The Placebo Effect – How Real Is It?

If you have a headache, you probably take an aspirin or paracetamol. You do this because you expect this to decrease or even eliminate a headache. These positive expectations can affect the way the tablet works, even if there are no active ingredients in the pill at all.

That is the placebo effect, or the influence of a patient’s expectations on a certain, often medical, treatment. This means that not only the components in the paracetamol ensure that you feel better, but that your expectations also contribute to that. When the active substances are missing – as with a number of alternative medicines – there is also a positive effect of the treatment.

How it works?

There is no need to question the fact that the placebo effect exists. But exactly how it works has not yet been completely unraveled. Because how can a pill without active ingredients now ensure that you, for example, suffer less from headaches?
Science is trying to find answers to this. Although there are probably several factors that contribute to the effect, two are very important: expectation and conditioning. The doctor creates expectations about a particular drug or treatment, and the patient usually takes it as the truth. These positive expectations then contribute to a positive outcome. In addition, conditioning plays a role. This is learning the relationship between two stimuli, which causes behavioral changes. Think of the dog of Pavlov, for example, who always drooled when he heard the bell. Just because the dog expects him to eat after the bell, his body reacts by making drool.


The placebo effect can also be seen in the brain. The moment you experience pain, the neural pathways in your body give signals to your brain, making you “aware” of the pain. There are different brain areas involved in pain, such as the thalamus, the somatosensory cortex, the insula and the anterior cingulate cortex (ACC). In these areas of the brain, there are not only receptors involved in pain but also receptors involved in pain reduction, the so-called opioid receptors. Scientific research by F. Benedetti and colleagues shows that a placebo responds to those opioid receptors and thus triggers pain reduction. It is possible that a placebo makes a body’s own painkiller, or opioid.
Important to mention is that a placebo never cures, but only certain symptoms or symptoms can reduce. Placebo effects mainly occur with vague complaints, such as pain or fatigue. A placebo can never heal a broken arm, but can only reduce subjective symptoms.


Other things that contribute to the strength of the placebo effect are the amount
pills, the color of the pills, the condition, the attitude of the treating physician and all actions concerning the prescription of the treatment. Furthermore, the better known and more expensive the pill is, the better the user experienced the effect. Finally, many complaints also pass automatically and the proverb ‘time heals all wounds’ also applies to the placebo effect.

Although doctors and researchers want to avoid the effect of a placebo, you can also look at it in a positive light. Because if you want to get rid of your headache the next time, it may be useful to have high expectations for that simple paracetamol.

Source: Benedetti, F., Mayberg, H. S., Wager, T.D., Stohler, C. S., & amp; Zubieta, J. K. (2005).
Neurobiological mechanisms of the placebo effect. Journal of Neuroscience, 25 (45), 10390-

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