection between what we expect, how we feel cared for, and how our bodies actually feel is one of the coolest things about being human.

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And if you want to shout out on the show or just want to say hi, email us at hello at kidopoly.com.

We love hearing from you all. See you next time on Philosophy is not boring. Bye, everyone.

What is the placebo effect?

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