food was offered. The results of this study have been used to suggest that high dissonance
influenced the subject’s physiological state, and the physiological state changed in order
to resolve the problem of dissonance.
Research has also examined the effects of justification on placebo-induced pain
reduction. Totman (1987) induced pain in a group of subjects using heat stimulation.
Subjects were then offered the choice of a drug in order to reduce pain. In fact this drug
was a placebo. Half of the subjects were offered money to take part in the study, and half
were offered no money. Totman argued that because one group were offered an incentive
to carry out the study and to experience the pain they had a high justification for their
behaviour, they therefore had high justification and were in a state of low dissonance.
The other group, however, were offered no money and therefore had low justification for
subjecting themselves to a painful situation; they therefore had low justification and were
in a state of high dissonance. Totman argued that this group needed to find some kind of
justification to resolve this state of dissonance. If the drug worked, Totman argued that
this would provide them with justification for subjecting themselves to the experiment
and for choosing to take the drug. The results showed that the group in a state of high
dissonance experienced less pain following the placebo than the group in low dissonance.
Totman argued that this suggests that being in a state of low justification activated the
individual’s unconscious regulating mechanisms, which caused physiological changes
to reduce the pain, providing the group with justification for their behaviour, which
therefore eradicated their state of dissonance.An example of Totman’s theory
The following example illustrates the relationship between justification, the need to see
oneself as rational and in control, and the problem of dissonance between these two
factors.
Visiting Lourdes in order to improve one’s health status involves a degree of invest-
ment in that behaviour in terms of time, money, etc. If the visit to Lourdes has no effect,
then the behaviour begins to appear irrational and unjustified. If the individual can
provide justification for their behaviour, for example ‘I was paid to go to Lourdes’, then
they will experience low dissonance. If, however, the individual can find no justification
for their visit to Lourdes and therefore believes ‘I chose to do it and it didn’t work’, they
remain in a state of high dissonance. Dissonance is an uncomfortable state to be in and
the individual is motivated to remove this state. Changing the outcome (e.g. ‘I feel better
following my visit to Lourdes’) removes this dissonance and the individual can believe,
‘I chose to do it and it worked’. Therefore, according to cognitive dissonance theory,
dissonance can be resolved by the placebo having an effect on the individual’s health
status by activating unconscious regulating mechanisms.Support for cognitive dissonance theory
The following factors provide support and evidence for cognitive dissonance theory: The theory can explain all placebo effects, not just pain.PLACEBOS AND THE INTERRELATIONSHIP BETWEEN BELIEFS, BEHAVIOUR AND HEALTH 321