Can Placebos Work If You Know They're Placebos? NPR's Mary Louise Kelly asks writer Robert Siegel about "open label placebos" and whether placebos work even when patients know they're placebos. He wrote about his experience in Smithsonian Magazine.

Can Placebos Work If You Know They're Placebos?

Can Placebos Work If You Know They're Placebos?

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NPR's Mary Louise Kelly asks writer Robert Siegel about "open label placebos" and whether placebos work even when patients know they're placebos. He wrote about his experience in Smithsonian Magazine.


Our next guest suffers from writer's block, which is a problem because he is a writer. So he started taking prescription medication to help him focus, to sort out his panic attacks and insomnia. So far, so good - except the pills he's taking are fake, placebos. And he knows it. This is what's known as open-label placebos. And there is growing research that shows placebos still work, even when you know they're not real. Robert Siegel - no, not the NPR Robert Siegel - Robert Siegel has written about the phenomenon and his own experience in Smithsonian Magazine. And he joins us now from member station WHQR in Wilmington, N.C.

Robert Siegel, hello.

ROBERT SIEGEL: Hi. How are you?

KELLY: I am well. Thank you. I have so many questions about this.

SIEGEL: I do, too.

KELLY: (Laughter) We'll start with - you not only knew that the pills are fake, but you helped design them?

SIEGEL: Yes. I was working with a research psychologist at Harvard University's Program in Placebo and Therapeutic Encounter (ph), and we designed a a one-man trial program.

KELLY: All right. So how do you go about designing a placebo pill that's going to help you write?

SIEGEL: My article in Smithsonian focuses on this one research psychologist. His name is John Kelly, and he and I just happened to go way back. We went to college together. So I asked - can I try? And he said to me - Robert, you're not sick. And I said well, I may not be sick, but I got problems. You know, I have always wanted to write better. And he was - he thought, oh, I think we could design a pill for that.

KELLY: And so what did that process look like? How do you go about designing it?

SIEGEL: He asked me - what would a good writing pill look like? I closed my eyes, and I tried to visualize, and I said it would be gold. And we wrote a set of instructions essentially - what I wanted the placebo to do - that is, to release my creativity and lower my anxiety and my fear of failure or whatever it was that was holding me back. Like anybody, any anxious person, I tend to procrastinate. So he was like, this should be a two-hour pill. Right? So you take it, and you get to work, and then it's done.

KELLY: Now just to be absolutely clear, what is actually inside this large yellow capsule is...

SIEGEL: An inert...

KELLY: ...Completely inactive.

SIEGEL: Right. It's completely inert. I interviewed a number of people who had participated in open-label placebo trials. And they described the experience that I was in the middle of - that, yeah, it feels a little silly. But suddenly, I started to get better. Belief is not the key element in what we think of as the placebo effect. Doubts are natural, and they will not stop the placebo from working if it's going to work.

KELLY: So I have to ask the dreaded question. And I say dreaded because I know this is the worst thing you can ever ask a writer. But did it help? Are you writing?

SIEGEL: It absolutely helped a great deal. It's not just the pills themselves. I think it's the ritual of pill taking. There was suddenly a clock ticking. I knew I had two hours, and it made me more mindful about how I felt and how I approached the task of writing. And basically, I ended up abusing my pills a bit. But the act of taking the pill became, in itself, strangely calming.

KELLY: How do you explain - what's your explanation for why this placebo pill worked?

SIEGEL: I have my own novelist explanation, which is that we are imaginative creatures - that the lives we lead are a mixture of fact and imagination. And, you know, the poet Shelley says that poetry is just a branch of the sciences. That idea has been lost now that we spend a great deal of time talking about STEM and the importance of technology and hard science. But I think he was on to something.

KELLY: That's Robert Anthony Siegel. He is an author and professor of creative writing. He joined us from member station WHQR. Thanks so much.

SIEGEL: Oh, thank you so much. It's been a true pleasure.

KELLY: OK. Tomorrow on WEEKEND EDITION, old school antibiotics. Lynn Neary is getting recipes for stuff like Bald's eye salve.

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