What is the extent of the placebo effect in online psychological therapy?

Most people have heard of the placebo effect at some point. In the popular imagination, this phenomenon is usually related 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 these cases, the placebo effect can become an empirical resource to relieve discomfort quickly and effectively so that you, as a patient, can focus on treatment, as well as enhance 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 psychological therapy.

What is meant by placebo effect in psychological therapy?

To understand the impact of the Placebo effect In psychological therapy it is important to know what is meant by the placebo effect and its distinction from placebo.

There are various definitions for the term "placebo" but, without a doubt, one of the most accurate is the one offered by psychologists Steve Stewart-Williams and John Podd, who conceive it as "a substance or procedure that has no inherent power to produce an effect that is sought or expected. Basically, in the field of psychological therapy it is understood as those

methods or techniques that generate a change in the patient that does not come from the therapeutic effect of those 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 said effect. In other words, it is nothing more than the effect or consequence of the placebo on our body and/or mind.

In the therapeutic field, the placebo effect would be all that psychological intervention with innocuous effects that is applied to the patient, but that actually has no real effect on the problems being treated, and yet produces beneficial effects on they. For example, one can speak of a placebo effect when you feel more confident in yourself simply because you have had a therapy session and you believe that the therapy itself is beneficial.

In this context, the placebo effect not only brings out the powerful impact that your expectations, beliefs, thoughts and emotions have on your body. and, above all, on your mind, but it can become a useful resource to accelerate your improvement or recovery, helping you to commit to therapy.

• Related article: "What to expect and what not to expect from psychological 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 usually a therapeutic technique or procedure that the psychology professional uses to generate a change in the patient. In general, 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 that occurs without the direct intervention of the therapist.

In any case, the placebo is only half of the equation, the other half corresponds to the subjectivity of the patient. This means that, for a placebo effect to occur, the person has to be conditioned on the expected result. It is precisely this conditioning that is capable of activating 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 carried out at the Medical University of Turin, in which 229 people were exposed to a placebo drug with an alleged analgesic effect. The neuropsychologists found that the expectation of pain relief in these people reduced their anxiety and stimulated the natural release of painkillers, which really helped them alleviate the discomfort they they felt.

However, although we are all vulnerable to being carried away by the placebo effect, the truth is that this phenomenon is stronger in some people than in others. This is because there are a few factors that influence the way we deal with placebos:

1. The expectations

Your expectations play a critical role in the effectiveness of the placebo. Basically, the more sure and convinced you are that this technique or therapy will work, the greater your conditioning will be and, as a consequence, better results will offer you. In these cases, the effect of the self-fulfilling prophecy also applies, according to which the expectations that the people around you have about said result can also influence your perception and suggestibility.

• You may be interested in: "Expectations in Psychological Therapy"

2. The personological characteristics

Did you know that if you are a sensitive person you will be more vulnerable to the placebo effect? Likewise, more structured people, 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 are resilient, you will give in more easily to this effect, as revealed by a scientific study conducted at the University of Michigan.

3. The experience

Your experience is another factor that can influence your suggestibility to a placebo. Basically, as you accumulate life experiences, it becomes more difficult for you to let yourself be conditioned and give in to a placebo effect. Of course, It is not only the quantity of experiences that influences, but also the quality of them.. In the same way, if you have had previous positive experiences with the use of psychological services, you it will be easier to trust the therapy and succumb to a placebo effect than if you have experienced negative.

4. Stress and anxiety levels

Did you know that people who suffer anxietyare more easily suggested to a placebo? Likewise, you're more likely to give in to the placebo effect if you're under high levels of stress. The causes are not known with certainty, but it is believed that it may be related to the action of the placebo. in neurotransmitters at the brain level that act, in turn, reducing your levels of anxiety and stress.

5. The genetic

relatively recently genetics have also been found to influence your predisposition to the placebo effect. An investigation carried out at the University of Uppsala, in Sweden, found that a variation of the TPH2 gene, which is involved in the regulation of the activity of the amygdala, a crucial brain structure in emotional processing, increases the sensitivity of people to a placebo.

Of course, the relationship established between the psychologist and the patient is also essential in the response to placebo. Other factors may also play a role, such as the trust you place in your therapist, the characteristics of the space in which you are at the time of the consultation or even the attitude of your psychologist.

• Related article: "The 8 branches of Genetics (and their characteristics)"

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 "deceive" the patient, nor is it a simple suggestion technique. Used well, the placebo effect may become a valuable empirical resource to alleviate the patient's symptoms and improve her commitment to treatment in online therapy. Its proper use can help reduce your psychological discomfort so that you can focus on the techniques and procedures that will help you 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, in addition to contributing to reducing anxiety and stress levels and improving the signs of depression. A study carried out at the University of Chile found that the placebo effect can also alleviate the symptoms of hypochondria, at the same time that it can contribute to reinforcing self-esteem or self-confidence. Hence, it can not only become a useful resource in online therapy to reinforce therapeutic adherence, but also to help you during your recovery.

In short, the placebo effect has to do with the efficacy that we attribute to a drug or a technique that we subjectively interpret as good or bad for each one. Hence, many people are suggested when reading the leaflets of the medicines with the effects that they can cause. If we believe that something is going to do us good, it is more likely to have that effect on us, hence the importance of considering therapy as beneficial even before starting it.