The power of the mind

It's all in your head. No, really: How mental imagery training aids perceptual learning

This is Elisa Tartagalia from EPFL in Lausanne, Switzerland, with her experiment proving that learning through mental imagery is possible. Credit: Alain Herzog/EPFL

Practice makes perfect. But imaginary practice? Elisa Tartaglia of the Laboratory of Psychophysics at Switzerland's Ecole Polytechnique Federale de Lausanne (EPFL) and her team show that perceptual learning—learning by repeated exposure to a stimulus—can occur by mental imagery as much as by the real thing. The results, published in Current Biology, suggest that thinking about something repeatedly could be as good as doing it. Read more.

'Mind's eye' influences visual perception.

A graphic depiction of the sequence of events in the experiment from top left to bottom right. First, a person looks at a blank screen and imagines a green pattern. Next, she puts on the red-green glasses and looks at a screen with two superimposed patterns: green and red. The green pattern is visible to one eye, and the red image is visible to the other eye. The longer she has spent imagining the green pattern, the more likely she will see the green pattern, demonstrating that what people imagine can influence what they see later in time. Credit: Joel Pearson

Letting your imagination run away with you can influence how you see the world. New research from Vanderbilt University has found that mental imagery—what we see with the "mind's eye"—directly impacts our visual perception. Read more

Placebo Effect - A Cure in the Mind

Belief is a powerful medicine, even if the treatment is a sham. New research shows placebos can also benefit patients who do not have faith in them. By Maj-Britt Niem, February 2009 Scientific American - MIND

In recent decades, reports have confirmed the efficacy of various sham treatments in nearly all areas of medicine. Placebos have helped alleviate pain, depression, anxiety, Parkinson's disease, inflammatory disorders, and cancer.

Placebo effects can arise from a conscious belief in a drug and subconscious associations between recovery and the experience of being treated—from the pinch of a shot to a doctor's white coat. Such subliminal conditioning can control bodily processes of which we are unaware, such as immune responses and the release of hormones.

Researchers have decoded some of the biologies of placebo responses, demonstrating that they stem from active processes in the brain. Read more

Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why. By Steve Silberman - August 24, 2009

Merck was in trouble. In 2002, the pharmaceutical giant was falling behind its rivals in sales. Even worse, patents on five blockbuster drugs were about to expire, allowing cheaper generics to flood the market. The company had yet to introduce a new product in three years, and its stock price plummeted.

In interviews with the press, Edward Scolnick, Merck's research director, laid out his battle plan to restore the firm to preeminence. Key to his strategy was expanding the company's reach into the antidepressant market, where Merck had lagged. At the same time, competitors like Pfizer and GlaxoSmithKline created some of the best-selling drugs in the world. "To remain dominant in the future," he told Forbes, "we need to dominate the central nervous system."

His plan hinged on the success of an experimental antidepressant codenamed MK-869. Still, in clinical trials, it looked like every pharma executive's dream: a new kind of medication that exploited brain chemistry in innovative ways to promote feelings of well-being. The drug tested brilliantly early on, with minimal side effects, and Merck touted its game-changing potential at a meeting of 300 securities analysts.

Behind the scenes, however, MK-869 was starting to unravel. True, many test subjects treated with the medication felt their hopelessness and anxiety lift. But so did nearly the same number who took a placebo, a look-alike pill made of milk sugar or another inert substance given to groups of volunteers in clinical trials to gauge how much more effective the real drug is by comparison. The fact that taking a faux drug can powerfully improve some people's health—the so-called placebo effect—has long been considered an embarrassment to the serious practice of pharmacology.

Ultimately, Merck's foray into the antidepressant market failed. In subsequent tests, MK-869 turned out to be no more effective than a placebo. In the jargon of the industry, the trials crossed the futility boundary.

MK-869 wasn't the only highly anticipated medical breakthrough to be undone by the placebo effect in recent years. From 2001 to 2006, the percentage of new products cut from development after Phase II clinical trials, when drugs are first tested against a placebo, rose by 20 percent. The failure rate in more extensive Phase III trials increased by 11 percent, mainly due to surprisingly poor showings against placebo. Despite historic levels of industry investment in R&D, the US Food and Drug Administration approved only 19 first-of-their-kind remedies in 2007—the fewest since 1983—and just 24 in 2008. Half of all drugs that fail in late-stage trials drop out of the pipeline due to their inability to beat sugar pills.

History of the Placebo Effect

The roots of the placebo problem can be traced to a lie told by an Army nurse during World War II as Allied forces stormed the beaches of southern Italy. The nurse was assisting an anesthetist, Henry Beecher, who was tending to US troops under heavy German bombardment. When the morphine supply ran low, the nurse assured a wounded soldier that he was getting a shot of a potent painkiller, though her syringe contained only salt water. Amazingly, the bogus injection relieved the soldier's agony and prevented the onset of shock.

Returning to his post at Harvard after the war, Beecher became one of the nation's leading medical reformers. Inspired by the nurse's healing act of deception, he launched a crusade to promote a method of testing new medicines to find out whether they were truly effective. At the time, vetting drugs was sloppy: Pharmaceutical companies would simply dose volunteers with an experimental agent until the side effects swamped the presumed benefits. Beecher proposed that if test subjects could be compared to a group that received a placebo, health officials would finally have an impartial way to determine whether the medicine was responsible for improving a patient.

In a 1955 paper titled "The Powerful Placebo," published in The Journal of the American Medical Association, Beecher described how the placebo effect had undermined the results of more than a dozen trials by causing improvement mistakenly attributed to the drugs being tested. He demonstrated that trial volunteers who got actual medication were also subject to placebo effects; taking a pill was somehow therapeutic, boosting the curative power of the medicine. Only by subtracting the improvement in a placebo control group could the actual value of the drug be calculated. The article caused a sensation. By 1962, reeling from news of birth defects caused by a drug called thalidomide, Congress amended the Food, Drug, and Cosmetic Act, requiring trials to include enhanced safety testing and placebo control groups. 

Placebo and Pharma Industry's Response

Ten years and billions of R&D dollars after William Potter first sounded the alarm about the placebo effect, his message finally got through. In the spring, Potter, now a VP at Merck, helped rev up a massive data-gathering effort called the Placebo Response Drug Trials Survey.

Under the auspices of the FNIH¹, Potter and his colleagues are acquiring decades of trial data—including blood and DNA samples—to determine which variables are responsible for the apparent rise in the placebo effect. Merck, Lilly, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi-Aventis, Johnson & Johnson, and other major firms are funding the study, and the process of scrubbing volunteers' names and additional personal information from the database is about to begin.

In typically secretive industry fashion, the project is being kept under wraps. FNIH staffers are willing to talk about it only anonymously, concerned about offending the companies paying for it.

For Potter, who used to ride along with his father on house calls in Indiana, the significance of the survey goes beyond Big Pharma's finally admitting it has a placebo problem. Read more...  

Placebo and Alternative Medicines (Natural Cures) By Associated Press November 10, 2009

People looking for natural cures will be happy to know there is one. Two words explain how it works: "I believe." It's the placebo effect — the ability of a dummy pill or a faked treatment to make people feel better just because they expect that it will. It's the Mind's ability to alter physical symptoms, such as pain, anxiety, and fatigue.

The placebo effect looms large in alternative medicine, which has many therapies and herbal remedies based on beliefs versus science. The problems they seek to relieve, such as pain, are often subjective.

"It has a pejorative implication — that it's not real, that it has no medicinal value," said Dr. Robert Ader, a psychologist at the University of Rochester in New York who has researched the phenomenon.

But placebos can have natural and beneficial effects, he said.

"Much of the results of certain alternative procedures are largely placebo effects unless you believe there are people who exert magical powers so they can hold their hands over your body and cure you of disease," Ader said. "Make you feel better? That's entirely possible, especially if you believe it."

Scientists say the placebo effect accounts for about a third of the benefits of any treatment — even carefully tested medicines. This dates to a landmark report in 1955 called The Powerful Placebo. Viewed as groundbreaking, the analysis of dozens of studies by H.K. Beecher found that 32 percent of patients responded to a placebo. Read more

Other related articles

1. Scientific American - A Cure in the Mind
2. Times of India - Practicing in the Mind can make you perfect
3. The mind's eye influences visual perception.
4. Switzerland's Ecole Polytechnique Federale de Lausanne - Its all in your head
5. Wired Magazine - Placebos are getting more effective. Drug makers are desperate to know why.
6. MSNBC - Placebo effect behind many natural cures
7. New Scientist - Placebo effect caught in the act in Spinal Nerves
8. Wikipedia - Placebo