The Placebo Effect
Saturday morning was one of those perfect early fall mornings. It was jacket weather and the skies were a crisp blue, dotted with fluffy white clouds. Although I wanted to pick apples because it seemed like the perfect day for that, Gloria, my cosmopolitan, 12-year-old daughter with seasonal allergies suggested that the two of us go out to breakfast instead.
As we ambled west through the cobblestone streets of Greenwich Village, I recapped my Friday evening at The Satellite Art Show for Gloria. Specifically I wanted to tell her about seeing my friend Kylin’s art project, which she titled “The Placebo Pharmacy.”
“Kylin created a Placebo Pharmacy. Do you know what a placebo is?”
“No,” my daughter said with her hallmark curiosity.
“A placebo is something that is thought to have has no medicinal properties, usually like a sugar pill.”
“Yum,” Gloria interjected, rubbing her belly.
Hunger was hitting me. A sugar pill did sound good. Determined to get through this explanation and not get sidetracked by the deliciousness of sugar, I continued, “And it is given in studies to one group - the control group. You know what that is?”
“Yup.” I think she learned about it in school but we have some unusual dinner conversations so you never know. It could have been from me or her father too.
“Okay. So let’s say a company wanted to test if their pill treated depression. They give one group the pill and another group they give the placebo. And this is one way to see the effect of their drug. But what is interesting is that sometimes even the placebo group has positive benefits from receiving the treatment.”
“Well that’s because sugar is delicious.” We giggled and then I continued.
“I find all of this very interesting because we talk about placebo like it is fake. I mean, it is a fake pill but if it has a positive effect, is it a fake treatment? Is it a fake effect? I think it might be a treatment and an effective one at that! And there has even been a study that has found that people even see a positive placebo effect when they know it is a placebo! That’s what Kylin’s project is about.”
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Kylin O’Brien’s “Placebo Pharmacy.” Photo from the artist’s Instagram
When I learned about Kylin’s Placebo Pharmacy I was giddy and bought tickets to the art show right away. Graduate school has me thinking about how committed I am to providing care through a wellness lens - one in which we see the client as a whole multidimensional being and as an active participant in their own treatment. A wellness model is non-hierarchical and assumes the individual is an expert in themselves. Many doctors, however, provide care using a medical model—one that is narrowly focused on symptoms and deficiencies and does not take into consideration that that the patient may be motivated to be an active participant in their own treatment. Furthermore, since they are an expert in the symptom, disease, or body part they are considering, they are the expert in this situation which makes it hierarchical and fragmented. This is a cultural by-product of the business of medicine and medical school.
This is not to say that doctors don’t care. However, it has major implications for healing trauma. When we are recovering from trauma, we need to feel safe and then a sense of agency in order to start to heal. A nonhierarchical wellness model allows for this in a way a hierarchical medical model does not.
Kylin brought the wellness model to life in her interactive project. On her Instagram she described her project as “a performative-treatise on why the placebo effect exists, why it sometimes works and what a wonderful thing it can be—if we perceive its medicinal potential in a positive light.” It is performative and interactive. When you arrive you are given an appointment time. At the time of your appointment - I had to wait about 25 minutes so I took in some of the show, you remove your shoes and climb into the tent pharmacy. Dressed in a lab coat, Kylin sees you for a 10-minute consultation, privately, in her remarkably comfortable space. You share with her what ails you. I brought a more abstract complaint, wanting to reintegrate my young self, but I assume folks mentioned things like headaches or gas pains too. In a collaborative effort you discuss what would you would like to happen and then Kylin provides you with a prescription that you arrived at together, and a childproof bottle of empty capsules. Kyin is providing care. I know it is a placebo and yet I am keenly aware of feeling treated.
I am now on a 30-night regimen of “Keep Her Close.” “Her” is. my young self. When I take an empty capsule each night, I am reminded of being seen and feeling heard by Kylin. During our conversation she met me with compassion and curiosity. She sought to truly understand what I was dealing with and each night I am reminded of that. This provokes a nice feeling akin to being held. And each night I am also reminded of what I want for myself which prompts me to hold that intention.
Perhaps the placebo effect comes from the relationship.
Perhaps the placebo effect comes from the intention.
Perhaps the placebo effect comes from the act of ingesting an empty pill.
Does it matter if it works? Depends on who you ask.
Gloria knew I was excited about Kylin’s work and I think my excitement was infectious. She took my hand as we stepped down off the curb and we hung a right. We turned our faces toward one another and took in each other’s smiles. I could feel her warm hand being held by my own. The cuff of her sweatshirt brushed my thumb softly. “I love you mom,” she said looking right into my eyes with a smile. She then rested her head on my shoulder for just a moment, while tiny fireworks of joy erupted inside of me. “I love you, too, monkey.”
Some of Gloria and my best conversations have been on walks like these, and here was another one. On our way to breakfast, my 12-year-old daughter made me feel seen and whole. And so I am prescribing for myself autumnal walks with loved ones as needed. While doctors and prescriptions are sometimes needed to help us with our symptoms, please remember that you are an expert in you, and you are so much more than your trauma and your symptoms.