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THE PLACEBO EFFECT IN PARENTING

Why Kissing it better ACTUALLY works...and why you should do it too.

Adapted from the Blog article on the placebo effect 28/03/2019.

Setting the scene


So you've made it out to the park, the sun is shining, you've just sat down on the bench to start drinking your coffee (it's now cold, why does this always happen?!) and to gaze lovingly as your little one plays blissfully on the slide... when a slightly bigger one comes barging past sending yours spinning... and flat out on the ground.


Here we go.


However you reach them, maybe you're the leap-up-to-their-rescue kind, or the wait-for-them-to-come-over kind, or the -'just one last sip' and mentally prepare yourself for the next few minutes-kind, but you'll encounter utter devastation.


It must be some serious injury!


Where is it? You are tearfully presented with the tiniest area of red on a tiny hand.


"Oh dear, rub it better! Kiss it better! Big hug. What a brave little one you are! (pause for breath...) Do you want to go back and play now?" Cue tearful nod before they are swiftly jumping down and running back to play in a feat of dramatic turnaround that you only thought politicians were capable of...


It's so instinctive to us isn't it? But why does it work? Or is the pain just not that bad so that they soon forget?

Perceptions vs Reality

The secret lies in this one fact - our minds and our bodies are utterly connected. We don't experience anything separately from our bodies. What's the first thing that happens when you feel extremely sad? The tears come. How do we sometimes know we are worried before we even feel it? The butterflies flutter in our stomachs...


Sometimes our perceptions are spot on - yes my hand is hurting because my three year old just bit me. Sometimes our perceptions are massively altered by our minds - which explains why my head itches like mad whenever I have to take the nit comb to anyone's head, or even just think about nits, let alone google a video of 'the worst case of nits ever'....


Doctors have been making the most of this link for centuries, it's called the 'placebo effect'. The idea goes that if you give someone a fake medicine and tell them it will take their pain away, then their mind will be tricked and convince them it's true.


But the story is much more complicated and interesting than that...


How the Placebo effect Works

Studies have shown that the same chemicals and pathways in your brain that lots of drugs target, are actually physically activated by the placebo effect -


It's not just that you believe the pain is less, it actually is less! (1)


And it's not only medicines. The physical act of going to the doctor/physio/homeopath can improve symptoms, especially if the doctor spends longer with you.


It's known that the act of taking any medicine can help. But if you take a medicine that is known to work for your problems, and are also convinced it is going to help you, it can enhance the benefits even further:


In 2014, there was a study of migraine sufferers, the patients were split into 3 groups. The first group received a placebo medicine, labelled with the real drug name (the bottle had been intentionally wrongly labelled). The second group received the real drug labelled 'placebo' (again wrongly labelled on purpose). And the third group received the real drug labelled properly. The first two groups reported a similar amount of mild benefit (despite one group receiving the active medicine!) The third group received a 50% greater benefit than either of the first two(3). So even a real drug that is known to work, could work as much as twice as well - if you also think it's going to help you. Is your mind playing tricks on you yet?!


So what?


This means that as a parent, harnessing the power of the placebo effect could really benefit you and your children (and you don't need to deceive them to make it work).


Just the act of focusing on them, finding out where it hurts, or how much they don't like coughing, will ACTUALLY make them feel and be physically better. Amazing!


Now I'm sure you do a lot of that already - so it's important to remember to trust your instincts, those instincts to scoop them up and make them feel better. Their "feeling better" is backed up by research (4).

The Nocebo effect


But interestingly, we can also take it too far; the 'nocebo effect' is a well documented phenomenon, and can be just as strong and powerful(2).

This means that a problem or symptom can actually be caused or worsened by believing that it is bad. So over-egging the sympathy can backfire.


I've accidentally done it so many times: 'Oh, that looks sooo sore!' - cue floods of tears. So 'this will make your tummy upset' or 'this is going to hurt' can become self-fulfilling prophesies that you may regret.


This means that how we react, and what we say to our children really is medically significant. If we are thoughtful and careful, we can use that to help and benefit them.


So whatever you do, make sure it's the experience of being looked after that they notice. That will make whatever you actually do far more effective.


If they need more than just some reassurance, you can have in your armoury all sorts of mystical medicines...

Practical ways to use the Placebo effect


I have my special hand cream that helps all bruises and grazes. Administered with great seriousness and expectation, the soothing powers of whatever my husband last got me for Christmas are maximised.


An amazing beeswax balm that means 'the bees will make you better' which is especially good for itchy bottoms, or itchy anywhere really.


A stash of plasters for when only a plaster will do. Including larger and more elaborately decorated ones for them to choose depending on the seriousness of the injury.


A glycerin-only cough syrup can make sore throats and colds feel better (remember the act of taking something can help you even if it doesn't contain any active substance).


And finally, if you give them Calpol or any prescribed medicine when they are unwell, tell them that it will make them feel better, and it may make them feel a lot better than if you hadn't said it (maybe even 50% better!)


So, be aware of the power of your words and actions over things like pain, feeling sick, stomachs, skin and rear ends, and use that power for good this week.


Oh, and of course, remember the kiss!


References:

(1) Finniss DG, Kaptchuk TJ, Miller F, Benedetti F. Biological, clinical, and ethical advances of placebo effects. Lancet 2010;375:686-695

(2) Kaptchuk TJ, Miller FG. Placebo effects in medicine. N Engl J Med2015;373:8-9.doi:10.1056/NEJMp1504023 pmid:26132938

(3) Kam-Hansen S, Jakubowski M, Kelley JM, et al. Altered placebo and drug labeling changes the outcome of episodic migraine attacks. Sci Transl Med 2014;6:218ra5-218ra5

(4) Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits? BMJ 2018;363:k3889