I purchased new razor blades recently. Thinking I was getting comparable quality at a bargain price, I bought an in-store brand that was about half the price of the name brand. The bargain blades ripped my face to shreds. After trying three, I gave up and bought the name brand. My face is much happier now.
This is an instance where a higher price really did indicate a better product. Although there are many exceptions, we in general expect a better product when we pay more for it. Our economy works that way; our culture works that way. Price means value.
This identity of price with value even works in medicine. A recent study by some economists showed that when people were told a placebo was priced at $2.50 per pill it was more effective in alleviating pain than when they were told the same pill was discounted to a price of 10¢. This is quite remarkable: price signaled more than market value; it signaled pain relief. What’s even more remarkable is that both groups experienced significant pain relief: not only did 85% of those taking the $2.50 pill report pain relief but 61% of the 10¢ pill group also reported relief.
Newspapers had some fun with this. Their spin was that people’s expectations were set by the price and those expectations affected the outcome. It almost seems like cheating. There is this aura about placebos that those who improve aren’t playing fair. In fact, there’s a characteristic of clinical trials called “placebo washout.” The purpose of placebo washout is to eliminate people who will respond positively to a placebo so it doesn’t interfere with the results, which, of course, are intended to show the efficacy of a drug. No cheaters are allowed in clinical trials.
I wonder if any big deal researcher has wondered about studying what’s going on with these “washouts” who get better with a signal that “Help is on the way” in the form of a pill that isn’t supposed to work? That’s really what a placebo is doing: it’s sending a signal that “Help is on the way.” The price experiment and the news articles about it frame the placebo effect as being about expectations. In fact, there’s an extensive literature on the placebo effect that does much the same thing. Administering a placebo gives people the expectation that they’ll be cured.
It comes close to saying “It’s all in their head” and “It isn’t really real.” But “It’s all about expectations” really begs the question. How exactly does the mental state of expectation affect the body?
Another recent study points to an answer and supports my idea that your body understands very well what kind of signal it’s received when you take a placebo pill or received any other kind of care that says “Help is on the way.” The study I refer to involved words delivered both subliminally and consciously before performing a task. Would it make a difference in how the task is performed? The test was to see what effect these words would have on a motor response, in this case the force with which subjects grasped a handgrip. The subliminal words were about physical exertion, words such as “vigorous.” The consciously visible words were about encouragement and consisted of positive adjectives such as “good.”
Those who experienced only the subliminal words exerted more force than the control group, in a process that’s called priming. But the group who experienced both subliminal exertion words plus consciously visible encouraging words had a dramatically greater grip force.
This experiment wasn’t about expectations. It was about words, our vessels of meaning, directly signally the body. Meaningful acts are not restricted to words. Taking time to listen, sharing a meal, or giving a pill that’s not supposed to do anything can all mean that “Help is on the way” so far as your body is concerned. And they can all support your body’s innate capacity to heal.
The literature on the placebo effect alludes to this connection between meaning and health effect. It discusses placebo effects that vary by culture. Some of this literature calls the placebo effect the middle ground between your body’s amazing capacity to sustain and heal itself and the intervention of a priestly healer, whether that’s an MD or a shaman.
The reason that the power of the placebo effect doesn’t get much research funding is obvious: it’s a financial washout for drug companies, medical device manufacturers, and the organizations that protect what they have defined as the interests of priestly healers. It seems to me that for reasons of both cost and humanity, healing should start with what your body is already capable of doing and supporting that, then move on to sending and receiving the signals that tell your body that “Help is on the way,” and only as a last resort move on to the priestly healers.
