The placebo effect on everyone's understanding. Why the way treatment is presented changes what the body feels

American author Gregg Braden, in “The Spontaneous Healing of Faith” (For You Publishing House), brings to the fore studies that show that the simple belief that a treatment will work can trigger real biological reactions. In the office, confirms psychotherapist Laura Găvan, these mechanisms are seen daily: what the person thinks is going to happen, the way they are received and the way words are used can regulate physiology, reduce anxiety and speed up recovery.

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The placebo effect means, in simple terms, that the body can start a real healing process even when the treatment contains nothing active. A harmless pill, a saline injection, or even a simulated medical procedure can trigger reactions in the body that resemble the response to real medicine. The explanation lies in the way the brain interprets the situation: if the person thinks they are going to be helped, the body activates internal mechanisms to calm, regulate and control stress.

Gregg Braden cites in his materials several well-known studies in the medical literature of situations in which people have reported improvement, even though what they are receiving is not actual treatment. He refers, among others, to Henry K. Beecher's analysis, published in the Journal of the American Medical Association in 1955, where about one-third of the patients evaluated said they felt better after symbolic interventions. Braden also recalls the accounts of simulated operations on patients with chest pain, documented including in The New York Times: people went through anesthesia, incisions and sutures, without doctors actually doing the procedure, and their evolution was comparable to those who had actual surgery.

Fabrizio Benedetti's experiment

In the research cited by Gregg Braden, there is also an experiment carried out by Professor Fabrizio Benedetti at the University of Turin. People were first given a drug that made them feel better for a short time. The next day, they were given an injection of plain serum, but were told it was the same treatment. Even so, their bodies reacted the same way as the real drug. The research team, quoted by New Scientist magazine, said it was the first time the placebo effect had been observed even at the level of a single nerve cell.

This information, presented in accessible language by Gregg Braden, leads the conversation to a natural question: If the body really does respond to a “empty” treatment, what does that mean for the way we understand healing today?

The answer is completed by the field of clinical psychology. Psychotherapist and clinical psychologist Laura Găvan explains to “Adevărul” that many of the mechanisms observed in the above-mentioned studies also appear in therapy. She describes exactly what happens in the office: “What the person thinks is going to happen and the clinical context are not “set'': they activate concrete neural circuits. When a client anticipates a benefit, the prefrontal cortex (especially the networks that generate predictions and cognitive control) recalibrates its ratio between expected signals and sensory signals. Associative conditioning transforms elements of the therapeutic ritual (setting, language, presence of the therapist) into signals that release physiological responses: decreased HPA activation, changes in autonomic activity and adjustments in sensory perception. In practice, this means that a well-constructed contextual 'treatment' can produce measurable changes (subjective and objective) comparable, under certain conditions, to the effects of a pharmacological intervention.”

Then continue: “In CBT, trust (positive expectation and commitment to the process) accelerates the therapeutic process: patients engage more quickly in exercises (exposure, behavioral activation), comply with homework and test alternative hypotheses. This behavior facilitates experiential learning; changing cognitive automata does not come only from 'believing', but from repeated encounters with reality that disprove dysfunctional beliefs.”

Why trust accelerates the therapeutic process

In cognitive-behavioral interventions, she observes, the way a person enters the process matters a lot: if at the beginning he trusts that the sessions can help him, he engages more easily in the exercises, does his homework between sessions and agrees to try new options on the thoughts that keep him stuck. The change comes not only from the fact that he “believes”, but from the repeated moments in which reality shows him that his gloomy predictions are not confirmed. Trust can accelerate improvement, but it cannot take the place of well-structured therapeutic work; solid progress comes through new learning, not just hope.

Differences in reaction between people are, from her perspective, natural. Some respond quickly because they come with positive prior experiences, have brain chemistry that helps them, or are more flexible in the way they think. Others progress more slowly, either because of mental rigidity, or because they are skeptical, have other related issues, or lack support around them. All these elements change the way the body can react to the context, the relationship and what is happening in the session. This is exactly why two people can receive the same protocol but have completely different results.

Laura Găvan emphasizes that the placebo effect is not due to self-delusion, but to the activation of real mechanisms in the body: internal opioid releases, adjustments in the dopaminergic system and the reduction of reactions in the brain areas involved in anxiety. She says the line between psychology and biology is much thinner than it seems, because the way a person thinks, relates and interprets situations in his life sets real neural circuits in motion. In this perspective, the therapeutic context is not a decorative element, but an active part of the healing process.

“A central element is the therapeutic relationship,” she adds. The safety of a trusted therapist can reduce panic reactions, temper amygdala hyperactivity, and allow the brain to learn new responses to fear and stress. Without this foundation, many techniques work poorly or very late. “With this foundation, however, lived experiences in therapy can change the person's internal predictions, reducing symptoms and supporting long-term recovery,” she adds.

She notes that placebo effects also occur in anxiety, depression or somatic symptoms, because the same regulatory network, namely the way we think, what motivates us and how the body reacts, works in all these situations. In practice, explains the specialist, this means providing clarification on how change occurs, building small moments of success that can be verified and using language that supports motivation without creating unrealistic promises. “Context does not replace scientifically validated interventions; it makes them more effective.”

When placebo is confused with positive thinking

Another point he emphasizes is the risk of confusing placebo with “positive thinking”. When everything is reduced to optimism, people end up blaming themselves if they don't feel better or give up effective treatments. “Placebo means real processes in the body and new learning, not self-delusion.” That's why, she says, the therapist has a responsibility to make the differences clear and to use the power of context only as a support, not a substitute for treatment.

For Laura Găvan, the placebo effect does not fundamentally change medicine, but shows more clearly that the way we communicate, how we build the relationship and how the therapeutic context is structured influences the response to treatment. “Medicine remains based on pharmacotherapy and validated interventions, but it is becoming increasingly attentive to how the brain can amplify or reduce their effects.”

“In the cabinet,” she recounts, “a common example is the adolescent with severe social anxiety, who comes after years of avoidance and interrupted treatments. After a few sessions where we build a base of safety, I introduce gradual exposures and concrete experiments, short questions with strangers, clear feedback. In two months, the symptoms decrease noticeably. Not because he “believed,” but because the safe state allowed him to participate in exposures that changed internal predictions. Physiologically, anxiety reactions decrease in the session, and functional recovery becomes evident. It is a mind-body interaction mediated by context and learning.”

The same mechanism is seen in medical studies: the way a treatment is presented changes the way the body experiences symptoms.

How communication influences the illness experience

A study published in BMC Medicine in 2025 shows this effect very clearly in real inflammation situations. Specifically, the research involved 124 healthy volunteers undergoing an experimental model of inflammation produced by a substance that temporarily causes fever, chills, muscle aches, anxiety and general malaise. All participants received either an actual dose of ibuprofen or an identical but inactive capsule.

The major difference was how the doctor presented the pill to them. Some participants were told in a clear and positive way that they were receiving “a well-known and effective anti-inflammatory, frequently used to reduce symptoms of illness“. The others were given a neutral message, such as: “You will receive either an inactive substance or ibuprofen in a 50%-50% ratio, as is the case in experimental studies”.

“The doctor's positive message reduced physical and emotional symptoms of inflammation, even when participants had only received an inactive pill,” wrote the authors of the study. In other words, simply believing that the treatment would help lessened, for a few hours, malaise, fatigue, body aches, anxiety, and irritability.

Moreover, the same effect occurred when the drug was real. The study shows that “positive message enhanced the effectiveness of ibuprofen in reducing emotional symptoms”that is, people who were presented with the treatment in favorable terms had a better affective state than those who received the exact same pill, but accompanied by neutral communication.

The authors also checked biological markers of inflammation: substances in the blood such as interleukin-6, TNF-alpha, cortisol or ACTH. Here, the researchers explained: “The doctor's messages did not change the biological parameters of the inflammation.” This means that the immune system and the inflammatory response itself were not influenced by the psychological context, but only by the way the body experiences the symptoms.

“The way they communicate to the doctor can independently reduce symptoms generated by inflammation and increase the effectiveness of an anti-inflammatory in reducing emotional distress.” In practice, this means that the way a medical intervention is explained becomes an active part of the treatment. The words, tone, and confidence conveyed can change the subjective experience of illness even when biological parameters remain unchanged.

Therefore, clear, empathic and trust-oriented communication can improve the therapeutic outcome at no additional cost and without changing the treatment itself. In a world dominated by sophisticated medical technologies, this research reminds us that the relationship between man and doctor remains an essential vector in the healing process.

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