Twenty-five percent of Americans take psychoactive prescription drugs or have done so within the last five years. (Not to mention our other psychoactive drugs: alcohol, cigarettes, food, shopping, sex, gambling, television, smart phones.....) Drug companies promote psychoactive drugs for obvious reasons and insurance companies do the same because drugs shorten treatment. So many people can't be wrong: drugs must help or we wouldn't take them.
Research has shown that, for many psychoactive drugs, the placebo benefit is relatively strong: a pill containing no drug leads to a 'cure' (the problem appears to be resolved to some defined degree) almost as well as the drug itself. These studies necessarily under-measure the placebo benefit because psychoactive drugs cause other very noticeable changes in mental state (sedation, flattening of affect, increased appetite): subjects may guess - from the presence or absence of these other changes - whether they are getting the drug or the placebo. (If you know you are only getting the placebo the benefit is less because you don't expect it to work.) For many psychoactive drugs, when people take the real drug the cure may be entirely accounted for by the placebo benefit. That statement may seem exaggerated but it is what the balance of clinical trials suggests. FDA regulations, influenced by lobbying, do not require that the balance of trials demonstrate effectiveness: a company can keep doing trials until it gets one that shows the desired result, then use that trial alone to qualify for approval.
The placebo benefit is not an illusion: in many cases it accounts for the effectiveness of the drug and it does not include the disturbing and dangerous side effects which are common to psychoactive drugs. It appears to work by suggestion, that is, by suggesting a story something like this:
This doctor completely understands my pain and is giving me the medecine which can fix it. If I accept the doctor's wisdom I'll be fine.
That story evokes - in the back of our mind where we may not notice them - a series of related stories:
I've fixed the problem. I'm getting the help I need. The doctor is a friend who will look out for me. I'm a child at home where my parents are keeping me safe. My suffering has a meaning which the doctor understands. Wisdom will cure me so I can relax.
Body and mind both have strong inbuilt capacities for self-healing. If we can evoke these capacities and relax enough to allow them to operate, then they are frequently successful. It should be apparent that the stories I just described all promote inbuilt healing.
The doctor understands me so I'm not crazy (anxiety reduced); the doctor is not shaming me so I don't have to be ashamed; the doctor cares about me so I'm not alone with this but in relationship (anxiety and depression reduced); I've taken care of the problem so I can relax and stop worrying (anxiety reduced); a benign, larger-than-myself, outer force is on my side so I can feel safe like a well-looked-after child (anxiety and depression reduced); a benign internal healing force is evoked and supported (hope aroused). When we understand the details of the story it is easier to see how it benefits us.