The placebo effect is very well known, being replicated in many scientific studies. At the same time, its exact mechanisms still remain unknown. Quite a few hypothetical explanations for the placebo effect have been suggested, including faith, belief, hope, classical conditioning, conscious/subconscious expectation, endorphins, and the meaning response. This article argues that all these explanations may boil down to autosuggestion, in the sense of "communication with the subconscious." An important implication of this is that the placebo effect can in principle be used effectively without the placebo itself, through a direct use of autosuggestion. The benefits of such a strategy are clear: fewer side effects from medications, huge cost savings, no deception of patients, relief of burden on the physician's time, and healing in domains where medication or other therapies are problematic.

The human mind contains much more than concepts. By only taking into account the conceptual level, a cared-for person may feel utterly lonely and abandoned, not deeply in contact with the caregiver, not deeply understood for who he or she really is. A chronic pain patient, for instance, may react to a purely conceptual-level communication, with its lack of deeper contact, by an increasing sense of loneliness. This in itself may substantially contribute to the suffering of chronic functional pain or even functional disorders in general. In dealing with chronic pain patients, as with any patients, it is therefore very important to develop a sense of empathy that goes beyond this, towards deeply understanding the patient as complete person. This sheds a profound light on the all-important nonspecific factors of psychotherapy, which according to many researchers form the only profoundly active principle in psychotherapy.

BackgroundIncreasing numbers of students use stimulants such as methylphenidate (MPH) to improve their study capacity, making them prone to subsequent prolonged drug abuse. This study explored the cognitive effects of MPH in students who either assumed they received MPH or assumed they received a placebo.MethodsIn a double-blind, randomized, placebo-controlled trial with a between-subjects design, 21 students were subjected to partial sleep deprivation, receiving no more than 4 hours sleep the night before they were tested. In the morning, they were given either a placebo or 20 mg of MPH. They then performed free recall verbal tests and Go/No-Go tasks repeatedly, their moods were evaluated using Profile of Mood States and their tiredness was assessed using a visual analog scale, with evaluation of vigilance.ResultsNo significant differences were found between those subjects who received MPH and those who received a placebo. However, significant differences were found between subjects who assumed they had received MPH or had no opinion, and those who assumed they had received a placebo. At three minutes, one hour, and one day after memorizing ten lists of 20 words, those who assumed they had received MPH recalled 54%, 58%, and 54% of the words, respectively, whereas those who assumed they had received placebo only recalled 35%, 37%, and 34%.ConclusionHealthy, partially sleep-deprived young students who assume they have received 20 mg of MPH experience a substantial placebo effect that improves consolidation of information into long-term memory. This is independent of any pharmacologic effects of MPH, which had no significant effects on verbal memory in this study. This information may be used to dissuade students from taking stimulants such as MPH during examination periods, thus avoiding subsequent abuse and addiction.

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In this article, a "healing method" (HM) is defined as any method intended to improve health through non-somatic means. For many healing methods, especially within the realm of complementary and alternative medicine (CAM), there is mounting debate over the question "Does it work?" Indeed, this seems to be the primary question for most stakeholders. Yet in light of the well-documented effects of nonspecific factors, particularly empathy and placebo (EP), we contend that the basic question is: "What is 'it'?" Without answering this question, scientific progress is impossible, and research costs will spiral upwards without producing tangible results. Furthermore, it is impossible to characterize the potential side effects of healing methods without a full understanding of the underlying mechanisms through which they act. It is generally acknowledged that many healing methods are sociohistorical artifacts, based on underlying theoretical models that are divorced from established science. There is a need for healing method research that is accommodating of such methods' fluid nature while being congruent with accepted scientific practices. "It works" is no longer an adequate justification for any healing method, as "it" often turns out to be a combination of nonspecific factors.