Every medical technology inherently contains a placebo effect due to its intensity. For example, a sham surgery is more effective than a saline injection, and a saline injection more than a sugar pill.
Some argue this placebo response addresses cognitive dissonance – patients invest more in the intervention and thus hope for its success. Similarly, studies show that the more expensive you believe a bottle of wine is, the more you enjoy it, as price influences your expectations. The brain, as a prediction machine, is primed to interpret stimuli based on these expectations.
However, even the smallest intervention carries a narrative. A larger pill may seem more powerful than a smaller one, and colors like red, yellow, or orange are linked to stimulation, while blue and green suggest tranquility, according to Dr. A. J. de Craen. These small details, combined with factors like the doctor’s demeanor or the drug’s advertising, shape the pill’s believability, or verisimilitude.
Verisimilitude, the believability of a story, has two forms: cultural, which aligns with real-world norms, and generic, which maintains internal consistency within the narrative. This concept applies to both fiction and medicine. Just as a good story invites us to suspend disbelief, confidence in a treatment’s effectiveness can enhance its medical potential. Some researchers, like Irving Kirsch, argue that much of Prozac’s efficacy comes from the placebo effect, magnified by social influence and belief in the drug’s power.
Hope plays a crucial role here, often more personal and emotional than mere expectation. While expectation relies on evidence, hope thrives in uncertainty, actively pushing the placebo effect. In clinical trials, patients unsure if they received the real drug often demonstrate the strongest placebo responses, driven by hope.
Clinicians can harness this emotional power, as hope builds confidence in treatment. As Vaclav Havel noted, hope is not just believing things will turn out well but finding meaning in the process. Storytelling, like good medicine, bridges emotion and evidence, helping patients heal faster when they perceive empathy from their doctors.
Ultimately, hope, empathy, and compassion are powerful but not enough on their own. Medicine and storytelling both benefit from a dialogue between fact and fiction.
Source: Psychology Today