Embodying the art of medicine.
Which do you think has a more powerful effect on the outcomes of people you treat? The medicines and natural remedies you give them? Or the words that you offer along with them?
You may be surprised that research shows the answer is “Your Words.” Why?
Because the words you use engage the body and mind’s ability to both heal and cripple. To paraphrase Dr. Kenneth Pelletier, who coined the term “Mind As Healer, Mind As Slayer,” the words you use can support healing, or even kill.
Let’s look at the degree of effect. This varies on whether you’re looking at changes in patient perception (e.g.—pain, fatigue, nausea) versus biochemical markers (e.g.—glycosylated hemoglobin/average blood sugars). Overall, for the former group, the effectiveness of placebo in studies is often far over 30 percent. Interestingly, it is eye-opening to look at the side effects in the placebo group as well.
It is remarkable how the specific side effects in the placebo group often seem to match those in the active treatment group. It is suspected that this occurs because the informed consent process tells people to expect those side effects. For example, in a meta-analysis of migraine treatment studies, researchers “found a high rate of adverse events in the placebo arms of trials with anti-migraine drugs matching those described for the specific type of real drugs under investigation. For example, anticonvulsant placebos produced anorexia, memory difficulties, paresthesia and upper respiratory tract infection—all adverse events [commonly] reported in the side effect profile of this class of anti-migraine drugs.”1 This was also seen in another large meta-analysis comparing tricyclic antidepressants with serotonin raising medications. These two medications have quite different sets of side effects, each of which they would have been warned about during the informed consent.
The fascinating finding? Simply giving the warning of specific side effects increased the prevalence of these side effects upwards of 300 percent. For example, patients receiving TCA (tricyclic) placebos reported higher side effect rates than those receiving Prozac like SSRI placebos for dry mouth (19.2 percent vs. 6.4 percent), vision problems (6.9 percent vs. 1.2 percent); fatigue (17.3 percent vs. 5.5 percent) and constipation (10.7 percent vs. 4.2 percent).2
Looking at effectiveness, as much as 90 percent of the effectiveness of Prozac medications was attributed to the placebo response. There was only a 10 percent difference between the active and placebo group. This was enough, because of the large sample size, to torture statistical significance out of the data. Even this 10 percent difference over placebo effect may be optimistic. As Dr. Colloca noted in her review “the drug-placebo difference was zero for people who were moderately depressed. For this rather large group of sufferers, anti-depressants seemed to have no drug effect at all.”2
The effect that occurs when one suggests the possibility of harm has been called the “nocebo effect.” This is a rather old concept, and used to be called putting a curse on someone!
Physicians, and sadly even holistic practitioners, are often putting curses on the people we treat day in and day out. When the traditional MD tells a person that “those unscientific natural remedies can’t help you, and may kill you,” or when we as healers drone on about the horrific toxicity of the person’s medications, we are putting a curse on people. For example, when we use unreliable IgG testing for food allergies that act like a random result generator,3 telling the person that they are allergic to 30 foods for the rest of their lives, we are putting a curse on the person, making them sick every time they eat those foods. Then we go on and on and on about GMOs (genetically modified organisms), chemicals, and countless other things, our words often being more toxic than the environment itself.
These are not benign things to do to people. When wielding tools as powerful as our words, it behooves us to do so consciously.
So simply put, to the degree that it is consistent with the truth, paint as positive and hopeful a picture as you can for those you treat. Whether you tell the person there is no hope, or that there is good reason for hope, you are likely to be correct. Which of these are you choosing to offer those who come to you for help? Another option? Teach people that we are giving their bodies what they need to thrive in the current environment. Then do so! In my experience, effective treatment (or at least functional improvement) is available for almost all conditions. Unfortunately, standard medicine only knows about those treatments that are very profitable, leaving them helplessly incompetent at treating fatigue, pain and a host of other conditions. Though this is a problem, it also gives us a tremendous opportunity to help people.
Free Tools to Make You an Overnight Holistic Expert
Having been in holistic medicine for 40 years, and having read tens of thousands of studies, it was a shock to find that natural remedies are often more effective than the medications we were taught about in medical school. To make this complex information easily available to both the public, and health practitioners, I have made three powerful, but simple, free tools available:
1. Cures A-Z. This popular app is available for both iPhone and Android. It lists hundreds of different health topics (from acne to zoster), offering a quick summary of the condition along with the treatment options most supported by the science and clinical experience. In addition to natural remedies, it often discusses the pros and cons of some of the medications as well. This way, when somebody walks in your office, you can become an expert on his or her condition in 30 seconds!
2. The free Energy Analysis Program at www.endfatigue.com can analyze your client’s symptoms, and even their pertinent lab tests if available, to determine what is causing their personal “energy crisis.” This can be especially helpful for people with fatigue, fibromyalgia and pain. You can send people to the website to do it. Another option? I am happy to send you the questionnaire (see number three below). Simply have the person fill out the questionnaire, and have your staffer enter the information. Then the printout will give you a detailed list of the contributing factors to their fatigue and a comprehensive treatment protocol based on these. Feel free to not even mention the program. They will think you spent hours analyzing the data and that you are a wizard!
3. I am happy to email you a free set of treatment tools that include a patient questionnaire and treatment checklist for CFS (chronic fatigue syndrome) and fibromyalgia. Simply email me at firstname.lastname@example.org and request the “Treatment Tools.” The questionnaire will allow you to gather information that would take over an hour to get verbally, and assess it in under five to 10 minutes, organized in a way that also clarifies the person’s diagnoses. In addition, are you finding that you are writing the same thing over and over each day (and often illegibly)? That is a waste of your time and usually not very effective for the person you’re treating. The treatment tools contain a checklist of the most common treatments used for fatigue, fibromyalgia, sleep, pain, candida, hormonal issues and a host of other topics. Simply check off the ones that you want for the person. It will have detailed information on how to use it and any problems to watch for—all in the one second it takes to check it off. These also give you a template that you can easily modify for your practice.
One final note. Practicing the healing arts should be fun. If it’s not, you’re doing it wrong and it is time to explore your next stage of growth. I would note that spending more than 28 hours a week in direct patient care may be a recipe for compassion burnout. If you are finding that you’re getting exhausted, cut back. You may feel more balanced using the additional time you spend beyond 28 hours a week to produce income in other ways—that will leave you better balanced. Or instead, you may simply invest the time in yourself and your family. My e-book Three Steps To Happiness—Healing Through Joy is a simple guide that can help both you and those you are treating.
As our old health care system becomes obsolete, we are now creating amazing possibilities of health and vitality for people’s futures. There is very good reason to be optimistic!
Love and blessings, Jacob Teitelbaum, MD
1 Amanzio M, Corazzini LL, Vase L, Benedetti F. A systematic review of adverse events in placebo groups of anti-migraine clinical trials. Pain. 2009;146(3):261–269.
2 Colloca L. Miller FG. The nocebo effect and its relevance for clinical practice. Psychosom Med. 2011 Sep; 73(7): 598–603. Published online 2011 Aug 23. www.ncbi.nlm.nih.gov/pmc/articles/pmc3167012/#r31.
Jacob Teitelbaum, MD, director of the Practitioners Alliance Network, is one of the most frequently quoted integrative medical authorities in the world. He is the author of the best-selling From Fatigued to Fantastic!, Pain Free, 1,2,3!, the Beat Sugar Addiction Now! series, Real Cause Real Cure, The Fatigue and Fibromyalgia Solution, and the popular free Smart Phone app Cures A-Z. He is the lead author of four studies on effective treatment for fibromyalgia and chronic fatigue syndrome, and a study on effective treatment of autism using NAET. Dr. Teitelbaum appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN and Fox News Health. Learn more at Vitality101.com.