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Take this pill, it won't do a thing for you (or will it?)

About the author: 
Bryan Hubbard

The placebo, or dummy pill, has always been used in drug tests. Now entrepreneur Robert Richman is taking it to the next stage—welcome the Xpill.

Suppose you were given a pill that was actually just a sugar. In other words, it contains no chemical compound that could have a biological effect in your body. You were even told this before you took it, and yet, nonetheless, things did start to happen. Perhaps issues in your life started resolving themselves, or aches and pains began to get better.

The idea of the 'dummy' pill is well known in medicine. It's called the placebo, and it's often tested against the real drug when patients are given one or the other, but aren't told which. Arguably, it's the most powerful 'drug' that's ever been invented, because placebos average around a 30 percent success rate against all diseases—and the real drug is deemed to be effective if it achieves a positive result that's just a few percentage points higher.

Testing the placebo effect has become the life work of Ted Kaptchuk, a professor of medicine at Harvard Medical School who, in a recent TED talk, explained that it works because the brain is essentially a prediction machine. If you're walking through a forest where you know snakes live, you'll see a stick and immediately think it's a snake, he says.

Similarly, because we know a pill is supposed to make us feel better, it invariably will, even if we know it's a dummy pill. And it's not just about the pill: it's about the whole process, including the doctor's white coat, the ritual of writing out the prescription and the engagement with the doctor, says Kaptchuk.

All change

Business coach Robert Richman wasn't thinking about healing when he started playing around with a dummy pill. As a motivational speaker, he was more interested in changing people's mindsets and the blocks that stopped them from achieving a better life.

His inspiration was the seminal moment in the movie The Matrix when the hero is offered a red pill or a blue pill: the blue one sends him back to sleep and to what he thinks is real, and the red one wakes him up to reality.

"I want movies to be real," said Robert, a resident of San Diego, California, who studied filmmaking in college, "and yet I've always thought that reality isn't as it seems, that something else is going on." Motivated by those two thoughts, he decided to test The Matrix theory at America's wildest festival, Burning Man, which is held every year in a desert in Nevada. He took a bundle of prescription-like tubes, filled them with red sweets, and invited participants to "know their reality" and take them.

A few weeks later, Robert got a call from a psychologist who he'd unwittingly given the sweets to, and who wanted fresh supplies. She'd been giving them to her patients, who were reporting remarkable breakthroughs. "They're just sweets, I remember telling her," said Robert.

Thinking he had stumbled on something more than just a fun test, Robert then invited a Facebook group to try out some vitamin pills. This time the pills were purple—a mix of red and blue—because of a comment by New Age philosopher Ken Wilber: "Red pill? Blue pill? Hell, in the 1960s we'd take both!"

Again, the effects were immediate and impressive. Each participant was asked to intend an outcome before popping a pill—such as deciding to finally do what they'd put off for years, set goals or get in touch with their emotions—and any changes were tracked for six months.

In that time, Robert collected more than 40 video testimonials from people who reported major life changes, such as quitting smoking or starting a new business project, and even Robert was helped by his dummy pill, as it helped him complete a half-marathon when before he could run only a fraction of that distance.

What's going on?

The dummy pills didn't help everyone who took them—but perhaps the real surprise was that they helped anyone. So what's going on? Robert believes the dummy pills allow us to tap into our unconscious mind in a way that our conscious mind—and its use of language—simply can't do. Essentially, the pill is a symbol, and symbols are the way in which our unconscious communicates, at least according to psychologist Carl Jung, he says.

It also seems to drill down to deeper emotions that could be holding us back, and which can be teased out by constantly asking the question 'why?' Jack Canfield, author of the bestselling Chicken Soup for the Soul series, decided his intention when taking one of Robert's pills was to have a clear desk. When asked why, he said he wanted the space to write more books. Again, when asked why, he said he wanted to write books because he wanted to be loved and respected.

Today, hundreds of people have used one of Robert's dummy pills, and now he's putting the whole idea on more of a commercial footing. He's just launched the Xpill (the brand name came to him after he had popped one of his dummy pills), which are packaged in boxes and capsules that mimic a prescription drug.

Thousands of Xpill packs have come off the production line, and they contain just brown rice powder—nothing that should be making a difference to people.

He dislikes using the word 'placebo' when talking about the Xpill as it smacks of medical practice and the treatment of diseases. He makes no claims for Xpill; as he says: "There's nothing in these pills—and yet there's everything."

Researchers are starting to take an interest and are planning a series of independent studies into the strange phenomenon of Xpill. In the meantime, Robert is also looking at apps that can be built around the Xpill experience.

From being a simple experiment, Xpill has now taken over Robert's life. He says he will be doing less business coaching as his focus shifts to a pill that contains nothing—but seems to do so much.

For more on the Xpill: www.xpill.com

It still works when you know

When people take the Xpill, things can happen—even when they're told there is absolutely nothing in the pill. The same goes for the placebo, the dummy pill given to patients in drug trials.

In one experiment carried out by Ted Kaptchuk and his team of researchers from Harvard Medical School, 40 people with irritable bowel syndrome (IBS) were given a placebo, while another 40 weren't given anything at all.2

The placebo group knew they were taking a dummy pill—the container in which the pills came even had the word 'placebo' written across it.

Despite this, 59 percent of the placebo group reported a "significant improvement" in their symptoms within three weeks, compared to 35 percent of those who weren't given anything at all. In their case, time seemed to be the healer.

The results from the placebo group were as good as would be expected if they had been given a drug.

Kaptchuk said he wasn't entirely sure why the placebo had worked as well as it did, but he thinks it has more to do with medical ritual than just positive thinking, especially as improvements were twice as strong in the placebo group.

Placebo surgery

It's not just pills that can elicit the placebo effect. Patients who undergo surgery also report positive results even when nothing has been done to them.

Carrying out placebo procedures instead of proper surgery is rare because it's considered to be unethical—but when it does happen, patients are seeing similar benefits.

Orthopedic surgeon Andy Carr, from Oxford University Hospitals, says that several studies have tested the proper surgical procedure against a 'sham' operation on elective (non-emergency) surgery for arthritis of the knee, spinal cement injections for vertebral fractures and gastric balloon operations.3

Professor Carr says the placebo effect could partly be explained by the fact that surgery hasn't been properly tested scientifically in the way drugs are evaluated—and so the placebo effect could be happening far more often than surgeons realize.

"The correct thing is . . . not to continue doing operations where we don't know whether or not there's a strong placebo component or an entire placebo component because that means that tens or hundreds of thousands of patients are having unnecessary operations," he said.

It's not about the pill

When it comes to the placebo effect, it's not just about the pill. Instead, it's about the whole ritual of care, including the interaction with the doctor or nurse, actually taking the pills and "all the rituals and symbols of our healthcare system," said Professor Ted Kaptchuk of Harvard Medical School.

He's been pondering what makes up the placebo effect ever since a small test he carried out came up with extraordinary results.4

He gave a dummy pill—clearly marked as a placebo on the packaging—together with an NSAID (nonsteroidal anti-inflammatory drug) painkiller to around half of 97 patients with chronic low back pain, and just the NSAID to the rest.

It was explained to those given the placebo that it had no active ingredients—and yet those given the placebo along with the NSAID reported a 30 percent reduction in pain, compared to just a 9 percent pain reduction achieved by the NSAID alone.

If the placebo effect really is all in the mind, it's clearly a mind that doesn't care whether or not it's taking a dummy pill.


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References

1

Pain, 2015;156:2616-26

2

PLoS ONE, 2010; e15591

3

The Guardian, June 11, 2017

4

Pain, 2016;157(12):2766-2772

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