I recently came across this fascinating TEDx talk on YouTube after a friend turned me on to Dr. Lissa Rankin, author of the book Mind Over Medicine. If you have an interest in health and healing, I strongly suggest that you take the time to watch this video and read my recap below, where I share some of my personal perspective.
In this video, Dr. Rankin introduces the power of the placebo and nocebo effect, both of which I feel have significant impact on public health and merit further clinical research. Looking back on my own health history, I can cite multiple examples of having been subject to the effect of both placebo and nocebo.
At the ripe young age of 30, after an annual physical appointment with my internist, I discovered that I had high LDL (bad) cholesterol. This news, combined with my family history (both of my parents are on cholesterol-lowering medicine), prompted the doctor to put me on a daily regimen of Zocor. While the medicine was effective in lowering my LDL levels, I had no intention of staying on it for life. I remember speaking with my doctor months later, after having lost some weight, curious as to whether or not I needed to continue taking Zocor. My doctor’s response left me puzzled. He said it would take several weeks of being off the medicine to get an accurate result, which was counter-productive to what he was trying to accomplish in the first place….keeping my cholesterol levels within range. So the “action plan” for my medical treatment, or lack thereof, was essentially my nocebo. My doctor’s defeatist approach to getting me back to health suggested that I should accept the diagnosis and embrace my life-long sentence of hypercholesterolemia. The basis of this blog and my own journey is proof to the contrary.
A few years ago, I began seeing a local chiropractor for some neck and back pain I was experiencing. Be it due to my exercise regimen, lengthy work commute and/or stress, I was in pain….and all I knew was my chiropractor was able to make me feel better by adjusting me. Every time I visited him he would go through a nearly identical series of adjustments, lasting no more than 5 or 10 minutes total. And I consistently felt in better alignment (physically and mentally) each time after seeing him. A few months into treatment, after my pain had subsided, I did something unthinkable. I continued to see him on a monthly basis. Not because I was in pain, but to keep myself in proper alignment. Much to the chagrin of my insurance provider, I continue to do so to this day. While this practice is arguably somewhat controversial, there is an abundance of research that demonstrates the benefits of maintenance therapy as it pertains to chiropractic. I view my monthly adjustments the same way I look at visiting the dentist every 6 months for a preventative cleaning. My stance on chiropractic, however, is not the key takeaway here. The point I’m making is that this quite possibly is my placebo, and I am totally fine with it. Whether or not I “need” the treatment, I see and feel the everyday benefits, which is all that matters.
Another important point Dr. Rankin introduced in the video, is the power and influence of the medical practitioner when it comes to placebo and nocebo effects. Approximately one year ago, I was suffering from sharp pain and inflammation in my left knee, occurring most often after rigorous exercise. I was referred to an orthopedic surgeon, who said this was abnormal and recommended doing an MRI. After reviewing my results, the orthopedic surgeon determined that I had several meniscus tears in my left knee. He offered to operate on me to clean it up and alleviate my symptoms. In the process of thinking it over, I spoke with my integrative medicine specialist, whom I have seen for years and trust implicitly. She more or less implied that I would get better either way, but ultimately recommended against the surgery, due to the excessive cost and recovery time involved. Her recommendation was based on her knowledge of my health and the simple facts of my overall condition. I had not suffered an acute injury, my condition was not debilitating, and this was all likely an expression of my body’s normal aging process. Her advice to wait it out was spot on. After a couple of weeks, the pain and swelling after exercise completely subsided. It just vanished without any explanation. Perhaps the healing process took place naturally – or maybe not – it’s likely that an MRI would still reveal the same clinical results on paper. But what I know for sure is that my knee is no longer a problem for me. And, after watching the video of Dr. Rankin’s talk, I genuinely believe that the healing process was a direct result of the trust and respect that I have for the advice given to me by my integrative specialist.
One of the final and most relevant points in the video of Dr. Rankin’s talk – the one that I quoted above as the title of this post – is that “Your body is your business”. Too often we put our health in the hands of others, who are treating us for something we know better than they do….right? I’m not saying we are experts on anatomy, disease and medicine. What I am saying, however, is that no one knows you better than you do. You are your own expert on your overall condition and what you are experiencing on a day-to-day basis, so….at the very least, get involved in the treatment process! Your health goals, whatever they may be, will be far more achievable if you communicate with and fully align yourself with your practitioner. Disease does not operate in a vacuum. There are, undoubtedly, many things going on in your life which may compromise your ability to achieve optimal health (i.e. diet, exercise, sleep, stress, lifestyle, relationships, responsibilities, etc). The more you can appreciate this interconnectedness and discuss these things with your practitioner – so long as they are willing to listen – the better they will be able to treat you holistically.