The Therapeutic Value of the Relationship for Placebo Effects and Other Healing Practices

Response to placebos has been documented experimentally for many medical disorders and had been verified in laboratory studies. However, the mechanisms that produce the response to placebos are not well identified, although it appears that the relationship between the medical practitioner and the patient plays an important role. Humans and other eusocial animals evolved to heal in a social context, so it is not surprising that the healing relationship is an important factor in the delivery of health services. Several well-designed studies have examined aspects of the relationship and response to placebo and the evidence is strong that various aspects of the relationship augment response to placebo. There is also meta-analytic evidence that the relationship improves physical and mental health services. Finally, there are three possible ways the relationship augments the response to placebo: combats loneliness, increases expectancies for relief, and coregulates emotions and decreases arousal.