The Placebo Effect: Can Optimism Replace Medicine?

‘Placebo,’ a euphonic word with an exotic charm, which was penned across a fresh copy of ‘As Long as The Lemon Tree Grows by Zoulfa Katouh, seemed to call out to me, evoking a sense of curiosity.

The protagonist of the novel, Salameh, is a circumstantial doctor who struggles during the Syrian Revolution. Tired of her patients’ sufferings, she decides to administer saline water to the wounded to ease their suffering as they are made to believe that they are being given Morphine.

During the sixteenth century, the Catholic church used a Placebo during exorcism to distinguish between real and false possessions by administering water disguised as holy water. Upon a strong reaction, it was understood that all of it was just an act. The modern understanding of Placebo came in the twentieth century, during World War II, when Henry Breecher started administering saline injections to wounded soldiers when morphine was not present. He also realised that soldiers have greater immunity to pain inflicted by their wounds on the battlefield compared to hospital beds. He hypothesized that the soldier becomes euphoric over the idea that the wound meant that he was free from the danger of the battlefield and would be returned to the camp shortly. Despite the lack of proper evidence, this realisation motivated him to delve deeper into the study, earning him the title ‘Father of Placebo.’

We still haven’t fully grasped the neurological workings behind the Placebo effect. It involves increases in feel-good neurotransmitters, like endorphins and dopamine, along with greater activity in certain brain regions linked to moods, emotional reactions, and self-awareness. The placebo effect is a way for your brain to tell the body what it needs to feel better. A study published in PLOS Biology may have uncovered what happens in the brain during the placebo effect. Researchers used functional magnetic resonance imaging (fMRI) to scan the brains of individuals suffering from chronic knee osteoarthritis pain. After administering a placebo and conducting a second round of brain scans, they recorded that participants who reported pain relief showed increased activity in the middle frontal gyrus, a region that a region in the frontal lobe. This area is associated with higher cognitive functions such as attention, decision-making, and expectation, suggesting that the brain’s belief in treatment can actively shape the perception of pain.

We know that Placebos work, but do they still work if you know that you are being given a Placebo? Is it only effective if your brain is being tricked into it?

This was tested in a study published in Science Translational Medicine by experimenting with how people reacted to migraine medication. The participants were divided into three groups: one group was administered a migraine drug with the drug’s name, another was given a placebo, labelled ‘placebo’, while the third one received nothing. It was discovered that the placebo was 50% as effective as the real drug in reducing pain after a migraine attack. Hence, it is concluded that the simple act of taking the pill induces a healing effect.

"You take the blue pill—the story ends. You wake up in your bed and believe whatever you want to believe.

You take the red pill—you stay in Wonderland, and I show you how deep the rabbit hole

goes."

— Morpheus, The Matrix

While this scene in ‘The Matrix’ shows a philosophical choice between the truth and the illusion by integrating colours in a metaphorical sense, red and blue have a deeper significance in pharmacology.

Human psychology associates red with power and blue with calm. Studies show that patients who were given red pills feel more energized and attentive, whereas patients who were given blue pills of the same type feel calmer. Placebo is not limited to medication only. This psychological effect, which yields therapeutic wonders, is also based on doctor-patient interaction. When patients visit the hospital and are being attended to, asked questions, and given suggestions, their brain registers the attention as a step closer to a cure. Trust in another person stimulates the release of the hormone oxytocin, which plays an important role in cognition. Untrustworthiness, on the other hand, results from the activation of the amygdala, the brain’s fear centre. Untrustworthy judgments can be blocked by the binding of oxytocin to its receptors in the amygdala. I can’t help but wonder: Can Placebo breathe a new life into the dead? When the world fails to provide anesthesia to Palestinian children, leaving them to endure the knife fully awake, do Palestinian doctors turn to the same desperate measure? Or has the situation in Gaza become so dire that even saline water is too scarce to offer as comfort, now that the region is starving?

Works cited from:

LeWine, H. (2024). The power of the placebo effect, Harvard Health. Available at:

https://www.health.harvard.edu/newsletter_article/the-power-of-the-placebo-effect

(Accessed: 12 June 2025).

Jilch, S., Sel, R., and Shariat, S.F. (2020). Medical Practice and Placebo Response:

An inseparable bond?, Wiener klinische Wochenschrift. Available at:

https://pmc.ncbi.nlm.nih.gov/articles/PMC7253381/#Sec6 (Accessed: 12 June

2025).