Magic Cookies: The Placebo Effect

18 Jan

 

 Our expectations  can be remarkably  powerful.  The magic feather that Dumbo, the flying elephant, was told would help him fly,  is a classic example of what is known as a placebo.  The word placebo is Latin for “pleasing” and refers to an object that has no actual effect, other  than to bolster our expectations.  

In the early 70’s when I was a brand new psychology  student,   my study group was assigned to devise  an experiment involving preschool  children. I believe it was Thurmond Culpepper, a member of our  group, who proposed that we study expectations and  preschoolers’ memory for  pictures.  This evolved into the “Magic Cookie Study”.

In step one of our study,  all the children were to be given a rather  odd looking cookie to eat. This sugar cookie, covered with  marshmallow and sprinkled with pink  coconut, was to serve as the  placebo. 

Half of the class was to be  told that the cookie was magic and would help them remember things perfectly.  The other  half of the kids  were told that  it was just a snack.  Then we planned  to  test them  by  showing    pictures of   animals , and then recording how many  of the animals they could  recall five minutes later. 

It turned out that most of the kids hated the cookies and not only  refused to eat them but  physically  threw them at Thurmond while making  fun of his name. Evidently coconut is not very popular with the  preschool set,  as  many complained vocally  about the pink  hair on their cookies.

Also, it was  nearly impossible to get them to  sit down long enough to  look at the animal pictures. And when it came  time to telling us what animals they remembered,  few subjects  felt that this boring  task was  worth their time or effort, especially compared  to throwing cookies or  grabbing  the experimenter’s stopwatch and dashing madly  about the classroom. We did  not demonstrate  the  placebo effect,  but  we did  discover that   our study group needed someone who actually knew something about kids.     

Newsweek magazine science editor Sharon Begley has reported on a  new placebo study  published in the Archives of Internal Medicine.    Daniel Cherkin  at theGroup Health Center in Seattle  compared the effectiveness of  acupuncture,   simulated acupuncture,  and  standard treatment on back pain. The researchers found that pain decreased  significantly for 60% for both acupuncture groups,  but only 39 % for the standard care patients.  Although the results  were used to support alternative  approaches, like acupuncture, the most intriguing  finding, as Begley points out,  is  that   fake acupuncture (randomly getting poked with toothpicks)  worked as well  as real acupuncture,  and twice as well as standard procedures.   

A survey of Chicago area internists   revealed that half  of  them  used   placebos with their patients. Twelve per cent, however,  had ethical qualms and said that placebos should never be used. Most physicians, who used placebos, were somewhat  cagey in what they actually told their  patients– not wanting  to lie outright, but also not wanting to diminish  the benefits of  positive expectations.

According to Fabrizio Benedetti of the Universityof Turin, a pioneer in placebo pain research, positive expectations  can lead to the release of natural pain killers in the brain. The greater the expectations, the greater the  relief  that people feel.  About 30% of the population  appears  capable  of a   strong placebo effect and   magic cookies not withstanding, children have a greater response than adults.

 According to MIT behavioral economist  Dan Ariely,  we  associate the cost of medicines  with their  efficacy and this  may be why expensive placebos work best and  people  claim that generic medications do not work as well as brand names.   Placebo effectiveness is also  related to factors such as  exoticness,  intrusiveness,  and technological sophistication.   Injections, for example  are more potent that capsules, which in turn  are better than tablets. Procedures   associated with   elaborate scientific looking equipment or arcane devices, also tend to have greater credibility. 

One mental hospital used an impressive looking electroconvulsive shock machine to successfully  treat depressed patients for many years. However a technician found  that the  machine had never been plugged in properly and it’s success was purely placebo effect.        

 The size of a  pill is also related to its  placebo value. As you  might  expect,  if a  little is good,  a lot is great.  When they feel bad,  most people want the maximum strength  possible.  As comedian Jerry Seinfeld said,   “We want them to figure what dose can  kill  us and then back off just a little.”     

Placebo saline injections even helped some Parkinson  patients in  a study at   theUniversityof British Columbia.  The very brain chemicals that placebos stimulate, may actually help  reduce some  Parkinson Disease  symptoms, such as stiffness and rigidity.  

Placebos  may also be  effective  when people  learn, through association, that a particular experience is routinely followed by a  specific  response. This is known as classical  conditioning.   In a 1999 study,  patients   received several  injections  of a substance  that quickly depressed their respiration. Later  the  injection of an inactive  substance produced the same results. The  nervous system  had learned to associate all  injections with the depressive response.  

Similarly  when kidney transplant patients were repeatedly given a strong  anti-rejection medication, along with a  distinctly flavored drink,   the drink alone began to have the same beneficial effects as the medication.   Begley says  that this “was like finding that Kool-Aid can prevent organ transplant rejection”.  

            Harvard psychologist Robert Rosenthal and school principal Lenore  Jacobson  wrote a controversial book in 1968 entitled  Pygmalion in the Classroom about their  study  in which teachers were told  that certain (randomly selected) children had been  scientifically identified as  “late  bloomers”  and would show tremendous academic  progress  in the next school year . The teachers’ expectations were a self-fulfilling  prophecy and the designated  children  showed a tremendous gains in achievement.

This  research demonstrates that, not only our own expectations, but those of others, can result in a significant placebo effect. The story of the unplugged  shock machine also dramatically displays this effect.   In addition to the machine, the expectations of the attending staff  influenced  patients to the point that they  exhibited sham seizures, when they thought shock was bring administered.

The placebo effect is a real testament to the  power of our expectations. It also explains why I still want a big  antibiotic pill every time  I catch a cold,  even  though I know it doesn’t work on viruses.  Maybe I should just eat a cookie instead.

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One Response to “Magic Cookies: The Placebo Effect”

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  1. How The Mind Really Works: 10 Counterintuitive Psychology Studies | test - May 9, 2012

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