When Friends Believe Nonsense

Should you go along with your friend's fake therapies?

Posted May 19, 2017

The popularity of crystal healing is on the upswing, according to Cassandra, a market research company that monitors trends among younger customers.  “The healing gemstone industry is now a billion dollar business and becoming more mainstream by the day,” notes the latest newsletter.

The newsletter describes a 40-minute “chakra-scrubbing crystal bed therapy session” to “manage anxiety and boost vitality” which includes special sounds and light filtered through a 1.2 million-year-old Vogel-cut quartz crystal that is supposed to help you release “toxins.” Or you can take a fitness class in New York in a studio full of crystals.

What do you say when someone you care about spends her money this way? If she says it makes her feel calmer, should you argue?

Probably not. Usually, your job is to ask questions and listen rather than give advice.

After all, the crystals really may be giving her more hours without anxiety. All that theater is a powerful placebo. We know, for example, that giving people pills made out of cornstarch—or fake acupuncture, with needles that never pierce the skin—can prompt relief from pain. Drug companies give volunteers placebos and sugar pills in studies to tease out how much benefit a drug provides beyond hope. In 2012, a group of Harvard-affiliated hospitals created the Program in Placebo Studies and the Therapeutic Encounter (PiPS) to study how placebos work, in hopes of harnessing their power legally and safely.

The placebo effect can be large and measurable—changes in heart rate and blood pressure or even symptoms of Parkinson’s. Placebos can also elicit measurable bad reactions like swelling.

A health practitioner who appears caring gets the best results.  Ted Kaptchuk, one of the researchers behind the Harvard program, is an acupuncturist as well as a professor of medicine at Harvard. To test the effect of seeming concerned, he designed a test with gastroenterologists studying irritable bowel syndrome (IBS)—the condition when you are intermittently struck with sudden abdominal pain followed by diarrhea or constipation. In the experiment, one third of the subjects got no treatment. A second group received sham acupuncture without much interaction with a care giver. A third group got the sham acupuncture along with at least 20 minutes of attention, including statements like "I’m so glad to meet you”; “I know how difficult this is for you”; “This treatment has excellent results.”

As part of the protocol, the practitioners touched the hands or shoulders of the volunteers and took at least 20 seconds lost in “thoughtful silence.”

As you'd guess, the last group who got the smaltzy treatment, reported the most improvement.

So that's proof that scoffing at your friend’s crystal-bed boost probably isn’t helpful. Have you ever stuck with a helper—maybe a “body-work” person, or chiropractor—who provides some relief, largely because the helper is also a good listener?  I’ve done this myself. I knew I was paying for hope and attention, and your friend probably does too.

In fact, when Kaptchuk gave patients with irritable bowel syndrome bottles labeled “placebo pills,” telling them that placebos can help, the patients reported twice as much improvement as patients who got no treatment.

All that said, sham treatments aren't harmless. Some hurt you. Others lead you to harm yourself. People may opt for expensive out-of-the-box treatments when seriously ill and decline standard care. The famous example is Steve Jobs, who put off surgery for a tumor in favor of nine months of acupuncture, herbs, bowel cleanses, and fruit juice. He didn’t have to die, doctors say.

Even when lives aren’t at stake, you pay for your placebo effect in more than dollars (though the prices can soar). Often what you really need to do is change your habits, and your placebo gives you an out. Here’s a garden-variety example: A friend of mine pays $300 a week to go to a physical therapist for back pain. This has been going on for a couple of years.  She hasn’t had a stroke or any other kind of major injury, just the usual aches and pains that come from poor posture and extra pounds over the years.  She doesn’t exercise or do any weight-training, in her late sixties, when our muscles are steadily shrinking unless we work out.  I could give her a gift certificate to a trainer—but only if she said she was interested.  

What about someone who goes to the same psychotherapist for years and seems to make little progress? Maybe your friend complains that she wishes it helped more, but still keeps going.  You might suggest switching therapists, hoping that the change might prompt your friend to address the usual list of unaddressed problems. Or maybe not.  

If you opt to listen, only, you’re not copping out. Kindness, encouragement and simple attention are healing. We have science to prove it. 

A version of this story appears on Your Care Everywhere.  

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