The placebo effect and hypnotherapy
Updated: Dec 30, 2021
I went to an interesting talk recently by clinical neurologist and BBC Radio 4 presenter, Dr. Ash Ranpura, on The Placebo Effect. He asked us to "imagine a therapy that made use of the body's own biology to specifically and selectively attack disease, with no side effects and at minimal cost. A therapy that could serve as an anaesthetic, like morphine, but without drowsiness or addiction. That could lower blood pressure and reverse heart disease, and help with treating mental health issues."
The truth is that we may have had this powerful tool in medicine all along, but just failed to recognise it until now. In the last 5 years, researchers have made huge strides in understanding the biology of the placebo effect. Their work represents a fundamental change in the way doctors see the mind-body relationship. Mind and body can no longer be separated.
Recent trials have shown that even when a patient is told explicitly that they are taking a placebo drug (a sugar pill), their anxiety decreases, they get a dopamine rush (the reward hormone) and feel better. And people who produce a lot of dopamine respond better to placebo. In one study with IBS sufferers, 65% of patients felt better after taking placebo pills. A 2017 study found that the placebo effect is enhanced if the patient or client has rapport with their physician, and feels that their physician is empathetic and competent. But does our NHS system allow for rapport? GP consultation times in the UK last only an average of 9.2 minutes - a considerably shorter time than in other rich nations. And patient contact time on wards is getting less with studies showing that nurses, when pressed with time, cut out activities such as comforting, talking with and educating patients - activities which have a direct correlation with a patient's clinical effectiveness and safety. So, if a patient can be trained to become an active agent of the therapy and has the time to develop a relationship or rapport with their therapist, this in itself becomes the placebo effect. Hypnotherapy gives the client these placebo effects :- it gives time (up to 1 hour each session), the client has an active role in directing their therapy, and rapport and respect are hopefully created through the exchange. And, whilst the hypnosis element of hypnotherapy is not directly placebo, there are similarities. According to retired Harvard psychologist Irving Kirsch, who studied placebos decades before it was fashionable for scientists to do so, hypnosis and placebo tap into a deep force in the brain: expectation. And while a placebo says, “Take this amazing thing and it will make you feel better”, giving you a promise for the future, a hypnotic suggestion says, “Entering into your special room, you feel confident, calm and relaxed", which is a promise for right now. So to be heard, listened to and understood is what a hypnotherapist can offer to their client, and then the provision of a very specific, personalised treatment to start their client's journey of recovery or change. Dr Ranpura speaking about the placebo effect:
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