Abstract: Physicians frequently consider the placebo effect in evaluating
the efficacy of medical treatments on the human body. It may also be wise to
consider the placebo effect and its organizational and psychological analog,
the Hawthorne effect, in religious treatments of
humans. In suggesting that the placebo effect be considered as a factor in
treatments such as LDS Priesthood blessings or declarations of forgiveness or
salvation in a variety of faiths, the divine power behind such treatments is
not necessarily challenged. The placebo effect, in religious terms, is not a
sign of weakness in the patient or a tool for trickery by the therapist, but
may be a real expression of the importance of our mental state: when we feel
loved and cared for, we are strengthened. There may be a relationship between
the placebo effect and both faith and charity that may be helpful to explore
and understand. Analysis of changes in performance of a group of people must
also be considered in light of the Hawthorne effect. Failure to do so may result in
some inherently bad decisions and programs being implemented.
I have long been fascinated with the placebo effect. Though I've
used it for a variety of lame joke such as my spoof company, Mega
Placebos Plus, the placebo effect itself is a serious matter that
physicians, scientists, and others must take into consideration when evaluating
the efficacy of any kind of treatment on human beings.
Though some aspects of the placebo effect are controversial (see Carol Hart, "The Mysterious Placebo Effect," Modern Drug Discovery, 2(4): 30-40 (July/August 1999) and Robert T. Carroll, "The Placebo Effect" in The Skeptics Dictionary (New Jersey: John Wiley & Sons, 2003)), the reality of the placebo effect has been demonstrated in some surprising recent studies, such as the Penn State discovery that cough medicines are no better than non-medicated placebo syrup for children's coughs (thanks to ScienceBlog.com for the story), or the remarkable finding that 75% or more of the benefit of anti-depressant medications stems from the placebo effect, as reported by Drs. Irving Kirsch and Guy Sapirstein, "Listening to Prozac but Hearing Placebo: A Meta-Analysis of Antidepressant Medication," Prevention & Treatment, Vol. 1, June 1998.
What does the placebo effect mean for religion? One of the
obvious applications may be Priesthood blessings. Surely a portion of the
benefit of these blessings must lie within the scope of the placebo effect,
which is not to discount the value and benefit of these blessings at all or the
very real miraculous power of God in blessing lives through such means. But in
some cases, expressions of love and concern from another, and the belief that
treatment is being applied, can provide meaningful aid to the recipient apart
from external miraculous actions. I know of many blessings that succeeded far
beyond any placebo explanation - genuine divine intervention is the only
rational explanation in some cases - but in many cases, it may be that the
major benefit provided comes from the love that is expressed by those giving
the blessing, who sometimes make genuine sacrifices to be visit the afflicted
person and provide the blessing.
If we understand that the placebo effect can play a role in
Priesthood blessings, then we may also conclude that the blessing can be more
helpful if we take steps to strengthen that effect. For example, most
experienced Priesthood holders tend to dress up and put on a tie when they go
to give a blessing. Some take extra time for prayer before leaving and may have
a prayer first before performing the blessing. These extra steps are often
described as ways of showing respect to the Lord in performing Priesthood
duties, and I agree. But it also shows the recipient that the Priesthood
holders care enough about this act, and about the recipient, to dress up or take
other steps. If feeling important and loved contributes to the well-being of
the recipient, as I believe it surely must in many cases, then we may wish to
take further steps to strengthen our conveyance of love. Follow-up visits and
calls, a plate of cookies or a hot meal, a card of sympathy, all these small
acts of kindness help convey the love that should already be in our heart, and
may help the physical well-being of the recipient.
With a slightly warped perspective, faithful home teaching and
visiting teaching could be viewed as providing regularly doses of preventative
placebos. Improved physical and mental health may be desirable side effects of
our efforts to care for the spiritual well-being of those we serve, thanks to
the placebo effect.
It should be no surprise that many aspects of our lives are
affected by how we think about ourselves and our situation. Guilt, for example,
can be like other forms of psychological stress and can do more than just harm
our spirit. The anguish and pain that Alma the younger felt when he confronted
the reality of his sins was utterly debilitating (Alma 36), while the joy he
experienced when his sins were removed by the power of the Atonement truly
empowered him and gave him strength to heal many others for many years.
Skeptics will say that guilt is all in our heads and is a sign of mental
illness, but I see it as a genuine and often helpful indicator analogous to
physical pain that can motivate a person to seek a cure.
Church leaders, parents, spouses, friends and others in the
Church (and outside the Church, of course) often have opportunities to those
who are dealing with spiritual crises, including guilt and anguish of soul.
Drawing a lesson from the reality of the placebo effect, I think we can't
underestimate the importance of simply paying attention to those who suffer.
When a sinner humbly goes to meet with a bishop and confess, that person will
usually find out that the bishop really cares, that the person is important,
and that the bishop or other leaders are willing to spend significant amounts
of time listening and trying to help. Even when courts are needed, the result
can be a marvelous manifestation of love. My experience in Church leadership
positions, beginning as a Stake Clerk many years ago, repeatedly showed me that
true charity can be provided in Church courts, even when the sinner is
rebellious and excommunication is the outcome. And in many cases, love does
much to heal. I think that's the key lesson from the religious application of
the placebo effect. Love heals.
I've heard from a variety of people that confessing sins to a
bishop was a critical step for them in overcoming sin, and that they came away
stronger for the experience. Not to downplay the power of the Lord's
organization in blessing our lives, I would like to know what portion of the
benefit of confession comes from placebo-like benefits?
We can extend this idea by drawing upon the finding that side
effects can play a critical role in medical placebos. The study that found 75% or more of the benefit of
anti-depressant medications stems from the placebo effect also raised the
possibility that the remaining 25% of the benefit also might come from the
placebo effect, due to side effects. When patients were on placebos and did not
experience adverse side effects, they suspected they were receiving placebos
and this probably did not get the full placebo benefit. When painful side
effects are present, they are more likely to think the treatment is effective.
Perhaps this explains some of the religious appeal (?) of flagellism. In terms
of LDS confession by someone with serious sins, the painful consequences
imposed by a bishop such as temporary probation, restrictions on membership
privileges, or even a disciplinary council (as loving as they can be) may have
the benefit of adding a "painful side effect" to the treatment to
help the person feel that there is an actual treatment being applied that
should help.
I absolutely believe in the divine power of the Atonement, the
miracle of divine forgiveness, and the divinity of the Priesthood - but there
may be some aspects of the human administrative actions at the Church level
that also aid and strengthen the penitent person through means that may be
partially interpreted in light of the placebo effect. This is not to say that
sinners will get the same benefit by confessing to roommate or imposing
self-discipline. The Priesthood is real, and God has revealed the proper
channels for us to deal with serious sin. The issue I raise is whether internal
mental processes akin to the mechanisms behind the placebo effect might
contribute to the benefits that one can experience when going through formal
repentance processes in the Church. I suspect the answer is yes.
The
Having discussed the placebo effect on individuals, let's turn our attention to
a related phenomenon for groups or organizations, the Hawthorne effect. According to this effect, the
productivity of people improves when attention is paid to them and they believe
that the efforts of management or others are designed to help them. The
A common expression of the
If you'd like to try the
The difficulties raised by the
I think the Hawthorne effect may come into play in a church when
there is a change in leadership, programs, policies, or other factors.
Implement some new way of promoting home teaching, let the leaders and the
members know that it is being tracked, and it just might increase. At local
levels, I've sometimes seen some questionable decisions made or arguably
suboptimal programs implemented on the basis of a boost in measured performance
from a pilot study. I've also wondered about the emphasis on numbers that we
sometimes see: if home teaching statistics are given great importance by
leaders, and people know that their performance is being measured, we might see
the numbers jump, without a corresponding actual improvement in Christlike
service. But I would agree that for the most part, higher statistics ought to
mean that more people are being visited and more good is being done, so I don't
want to criticize the value of the statistics, and recognize that they are
helpful indicators, as long as they are not means unto themselves.
Bottom line (sorry I rambled so much on this post!): the placebo
effect in its various forms is a real effect with applications to our religious
lives and ministry to others. Understanding its impact may help us to better
understand the importance of charity in helping to strengthen the physical,
mental, and spiritual facets of other human beings. Understanding its
organizational sister, the Hawthorne effect, may also be helpful, especially
for Church leaders.
And hey, if you're like me, you'll want to enjoy the benefits of
placebos in your own life by taking daily placebo supplements. I make mine from
chocolate, when available.
Jeff Lindsay, Jan. 28, 2004
URL: https://www.jefflindsay.com/snippets/wmd.shtml
Copyright © 2004. This snippet was written by Jeff Lindsay for
JeffLindsay.com.
What's NEW at JeffLindsay.com?