"You Gotta Have Faith!" *

David A. Gershaw, Ph.D.

From the beginnings of recorded time, tales of the miracles worked by healers have been commonplace. How are healers able to provide these miraculous cures?

Looking at the history of medicine, it seems amazing that even the hardiest patient could survive under the primitive methods let alone improve. To provide cures, healers had their patients eat all sorts of substances. A partial list includes crocodile dung, teeth of swine, precious stones ground into a powder, furs, feathers, human sweat, blood, earthworms, and oil from ants. Besides being forced to take these concoctions, patients were also purged, poisoned, punctured, cut, blistered, bled, leached, heated, frozen, and sweated.

Now we realize that most of these methods had no medical value. Even so, there are many well-researched accounts of people getting well after receiving such treatments. How do these treatments work? (Maybe they got well to avoid further treatments.)

In contrast to this guess, several researchers have concluded that seemingly miraculous cures are primarily due to the placebo effect. In the placebo effect, the treatment itself has no curative effect of its own. Whatever curative effect it has depends on the patient's belief that it will work. Most of us are aware of placebos being used in medicine. In fact, most people would tend to define placebos as "sugar pills."

Some psychologists believe that the placebo effect may be one of the major reasons for the success of psychotherapy. Psychotherapy essentially uses conversations with professionally trained people to help clients make positive changes in their lives. Some of these changes are extreme enough to be called "cures." Using the placebo effect, almost any type of psychotherapy can show positive results if the client believes it will help. For this belief to develop, the therapists must convey their confidence that their methods will work.

Of the possible reasons for the placebo effect, one involves the self-fulfilling prophecy. Our own expectations (prophecies) lead us to act in ways that will make them come true. People tend to interpret events according to their expectations, and their behavior changes according to their interpretations. Let's illustrate this with two people, Bob and Mary, who are in group psychotherapy to overcome their shyness. Mary believes her therapy will help, while Bob does not.

After a few therapy sessions, both separately meet strangers and converse with them. Mary views this event as a sign that her therapy works. Even though she was uncomfortable, she would never have talked to a stranger at all before her therapy sessions. Her new sense of confidence leads her to talk to other strangers and eventually reduce her feelings of shyness.

In contrast, Bob emphasizes his discomfort in talking to the stranger. Because he still feels uncomfortable, he now is even more certain that the therapy cannot help him. Finally, his confidence in the therapy decreases so much he drops out of the therapy group. In these examples, their expectancies not only controlled their interpretations, but their interpretations had significant consequences on their future behavior.

The placebo effect also depends on the feeling of control. In situations where we think that we lack control, we feel stressed. Many people finally seek therapy, because they think that they have no control over their feelings, thoughts, or behaviors. Having confidence in their therapy helps people to restore the feeling of control over their lives. By itself, the perception of control reduces stress and anxiety.

A third explanation of the placebo effect relates to effort justification. People are motivated to justify their efforts. The more effort you put forth, the more you have a need to justify it. To justify the effort you extend, your view about the effortful behavior changes you see it as a positive, valuable experience.

Psychotherapy frequently involves a great deal of effort on the part of the clients. First, clients find it uncomfortable to talk about their problems with a relative stranger. This takes a great deal of effort. In addition, clients sacrifice their time and money. If they believe therapy is not helping them, it would be even more difficult to justify continued sacrifices. So, to justify their efforts and sacrifices, they want to believe that the therapy works.

To achieve your goals,
you have to have faith
especially faith in yourself.

Some people may see the placebo effect in psychotherapy as merely a way of "fooling yourself" into thinking that it works. This is not what really happens. Physicians, psychologists, and other therapists have known for a long time that their clients' attitudes are important in determining the success of any treatment. No matter what the therapy, if clients believe in it and are willing to follow the advice they receive, it will be more effective. If you don't think it will work, guess what? It probably won't. You gotta have faith not only in the therapy, but also in yourself.

* Adapted from Stephen Worchel and Wayne Shebilske's Psychology: Principles and Applications, Prentice Hall Publishers, 1992, page 61.

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