TO CONCLUDE
Placebos have been shown to have a multitude of effects ranging from pain relief to
changing cognitive state. Many theories have been developed in an attempt to explain
how placebos work, and these can be categorized as non-interactive theories, which focus
on the characteristics of either the patient, the health professional or the treatment, and
interactive theories, which regard placebo effects as arising from interaction between
these different variables. In particular, most explanations of placebos point to a central
role for expectations both of the patient and the health professional. These theories
suggest that if a patient expects to get better, then this expectation will influence their
health. Therefore, through expectancies, it is possible that patient and doctor expecta-
tions, anxiety, conditioning, opiates and cognitive dissonance, could interact with each
other. However, how this interaction would actually influence health remains unclear.
Finally, placebos have many implications for the areas of health psychology examined
in this book. They indicate that beliefs, behaviours, stress, pain and illness may not
be separate areas, requiring separate theories and research, but may be interrelated, and
that rather than being a factor to be taken out of an understanding of health the placebo
effect may itself play a central role in determining health status.ASSUMPTIONS IN HEALTH PSYCHOLOGY
The research into placebo effects highlights some of the assumptions in health
psychology:1 The mind–body split. Placebos suggest an interaction between the mind and the
body – expecting to get better may produce both subjective (‘I feel better’) and
objective (‘You did not have another heart attack’) changes in the individual’s? QUESTIONS
1 Discuss the evidence for the possible theories of the placebo effect.
2 Placebos are all in the mind. Discuss.
3 Placebos are a useful treatment for pain. Discuss.
4 Discuss the role of patient expectations in improvements in health.
5 Discuss the implications of theories of placebos for the interrelationship between
beliefs, behaviours and health.
6 Design a research study to illustrate the role of expectations in recovery from an
acute illness.FOR DISCUSSION
Consider the last time you took any medication (e.g. pain killer, antibiotics, etc.). To
what extent were any subsequent changes due to the placebo effect?PLACEBOS AND THE INTERRELATIONSHIP BETWEEN BELIEFS, BEHAVIOUR AND HEALTH 325