The term placebo comes from the Latin placere meaning “to please”, it is basically is a substance with no medical effects that is given during a clinical trial to test whether the actual test drug works. The reason for this is that, it was found that taking something can elicit a response in study subjects – the fabled placebo effect – where either a genuine or perceived improvement is seen in subjects. Interestingly, placebo effects were also seen in sports performance – here have a pill = bham response.
It is not actually known how placebo effects actually occur, although there are theories. So let’s have a look at three of them:
1. The Expectation Model:
The Expectation Model is built upon the idea that thoughts and beliefs can influence our bodies and their neurochemical reactions leading to a genuine response whether hormonal or immunological in the subject (Benedetti 2013). Simply put, it is not really the effect of the placebo (the fake drug), as much as a genuine response of the body – yes it makes “People got the power” take on a whole new meaning!
2. Reflex Conditioning:
This theory is based upon Pavlov’s classical conditioning. In a nutshell, conditioning involves learning to associate a stimulus (with Pavlov’s dog experiments, this was food), that already brings about a specific response (salivation) with a new stimulus (the sound of a bell), so that the new stimulus brings about the same response (i.e. ringing a bell makes the dogs salivate), (Pozgain et al. 2014). Simply put, the placebo effect is a learned response to being given a drug, since, in our experience, we have experienced improvements when given drugs and therefore, we are conditioned to associate taking a drug with getting better.
3. The Opioid Model:
Here, placebo effects are explained using endorphins, the feel-good chemicals of the body. Endorphins are released when we are given a placebo drug, which then brings about the placebo effect. This model is used to explain placebo analgesia, where doctors give a placebo drug to patients for pain management. This was proven by a clever study where one group of patients was given a placebo, and the other a placebo with an opioid inhibitor – it was found that those patients given the inhibiting drug reported no relief from the pain (Price 1999).
These three models are the most popular ones used to explain how placebo effects occur, and it seems that it is not one of them alone that is correct, but all of them together play a role in the effect of a placebo.
Placebo in Sports and Fitness:
Several papers suggest that psychological variables such as motivation, expectations and classical conditioning, might be significant factors in driving positive outcomes, (Beedie and Foad 2012). In other words, its mind over matter.
What is Nocebo?
Nocebo is simply the opposite of Placebo (Colloca & Miller 2011), comes from the Latin nocere meaning “I will harm”. It is explained using the expectation and reflex conditioning models. Interestingly, some research suggests that anxiety plays a role in nocebo effects, where the body translates anxiety bought about by expectations of harm to pain through the mediation of the hormone cholecystokinin (Finnis and Benedetti 2007)
In closing, I think it is apt to say “people have the power”.