Table of Contents >> Show >> Hide
- What exactly is CAM, and why is it being rebranded?
- The placebo effect 101: What it really is (and isn’t)
- CAM and the placebo effect: A very long relationship
- “Harnessing the power of placebo”: Smart framing or noble-sounding spin?
- What placebo can doand what it can’t
- The ethics of selling placebo as medicine
- Can we use placebo effects ethically in science-based care?
- How to think about CAM and placebo as a patient
- Experiences and stories around CAM and placebo
- Bringing it all together
For years, complementary and alternative medicine (CAM) has promised everything from
“natural detox” to “quantum healing,” usually with very little scientific evidence to
back it up. As skeptical doctors and researchers kept asking awkward questions like
“Where’s the randomized trial?” and “Why doesn’t this beat sugar pills?”, something
interesting happened: CAM started to shift its marketing. Suddenly, instead of
claiming miracle cures, many practitioners began talking about “harnessing the power
of placebo” and “activating the body’s self-healing.” It sounds science-y, almost
humbleand very clever.
This rebranding, explored in depth by Science-Based Medicine, raises a big question:
Is this an honest, ethical way to help people feel better, or just a new label for
the same old pseudoscience? Let’s dig into what CAM is, what the placebo effect can
(and can’t) actually do, and why “placebo-powered” medicine is more complicated than
it sounds.
What exactly is CAM, and why is it being rebranded?
Complementary and alternative medicine is a grab bag of treatments that range from
the somewhat plausible (like certain mind–body practices) to the outright magical
(like homeopathy, where remedies are diluted so much that not a single molecule of
the original substance remains). What these treatments have in common is that they
either lack convincing evidence of specific efficacy, or have been tested and found
no better than placebo for most conditions.
As evidence-based medicine became the norm, that lack of solid data became harder to
hide. Patients, insurers, and regulators started asking for proof. In response, many
CAM advocates shifted away from claims like “cures cancer” toward softer talking
points: “supports wellness,” “balances energy,” and now the big one“harnesses the
power of placebo.”
In practice, this often means admittingsometimes quietly, sometimes proudlythat
the treatment’s main effect is not from any special ingredient, needle position, or
energy field, but from how the ritual makes the person feel: cared for, hopeful, and
heard. That’s not nothing. But it’s also not the same as a specific, proven medical
therapy.
The placebo effect 101: What it really is (and isn’t)
First, let’s define our terms. A placebo is usually an inert
treatmentlike a sugar pill, sham procedure, or fake creamused in clinical trials
to compare against an active treatment. The placebo effect is the
change in a person’s symptoms that occurs because of their expectations, the meaning
of the treatment, and the context in which care is delivered, not because of any
direct biological effect of the treatment itself.
Key mechanisms behind placebo responses
Research over the past few decades has shown that placebo effects are not “all in
your head” in the dismissive sense, but they are very much rooted in the brain and
nervous system. Several mechanisms have been identified:
-
Expectation: When people believe a treatment will help, their
brains can modulate pain perception, anxiety, and other subjective experiences in
powerful ways. -
Classical conditioning: If you repeatedly get real relief from a
specific setting (like a hospital or a pill that truly works), your body can start
responding even when the pill is inert, simply because the context triggers a
familiar pattern. -
Meaning and context: The white coat, the gentle touch, the time
spent listening, and the confident explanation all act as signals that “you are
being helped,” which your brain takes very seriously. -
Neurobiological changes: Placebo responses in pain, for example,
can involve real changes in endogenous opioid and dopamine signalingso you
actually hurt less, even though nothing directly pharmacologic was given.
So yes, placebos can produce real changes in how people feel. But that’s
not the same as curing infections, shrinking tumors, or reversing heart failure.
Placebo effects tend to be strongest in conditions driven by subjective symptoms:
pain, nausea, fatigue, anxiety, itch, and so on.
CAM and the placebo effect: A very long relationship
Many CAM modalities are surprisingly good at creating the ideal environment for
placebo responses:
- Long, unrushed visits with a practitioner who listens carefully
- A soothing, spa-like setting with soft music and calming smells
- A compelling story about energy, balance, or natural healing
- Hands-on ritualsneedles, manipulations, or elaborate preparations
All of that adds up to what some researchers call the “healing ritual.” Even if the
underlying theory (say, manipulating invisible energy meridians) has no scientific
support, the ritual can still produce placebo effects. People may genuinely feel
betterless pain, less stress, better sleepat least for a while.
Science-Based Medicine and other evidence-based critics argue that much of the
benefit people report from acupuncture, homeopathy, “energy healing,” and many
herbal products can be explained by placebo responses, natural disease fluctuation,
regression to the mean (symptoms tending to move back toward average over time), and
simple time and attention, rather than by any special power in the treatment
itself.
“Harnessing the power of placebo”: Smart framing or noble-sounding spin?
Once you accept that many CAM treatments don’t outperform inert controls in high
quality trials, you’re left with a dilemma:
- If they don’t work better than placebo, should we keep using them?
- If we do keep using them, what exactly are we selling?
The “harnessing the power of placebo” narrative tries to solve this problem by
leaning into the idea that placebo effects are powerful, natural, and goodand that
CAM is uniquely positioned to evoke them. The marketing pitch goes something like:
“Sure, maybe homeopathy doesn’t work through chemistrybut it works through the
mind-body connection. We’re using the placebo effect on purpose.”
That framing makes CAM sound modern and aligned with neuroscience rather than
opposed to science. It also allows practitioners to keep offering unproven
treatments while pivoting away from bold cure claims and toward vaguer benefits like
“support,” “balance,” or “well-being.”
Critics point out a few problems here:
-
Calling something “placebo-powered” doesn’t magically create new therapeutic
effects; it simply acknowledges that the real benefits are non-specific. -
If the effect is purely placebo, cheaper and more honest ways to create those same
benefits might existwithout elaborate rituals, pseudoscientific explanations, or
high out-of-pocket costs. -
Emphasizing placebo can distract from the fact that serious, objective outcomes
(like survival, progression of disease, or organ function) typically don’t change
with placebo the way they do with effective medical treatments.
What placebo can doand what it can’t
Where placebo shines
Placebo effects are most impressive in areas where perception plays a big role:
- Chronic pain conditions like back pain, headaches, and fibromyalgia
-
Functional disorders such as irritable bowel syndrome, where symptoms are real but
not driven by obvious structural damage - Subjective symptoms like fatigue, nausea, hot flashes, or sleep quality
In these domains, carefully designed placebo or “open-label placebo” (where people
are told the pill is inactive but are educated about placebo effects) can sometimes
reduce symptom burden to a clinically meaningful degree. That’s fascinating and
potentially useful for designing better, more humane care.
Where placebo falls short
Placebo, however, has clear limits. It does not:
-
Eradicate infections the way antibiotics can, especially in serious diseases like
sepsis or pneumonia - Shrink malignant tumors or cure cancer
- Unclog coronary arteries or reverse advanced heart failure
- Correct severe insulin deficiency in type 1 diabetes
While people with these conditions might feel somewhat better with placebo
(for example, less pain or anxiety), the underlying pathology remains unchanged.
That’s why substituting CAM-as-placebo for proven treatments isn’t just scientifically weakit can be downright dangerous.
The ethics of selling placebo as medicine
Even if we grant that placebo effects can bring real symptom relief, the ethical
question is: How do we use them without fooling people?
Deception vs. informed consent
Traditional placebo use often involved deception: patients were told they were
getting an active treatment when they were not. Modern medical ethics, however,
place a high value on informed consent and honesty. Major medical organizations
generally hold that giving a placebo instead of an effective treatment, without
clearly explaining what is happening, is unethical.
CAM rebranding doesn’t always solve this. Telling someone that you are “balancing
their energy,” “detoxing their body,” or “tuning up their meridians” is not really
the same as saying, “This treatment doesn’t have strong evidence beyond placebo, but
the ritual and attention might still make you feel better.”
If the story around the treatment is inaccurate or pseudoscientific, the patient is
still being misledjust in a more poetic way.
Trust, money, and opportunity cost
There are other ethical concerns too:
-
Financial cost: Many CAM interventions are paid out-of-pocket and
can become very expensive over time. -
Delay of effective care: Relying on placebo-only CAM for serious
conditions can delay diagnosis and evidence-based treatment, sometimes with
catastrophic consequences. -
Trust in medicine: When patients later discover that a treatment
was basically a dressed-up placebo, it can erode their trust in all healthcarenot
just CAM.
“Harnessing the power of placebo” sounds noble, but if it’s built on misleading
explanations, cherry-picked studies, and the suggestion that “science just doesn’t
know everything yet,” it can become a very fancy way of selling false hope.
Can we use placebo effects ethically in science-based care?
Here’s the twist: mainstream medicine is also interested in placebobut with a very
different goal. Instead of using placebo to prop up unproven treatments, researchers
want to:
- Understand how expectations and context influence symptoms and outcomes
- Design better doctor–patient interactions that enhance comfort and trust
- Explore transparent, “open-label” placebo approaches that don’t require lying
Imagine a visit where your doctor:
- Takes time to listen empathetically and explain your condition in plain language
-
Offers an evidence-based treatment and also teaches you how expectations,
lifestyle, and coping strategies can shape symptoms -
Uses simple, low-cost adjunctspossibly including open-label placebo in certain
chronic symptom conditionsas part of a clearly explained plan
That’s still “harnessing the power of placebo,” but in a way that is honest,
science-guided, and built on treatments that actually outperform inert controls when
it matters.
How to think about CAM and placebo as a patient
If you’re considering a CAM therapy, here are some practical questions to ask:
-
What is the evidence? Has this treatment been tested in
well-controlled trials, or are claims based mostly on testimonials and tradition? -
What are the risks and costs? Even “natural” treatments can have
side effects, interact with medications, or drain your wallet. -
What am I hoping to achieve? If your goal is symptom relief for
pain, stress, or sleep, the bar is different than if you’re trying to treat cancer
or heart disease. -
Is my practitioner honest about limits? A trustworthy provider
should be willing to say, “This might help you feel better, but it won’t cure or
prevent serious disease, and it shouldn’t replace standard care.”
It’s absolutely fine to value how you feel and to seek care that treats you as a
whole person. Just remember that you don’t need pseudoscience to get time,
compassion, and a sense of control. A good science-based clinician can provide those
too.
Experiences and stories around CAM and placebo
To see how all of this plays out in real life, it helps to look at a few
experience-based scenarios that mirror what research has found about CAM and
placebo.
Experience 1: Chronic pain and a “miracle” therapy
Picture someone with long-standing back pain who has tried standard treatments:
physical therapy, anti-inflammatory medications, maybe a supervised exercise
program. These help a bit, but the pain never fully disappears. A friend suggests a
CAM clinic that offers an elaborate “energy alignment” session.
The clinic is beautiful. The practitioner spends an hour listening to the full story
of the pain, the stress at work, the sleep problems, and the fear that it will be
like this forever. Soft music plays. A gentle hands-on ritual follows, complete
with crystals, aromatic oils, and impressive-sounding explanations about “blocked
energy” and “vibration.”
After two or three sessions, the person reports feeling much better: less pain, more
relaxation, better mood. The practitioner calls this “evidence” that the energy work
is powerful. But viewed through a science-based lens, what likely happened is a
combination of:
- A strong placebo response driven by expectation and attention
- Nervous system downshifting as stress and fear are reduced
-
Natural fluctuation in pain, with a lucky run of “good days” after the new
treatment started
None of that means the person’s experience isn’t realit absolutely is. But it also
doesn’t prove that the crystals or “energy fields” themselves did anything.
Experience 2: CAM in serious illness
Now imagine someone receiving chemotherapy for cancer. They feel exhausted, nauseated, and
anxious. A family member recommends high-dose vitamins and special herbal infusions
from an alternative clinic that claims to “boost the immune system” and “fight
cancer cells naturally.”
The patient goes, in part because the conventional system feels rushed and cold. At
the CAM clinic, they are treated like a VIP. Staff offer tea, comforting words, and
long conversations. Unsurprisingly, the patient feels better during and after
visitsless alone, more hopeful, sometimes even physically more at ease.
The danger appears if the clinic suggests replacing or delaying chemotherapy in
favor of unproven “natural” infusions. The support and attention are valuable, and
the placebo effects on mood and symptoms can be meaningfulbut they cannot substitute
for treatments that actually change survival odds. The ethical path is to
supplement, not replace, proven therapy, and to be honest about what is known and
unknown.
Experience 3: Open-label placebo done transparently
Consider a different scenario: someone with irritable bowel syndrome joins a research
study. The clinicians explain, in plain language, that the pill being offered
contains no active drug. They also explain how the brain–gut connection works, how
expectations and routines can influence symptoms, and how taking a pill regularly,
even an inert one, can sometimes “remind” the body to settle into a calmer state.
The participant decides to try it anyway, fully informed. Over a few weeks, they
notice less cramping and bloating and better bowel habits. They’re not “cured,” but
the improvement feels real and valuable.
Here, placebo is being harnessed openly and ethically. There’s no fantasy story about
energy or secret ingredients, no implication that the pill does more than it really
can. Instead, the person’s own expectations, routines, and nervous system are being
engaged in an honest partnership. That’s a very different experience from being sold
an expensive CAM package based on magical claims.
Bringing it all together
The rebranding of CAM as “harnessing the power of placebo” is, in one sense, an
improvement. It’s a step away from grandiose claims of miracle cures and toward
acknowledging that much of what people experience as “healing” comes from context,
attention, and meaning.
But it’s also a slippery strategy. If “placebo” becomes a marketing buzzword rather
than a carefully understood scientific concept, it can be used to justify almost
anythingfrom harmless but pricey rituals to dangerous advice that leads people away
from effective treatments.
Science-based medicine doesn’t reject the placebo effect; it studies it. It asks:
How can we design care that is both honest and deeply supportive? How can we combine
the warmth and time often found in CAM settings with the rigor and results of
evidence-based treatment?
In the end, you deserve both: treatments that actually do something specific to your
disease and care that makes you feel heard, respected, and hopeful. If
someone tells you that their unproven therapy “harnesses the power of placebo,” it’s
worth asking: “Why not give me the real treatment plus the good
bedside manner instead?”
