How big is the placebo effect in online psychotherapy?

Most people have heard of the placebo effect at some point. In the popular imagination, this phenomenon is generally linked to those remedies and/or pseudosciences with no real or proven effect that help us feel better physically or mentally. However, the truth is that there are also placebos in the field of medicine or psychology that are often used for therapeutic purposes.

In such cases, the placebo effect can become an empirical resource to quickly and effectively relieve discomfort so that you as a patient can focus on treatment, as well as to improve your commitment to therapy. However, for this to happen, it is not enough to get carried away by the influence of the placebo, but it is important that you know how this phenomenon works in psychotherapy.

What is meant by the placebo effect in psychotherapy?

To understand the impact of the placebo effect on psychological therapy, it is important to know what is meant by the placebo effect and how it differs from placebo.

There are several definitions of the term “placebo” but, without a doubt, one of the most precise is that proposed by the psychologists Steve Stewart-Williams and John Podd, who conceive of it as “a substance or procedure which has no inherent power to produce a desired or expected effect”. Basically, in the field of psychological therapy, it is understood as such methods or techniques that produce a change in the patient that does not come from the therapeutic effect of these methods.

Now, the placebo effect is the physiological and/or psychological impact that we attribute to a certain procedure without actually having the inherent power to cause that effect. In other words, it’s nothing more than that the effect or consequence of the placebo on our body and/or mind.

In the therapeutic field, the placebo effect would be any psychological intervention with innocuous effects which applies to the patient, but which in reality has no real effect on the problems treated and which, however, produces beneficial effects on those -this. For example, you can talk about the placebo effect when you feel more confident just because you have had a therapy session and you think the therapy itself is beneficial.

In this context, the placebo effect not only shines a light on the powerful impact that your expectations, beliefs, thoughts and emotions have on your body and, most importantly, on your mind, but it can become a useful resource for accelerating your improvement or your recovery. , helping you engage in therapy.

And in online therapy, how does the placebo effect work?

The bases on which the placebo effect is based are the same in online therapy as in face-to-face therapy. It all starts with a harmless placebo which, in the case of psychological therapy, is generally a therapeutic technique or procedure that the psychology professional uses to bring about change in the patient. Usually it is an intentional process that is carried out with the aim of making the person feel better, but sometimes an unintended placebo effect can also be generated without the direct intervention of the therapist.

In all cases, placebo is only half of the equation, the other half is patient subjectivity. This means that for a placebo effect to occur, the person must be conditioned to the expected outcome. It is precisely this conditioning that is able to activate in your brain the same neural circuits that would be activated if the technique had a real therapeutic effect. This was corroborated by a study conducted at the Medical University of Turin, in which 229 people were exposed to a placebo drug with a supposed analgesic effect. Neuropsychologists found that waiting for the pain to subside in these people reduced their anxiety and stimulated the natural release of painkillers, which really helped them relieve the discomfort they were feeling.

However, although we are all susceptible to being swept away by the placebo effect, the truth is that this phenomenon is more powerful in some people than in others. Indeed, certain factors influence the way we deal with placebos:

1. Expectations

Your expectations play a key role in the effectiveness of the placebo. Fundamentally, the more certain and convinced you are that this technique or therapy will work, the more important your conditioning will be and, therefore, it will offer you better results. In these cases, the self-fulfilling prophecy effect also applies, whereby the expectations of people around you about this outcome can also influence your perception and suggestibility.

2. Personal characteristics

Did you know that if you are a sensitive person you will be more vulnerable to the placebo effect? Likewise, more structured people, those who like to follow instructions to the letter and those who easily trust others are more suggestible with this phenomenon. In the same way, if you were resilient, you will give in more easily to this effectas revealed by a scientific study conducted at the University of Michigan.

3. Experience

Your experience is another factor that can influence your suggestibility in front of a placebo. Basically, as you accumulate life experiences, it becomes more difficult for you to allow yourself to be conditioned and give in to a placebo effect. Sure, it is not only the quantity of experiences that influences but the quality of these. Similarly, if you have had positive past experiences with using psychological services, you will find it easier to trust the therapy and succumb to a placebo effect than if you have had negative experiences.

4. Stress and anxiety levels

Did you know that people with anxiety they are suggested more easily than a placebo? Similarly, you are more likely to succumb to the placebo effect if you are under high stress. The causes are not known with certainty, but it is thought that it could be linked to the action of the placebo on neurotransmitters in the brain which, in turn, work by reducing your level of anxiety and stress.

5. Genetics

A relatively short time ago it has been discovered that genetics also influence your predisposition to the placebo effect. Research conducted at Uppsala University, Sweden, revealed that a variation in the TPH2 gene, involved in regulating the activity of the amygdala, a brain structure crucial in emotional processing, increases the sensitivity of people to a placebo.

Sure, the relationship established between the psychologist and the patient is also fundamental in the response to the placebo. Other factors may also come into play, such as the trust you place in your therapist, the characteristics of the space in which you find yourself at the time of the consultation or the attitude of your psychologist.

How can the placebo effect help in online therapy?

Contrary to what many believe, the placebo effect is not a method that the therapist uses to “trick” the patient or a simple technique of suggestion. Well used, the placebo effect it can become a valuable experiential resource for alleviating patient symptoms and improving commitment to treatment in online therapy. Its proper use can help reduce your psychological discomfort so that you can focus on techniques and procedures that will help solve your problems and improve your quality of life.

In fact, the placebo effect can be a good ally in reducing emotional pain in people, while helping to reduce anxiety and stress levels and improving signs of depression. A study conducted at the University of Chile revealed that the placebo effect can also alleviate the symptoms of hypochondriasis, at the same time as it can help boost self-esteem or self-confidence. That’s why it can not only become a useful online therapy resource to reinforce therapeutic adherence, but also to help you during your recovery.

In summary, the placebo effect is related to the effectiveness we attribute to a drug or technique that we subjectively interpret as good or bad for each. This is why many people are suggested when reading leaflets of drugs with the effects they can cause. If we believe something is going to do us good, it is more likely to have that effect on us, hence the importance of viewing therapy as beneficial before even beginning it.

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