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Placebo

Is Optimism the World's Most Powerful Placebo Effect?

Placebo effects are more pervasive and powerful than you think.

Key points

  • Optimism is a well-known attitude linked to better health, happiness, and prosperity.
  • Placebo effects are widely misunderstood and work by internally producing changes aligned with beliefs.
  • Because optimism works through beliefs, expectations, and bio-behavior changes, it's a type of placebo effect.

How would you define optimism? Would you call it seeing the glass as half-full rather than half-empty? Perhaps say optimism is a positive attitude or the ability to see the bright side of a situation. Or maybe you're a more scientific thinker and prefer a rigorous definition: "A positive orientation toward the future. Optimists are people who have the habitual tendency to expect positive future outcomes even when difficulties arise."1

Have you ever considered that optimism is actually a placebo effect? In fact, not only is optimism a placebo effect, it may be the most powerful placebo effect ever studied. If this sounds implausible, the next few paragraphs may just persuade you to a whole new way of thinking about what optimism is and how it works.

What almost everyone gets wrong about placebo effects.

If there was a "Top 10" collection of the most misunderstood findings in psychology, placebo effects might lead the list. Ask a typical person about placebo effects and you will likely hear examples about sugar pills and pain relief, people acting jittery after (unknowingly) drinking decaf coffee, or people showing signs of intoxication after (also unknowingly) consuming alcohol-free beer. And they'd be right: These are legitimate examples of placebo effects.

However, the first mistake even many experts routinely make about placebo effects is believing they are limited to medicines or psychoactive substances. The second mistake is thinking they are imaginary.

Thomas Rutledge
Placebo effects are not what you think
Source: Thomas Rutledge

The table above provides a practical definition of placebo effects, pervasive misunderstandings about placebos, and a concise summary of placebo facts—most of which are directly the opposite of how placebos are commonly perceived. Placebo effects are just as real, and frequently just as strong, as those produced by conventional medicine and treatments. However, rather than the effects resulting from an outside source, placebo effects are produced on the inside; beliefs, expectations, and prior experiences can induce endogenous neurochemical changes and external behaviors aligned with the internal mental state.

This means that the relief a person experiences when taking a sugar pill (masked as a painkiller) is not just in their head. Instead, it is in their whole body, as their expectations trigger the release of endogenous opioids, endorphins, and enkephalins that produce a similar pain-reducing effect.

But what if these same placebo effects—beliefs, expectations, and prior experiences about what is going to happen in the future, manifesting chemically inside your body and externally through your behavior—could do more than blunt pain and mirror the effects of drugs? What if they could also lengthen your lifespan, increase your bank account, improve your stress resilience, and enhance your love life? They can.

Thomas Rutledge
Source: Thomas Rutledge

Each day, millions of people wake up endowed with the most powerful placebo effect scientists have yet discovered. This effect enhances their mood, optimizes their behavior, makes them more flexible, creative, and persistent in the face of obstacles, and improves their communication skills. These people will enjoy these benefits not only today but perhaps even for many years to come, with the rewards they reap actually expanding over time. Best of all, they don't have to take a pill or even see a specialist to get it. This remarkable placebo effect is simply a short- and long-term benefit of developing an optimistic attitude.2-3

Summary

Now that you understand a little more about optimism and placebo effects, you may also appreciate that optimism isn't "just" an attitude or "just" positive thinking. Positive or negative, your thoughts and attitudes have consequences. They up- and down-regulate hormones and neurotransmitter activity, affect pain sensitivity, impact gene expression, alter brain function, and predispose decision-making and behavior patterns that shape the quality and even length of our lives. Placebo effects are everywhere. Choose yours wisely.

References

1. Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67, 1063–1078.

2. Rozanski A, Bavishi C, Kubzansky LD, Cohen R. Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019 Sep 4;2(9):e1912200. doi: 10.1001/jamanetworkopen.2019.12200.

3. M.J.C. Forgeard, M.E.P. Seligman. Seeing the glass half full: A review of the causes and consequences of optimism,
Pratiques Psychologiques. Volume 18, Issue 2, 2012, Pages 107-120. https://doi.org/10.1016/j.prps.2012.02.002.

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