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Which, perversely, might decrease the placebo effect that accompanies all treatments prescribed by doctors…. I see the example of Stanislaw Burzynski and I understand the problem here. The routine of taking out the bottle, opening it, swallowing a pill and considering that the ailment might go away is powerful indeed. If labels and pricing and retail strategies somehow persuade us that wine tastes better or cables sound magical, how can we not work to provide these benefits? In other words, scientists need to show us that it works even without a placebo. That means that the bridge across that river will stay standing, the quark will be measured, the drug will have an impact.

That means that the wine ought to be good wine regardless of what the label says , the medicine ought to be as effective as we can find regardless of what we call it. Be mindful of what happens later. When the patient or customer or client finds out you used a placebo, will they be angry with you?

This is the lesson of the Wizard of Oz. Right intent and clear communication are more important than ever before, and they are what separate us from the tarred and feather snake-oil salesman. This occurs when we talk ourselves into feeling worse, enjoying it less or generally wasting an opportunity for improvement. We can argue for informed consent.

The Placebo Effect: What Is It?

We can ask patients up front if they want us to make them better, or only prescribe things that work in a double-blind study. We can admit to readers of our fashion, style and hobby magazines that in fact, there are placebos everywhere. Ted J. Kaptchuk, the reigning guru of the placebo, points out that the tribal effects of placebos provide a powerful if secondary support to those that need it. We see this effect with the marketing of famous colleges.

This is one reason why amplifying the positive experiences of someone with a tribe has such a powerful impact on the others in the tribe. And yet, instead of getting stressed at paying three or four times more than the same or similar item sells for in a store, we eagerly engage with the sommelier about which one to buy.


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Is there any doubt that a skillful sommelier increases the satisfaction of the diner? The way the object is sold and served dramatically changes the experience of consuming it. Compare this to the inexorable decline of specialty dealers, of independent bookstores, hobby shops, stereo stores, record stores, etc. All that satisfaction is thrown out the window in exchange for the vast selection and lower prices of Amazon and other online merchants.

The mistake these outlets made was in trying to out-Amazon Amazon.

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Instead of cutting costs in an effort to cut prices, they could have chosen to become the local sommelier, the seller who adds value as opposed to merely being an impediment. Which leads to the South African rainmaker. More than ten years later, I still remember the obituary for the last South African rainmaker.

She had greeted kings and prime ministers, and made her living accepting donations in exchange for making it rain. Not once, not ever.


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At an appropriate price, her service could indeed be justified… if the price paid gave people a sense of control in a world out of control, then who are we to criticize her. On the other hand, if it led people to make bad choices, to not plan for drought, etc. Where do they come from and how do we make them louder and more effective? The largest source of the placebo is confirmation bias. Confirmation occurs when we expect something to happen.

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When we spend a lot of money on cables, we want them to sound better. When the leader of our spiritual institution tells us to expect something to occur, we look for it to happen. When we choose to make a living selling something, we decide that the thing we sell works. Confirmation makes sense. Since most measurement of joy, well-being and effort is internal, the confirmation bias produces huge impacts.

Why do placebos work?

This is one reason why marketers who care often charge a lot for what they sell. Charging a lot increases user satisfaction. Perverse but true. At a certain level, this effect reverses, where the expectations are too high. Comparison : There are subsets within confirmation bias, and comparison is one of them.

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If A is better than B where better means more expensive, more recommended, more coveted, whatever we define better to be , then when I use A, my instinct is that it will work better, right? For some people, then, an expensive Park Avenue doctor is going to do a better nose job than some guy in an alley in Tuscaloosa. On the other hand, for someone with a different belief set, the pain relief from a chiropractor who is a friend of the family might be far greater than what we get from the gruff surgeon at the Hospital for Special Surgery.

While the US medical system has decided that placebo pills are unethical, they use placebos all the time. Our culture has pushed us to compare everything. These comparisons almost always happen before we engage with the product, the service or the cure, and they build up confirmation bias as they do. Marketers have spent billions creating comparisons and selling them to us, all in an effort to get us to choose their brand over the other brand.

Affiliation is a huge contributor to confirmation bias. Who said that? What do people like me do in this situation? Peer pressure extends far, far beyond high school. Suicide can be contagious , because our affiliation with people who make self-destructive decisions can cause us to think in the same way.

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Establishing groups of wine fans, asthma patients or inventors is a highly-leveraged way to create affiliation that leads to a positive confirmation bias. Ritual : People respond better to physical medical placebos than those in pill form. Sham acupuncture delivers better pain relief than fake Tylenol. When we engage in a physical transaction with someone else, we increase the self-talk that leads to placebo effects. This is one reason why actually opening the bottle and taking the medicine leads to an effect, even when we know the pill is a fake.

How much time and effort do we spend changing the state of the people who hope to help? Fear underlies just about everything we do. It keeps us from starting, helps us finish and can transform our experience of almost anything. At the start, the placebo gives us permission to believe. It gives us the bravery to overcome our fear of change, it allows us to imagine a future where things are better, even if that place is frightening to get to. And then, as the placebo starts to work, the provide of the placebo provides community and authority as a structure to keep it working.

The cheers from the crowd or the pleasing of the provider help us overcome our fear of change and continue pushing us forward. The authority of the preacher up front. The community coming together under the tent. The amplification of the successful intervention — we bring him right on stage, for all to see. When someone is able to use the placebo to walk without crutches, all eyes turn. A hero! And there are times when it is not. You have to meet them where they are.

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