Enhancing the Power of Self-healing

Tom G. Bartol, NP


November 07, 2017

Self-healing and Placebo Effects

In complementary therapy settings, communication between patients and their therapists is considered important for raising consciousness and activating the patient's power of self-healing, which is the chief aim of therapy.[1] Self-healing power is understood to be a placebo effect derived from establishing trust and belief in the treatment process.

A recent qualitative study from Norway explored the relationship between clinician-patient interactions and their effect on healing.[1] A combination of methods, including semi-structured interviews, observation, and a focus group, was used to examine interactions between complementary therapists—chiropractors, naprapaths (musculoskeletal therapists), acupuncturists, and homeopaths—and their patients.

The pilot study showed that a successful consultation was characterized by a fruitful relationship between the therapist and the patient and that positive beliefs and expectations about the treatment can facilitate healing. Successful self-healing requires patient-therapist consultations that take adequate time, develop mutual understanding and treatment goals, and help the patient feel confident and hopeful.


What does all of this have to do with providing care in conventional healthcare settings?

This small pilot study suggests that the relationship between clinician and patient has an effect on healing. By exploring the foundations of successful consultations in complementary healthcare practices, the study provides some insights that may be useful in healthcare more generally. As healthcare professionals, our interventions—drugs, therapies, and procedures—are aimed at, but are not the sole source of, the patient's healing. An effect beyond these interventions comes from within the patient and is based on beliefs, hope, and trust. Patient self-healing can and does take place, and it can be facilitated through our relationships, connections, and interactions with the patient.

The term "placebo" is familiar to many of us as the "sugar pill" used as a control in drug clinical trials. The term "placebo effect" has a much broader meaning. It's not the result of a "fake" treatment but a neurochemical response in the brain that can facilitate healing.[2] It's the effect of a treatment that comes from patient expectations about a treatment rather than the treatment itself. In the complementary therapy study, the authors refer to the placebo effect as self-healing. This effect is real and is facilitated by both the patient's—and the clinician's—belief in the effectiveness of a treatment. If a clinician believes that something can help, it's more likely that the patient will believe it likewise and experience a healing effect. This effect is present in all clinical encounters even when attempts are made to try to control it. The placebo effect can be enhanced by the interaction and relationship between patient and clinician.

Strategies to facilitate the placebo effect and self-healing can be useful in clinical practice. Healthcare means caring for a person, not just treating a disease or symptom in that person. As Hippocrates said more than 2000 years ago, "It is more important to know what sort of person has a disease than to know what sort of disease a person has."[3] Focus on "connection before content." Before asking about symptoms, taking a blood pressure, or discussing lab results with a patient, build a connection or relationship by inquiring about family, life events, or other things that are important to the patient. Help the patient feel important and part of the process. Longer appointments could result in much more effective care and healing.

For many, the healing power of relationships has been lost in the sea of technology and pharmacology. Some doubt it exists, relying on traditional interventions. In his book Saving Normal, psychiatrist Allen Frances summed it up well: "Being able to enlist the confidence and hope of the sick patient has always been and still is the most essential skill in a great shaman or a great modern doctor. The technical skills of medicine are becoming increasingly routine and may soon be done better by computer programs—but the shamanic skills of medicine will always be important to patients and to society."[4]


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