Book Club: Suggestible You
Photo by Szilvia Basso on Unsplash
…first you have to understand that any placebo or hypnotic induction is nothing more than a device for storytelling. - Erik Vance
The power of the placebo effect lies in the story we tell ourselves about it.
You can see how this would be a hook for me and for anyone who believes in the power of story. This premise, that the power of the placebo effect lies in the story we tell ourselves about it, is a common theme in Erik Vance’s book “Suggestible You”. He tells us (and shows us through many experiments on himself) that two forces, expectation and suggestibility, have immense power over our ability to experience pain and healing.
What is the placebo effect? It’s when a sugar pill makes a headache go away. It’s when a pretend brain surgery can alleviate Parkinson’s disease (this is an actual real life example in the book). It’s when a medical intervention seems real, but has no contains absolutely no active substance that can affect your health. Vance describes how many medications we use barely out-perform a placebo in clinical trials. Many new drugs cannot show they work better than the sugar pill and never make it to market.
For a long time, the idea of the placebo was poo-pooed in medicine. Maybe those people whose symptoms improved after the sugar pill where just crazy or gullible. However, just in the past 20 years researchers found proof that people are not simply gullible through functional magnetic resonance imaging (fMRI) of the brain. The images in the people who reported decreased pain showed less activity in pain-related regions of the brain. They were truly experiencing less pain. They were not imagining less pain.
The placebo effect then, is something for us to embrace. How can we use this truth of science to help us feel better and live healthier lives?
The placebo effect relies on expectation and suggestibility
The big themes in the book of expectation and suggestibility are something that each of us can mold and experiment with, at least to some degree. Expectation, Vance says, is both the description of the brain and its currency. This is why studies find that simply arriving at the doctor’s office makes us feel better than we felt at home in bed. Because we expect it to. We are conditioned to the story of the doctor’s office: the waiting room, the hand sanitizer, the paper on the exam bed, the blood pressure cuff on the counter, the white coat and stethoscope of the doctor herself. This is the story. The story we have been conditioned to and therefore expect to make us feel better. Since our brains are expectation machines, we start feeling better based on that expectation alone.
There are serious limits of the placebo effect, of course. Certain conditions are more susceptible to placebo: chronic pain, irritable bowel syndrome, anxiety, nausea, mild depression, headaches, arthritis, fibromyalgia, Parkinson’s disease and addiction are some named in the book. Some diseases seem not influenced by placebo much at all including Alzheimer’s disease, cancer and obsessive compulsive disorder. There will be many cases of these conditions that are outliers and don’t fit into these categories of “susceptible to placebo” and “not susceptible to placebo”, but generally speaking, we can use this as a guide to think about our own health.
If we want to tap into the power of expectation, we need to change or shift what our brains are predicting will happen. This is where suggestibility comes in. Vance tells us that suggestion is the key to unlocking expectation. How do we make ourselves more suggestible? Storytelling.
My attempt to use the placebo effect to heal migraine
I have dealt with chronic pain in the form of migraines for over a decade. I have seen neurologists, tried traditional prescription migraine medication, acupuncture, manual physical therapy, yoga, meditation, gluten free, chiropractor, and on and on. Every single time I try something new it works. It’s glorious. I have a couple of weeks with no headache. I’m flying high. I’m on top of the world.
You know where this is going. Inevitably, the wind stops blowing and the sails come down. I feel a little ache on the right side of my head, near my temple. I try to will it away. I try to ignore it. But the ache flares and soon enough as I’m looking at my phone I’m closing my eyes to make the pain stop. I’m back to popping Advil and rubbing peppermint oil on the sides of my head. I’m crawling into bed at 6pm after I barely making it through the day with a throbbing head.
I have long felt that this initial burst of healing was the placebo effect at work. But why does it stop working so quickly? How can I get that effect to extend? I’ve been working with my chiropractor for many months now, long after the headaches started up again. I keep hoping if I just believe in it enough, it will start working again. Plus my chiropractor has an interest in headaches and likes trying new things with me. Also, my insurance covers most of the cost, so it’s affordable.
I was there just last week, when I was finishing up reading this book. I was very intentional during this visit. I tried hard to make myself more suggestible that usual. I noted all the “theater” of medicine, as Vance describes in the book. My self-talk was like this: “Here I am at the chiropractor, the place that makes my headaches go away. I’m so fortunate to have found something that works for my migraines. I’m really looking forward to being headache free in October.” I even said out loud to the chiropractor, “I’m not going to have a headache at all this month.”
Then, just a few days later, a woke up with a niggle of an ache on the right side of my head.
So I haven’t figured out for myself how to harness the power of the placebo just yet. But I’m working on it and open to it for migraine and other parts of my life too. I love this idea because it so closely relates to the version of storytelling that I firmly believe in - that changing your narrative can help you heal. The form of healing I teach is the emotional type. If story has the power to heal us physically as well, think of how much that opens up the world to us.