Mind-body: The surprising power of the placebo
April 4th, 2011
02:28 PM ET

Mind-body: The surprising power of the placebo

Dr. Charles Raison, CNNHealth's Mental Health expert and an associate professor of psychiatry and behavioral sciences at Emory University, writes regularly on the mind-body connection for better health.

The Germans are happier than we are. The average German also enjoys better health and lives longer than the average American, all of which raise the possibility that their medical system is better than ours. One has to keep this in mind when evaluating a recent move by the German Medical Association that will sound insane—or worse—to many Americans. Based on study published in early March, this venerable body advised German doctors to prescribe more placebos to their patients.

If this doesn’t sound earth shattering to you, would it be more compelling if I said, “German doctors are being told to give their patients fake medications that do not contain any active ingredients.” And to make matters worse, they are being advised not to tell their patients that they are receiving a fake treatment (most placebos are made of sugar, flour or dust), only that they are receiving a “unique” remedy. The fact that the German Medical Association recommends placebo treatments only for conditions with a psychological, or subjective, component, such as chronic pain asthma, inflammatory diseases and depression, softens the blow a little (the group suggests avoiding placebos for things like broken bones), but only a little.

Before we pass judgment on the Germans, however, let me talk a bit more about placebos, because you are unlikely to know much about them unless you’ve been in a drug study. That’s because in the U.S. placebos are used only in such studies as a means of examining whether a particular medication has specific effects, some type of activity that transcends the potent healing powers of hope, expectation and the therapeutic relationship (for more on the importance of hope for heart health see my previous post).

In a typical clinical trial, patients are given a medication and told that this medication may be an active drug or an inactive substance and that neither they nor the researchers will know which they’ve gotten until the study is over (the active drug and placebo are designed to look exactly alike). This design seems ridiculous on first hearing to many research subjects, because (obviously) if you get a drug that’s active you’ll get better, and if you get a “sugar pill” which has no effectiveness you’ll either stay the same or get worse. It’s a classic self-fulfilling prophecy. All the subjects who improve during a study believe they’ve received the real deal and everyone who doesn’t benefit curses his luck at being randomized to the placebo arm of the study.

And then—as we say in investigator land—the “blind is broken,” who got what is made known and the amazement begins, for both the researchers and their erstwhile subjects. Whenever we study the types of conditions for which the Germans want to prescribe placebos we find that even if the study medication is effective, many patients who got better during the study took placebo and many who didn’t respond took the active drug. When examined on a group level these differences reveal the power of placebo. For example, in studies of antidepressants, the placebo effect accounts for 2/3s of the medication efficacy. Said differently, although antidepressants can be lifesavers for individuals, in groups of patients they only add one-third more effectiveness than taking a sugar pill.

How can this be? There are only two possibilities. Either our active medications aren’t really active, or placebos aren’t really placebos. Fortunately for all of us, the second possibility is the true one. Just because a sugar pill has no power  itself, says nothing about the power it has when placed in a medical context, where it becomes a tangible talisman for a patient’s hope, expectations and belief in his or her doctor.

Let’s do a thought experiment. Mothers, would you be happy if a hospital emergency room gave your wheezing child an inactive treatment for his asthma? Would it make a difference if the doctor told you she was going to give your little boy a sham treatment? Whether you answered this second question yes or no, I’m sure your first thought was something like, “Well if the doctor told us it was a placebo, it would lose its power and wouldn’t work.”

Remarkably, however, a recent study from Harvard shows that this isn’t true at all. Patients with irritable bowel syndrome were randomly assigned to receive a placebo or nothing. Those who got the placebo were told point blank by their doctors that they were receiving “a sugar pill with no active ingredients.”  Even with this information, the patients who received the fake pill had significantly greater improvements in their bowel symptoms than those who got nothing.

So, apparently, the placebo effect taps into parts of us deeper than our common sense. So how do they do this? The short—and amazing—answer is that they do this by behaving like active medications do. Moreover, what is even more remarkable is the fact that the same inert sugar pill placebo will have very different physiological effects depending on the condition for which it is being given. For example, when a placebo to works in a depressed patient it causes many of the same brain changes that are seen with antidepressants. However, if that little sugar pill could hop out of the depressed person’s body and dive into someone with chronic back pain it would behave completely differently, this time mimicking the effects of opioid analgesics. Placebos have also been shown to work in Parkinson’s disease, but for this condition they don’t behave as they do in depression or pain. This time they work by causing damaged neurons in the brain to squeeze out more dopamine, the neurotransmitter needed to restore the rapid and smooth movements lost in the disease.

So what should we say about the Germans? If we combine what we know about the power of the placebo effect with the fact that Germans are medically healthier than we are, would it surprise you to learn that 50% of German doctors are prescribing placebos already?

soundoff (65 Responses)
  1. SoundGuy

    It's funny to hear the language used by materialists to attempt to explain an universal truth: consciousness heals. When will the majority come to the conclusion that chemicals and surgeries are not the solution to our health problems, but consciousness? And by the way, sound can heal, too. Visit TranscendentalTones to find out how.

    April 4, 2011 at 15:00 | Report abuse | Reply
    • Mohareb

      What you seem to be missing is that consciousnes is a product of material processes. So while it is true that your consciousness can influence your body in ways that you do not normally consider (like influencing the amount of stress hormones in your body by intentionally thinking positively), as opposed to the obvious ways it can influence your body (like consciously deciding to eat healthier), this does not mean that consciousness is magical and free from the physical laws of nature.

      April 4, 2011 at 23:43 | Report abuse |
    • The UNIVERSE

      @ mohareb-
      Before you summarily dismiss the notion that awareness is far more than an epiphenomenon of brain activity, you first must PROVE conclusively that consciousness cannot exist independently of electrochemical processes, which you cannot...

      April 5, 2011 at 03:34 | Report abuse |
    • Atheism is truth

      @ The UNIVERSE "Before you summarily dismiss the notion that awareness is far more than an epiphenomenon of brain activity, you first must PROVE conclusively that consciousness cannot exist independently of electrochemical processes, which you cannot..."

      Hey cool, another religious nut. You cannot prove "consciousness" can exist independently of electrochemical processes, nor can you prove god exists. It's sad that human beings still use the supernatural to explain the unknown, simply to have an answer. If you don't know, you don't know, don't make something up. Do you believe in Santa Clause too?

      April 5, 2011 at 03:59 | Report abuse |
    • Kato

      Our conscience healing us and our conscience making us "feel better" are entirely different things. You'll notice the Germans don't prescribe placebos to heal broken bones.

      April 5, 2011 at 11:49 | Report abuse |
    • tambolina

      thankyou! I will check out transcendentaltones.

      October 29, 2011 at 20:50 | Report abuse |
  2. charles s

    "Would it surprise you to learn that drug companies make their own placebo pills for research purposes? And that THEY choose the ingredients? And sometimes they purposely put ingredients into the placebos that match those in the drug and will affect the outcome of the trial. And they are not required to disclose the ingredients they use"
    see http://www.internetwks.com/owen/ETHICSPAPER.htm

    April 4, 2011 at 15:05 | Report abuse | Reply
    • Tim

      Why in the world would a pharmaceutical company put the same active ingredient in a placebo as in the drug they're testing? You realize their main goal is to differentiate their drug from the placebo so they can claim it works X percent better?

      April 4, 2011 at 17:31 | Report abuse |
    • Larry

      Wow! You really need to stop using the net as your source of information! What a bunch of nonsense! Take off the tinfoil hat and read a book.

      April 5, 2011 at 03:09 | Report abuse |
    • Glorifundel

      Re: charles s.

      " sometimes they purposely put ingredients into the placebos that match those in the drug and will affect the outcome of the trial."

      That is easily one of the dumbest things I've ever heard. A pharma. company is in the business of selling drugs. The clinical trial is one of the main hurdles they have to pass to sell those drugs. If they put active ingredients in the placebo that would make the patients react similarly to the actual drug, it would be more likely for that drug to fail its clinical trial because the results would be similar. This would mean they couldn't sell it.

      If a drug company did this sort of thing they would be out of business in a very short period of time. Unless I'm completely mis-understanding your statement, which I can't see how I would be.

      April 5, 2011 at 14:45 | Report abuse |
  3. Inupaaq

    "BRAIN Power !" NOT 'Placebo power' !

    April 4, 2011 at 15:13 | Report abuse | Reply
  4. Inupaaq

    "BRAIN POWER !" Not 'Placebo power' !
    The Brain IS a "Biological COMPUTER" which contains the DNA/RNA Codes for EVERY Biological FEATURE on the Physical Body that that Brain HAS Grown – SINCE CONCEPTION !
    IF you "Code" – i.e., "TELL" – the Brain to CONSULT the DNA/RNA Code for WHATEVER Biological Part that NEEDS HEALING – AND Direct the Brain to RE-BUILD Said Biological Part to "ORIGINAL Specifications" – the BRAIN "HEALS" the Body Part.

    April 4, 2011 at 15:19 | Report abuse | Reply
    • Atheism is truth

      yes, great post! Most people don't know how to do this without being "tricked" with a placebo though. Wouldn't it be wonderful if we could teach this in classes to children, so we could heal ourselves through our lives, simply with our thoughts.

      April 5, 2011 at 04:00 | Report abuse |
    • Toshin

      You need to look up Placebo- the word. Then you will know that it is one in the same. But the rest of what you said makes sense. I have studied on many things that is so weird, like I practice Rei Ki. But I have found how to use it to do many things, but the most unique of these things is, if I can convince a person that I am able to use Rei Ki to do something that either I am really unable to do with it, or cannot be done by it, doing such will help them out so much. But Rei Ki does work on its own for a simular reason being one's spirit. And I haven't found a need to get God involved in helping me out yet, he already gave me what I need, just need to get better at using it. And if using the spiritual energy to heal isn't proof of God, what is?

      April 5, 2011 at 08:06 | Report abuse |
  5. JonathanL

    When reading the list of side effects for a drug be sure to read the side effects for the placebo as well. I remember reading a list of side effects for what I think was Lipitor and was thinking – 'this doesn't sound good' (some % headache, nausea, muscle weakness and about 5 pages of side effects!) – then they listed the purported side effects from the group they gave the placebo to and they had higher reported side effects in most of the categories, Maybe the average person is born with side effects., or imagines pain and drama when there isn't any. I take Lipitor and don't feel any side effects.

    April 4, 2011 at 16:00 | Report abuse | Reply
  6. Abalone Pie

    The Germans also tend to eat a healthier diet than Americans, with foods prepared closer to their natural state, whole grains, lots of veggies. Plus their medical doctors have never stopped prescribing herbal medicines, which are often less toxic than pharmaceuticals... all of which may help Germans stay healthier than Americans, with less reliance on 20th century Western medical treatments.

    April 4, 2011 at 16:29 | Report abuse | Reply
    • Chai

      That's not really true. The typical foods in Germany include processed meats, breads/rolls/baguette, cheese, potatoes, eggs, smaller amounts of fruits and vegetables, beer and wine. There is a bakery on every-other street corner. However, they are more active, playing sports, or riding bikes everywhere, swimming, skiing, walking, and jogging.

      April 4, 2011 at 18:19 | Report abuse |
  7. Fuyuko

    Germans don't over-work like Americans do. At least the Americans that are employed, anyway.

    April 4, 2011 at 17:25 | Report abuse | Reply
    • Chai

      That is true. They go on a lot of vacations.

      April 4, 2011 at 18:20 | Report abuse |
  8. Boblight

    Placebo effects in anti-depressant therapy.. The placebo effect reinforced by nasty side-effects in the body ( it's working?).. Placebo pills plus psychtherapy is more effective than AD. No side-effects, bRith defects, impotence, and suicidial thoughts. No withdrawel either.. But no profits for drug companies?

    April 4, 2011 at 18:28 | Report abuse | Reply
  9. JK

    This is not surprising as many of the diseases have a psychosomatic element also.This is one of the reasons why homeopathic medicines appear to be effective. Mo st of the pills are sugar pills – as in homeopathic dilutions even a molecule of the active drug cannot exist in each pill.

    April 4, 2011 at 20:41 | Report abuse | Reply
  10. 1prophetspeaks.com

    Maybe the German dr's are more aware of the toxic effects of the drugs, since all the drug co's come from Germany; since they have more inside info, they are acting more responsibly? All psych meds are toxic. The nazis used them to dedliberately kill mental patients. Then the nazis came to the US and continued their agenda of genocide thru psychiatry in the US, UK and everywhere else. And it was and IS covert genocide of Christians, who they falsely called mentally ill thru atheistic psychiatry. (they didn't want to alienate the german christian population by openly killing christians. they have replicated the same technique in the US a supposed Christian society. God had me write a book exposing atheistic psychiatry and their toxic drugs, and how to heal mental & physical illness through prayer. Manual for Transformational Healing-God's Answer to Psychiatry. It is FREE at http://www.1prophetspeaks.com As a direct witness, I saw that 90% of psych patients called schizophrenic are NOT ill, they are Christians. 90% of dr's are atheists. THey are trained to call all spiritual experiences & beliefs symptoms of psychosis. The problem is theological. My article "Psychiatry, Nazis & the rise of the 4th reich (new world order) explains the historical & covert agenda. Dr Peter Breggin at http://www.breggin.com has written many books about toxic psych meds; he exposed the genocide of mental patients by Nazi psychiatry.

    April 5, 2011 at 00:00 | Report abuse | Reply
  11. 1prophetspeaks.com

    My book explains that mental and physical ilnesses are caused by demonic Spirits whose assignments are those diseases. The biblical solution is to rebuke them in Jesus name. It works I have done it. I have rebuked depress, asthm-, canc-. Jesus healed this way and gave his followers authority to do it. My book also explains that one need to assess what in one's environment may be an openibg for demonic oppression; this includes ALL drugs, including psych meds, caffeine, nicotine, alcohol, pot, lsd, etc; also bad music, books, art, symbols, occult objects and unrepentant Sin are openings. A lot of people improve just getting away from al the bad stuff in their house, because of the spiritual contamination. The word "inspiration: means 'a spirit goes into it' so whatever music, books etc are inspired by demonic spirits transmit those to the recipient. When you get rid of it, the oppression lifts.

    On schizophrenia; psychiatrists 2nd question is always "do you hear voices?" and anyone who says they hear God or demons, is thought to have auditory hallucinations, a supposed symptom of psychosis, hence the nonsense label. it is NORMAl CHRISTIAN theology to hear voices. Jesus said :"my sheep hear my voice" John 10:27. Everyone hears voices as thoughts in our heads; they come from the spiritual realm. The word "inspiration:" means :a spirit goes into it". The book of James ch 3 says there is "wisdom from above and wisdom from below". So the whole diagnosis issue is fraudulent and a scam to sell drugs and enslave the population by drugging them for control. The prpohetic book Brave new World by Aldous Huxley describes a fascist society where everyone is drugged for control. That is what mental health is being used to do. Huxley was an elite insider; he knew their plans. He said "a SCIENTIFIC fascism will be easy to sell the masses".

    April 5, 2011 at 00:15 | Report abuse | Reply
    • The UNIVERSE

      Your perception of reality is toxic to MY spirit. I rebuke you in MY name.

      April 5, 2011 at 03:19 | Report abuse |
    • J

      I want whatever it is your smoking....

      April 5, 2011 at 04:51 | Report abuse |
    • Chris

      @Jay: No, we DON'T want whatever it is that 1prophet's smoking, because that would make us have his hallucinations too. I prefer my own delusions, thanks.

      April 5, 2011 at 10:42 | Report abuse |
    • Glorifundel

      Sell your crazy somewhere else, we are all full here.

      April 5, 2011 at 14:48 | Report abuse |
  12. R Burns

    I don't see many comments against using placebo medications here yet, but I really don't think they are good medicine! For an antidepressant effect, for instance, this article states there is 1/3 more effectiveness with antidepressants than with placebo. And that isn't considered a significant difference? For some of these conditions the difference could be life-threatening! Honestly, if I were given a placebo and continued to suffer, especially from lupus, asthma or severe chronic pain, I would consult my attorney.

    April 5, 2011 at 04:18 | Report abuse | Reply
    • Toshin

      I would think that the info about placebo being 2/3 as effective is to state that 2/3 of those on AD don't need to be. Added the fact that the placebo has no chance of making things worse where the AD does. So it couldn't hurt to start treating a patient with a placebo effecting item or way of being, and if it doesn't work, then they can move on to see what AD will work. That wouldn't be too big of a deal because patients switch which AD they are taking from time to time because of mostly the side effects, or lessly for the fact that it isn't working. It can greatly cut down on medication need and cost for the ones that the placebo does work for. Hopefully this won't get banned like many other things out there that could save us money and make our lives better.

      April 5, 2011 at 10:28 | Report abuse |
    • Robert

      I bought the irneew recently, due to chronic pain and chronic balance issues. ANd was pleased that the package promised and gauranteed nothing. What I have found is that for me it works. My pain is halved in my shoulder and nearly nonexistent in my back (both the product of injuries that I recieved in my mid to late teens and which I have suffered with for 10 years and 7 years respoectively) My balance has been an issue since my early teens due to chronic ear infections from the time I was very small. Whether it is in fact a placebo effect or not I do not know, but I can tell you that it is quite effective in helping with pain and balance. I have tried some of the things they show on the infomercial. I used my autistic 8 year old (who is as strong as I am) And did them right with him pulling at the same angle each time and since I was expecting to be pulled the people who say that you are tensed for the second pull would be wrong in my case.No I was not paid to write this, did not recieve a free product to write this and yes I am a firm skeptic about any products that hit up the public on tv first. I have never bought another as seen on tv product before, and would not have bought this one if my doctor had not recomended it to me. And yes he did tell me that the effect was most likely due to the placebo effect.

      October 11, 2012 at 14:16 | Report abuse |
  13. Dystopiax

    Will the German physicians take the placebos THEMSELVES? The German Pharmacists?

    April 5, 2011 at 07:53 | Report abuse | Reply
    • T3chsupport

      I guess if they run out of sugar cubes for their coffee or something...

      April 5, 2011 at 11:14 | Report abuse |
  14. JLS639

    "For example, when a placebo to works in a depressed patient it causes many of the same brain changes that are seen with antidepressants"

    I cringe at this misleading explanation. The brain changes you are talking about occur whenever the person recovers from depression with or without medical intervention. Imagine me saying this:
    "It turns out many of the changes in bone structure when a fracture heals occur regardless of whether the physician used a cast or not."
    In other words, the bone healed. The depression went away. The upset stomach calmed down. The headache subsided. We understand how many of these things work and the medications and therapies speed them along.

    April 5, 2011 at 08:23 | Report abuse | Reply
    • Toshin

      Perhaps it was ment more towards, when the person was taking the placebo, they reacted the same as they would with an AD, but when taken off the placebo, they went back to having depression. Like how it would for those that are depressed because of a chemical balance. Or those that had chemical depression, a form that cannot be irradicated from therapy (therapy only easing the problems to teach how to distract from the depression), where the only way to treat is to rebalance the chemicals in the brain, to cause the right areas to fire off the right way, done by medication; those individuals showed the same result taking a placebo as the others that had chemical depression taking a real AD did (only in 2/3s of the cases). Somethings don't go away on there own without something treating it, even if it is your own mind doing the treatment; like a staph infection, or crabs. Somethings will resolve themselves, but if not aided properly, will cause more problems or come back, like ulzers, and broken bones.

      April 5, 2011 at 10:43 | Report abuse |
    • Balqies

      Gene therapy is an teserniting and promising area of research, but not a well-developed therapetic approach with a wide range of applications like traditional pharmaceuticals. The idea that we could individualize therapy in a meaningful sense is a good one, but we are a long way from achieving it, and in the meantime, the equivalency you seem to be trying to establish between this approach and homeopathy is false for a variety of reasons.For one thing, the individualization of therapy in clasical homeopathy is based on criteria which are pure fantasy, so the fact that a unique fantasy diagnostic and treatment plan is created for each patient is irrelevant. I can individualize a dream interpretation or horoscope for everyone I meet too, but that doesn't mean what I'm providing for them has any reality behind it. Gene therapy is at least based on plausible scientific principles, and if it shows anything it is how difficult and labor/time intensive it is to approach medicine this way and how much rigorous investigation is needed before one can be effective. Homeopathy is based on a fanciful notion and a series of experiments correlating symptoms witht therapies that are unsupported by any plausible scientific principles, so individualized nonsense is still nonsense.Secondly, clinical trials have been done in which homeopaths are allowed to follow the rules of classical homeopathy and prescribe their variously labeled water-soaked sugar pills based on their imaginary diagnoses. These have not shown any meaningful superiority for this approach over any other, so there is little evidence to suggest the individualization process accomplishes anything.Finally, the reality that this line of thinking ignores is how stunningly successful the scientific approach to limiting variables has been in developing effective therapies. If one focuses solely on the limitations of medicine and what one cannot achieve or what has not yet been achieved, one can try and argue that the fundamental approach is flawed. However, when one looks at the totality of healthcare interventions and how they have developed since the scientific approach began to be employed, the unprecedented success is obvious, and one has to admit that the appproach is the best game in town. Perhaps it will eventually be replaced by something better that is fundamentally different, rather than simply the result of incremental improvements. But that remains to be seen, and it is irrelevant to the manifest failure of homeopathy as a therapetic approach.

      March 5, 2012 at 23:13 | Report abuse |
  15. Toshin

    Here is a fun fact that many people will be surprised to know. During a test on cancer patients, some of the patients were given placebo, some where given apricot seeds. It was found that not only did the apricot seeds cure the cancer in more people than the placebo by a lot, but that it was found to be at least 3 times more effective than chemo. Yet the findings were to be hushed and considered a non-treatment for cancer because of not wanting to try to say that cancers can be caused by a vitiman deffecientcy. And a placebo ran close to the same cure rate as chemo. So why use something that has a 2% success rate with potetial side effects (chemo), instead of something that the only way it will mess you up is if you are allegic (apricot seeds) with a higher success rate, and not first try a placebo since it is a close third and with no risks? Properganda and marketeering is why. That is why so many things have been banned. It is up to us to educate ourselves, our kids, and resolve the issues, but knowledge is worthless without action. "It isn't the people that should be afraid of their government. But the government afriad of their people." I am not saying that we should riot and such. There are things we can do on our own peacefully. When you learn, spread the information. But make sure what you had learned was the truth, regardless of what you believe. You may be wrong, I know that I am about things, and I don't know what things.

    April 5, 2011 at 10:59 | Report abuse | Reply
  16. Dr Bill Toth

    The obovious fact is the brain produces better and more potent drugs than any drug company could hope to even come close to. The challenge with placebo studies is that some patients taking the drug don't believe it's going to work and therefore it doesn't and there is no way to measure that – yet. Modern medicine yes you bet, but common sense the best thing yet. Live with Intention, DrBillToth.com/blog

    April 5, 2011 at 11:59 | Report abuse | Reply
  17. Susan Harris

    I worked for an old time Doc who did the same thing and his patients always got better. Mind and body are linked and belief is a powerful healer.

    April 5, 2011 at 15:21 | Report abuse | Reply
    • Marcelo V Silva

      First time here that I see the word belief ! And we should also talk about faith, not a blind faith or religious faith, but a faith in which the good results will come ! Optimism is the true answer to all this use of placebo ! If we believe and have the appropriate faith we will have our problems fixed ! Any kind of problems, including health problems !

      April 5, 2011 at 17:03 | Report abuse |
    • Rajesh

      I recognize this is a ruinnng magazine so perhaps you can be forgiven for ruinnng this story. L-Arginine is not marketed, nor used, to "boost strength". It is primarily used in pre-workout formulas to increase blood flow to the muscles for a better pump, which, as the previous post suggests, it does quite well. No informed athlete expects that it will boost strength. Furthermore, most bodybuilders, the primary group to whom L-Arginine is marketed, are not interested in strength per se but in developing larger muscles. Weightlifting is an entirely different sport with a different aim (strength).

      December 17, 2012 at 12:19 | Report abuse |
  18. Steve In Germany

    There is so much misinformation in this article that I won't be able to cover it all with the time and effort I want to put into it. I'm an American living in Germany for the past 3 years and I can tell you that:

    1) They're not happier than we are. All you have to do is live here as a citizen for maybe 3 months and you'll see that easily. Schadenfreude is still done best here and misery loves company.

    2) Their diet WAS completely better than ours in past generations but that is going downhill fast thanks to Fast Food taking a firm hold; you can find a fitness club and a McDonalds sharing the same building without even trying. Your average breakfast for the younger generation is Nutella slathered on pieces of bread...diabetic nightmare. The big difference is that Germans really believe in getting the hell off of your behinds when the sun comes out whereas many Americans are content to stay inside. There are factors that influence this as well including the fact that, when you live here long enough, you desperately crave for blue skies and want to be out when that happens and also it is considered wasteful by many to have air conditioning in your homes. What would you rather do on a hot day? Stay in a steamy apartment or at least get out and get a tan and a breeze?

    3) Psychiatry/Psychology are still somewhat frowned upon here. If you think the US populace has trouble admitting that they have some emotional/mental problems, come over here for a healthy dose of cultural denial. And, unfortunately, a surprising portion of it stems not only from the "I must be broken!" paranoia but also from the way the employment system is set-up here. Germans do get more vacations and many enjoy being off on Sundays. Women also get time off after their pregnancy with over 65% of their salary for a year and the option to take another couple of years off without pay so they they can be a part of their child's first years of growing up. All of this sounds like a dream, right?

    Well, businesses have had to deal with these laws and still turn a profit. So they will look for any reason to legally fire you or not to hire you if they know you have a "problem"; these "problems" include mental/emotional issues and pregnancy because why should they hire you, let you into the company after the 6 month probation, and then be forced to deal with letting you off on their dime when you get pregnant or have to get treated as well as hire a temp when you're gone? I'm not saying they're completely right in thinking this but you can see how this can not only happen but be taken advantage of. This contributes greatly to why many won't admit they're having problems. I know both of these issues well as they're not only keeping my German wife from looking for another job as she's of the age that employers consider the "last chance stage" for attempting to have a child but also keeping her from going to a therapist for stress issues that she has. I could go on with other examples of German friends of ours but I've already written enough.

    Bottom line, I'm sure this article was presented to be helpful but the statistics about how "great" things are over here are poorly presented and even more poorly researched. It's akin to starting an article with the phrase "African Americans" are responsible for a good portion of the crime in this country and here's what we ought to do" without going into the real reasons contributing to those statistics in the hopes that real solutions can be found.

    April 5, 2011 at 15:41 | Report abuse | Reply
    • German Purell

      The biggest issue is that when Americans go to germany their internet connections fail leaving mushroom stamps abroad. We Americans pay for this by wasting time playing with CHRIIIIISSSS! CHRIIISSSS!

      April 6, 2011 at 13:12 | Report abuse |
  19. Frederica

    Germans are happier now they can blame everything on Americans.

    April 5, 2011 at 21:14 | Report abuse | Reply
  20. Frederica

    Faith on honorable Object(Jesus) and a sense of purpose with goodness – nothing is better for mind and body and quality of life.

    April 5, 2011 at 21:17 | Report abuse | Reply
    • Frederica

      I mean, "nothing else is better."

      April 6, 2011 at 08:08 | Report abuse |
  21. PookD

    We completely underestimate the power and pervasiveness of SOMATIZATION, a process whereby the brain converts psychological distress into physical symptoms. When medicine reinforces the notion that a symptom has a physical basis they obscure any consideration of a psychogenic cause. The real cause is not identified (the brain doesn't want it to be). Please read "From Paralysis to Fatugue" by Edward Shorter, and more recently "They Can't find Anything Wrong" by David Clarke. Seems to me Placebo's are just another distraction from getting to a true understanding of much human misery.

    April 6, 2011 at 14:37 | Report abuse | Reply
  22. Mohamed

    Thanks, Gloria, for your helpful cmmneots. I think you will be interested in another study about placebos that I didn't include because the article would get too long. It involved pain relief by intravenous pain medications following surgery. Patients were randomized to either be given their pain medicine without their knowledge or to be given their medicine with a clear positive explanation when it was being administered. A different researcher, blinded as to which method was used, rated the pain relief. The findings: As expected, the pain meds given without the subject's awareness were fairly effective. The ones given with the full knowledge of the patient, however, were much more effective. As amazing as it sounds, there are even reports where placebos have healed incurable cancers.God bless you, too, Gloria, and keep up your wonderful work!Chuck

    October 14, 2012 at 01:05 | Report abuse | Reply
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