Religious people may benefit from taking placebo medicines or interventions that claim to provide healing via spiritual or supernatural means, according to the first research showing that placebos could lead to significant brain responses as well as positive subjective experiences in the context of religious belief.

The study, conducted by Austrian researchers and published May 6 in Frontiers in Behavioral Neuroscience, could suggest a new approach for relieving physical and mental health issues among believers. It may also help explain some of the psychological benefits of religious belief and practice — especially its ability to provide hope and meaning in otherwise unpredictable situations. 

Anne Schienle, a professor of clinical psychology at the University of Graz and the first author of the paper, was inspired to study the interaction between religious belief and placebos while walking and biking through Styria, the Austrian state in which the University of Graz is located. Schienle described Styria as traditionally Catholic. 

"You see these springs, and often you find little chapels, or crosses or signs beside them that state, for example, 'I was cured from a specific illness or disease,' or 'Thank you, God,' or 'Thank you, Mary, for helping me out,'" Schienle told The Academic Times. "So people assign a specific meaning: It's helpful, and it gives hope. It has positive connotations."

A placebo generally refers to an inert substance or procedure that provides no direct therapeutic benefit and yet offers a degree of psychological improvement in some patients. A negative outlook on certain mental or physical conditions can worsen symptoms and outcomes, but placebos serve to counteract those interpretations. 

Although placebo interventions such as sugar pills or saline shots have no therapeutic value, patients often experience psychological relief after taking them if they believe the placebos are real treatments. In many cases, the belief alone, unaccompanied by any active ingredient or mechanism, can be powerful enough to ease symptoms. The benefits of the placebo effect may even extend to pain relief, since the human pain response is processed in the brain and may change as a consequence of various psychological interventions.

Placebos are frequently used in drug trials as a control in order to evaluate whether the anticipation of a positive outcome changes the efficacy of a particular medication. Meanwhile, the long-term use of placebos by doctors without patients' consent has been the subject of longstanding ethical debates.

The University of Graz team took a more open-ended approach to the study of placebos, viewing them as a tool that can invoke a "meaning response" in patients, a definition first described by medical anthropologist Daniel Moerman. In other words, placebos themselves have no effect until they are interpreted by someone as having a certain degree of power or value. Accordingly, each individual will have a different response, depending on the extent to which they are certain of the effectiveness of a particular intervention.

Schienle and her colleagues gathered a sample of 37 female participants who all believed that the water from a Catholic sanctuary in Lourdes, France, which is said to have supernatural healing properties, could indeed cure various ailments. The researchers offered half of the participants a sample of tap water, scanned their brains with a magnetic resonance imaging machine and conducted interviews with them. A week later, the group underwent the same process with identical samples of tap water. This time, though, they were told that the water came from the holy springs at Lourdes. The other half of the participants, meanwhile, went through the same procedure but were presented with the supposed Lourdes water the first week and the tap water the second week.

Although both samples of water came from an identical source, around a third of volunteers reported that the placebo water tasted different from the sample that was labeled tap water, suggesting that the placebo effect may influence our sensory perception. In addition, after drinking what they were told was the Lourdes sample, participants reported experiencing higher rates of gratitude, happiness and satisfaction as well as bodily tingling and warmth.

The neurological imaging aligned with those subjective reports: Participants' brains showed heightened connectivity in the salience network — a network responsible for monitoring internal bodily sensations and interpreting emotions — after drinking the supposed Lourdes water. Meanwhile, their brains showed reduced levels of activity in the cognitive control network — a circuit that assists with high-level thinking during intellectually rigorous tasks.

The researchers believe that, after drinking the Lourdes water, the participants may have felt less pressure to experience positive results, since they expected an outside force to intervene and create those outcomes automatically. "You think something else does it for you," Schienle said. "That's implicit emotional regulation. I think that's what's happening."

By believing that the placebo would lead to improved emotional and physical states, the participants had inadvertently created those states for themselves, Schienle explained. Those positive changes may continue long after a person has taken the placebo: the initial spark of positivity or relief can lead to a positive feedback loop that generates even more optimism. 

It's unclear how these results might change under different cultural or religious contexts, particularly outside a Christian framework. Future studies may also benefit from investigating placebos' effects on people with particularly strong religious beliefs, such as nuns and monks from various faith traditions, Schienle said.

After working on multiple placebo-related studies, Schienle has observed that the disclosure process — when patients finally learn that the substance they have taken is not actually what they had been promised — can have therapeutic value. Instead of feeling as though they have been deceived, many people report feeling empowered with the knowledge that their minds had been powerful enough to transform their experience without the help of any external intervention. "They have these 'aha' moments where they say, 'OK, so I did it myself and not a placebo.' And then they sometimes really have feelings of pride," Schienle said.

Schienle had previously studied the power of placebos to counteract participants' disgust responses to disturbing pictures. When she gave volunteers a fake herbal medicine, many reported that their nausea and disgust response had been dramatically reduced. "I feel so much better," she remembers some of them telling her. The same was true for patients with depression who were asked to take a supposedly calming medication that claimed to help them with relaxation exercises. 

But Schienle says it could also be possible to use placebos without any form of deception, as several recent studies have demonstrated. The new approach, known as "open-label placebos" involves telling patients up front that they will be taking a placebo while simultaneously teaching them about the clinical benefits of placebo interventions. "We tell them about all the positive effects of our research findings on placebos," Schienle said. "And [we] say, 'Here, would you like to take this placebo and see if it helps you as well?"

The study, "Placebo effects in the context of religious beliefs and practices: a resting-state functional connectivity study," published May 4 in Frontiers in Behavioral Neuroscience, was authored by Anne Schienle, Andreas Gremsl and Albert Wabnegger, University of Graz.