Friday, April 24, 2009

Healed by the right words

We all know that placebos can be surprisingly effective. But - though it's not exactly surprising - I hadn't realised that there is experimental evidence that simply saying the right thing can have a curative effect.

Two hundred patients with abnormal symptoms, but no signs of any concrete medical diagnosis, were divided randomly into two groups. The patients in one group were told "I cannot be certain what is the matter with you", and two weeks later only 39% were better"; the other group were given a firm diagnosis, with no messing about, and confidently told they would be better within a few weeks. 64% of that group got better in two weeks." (Bad Science, p. 75, citing Thomas 1987)

I can imagine a lot of factors that could affect the effectiveness of the doctor's words here - mainly anthropological, but some of them would certainly fall within the domain of linguistics. For example, the intonation pattern will affect the patient's perception of the doctor's confidence; does that affect the efficacy? Likewise, the accent and the choice of vocabulary could both affect comprehension and perceived competence, and hence presumably the efficacy. Not really my field, but it could be a line of research with unusually clear-cut potential benefits. The obvious problem with this example is that it involves doctors lying to patients, but if the effect could be reproduced without that it would certainly be worth doing.

Thomas KB. General practice consultations: is there any point in being positive? BMJ (Clin Res ed) (9 May 1987); 294 (6581): 1200-2.


Mattitiahu said...

I recall reading something like this today relating to Anatolian ritual medicine in Trevor Bryce's Life and Society in the Hittite World (2002); particularly the potential psychological effects of the ritual aspect when combined also with other sometimes actually effective medicine. Unfortunately the pages that I'm about to cite (165 - 167) aren't on the limited preview from Google Books, otherwise I'd just cite that to save the pain of cluttering your comment box:

(On Anatolian Holistic Medicine/Rituals)

"Hittite medicine often involved a comprehensive,‘holistic’ approach
to the treatment of patients. The more straightforward ailments, like repairable physical injuries caused by assault,probably required no more than basic medical treatment and the application of the appropriate medicinal products; practical medical procedures were supported by curative salves, potions, and poultices made from various plant extracts,minerals (like lead),and animal products (like blood, bones, milk, fat, and tallow), administered orally, anally, or externally. But complex illnesses, particularly serious and chronic diseases, were in many cases attributed to malevolent forces and demons,whose influence could only be fully negated by other means. In these cases practical medical procedures were complemented or replaced by rituals, which included the application of spells and incantations, and sometimes also by direct appeals to the gods. We should not underestimate the powerful beneficial effects that these alternative procedures could have, particularly in the treatment of what today might be classified as psychosomatic illnesses. Persons who sincerely believe that their afflictions are the result of evil malevolent forces or black magic, and who exhibit all the outward symptoms of a genuine illness, may well be restored to good health if they have strong faith in the ability of ritualists and incantation priests to cure them by dealing with these forces in an appropriate ritualistic way. In the Hittite world, medicinal preparations were often used to assist the process. Indeed it is quite possible that many of them had a good scientific basis and were quite capable of effecting a cure on their own. But in the context of the ritual in which they were used, they were seen as but one of the elements in the overall treatment of a patient, all of which were needed to achieve success. Of course this is a feature of healing practices in many civilizations. In relation to traditional African medicine, Chief Labulo Akpata (a well known Yoruba healer) states: ‘medical herbalism is divided into two branches: real treatment (i.e. treatment of physical injuries etc.) and psychological treatment. Real treatment is for those who require no incantations and other ceremonies. Psychological reatment requires incantations and other ceremonies such as sacrifices before the medicine can act—we require the services of the two together to cure the two aspects of sickness.’ Physicians, priests, priestesses, and magicians clearly understood and were able to exploit the benefits of what often amounts to faith healing, even if they thought of it in a quite different way. Certain types of ailments might indeed have responded positively to their services, within the context of ritual and mimetic magic. A ritual designed to cure a man of impotence and conducted by a priestess reads in part as follows:
(quotation of rituals follow)

The performers of such rituals must have had genuine faith in the
power of their magic to bring about the desired result. Indeed the greater their faith,the more effective their performance was likely to be. For the patients one of the most potent aspects of the ritual was its concreteness, its sensory character. They could actually see, hear, feel, and smell the various stages of their healing process taking place, via the path of ritual analogy. The mesmeric influence of the
priest’s or magician’s chanting and gestures and movements, the sight and the smells of all the paraphernalia prescribed by the ritual—these could in themselves be powerful enough to effect a
cure. So too the very process of washing, scraping, or scrubbing a patient’s body to cleanse it of a pollutant inflicted by sorcery, or a curse,or even by accident may well have been sufficient to convince the patient that he was undergoing a thorough spiritual cleansing as well as a physical one. He could actually see the cause of his defilement being removed by analogic magic and cast away where it could no longer do harm.

Granted, we don't know if any of this actually worked, but surely the psychological effects involved in the ritual aspects of the medicine could have worked in a similar fashion. This too is not my field, but I agree that there's a benefit to a positive attitude when sick?

Anyway, interesting thought towards how the right words or attitude could possibly elicit a positive psychosomatic response in illness.

(Again, sorry for cluttering your comments box with huge block quotations)

Lameen Souag said...

Interesting quote. From this perspective, the show business aspect is not so much humbug as a therapeutic tool like any other (though perhaps more easily abused than others.)

Mattitiahu said...

Just think if someone started utilizing techniques mass-hyponotism for nefarious purposes.

Well not to be cynical, now that I think of it I'm sure that there's quite a few religious leaders probably already do that.