Taking imaginary pills can reduce anxiety

The placebo effect is well-established. When people are given sugar pills for an ailment, their symptoms are often alleviated. What's less well-known is why placebos still work even when the people taking them know they are taking an inert substance.

Shayla Love's article in Nautilus, called "Sugar Pill Nation" looks into why so-called "honest placebos" work.

Whether open placebos work as well as deceptive ones is still being explored. A review on open label placebos from 2021 found a significant overall effect on conditions like back pain, cancer-related fatigue, allergic rhinitis, irritable bowel syndrome, and menopausal hot flashes. For emotions, in addition to the guilt study, emerging evidence suggests that open label placebos may work. People who took honest placebo pills for five days experienced less emotional distress and said they felt better and slept better than study subjects who took nothing. Honest placebo pills also helped students manage test anxiety. And research published this year from Gaab and his colleagues showed even taking imaginary pills could reduce test anxiety.

My friend Kevin Kelly buys and uses placebo pills. He wrote about them in a recent issue of the Recomendo newsletter that I write with him and Claudia Dawson. But one thing the article mentions is that self-administering honest placebos doesn't work as well as having someone prescribe them to you:

There are some good reasons to think self-administered open-label placebos might not work as well; interaction with another person seems to be a crucial component. But there are cases in which it might work.

Guevarra offers an example from his own life. Several years ago, he began pairing his morning coffee with the application of essential oils to his wrists, creating an association between the effects of the caffeine and the smell. "Whenever I just activate the scent, it produces similar effects, just as caffeine would do," Guevarra says.