Issue link: https://www.massageandbodyworkdigital.com/i/1492048
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 49 6. Harvard Health Publishing, "The Power of the Placebo Effect," December 13, 2021, www.health. harvard.edu/mental-health/the-power-of-the- placebo-effect. 7. Harvard Health Publishing, "The Power of the Placebo Effect." 8. Lauren C. Howe, "When Your Doctor 'Gets It' and 'Gets You': The Critical Role of Competence and Warmth in the Patient–Provider Interaction," Frontiers in Psychiatry 10 (2019): 475. 9. Fabrizio Benedetti et al., "The Placebo Response: How Words and Rituals Change Brain Circuitry," Physiology News Magazine, winter 2009, no. 77, www.physoc.org/magazine-articles/the- placebo-response-how-words-and-rituals- change-brain-circuitry. 10. Tiffany Fields, "Massage Therapy Research," Epub (August 1, 2014), https://pubmed.ncbi.nlm. nih.gov/25172313. 11. Interview with Darwin A. Guevarra, January 4, 2023. 12. Tiffany Fields, "Massage Therapy Research." 13. Darwin A. Guevarra et al., "Placebos Without Deception Reduce Self-Report and Neural Measures of Emotional Distress," Nature Communications 11 (2020): 3,785, https://doi. org/10.1038/s41467-020-17654-y. 14. Guevarra et al., "Placebos Without Deception Reduce Self-Report and Neural Measures of Emotional Distress." 15. Interview with Darwin A. Guevarra, January 4, 2023. Mark Liskey shares his 20-plus years of experience as a massage therapist and business owner at makethemostofmassage. com, a free, do-it-yourself resource for MTs who want to make more money, build a massage practice, and stay out of pain. In 2020, Guevarra and his colleagues performed a nondeceptive placebo experiment. Participants agreed to view pictures that would evoke negative emotions. Self-reporting and neural measures were used to determine degrees of emotional distress. 13 In the beginning of the experiment, participants were divided into two groups. One group was given a placebo nasal spray they were told would help with clarifying the imaging. The other group was given the same placebo nasal spray but told it was a placebo. The placebo group was also educated about how placebos could benefit them. Here's the amazing thing: The group who knew the nasal spray was a placebo experienced less emotional distress. 14 The explanation of the placebo effect became the expectancy. In other words, you can be told a placebo is a placebo and it will work if you are persuaded to believe it will work. 15 Warmth, competence, rituals, and good listening skills in the massage room will help you harness placebo pathways. As for my niece and her negative reaction to her placebo experience, I will make sure not to substitute decaf coffee for caffeinated coffee without her consent. Notes 1. Darwin A. Guevarra, "Harnessing Placebo Effects to Regulate Emotions," forthcoming, Handbook of Emotion Regulation, 3rd ed. (Guevarra, Kross, & Moser, 2023), https://psyarxiv.com/7c8z2/ download. 2. Guevarra, "Harnessing Placebo Effects to Regulate Emotions." 3. Interview with Darwin A. Guevarra, January 4, 2023. 4. Marius Henriksen, "Saline Injections vs Education and Exercise in Knee Osteoarthritis (DISCO)," www.clinicaltrials.gov/ct2/show/NCT03843931. 5. Ethan Kross, Chatter: The Voice in Our Head (Penguin Random House, 2021). competence. Shari left knowing how to apply medium pressure on herself, and I waited for her follow-up report. THE PLACEBO EFFECT RESULTS Two days later Shari emailed me: "I just wanted to let you know that the massage definitely lessened the pain! I had the best two nights of sleep since I got the massage! I'm really happy with the results so far." I was ecstatic, but my celebration wasn't long-lived. When she came back 10 days later, she was in pain again. Nevertheless, two days of reduced pain after 18 months of persistent pain was something. There was no way for me to know whether the massage itself, a placebo effect, or both helped Shari with pain reduction for two days. So, I proceeded as if both did. For the next session, I added relaxation massage using medium pressure on nonpainful areas of her body. I also told her about the research that demonstrated a parasympathetic response from medium- pressure massage, hoping that research would serve as an expectancy. 12 After the massage, Shari felt better. She was also in a good mood and made another appointment. Going forward, I'll continue to pay close attention to her responses and strengthen placebo enhancers that seem to be working. You can see my Shari updates at makethemostofmassage.com. OUR PLACEBO FUTURE IN THE MASSAGE ROOM I'll be the first to admit working for a placebo effect in the massage room is still more of an art than a science. There is no placebo-effect procedural manual. But there is hope on the horizon.