The Sports Doc Chalk Talk

Los Angeles Lakers player Metta World Peace (Ron Artest for the purpose of this article) viciously blind-sided James Harden in the head yesterday, prompting sports fans worldwide to attack Artest for his aggressive play and history of sport-related violence and suspensions.  There is no doubt that Artest has a checkered past when it comes to keeping his emotions under control, as his record of getting into fights speaks for itself.  It’s also very understandable that many fans are tired of Artest’s behavior, and rightfully so, as a shot like the one he delivered yesterday could have easily have been a career-ending hit.  Looking at the bigger picture, however, it becomes a very interesting discussion when you examine how intimidation, hard (but fair) play, and deliberate aggressive/violent acts all enter into sports.  What’s good, right, bad, or wrong? (Sport Success 360).

There isn’t much debate that Ron Artest has struggled with his emotional development throughout his career — many times admitting to his problems through various interviews over the years.  In fact, Artest has even talked about his work with a psychologist, which I find quite admirable that he would seek treatment (even if he is still showing signs of his uncontrolled anger).  But what about the aggression your child shows in sports?  Does he have an “anger problem,” or is his level of mental toughness good for the sport he plays?  Does your daughter have an appropriate level of intensity, or does she seem to cross the line with occasional cheap shots?  Many parents ask themselves these types of questions everyday, wondering if their child might, too, have an anger problem similar to Ron Artest.

What makes this a challenging conversation in sports is the fact that so many sports are physical in nature — making the “line” somewhat blurry when it comes to appropriate and inappropriate behaviors.  Case in point: If somebody in the office chucked you hard as you made your way to the copy machine, not only would this be inappropriate, it might also lead to that employee being fired – or even sued.  In a sport like hockey, however, players are encouraged to knock down the opposing player heading toward a goal.  Same behavior, yet the behavior is viewed quite differently across settings.

In addition to aggression being a part of most sports, there is also an emotional factor that enters into play that is very different than our day-to day work.  In other words, many athletes become emotional while being in the heat of a battle, and quite often they engage in physical play through the emotional experience.  Occasionally, they cross the line while in this mind state.  Of course, this doesn’t justify “cheap play,” but it may help us understand some of the contextual cues that enter in to aggression in sports.

When it comes to your child and sports aggression, ask yourself the following questions to see how he or she sizes up:

• Is her aggression usually tied to winning the game (i.e. blocking a player out under the rim, or checking a player into the boards), or is it tied to simply being frustrated (like hitting an opponent after the whistle)?  The first type of aggression is instrumental aggression, while the second is called hostile aggression. If your child regularly engages in hostile aggression, you might want to pay close attention to the situation to see if she might need help with controlling her emotions.
• Does your child regularly seem to be in the middle of fights while playing?  Sport psychologists will often look at prevalence and trends when it comes to aggression in sports, and if your son is seemingly always in the middle of scuffles there could be a problem.
• Has your child been disciplined for sports violence/aggression before?  If so, and he continues to display the same behaviors, you may want to seek professional assistance as it appears as though the consequences are not curtailing the behavior.

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Having studied psychology and mental health disorders for many years (as well as being a licensed practicing clinician), I have long been troubled by the trend for doctors to quickly prescribe anti-depressants to their patients without first encouraging other, safer alternatives.  Since the 1990′s, increasingly more doctors have quickly bypassed recommending things like professional counseling, exercise, or trying new hobbies and interests (all things that can really help with mood state), and instead quickly scribbled out scripts for anti-depressants.  Of course, if these new pills worked significantly better than the other ideas I just presented, and if these pills were 100% safe, I don’t think using them would be much of a concern.  Unfortunately, that’s simply not the case.

Last night 60 Minutes ran a segment on the efficacy of anti-depressants versus placebo effects, citing Harvard social scientist Irving Kirsch’s discoveries when evaluating real anti-depressant medications against placebos (or sugar pills).  Kirsch’s findings were really nothing new, and certainly not any different than what other research scientists have known for years — that is, anti-depressants only “work” because of the belief the patient has when using them, and not due to the chemical properties of the drugs themselves.  In other words, the changes patients claim they experience are due to the placebo effect, not the medication.

The problem, however, is that in the United States we are constantly bombarded with really great advertising that tells us if we are depressed, the answer to our problems might just be one quick office visit away.  As one of only two countries in the world that allows for direct drug marketing to consumers on television, these fancy ads coupled with our intense desire to get better provide for the perfect storm, so to speak.  In other words, when we feel depressed and are “ripe” for an answer, and then see a 30 second ad of a Zoloft egg bouncing around happy, it’s easy to see why so many potential consumers light up with excitement and quickly schedule a visit with their doctor as soon as possible.

Unfortunately, the problems we experience in life don’t simply “go away” by taking a pill (similarly to how they don’t go away from getting drunk, either).  The problems at home, mounting bills, and battles with health problems don’t get better by taking a pill — these situations only improve by learning important life coping skills.

So why are anti-depressants so widespread if:

A) they have been scientifically found to not work any better than a sugar pill, and

B) they put the patient at great risk for side-, interaction-, and withdrawal effects — check the black box warnings to learn more

Listed below are some of the big reasons why so many people continue to be prescribed these drugs:

• There is huge money in pharmaceuticals today, and these companies are not afraid to spend money.  This is the reason why we see so many ads today, and the more of the ads we see the more confident we become that these drugs really “work.”  Most people figure that if they see something enough, it must be true – this is called the mere exposure effect.
• Patients often ask their doctors directly for these medications, and often doctors are happy to acquiesce.  In some cases, doctors really believe in the value of anti-depressants, while in other cases doctors assume the placebo effect will “work” and that the potential side effects are worth the risk.  In other cases doctors know that patients expect to be given drugs during medical appointments, and would feel short-changed if the doctor told them the real things that help with mood state – like counseling and exercise programs.
• When clients do experience side effects, in most cases they continue to use these drugs because they blame the side effects on their disorder (i.e. depression), and not the medications!  In fact, in some cases patients take even more of the medication in order to overcome the side effects.

While we would all love to find a quick fix for our problems in life, the reality is these answers are not in the form of anti-depressant pills (as science is revealing through ongoing empirical findings).  Scott Peck, author of the popular The Road Less Traveled, starts his book with one very important sentence:

Life is difficult.

Think about that for a moment — the problems we face in life are difficult, and success doesn’t happen from casual efforts.  We need to also remember that there are no fast “silver bullet” answers when it comes to life’s problems, even if we wish there were.  Anti-depressants, which work no better than placebos and carry many potential problems with them, should not be the first thing we seek when we hit rough waters in life.  Instead, learning life skills like communication skills, conflict resolution, and stress reducing techniques should be tried first, along with developing a physical exercise program.  Most people dramatically improve their mood state from just those life changes, and professional counseling can help round out the self-improvement process for those still looking for even better improvement. 

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Athletes and injuries are nothing new, but did you know that the ways in which athletes recover from injuries today — and the potential problems that often follow after being prescribed pain pills — is very new, and quite alarming.  With sports being physical (and athletes becoming bigger, stronger, and faster), it’s not uncommon for an athlete to deal with an injury at some point in his or her career.  The problem, however, is usually not the injury itself (most heal successfully over time), but instead the injury recovery aftercare process that often includes prescription pain killer medication (i.e. oxycodone, vicodin, and other opiates).  Ironically, as the injury begins to get better, the pain pill addiction often becomes worse, all leading to very serious problems for athletes caught in this predicament (AHPS).

Athletes At-Risk

Delving deeper, it may not even be the pain pills that are the real problem these days, as pain pills have been prescribed by doctors to athletes for many years.  The real problem, it seems, is that increasingly more athletes are being left on pain pill prescriptions far beyond what is needed, creating a very strong physical addiction to the medication. It’s at this precise point where the real problems develop — where the athlete has become addicted to the opiate high, but his or her script has been terminated and the cravings still persist.  Sadly, more and more athletes are turning to hard-core street drugs like heroin (a relatively cheap opiate) to continue and satisfy their cravings.

For most people, the thought of a heroin-addicted person is very different than the thought of a current or former athlete in fantastic physical condition and widely popular with his or her peers.  Instead, most people think of a heroin addict as a strung-out junkie, dirty and homeless, hanging around on a street corner soliciting for a few cents.  In 2012 those folks still exist, but so, too, do a new breed of addicted heroin addicts that used to be amazingly skilled athletes.

When athletes become addicted to pain pills and their prescription runs out, their cravings do not end.  It is at this point where they have the following three choices:

a) Try to ween themselves off their addiction

b) Purchase pain pills off the street (they have become widely available, though not cheap)

c) Move onto to a more readily available, and cheaper, street drug (usually heroin)

Unfortunately, when athletes don’t stop using yet no longer have a prescription to fill, they often turn to buying pain pills and/or heroin to prevent them from getting sick from not having the drug.  In other words, they need the drug just to stay well. In these examples, athletes will sometimes sell things or even steal just so they can stay high and not experience the terrible withdrawal effects of “coming down.”  This is why we sometimes see previously upstanding people do things we could never imagine them doing (i.e. stealing, holding up banks, and even prostituting for money) just so they can feed their addiction.  And with heroin becoming so widely available, and relatively cheap, it’s easy to see where this story is headed.

Tips to Help

If you are a parent, coach, or an athlete who has a direct experience with pain pill (or heroin) usage/addiction, please consider the following tips and insights to help:

• First, if you are an athlete dealing with an injury talk to your doctor directly and explicitly about what alternatives there are (beyond opiates) to help manage and control your pain.  Pain pills are extremely addictive, so please consider them only as a last-resort option.
• If pain pills are prescribed, work with your doctor to explore the differences amongst the available medications, as well as pill strength (milligrams).  It goes without saying that you should always choose the lowest amount of pill strength to manage your pain, if possible
• If you are feeling better yet still have refills available, talk to your doctor about destroying the prescription so that the temptation to refill the script will no longer exist.
• If you are feeling addicted to pain pills (or heroin), STOP AND GET HELP.  Every medical expert agrees that these are drugs that are incredibly difficult to stop using on your own, and it is likely that you will need professional assistance to help with both the physiological and psychological symptoms and side effects.

Final Thoughts

As a clinician who regularly assists athletes, I have personally seen a spike in the number of athletes caught up in pain pills (and a few that moved onto heroin as a cheap alternative).  It’s astonishing how quickly this type of addiction occurs, and once it does it seems as though it is almost impossible to beat.  Unlike other non-opiate drugs, athletes who are innocently prescribed opiate pain pills to help manage an athletic injury are unknowingly rolling the dice with what could be a precursor to bigger future addiction problems.  It is for this reason that the entire athletic community – including athletes, coaches, parents, administrators, and sports medicine physicians – all need to tune in and take seriously the tragic potential consequences of pain pills and injured athletes.

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The Diagnostic & Statistical Manual (DSM), published by the American Psychological Association, is widely accepted as the bible for mental health descriptions and conditions.  The book has been updated several times over the years, and is slated for it’s next update in 2013.  If you have never seen the DSM before (and it’s likely you haven’t), you might be surprised at the depth and breadth of the number of “disorders” presented, and if you look close enough you might even find that you fit the criteria of one of them.  In fact, critics have argued that the DSM has become too liberal with identifying “new” disorders, as well as loosening the criteria needed to “qualify” for a disorder.

Mental Illness

So, what is mental illness, anyway?  Interestingly, there are many different ways to examine mental illness, and to some extent, what one person might see as “mentally ill” the next person might see as “quirky,” “creative,” or just “different.”  In fact, it is from this perspective that some are wondering if the DSM is becoming so loose in its defining mental illnesses that nearly everyone could be diagnosed with something — leaving conspiracy theorists to surmise that once these “disorders” are labeled, pharmaceutical companies end up being the true winners as the manufacturers of the drugs that psychiatrists recommend their patients use to address their problems.

If you were to develop a continuum of people ranging from those who seem relatively healthy and stable on one side, to those with clear mental problems/limitations (i.e. of harm to oneself or others) on the other, it’s actually all the people in the middle who are the ones that seem to be of the greatest interest to mental health professionals.  Who is “normal” versus “abnormal?”  And who needs to be “put on something” versus who might benefit from just a couple lifestyle changes and possibly therapy?  It is here where the debates rage, and where the DSM (and it’s ever-changing criteria) end up having real consequences for real people.

Having taught clinical psychology at the college level, it has always been an entertaining classroom discussion to hear students ponder over what’s normal, abnormal, quirky, odd, and different — as well as what people should be diagnosed with something, and what people should be put on something.  As the DSM evolves and spells out “disorders” for clinicians, decisions are made that in many cases lead to the prescription of one (or many) medications – some that include serious side effect concerns.  The other problems that often occur when a person is diagnosed with a mental illness are the following:

• Patients often overly-value the benefits of their new medication, and as a result place less emphasis on behavioral changes (after all, only the drug can fix their problems, right?)
• Patients often believe they are permanently “branded” with the mental disorder for the rest of their life (and therefore need to continue on using their medications forever).  Of course, in some cases medications may be needed to protect the patient from danger to himself (or others), but in many other cases positive changes occur in the patient’s life, leaving him less needy of the drug (i.e. he is no longer depressed).

The Impact of the DSM, Treatment Decisions, and Future Consequences

Unfortunately, for potential clients in the United States today seeking therapy they will likely need a DSM mental disorder code in order for their insurer to reimburse.  This is unfortunate for a number of reasons, including the fact that a disorder needs to be “found” – which often leads to an even bigger problem of a self-fulfilling prophecy.  For example, the person seeking assistance after going through a tough divorce may come to believe that she is depressed – and depression lasts for a lifetime – and the only way to control the depression is by taking several different pills each day.  Without a DSM diagnosis, the odds of an insurance company helping out a patient who is simply going through a tough time in life is almost zero.  Sadly, once a patient receives her diagnosis, it often only serves as a really bad lifelong tattoo, re-emerging during times like when the individual applies for future life and/or health insurance (she will now be a “high-risk,” and pay a ton more for her coverage).

Getting back to the original discussion, it’s interesting to see what the new DSM will evolve into in 2013.  If, as critics warn, the diagnoses become even more liberal (you should read some of the criteria to see what I am referring to), more people will soon learn they have “something,” and likely will feel the immediate need to remedy and temper their condition by quickly going on some kind of drug(s).  Skeptics wonder if it will be this new disorder discovery, coupled by the new drugs these patients take, that end up causing the real problems — and not the initial concern for the call to the doctor.  Interesting to think about, isn’t it?

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It’s no secret that millions of Americans each year are prescribed antidepressant medication to help them better handle their depressed mood state and overall outlook on life.  Ironically, even though millions of people (including many kids) are prescribed these medications, psychiatric medical experts like Dr. Peter Breggin are very outspoken about the many issues and problems with these drugs.  Still, the beat goes on as increasingly more people each year turn to pills to beat their woes, rather than other less risky endeavors to improve their mental toughness, including exercise, learning new coping skills, or psychological counseling.

Since around the year 2000 when anti-depressant commercials began to really hit the television airways, it’s been very interesting to look back and see how far we have come in the last 10+ years.  As a practicing clinician, I would like to make ten personal observations related to antidepressants (including efficacy), general wellness, and established paradigms in America that have stayed relatively stable over the last 10 years:

10 years later and…

• We still have antidepressant ads that run on television regularly, prompting millions of people to quickly reach out to their doctor for that “magic bullet” that will immediately improve their mood state.  Interestingly, the United States is one of only two countries in the world that allows pharmaceutical companies to market directly to consumers through television ads, prompting many critics to voice their concerns over how many people are literally lead to self-diagnose and treat (through drugs, of course).
• We are still looking for the “magic bullet.”  Rather than actually making personal changes and learning effective coping skills, we still have too many people who want to make it all go away by swallowing a pill daily.  While it would be nice to think a pill can fix your daily stress, this is more wishful thinking than reality.
• We are still ignoring side effects of these medications, or erroneously blaming the side effects on the disorder and not the medication.  Interactions with other drugs, and withdrawal effects have also been noted by medical experts – but again when these things happen many patients simply blame their experiences as a result of their depression, and not the medication(s).
• We are still minimizing and/or ignoring the facts that show placebo treatments to be on par with the actual efficacy rates of various antidepressant medications.  Most double-blind controlled studies, even today, still do not show statistically significant differences for these drugs versus placebo treatments.
• We still don’t want to face the fact that even with a medication to control symptoms, we still need to learn coping skills in order to be happy and successful in life.  Pills, at best, may help control symptoms (even if it’s a placebo effect), but they don’t fix a broken marriage or make your bills magically go away.
• There is still far less interest in investing time and money in counseling when a perceived effective medicine is available.  Counseling takes time, costs money, and is often viewed as a burden to one’s schedule or privacy — even though the long-term success rates from counseling are far better than the perceived temporary relief from an antidepressant.
• There are still far too many doctors that too easily comply with their patients when they request an antidepressant medication.  Sadly, all a person has to do is watch a few commercials and memorize the symptoms — most doctors will quickly acquiesce to the patient’s request for a prescription if he/she later describes having those symptoms (and will do this more regularly than advise a patient to seek therapy).
• There is still a general resistance to the fact that “life is difficult” (to quote Scott Peck in The Road Less Traveled).  What this means is that there are going to plenty of ups and downs in life, and simply because you are tired or feel sad doesn’t necessarily mean you should race out and jump on an antidepressant medication!
• There are still too many unknowns about “chemical imbalances” (the terrific marketing used in scaring us into thinking we might actually have one of these, and therefore need medicine to fix it!).  What is a chemically unbalanced brain?  Better yet, whats a chemically balanced brain??  Aren’t we really in flux all the time – from the tranquil state we experience at rest to the chaos of getting the kids off to school in the morning?  And isn’t this somewhat….normal?
• There is still too much elevated (false) hope in pills.  In a best-case scenario, patients on antidepressants should be working in conjunction with a therapist and making concerted efforts to change irrational thinking and harmful behaviors.  Unfortunately, the vast majority of patients today still only use their daily medication as their means for “improvement.”

Mental disorders are nothing to take lightly, and in no way am I suggesting that all medications are bad, per se.  Unfortunately, with multi-billion dollar pharmaceutical companies with big investments in medications, direct television advertising, and a country full of people yearning for a “quick fix” to their problems, far too many people — and especially kids — are being treated by unproven drugs and at the expense of actually learning coping skills and strengthening their resiliency!

What we need for the future is more research on these medications, less direct television ads designed to incite fear and paranoia, and a greater emphasis on better self-care and management.  We need to better understand and accept that life is full tough times, and it’s not unusual to feel the stress and depressed mood states that are associated with life difficulties and challenges.  We also need to realize that when we are “down,” it doesn’t automatically mean we have a permanant type of depression that can only be “fixed” by some pills in a prescription bottle.

As a professional counselor of almost 20 years, I have personally witnessed a decline in our collective resiliency, and a new generation emerge that talks as casually about prescription drugs as the generations before them did of street drugs.  Today’s teens are very aware of the various drugs being used to treat mental disorders, and they know how to find, steal, barter, and buy them.

Lets hope the next ten years are better than the last ten, and that fewer kids will turn to a perceived “quick fix” for their symptoms rather than more measured and prudent ways to cope with life stress.

Life Enhancement products can be found at Advanced Human Performance Systems – get 2012 off to a great start!!

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Interscholastic sports can be a challenge for kids, especially when you think about the time, effort, and dedication needed to excel in academics and sports – and still have time left over to spend with family and socialize with friends (AHPS).  If that weren’t enough, the upcoming winter sport season can make this juggling act even more difficult for a number of factors, including cold weather, shorter days, and cumbersome travel schedules.  It is for these reasons that families need to prepare now for the upcoming grind of winter sports.

Probably the toughest thing for student athletes when it comes to winter sports are the very short days – for many kids, it’s dark when they go to school, and by the time they leave after practice later that day it’s dark again! For some kids this can be a real struggle, and take a lot of the fun out of competing in their sport. Sport psychologists warn that even if the criteria for seasonal affective disorder is not met, this is still a concern to watch.

It also goes without saying that cold weather and delayed travel due to inclement weather can also take a mental toll on kids, making winter sports that much tougher.  As practices and games get postponed, family schedules and homework are also impacted, making the task of successful multi-tasking paramount for a successful winter sport experience.

Student athletes are often expected to show mental toughness on the field or court, but during the winter months their greatest mental toughness challenges might be staying positive and successfully balancing an atypical and often stressful schedule.  As a parent or coach, do your part today by preparing for the months ahead that can prove to be stressful for kids.  Talk to kids about the importance of communication skills, multi-tasking, effectively dealing with stress, and asking for help when needed.  There is no substitution for preparation, so prepare now for the long and tough winter season just ahead!

Check out our terrific high-performance audio programs for student athletes, parents, and coaches at www.drstankovich.com

As parents, fans, and coaches who appreciate sports, we often marvel at those special athletes who develop the necessary fortitude and perseverance to be the best (Advanced Human Performance Systems).   Specifically, I’m talking about athletes who are the first ones to practice and the last ones to leave; the athletes who “keep their eye on the ball” throughout the season by doing all the little things necessary in order to be successful (hitting the weight room, prioritizing adequate rest, living a clean life, etc.).  In fact, it is this prototype of athlete that coaches often point toward when looking for positive examples for the team to model.  Ironically, while this strong mindset can be advantageous, it can also lead to future, unforeseen problems as well (Sport Success 360).

The mental toughness and perseverance that makes some athletes great champions can also lead to a “machismo” mindset, making it almost a double-edged sword.  In other words, doing it alone and better than the competition might work on the field, but what about when these types of athletes experience trouble, problems, or even just an inordinate amount of life stress?  Do they seek help, or do they use the same do-it-alone mindset to figure out the problem?  While having great perseverance in life can be a wonderful thing, it can also cause and/or exacerbate problems as well.

In my experience, athletes who have learned the value of going longer and harder than their competitors very often are the last to reach out and ask for help.  Of course, this does not mean every athlete who shows great perseverance and fortitude will reject the notion of seeking help when needed, but instead illustrates that certain athletes may be more at-risk to certain specific problems than others (like dealing with sport retirement).

What may be most important is for athletes to compartmentalize their mental toughness and fortitude and use it for on the field success, while also allowing themselves to be human and realize that in some situations in life seeking help from others may be a very healthy thing to do (and not a sign of weakness!).  It’s funny, but oftentimes when I raise the subject of sport psychology to athletes, their first reaction is to back away and dismiss the notion that they themselves “need that kind of help.”  The initial knee-jerk reaction seems to be that outside help is for losers or people who have problems – which couldn’t be further from the truth.  As you can see from this simple example, athletes who think this way may be overly confident in their own stress-coping abilities, which may actually hinder their sport (and life) success.

Success in life comes as much from being determined to succeed as it does being savvy enough to know when to let the guard down and accept feedback and advice from others.   Unfortunately, some athletes feel as though it is a sign of weakness to talk about the challenges they face, which usually leads to bigger problems if the initial concern is dismissed or overlooked.  Athletes, in particular, can be difficult to convey this message to as they are literally taught at an early age to “be tough” and reminded that “no pain = no gain.”  It is for these reasons that we pay attention to warning signs of trouble for athletes, and find creative ways to encourage them to seek help when needed.

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I would like to share with parents a tricky issue that sometimes happens with kids and sports — and may even be happening in your family (Sport Success 360).For some kids, sports seem to come relatively easy to them, and as a result they often become the stars of their teams.  Ideally, the child also loves (or at least likes) playing the sport that she excels at playing.  While it is true that most kids who play sports enjoy the overall experience, we need to also pay attention to the kids who just happen to be good at something that they really don’t like to do.

As hard as this might be for some parents to accept, the reality is that not every good young athlete likes to play sports.Assuming a kid is good at a sport, there are two looming factors that will impact his interest (or lack thereof) in playing the sport:

1) Intensity of competition – Kids who play intense and competitive sports at an early stage in their development run a greater risk for youth sport burnout, a condition that can be both physically and emotionally demanding.  This does not mean competitive sports are bad, but it is important to remember when sports are no longer fun, kids often lose interest in playing. Playing sports year-round might help with athletic development, but it can also lead to mental challenges for kids that they may not be capable of handling at a young age.Some parents can also unknowingly pressure their kids to continue their athletic development because of early age success.  Kids can interpret these expectations as pressure, which can lead to having less interest in playing the sport.

2) The child’s social athletic identity - A persons identity is made up of both their self-identity and their social-identity.  Our self-identity is simply how we see ourselves (i.e. father, teacher, etc.).  Our social identity is how the world sees us (which may be different than how we see ourselves).  For some kids who are good at sports, their friends, school, and community begin to expect that the kid will one day want to play college and professional sports.  In these instances, kids can feel pressured to live up to societal expectations, leading to a host of emotional difficulties if not addressed.You dont have to feel like a “bad” parent for having your child involved in high-intensity sports, but it is important to carefully watch your child’s level of interest playing sports.  The challenge is to temper your emotions and look at the big picture, which should include watching for signs of burnout, expectations by others, and most importantly –  your child’s interest in playing sports.

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As a clinician who regularly assists people trying to overcome various mental, emotional, and behavioral problems, I have long been fascinated by the power of the placebo effect.  Honestly, “fascinated” doesn’t even begin to describe how in awe I am by the power of belief — and how powerful belief and suggestion can be when it comes to self-healing and improvement (Changing Habits for Life Success). Hey, who wouldn’t want to relieve stress, improve weight loss motivation, and decrease the likelihood of future mental health issues because of the help of placebos?!

A recent study by Kaptchuk (2010) has revealed an even more amazing discovery, one that offers even more hope when it comes to the efficacy rates when using placebos to help people overcome various pains and problems.  Until recently, most experts agreed that the “magic” of placebos (i.e. sugar pills, irrelevant suggestions, token products, etc.) lied in the deception portrayed by the healer.  In other words, if your doctor suggested that you eat blueberries to help with the headaches you have been experiencing (assuming there has been no empirical evidence blueberries help with headaches), and your headaches immediately disappear after eating blueberries, then it can be assumed that it was the suggestion by the doctor – and not the blueberries – that accounted for the healing.  Of course, most patients will immediately say it was the blueberries that caused the headaches to stop, but in reality this is an example of how the placebo effect deceptively works.

Interestingly, when “experts” tell us how to address our problems we almost always believe them, and often things do in fact get better — but whether the change is due to the intervention or belief about the intervention will always be the question.  Experts can be doctors, but they can also be mechanics, computer technicians, or police officers — so long as someone is viewed as an expert, people tend to stop using critical thinking skills and instead start believing just about anything the expert says if it sounds like it could help.  For example, a mechanic might tell you to constantly run your fan inside your car to prevent carbon build up in your motor — if you know little about cars, would you believe him?    Assuming you never have engine problems in the future, you might really believe that your car has been maintained because of always running the fan — even though this has nothing to do with engine performance.

When it comes to medicine, placebos would really help patients overcome a lot of their problems, but it is also unethical to deceive patients into believing something about a product that has no medicinal value (like a sugar pill).  Of course, this saddens a lot of physicians as they know that:a) more patients would heal faster, andb) there are no side effects with placebos.This has led to quite a conundrum, but Kaptchuk’s recent study may have shed new light on how we can use the placebo while avoiding ethical concerns and still see the same positive effects!

Kaptchuk’s study revealed that when subjects were recommended to use a placebo for their irritable bowel syndrome (IBS) but told that while the placebo pills had no direct medicinal value, the pills could improve IBS symptoms through the “mind-body healing process.”  Amazingly, 59% of the subjects in this condition reported adequate relief, versus only 35% for the control group who did not receive the placebo.Think about that for a moment — the patients knew they were receiving an inactive drug (a sugar pill), but told that the “mind -body healing process” would still kick in, helping patients overcome their IBS symptoms.  Amazingly, even when patients knew they were receiving a placebo, they still showed marked improvement versus subjects not prescribed a placebo!

This new finding is quite incredible as it may remove the deception variable that has always been assumed to be the main agent of change when it comes to the placebo effect.  In the future, it’s possible more doctors, clinicians, and various other helping professionals may turn to placebos, but instead of tricking their patients they might actually tell them they are prescribing placebos!

For more about this research study check out the May 2011 issue of Psychology Today.

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