None of Us Are Above the Placebo Effect

Webber Vitamin E Cream is fantastic in my mind. I put this stuff on everything. I use it on my lips, on dry skin, on minor cuts and abrasions. I use it instead of regular moisturizer on my hands and legs.

Whenever supplies start to run low, I stock up because I consider it a necessity. I swear when my kids are grown and they’re reminiscing about all the weird stuff that mom used to do, Webber Vitamin E Cream will be at the top of the list.

Does it work better than other products on the market? Probably not.

Is there some sort of magical ingredient? Nope. If you look at the ingredients, it’s essentially petroleum jelly and vitamin-E.

So why do I use it? Because I think it works, even though there’s no evidence that it works any better or worse than anything else. It is my placebo and I’m OK with that.

The placebo effect has a bad reputation. Most of us think that people who experience the placebo effect are ‘faking’ their illness or are just stupid. We need to toss that notion aside because, chances are, we’ve all experienced the placebo effect.

A prime example of the placebo effect in parenting is when our children miraculously recover from a minor injury when we “kiss and make it better” or apply that omnipresent placebo, the Band-Aid. From experience I can attest that my toddler has been beside himself with pain from a small or imagined injury but miraculously feels better mere seconds after a kiss or the bandage is applied.

A recent study has found that even when children are actually sick, the use of a sweet tasting placebo cough medicine actually improves their symptoms. Are kids “faking” the severity of their symptoms? No. But what kids are experiencing is a legitimate benefit from a treatment that’s more psychosomatic than medically based. And before we get all high and mighty judging kids, let’s not forget that adults experience the placebo effect even when we know we’re receiving a placebo.

So what’s actually happening in both kids and adults when we take a placebo, whether we’re aware of it or not? To be frank, we don’t really know.

The placebo effect works isn’t well understood, as it seems to work in nearly all aspects of medical (and even cosmetic) treatment. The working hypothesis places emphasis on the power of the mind and belief. In essence, if the person believes they are receiving treatment, the body reacts as if they have received that treatment, even if they haven’t.

When I was in labor with my first baby, I was incredibly nervous. On our way to the hospital I anxiety ate oatmeal cookies that my mother-in-law had made for us like I would never eat again. I didn’t know what to expect, I was nervous, I imagined all the worst-case scenarios playing out.

But, once we arrived and got settled in, I felt much better. The nurses were friendly, the hospital room was warm and welcoming, but I hadn’t received any treatment to make labor easier, if anything just the opposite. What made things easier was the idea that I was now in a safe place, with people trained to deal with any medical emergency. That made me relax and made labor easier to bear.

The difference was purely psychological, not at all physical. My body was reacting as if I was receiving treatment, even though I wasn’t.

This would seem like a great option to address the issue of viciously priced life-saving pharmaceuticals: just give people sugar pills and the body will heal itself. Unfortunately, the placebo effect doesn’t work as well as actual pharmaceuticals.

The placebo effect is typically short lived, with the ailment returning and requiring actual treatment. As parents, we can all relate to this. Once the Band-Aid comes off, or hours later after you’ve kissed and made it better, typically a toddler’s actual ailment returns.

If you take the example of my labor, the relaxation I experienced lasted a few hours. Then my contractions picked up and I experienced back labor (which is no joke if you’ve ever experienced it) and I was back to feeling anxious and desperate to deliver this baby. The placebo effect of being in the safe space with the friendly staff wore off. Enter the epidural!

The other issue with placebos is that they don’t work universally with all people experiencing an ailment. If you give a large group of people suffering from the same aliment a placebo, typically only about a third will experience the placebo effect, at varying levels of success. This doesn’t mean that the other two-thirds of the group are immune from the placebo effect, it just means that in this particular circumstance they didn’t experience it. This isn’t a great example of the dose-response relationship.

Imagine an antibiotic that only worked on 1/3 of the people who used it. Not a lot of doctors would prescribe it.

Finally, there’s the medical ethical issue that placebos raise: they usually require a doctor to lie to a patient. The same studies showing that we experience the placebo effect even when we know we’re not actually receiving treatment, also show that the placebo effect is stronger when we legitimately believe we’re receiving treatment.

Deceiving a patient is highly controversial and is almost universally frowned upon, and rightfully so. When doctors lie to their patients it degrades not only the doctor/patient relationship in that setting, but it also instills a sense of distrust of doctors and the medical profession in general.

When it comes to treating a child with a recurrent illness that is difficult to treat or diagnose, lying to the parent or the child is in itself something that’s not generally done or recommended. Kissing a scrape and making it better is one thing, but prescribing fake antibiotics to a child with recurrent ear infections is viewed as unethical.

I think my vitamin-E cream falls into the former category, rather than the latter. But that’s not going to stop me from using it. I know it’s a placebo.

We all believe in some sort of woo – that is some form of pseudoscience or placebo. If you think you don’t, then it likely means you aren’t aware of what your specific form of woo is. Believing in woo doesn’t make you stupid, a bad parent or a sucker for slick marketing. It makes you human.