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.Threedays later the tumours had  melted like snow balls on a hot stove,and in only these few days, they were half their original size.Within ten days practically all signs of the disease had vanished.About two months later reports began appearing in the pressindicating that the experimental drug had been proven ineffective.After reading these reports, Mr Wright lost faith in the treatmentthat seemed to have benefited him so greatly and relapsed to hispre-treatment condition.At this point, his physician managed topersuade him that the negative results were due to a deteriora-tion of the drug and that a new, refined, double-strength productwas due to arrive shortly.A couple of days later, treatment withan inert placebo was begun.The effects of placebo treatment were even more dramaticthan those obtained with the experimental drug.Once again thetumour masses  melted away and Mr Wright remainedsymptom-free for two more months.Then he read an announce-ment by the American Medical Association concluding that thedrug he thought he was getting was  worthless.He died a fewdays later.As provocative as it is, we have to be careful in drawing conclu-sions from Mr Wright s case history.At best, it is a tantalizingteaser.It is, after all, based on only one patient, and it is mostlikely that the changes in Mr Wright s condition were not due tohis belief in the medication.There is evidence that some cancersmay spontaneously go into remission,45 and this might be the bestexplanation of reported changes in Mr Wright s cancer.The timingof the changes in his condition  the fact that remission occurredwhen he thought he was taking an effective medication and thathe relapsed when he learned that the medication was ineffective might just have been coincidental.As convinced as I am by thedata that there is a powerful placebo effect on some conditions, Iremain sceptical of claims of remarkable cures of physical illnesses.124 The Emperor s New DrugsAs Carl Sagan said,  Extraordinary claims require extraordinaryevidence.With respect to seemingly miraculous cures of seriousphysical conditions, even ordinary evidence is largely missing.Nevertheless, Mr Wright s story seems compelling enough tosuggest that controlled research on the ability to affect cancerpsychologically might be warranted.The Nocebo EffectWe usually think of placebo effects as being beneficial.Placebosreduce depression, anxiety and pain, improve the symptoms ofParkinson s disease and open up the constricted airways of peoplesuffering from asthma.But placebos can have negative as wellas positive effects, a phenomenon that is called the nocebo effect.We have already encountered some of these.Just as placeboinhalants can open airways, they can also constrict them.It alldepends on what the person is told about the substance they areinhaling.In the Japanese study on contact dermatitis, beingtouched with placebo leaves produced skin reactions.In the casereport of Mr Wright s placebo treatment for cancer, althoughthe patient went into remission when he thought he was gettingeffective treatment, he relapsed when he became convinced thatthe treatment was ineffective.All of these are examples of thenocebo effect.One of the most fascinating examples of the nocebo effectcomes from a study of the effect of placebos on insomnia.46 Tworesearchers at Yale University advertised for students sufferingfrom insomnia to participate in a study that was supposedly investi-gating the effect of bodily activity on the content of their dreams.Some of the subjects were given placebo pills to take before goingto sleep; others were in a control group and were not given anypills.Students on the pills were given different information aboutwhat the pills contained.Half of them were told that the pillwould arouse them; the other half were told that it would relaxthem.The results were surprising.Insomniac students given the arousing pills fell asleep sooner, and those given the  relaxingThe Placebo Effect and the Power of Belief 125pills took longer to fall asleep.How did the researchers explain these strange findings?Actually, they had predicted the results in advance.Their ideawas that when people have trouble falling asleep, they may seethe cause of their difficulty as being a personal inadequacy [ Pobierz całość w formacie PDF ]