The findings build upon decades of fascinating research into the phenomenon of the placebo effect. Our beliefs and expectations about a medicine (or a sham treatment) can change the way it works. The placebo effect’s “evil twin,” the nocebo effect, is just as powerful—negative thinking has been linked to real symptoms.

Researchers are still trying to understand the connection between body and mind, and how our thoughts can influence our physiology. In the meantime, many are developing ways to harness it in hospital settings. Is it possible for a doctor to prescribe hope?

Alexander Montasem, a lecturer in psychology at the University of Liverpool, is trying to find an answer to that question. In his latest study, Montasem and his colleagues focused on people with cardiovascular disease.

The team reviewed all published research into the link between hope and heart health outcomes in such individuals. Hope is a pretty tricky thing to nail down, but these studies use questionnaires to try to do that. In one popular questionnaire, hope is defined as “a positive motivational state” based on having agency and plans to meet personal goals.

Montasem’s team found 12 studies that fit the bill. All told, these studies included over 5,000 people. And together, they found that high hopefulness was associated with better health outcomes: less angina, less post-stroke fatigue, a higher quality of life, and a lower risk of death. The team presented its work at the British Cardiovascular Society meeting in Manchester earlier this week.

When I read the results, it immediately got me thinking about the placebo effect. A placebo is a “sham” treatment—an inert substance like a sugar pill or saline injection that does not contain any medicine. And yet hundreds of studies have shown that such treatments can have remarkable effects.

They can ease the symptoms of pain, migraine, Parkinson’s disease, depression, anxiety, and a host of other disorders. The way a placebo is delivered can influence its effectiveness, and so can its color, shape, and price. Expensive placebos seem to be more effective. And placebos can even work when people know they are just placebos.

And then there’s the nocebo effect. If you expect to feel worse after taking something, you are much more likely to. The nocebo effect can increase the risk of pain, gastrointestinal symptoms, flu-like symptoms, and more.  

It’s obvious our thoughts and beliefs can play an enormous role in our health and well-being. What’s less clear is exactly how it happens. Scientists have made some progress—there’s evidence that a range of brain chemicals, including the body’s own opioids, are involved in both the placebo and nocebo effects. But the exact mechanisms remain something of a mystery.

In the meantime, researchers are working on ways to harness the power of positive thinking. There have been long-running debates over whether it is ever ethical for a doctor to deceive patients to make them feel better. But I’m firmly of the belief that doctors have a duty to be honest with their patients.

A more ethical approach might be to find ways to build patients’ hope, says Montasem. Not by exaggerating the likely benefit of a drug or by sugar-coating a prognosis, but perhaps by helping them work on their goals, agency, and general outlook on life.

Some early research suggests that this approach can help. Laurie McLouth at the University of Kentucky and her colleagues found that a series of discussions about values, goals, and strategies to achieve those goals improved hope among people being treated for advanced lung cancer.

Montasem now plans to review all the published work in this area and design a new approach to increasing hope. Any approach might have to be tailored to an individual, he adds. Some people might be more responsive to a more spiritual or religious way of thinking about their lives, for example.

These approaches could also be helpful for all of us, even outside clinical settings. I asked Montasem if he had any advice for people who want to have a positive outlook on life more generally. He told me that it’s important to have personal goals, along with a plan to achieve them. His own goals center on advancing his research, helping patients, and spending time with his family. “Materialistic goals aren’t as beneficial for your wellbeing,” he adds.

Since we spoke, I’ve been thinking over my own goals. I’ve realized that my first is to come up with a list of goals. And I plan to do it soon. “The minute we give up [on pursuing] our goals, we start falling into hopelessness,” he says.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

The findings build upon decades of fascinating research into the phenomenon of the placebo effect. Our beliefs and expectations about a medicine (or a sham treatment) can change the way it works. The placebo effect’s “evil twin,” the nocebo effect, is just as powerful—negative thinking has been linked to real symptoms.

Researchers are still trying to understand the connection between body and mind, and how our thoughts can influence our physiology. In the meantime, many are developing ways to harness it in hospital settings. Is it possible for a doctor to prescribe hope?

Alexander Montasem, a lecturer in psychology at the University of Liverpool, is trying to find an answer to that question. In his latest study, Montasem and his colleagues focused on people with cardiovascular disease.

The team reviewed all published research into the link between hope and heart health outcomes in such individuals. Hope is a pretty tricky thing to nail down, but these studies use questionnaires to try to do that. In one popular questionnaire, hope is defined as “a positive motivational state” based on having agency and plans to meet personal goals.

Montasem’s team found 12 studies that fit the bill. All told, these studies included over 5,000 people. And together, they found that high hopefulness was associated with better health outcomes: less angina, less post-stroke fatigue, a higher quality of life, and a lower risk of death. The team presented its work at the British Cardiovascular Society meeting in Manchester earlier this week.

When I read the results, it immediately got me thinking about the placebo effect. A placebo is a “sham” treatment—an inert substance like a sugar pill or saline injection that does not contain any medicine. And yet hundreds of studies have shown that such treatments can have remarkable effects.

They can ease the symptoms of pain, migraine, Parkinson’s disease, depression, anxiety, and a host of other disorders. The way a placebo is delivered can influence its effectiveness, and so can its color, shape, and price. Expensive placebos seem to be more effective. And placebos can even work when people know they are just placebos.

And then there’s the nocebo effect. If you expect to feel worse after taking something, you are much more likely to. The nocebo effect can increase the risk of pain, gastrointestinal symptoms, flu-like symptoms, and more.  

It’s obvious our thoughts and beliefs can play an enormous role in our health and well-being. What’s less clear is exactly how it happens. Scientists have made some progress—there’s evidence that a range of brain chemicals, including the body’s own opioids, are involved in both the placebo and nocebo effects. But the exact mechanisms remain something of a mystery.

In the meantime, researchers are working on ways to harness the power of positive thinking. There have been long-running debates over whether it is ever ethical for a doctor to deceive patients to make them feel better. But I’m firmly of the belief that doctors have a duty to be honest with their patients.

A more ethical approach might be to find ways to build patients’ hope, says Montasem. Not by exaggerating the likely benefit of a drug or by sugar-coating a prognosis, but perhaps by helping them work on their goals, agency, and general outlook on life.

Some early research suggests that this approach can help. Laurie McLouth at the University of Kentucky and her colleagues found that a series of discussions about values, goals, and strategies to achieve those goals improved hope among people being treated for advanced lung cancer.

Montasem now plans to review all the published work in this area and design a new approach to increasing hope. Any approach might have to be tailored to an individual, he adds. Some people might be more responsive to a more spiritual or religious way of thinking about their lives, for example.

These approaches could also be helpful for all of us, even outside clinical settings. I asked Montasem if he had any advice for people who want to have a positive outlook on life more generally. He told me that it’s important to have personal goals, along with a plan to achieve them. His own goals center on advancing his research, helping patients, and spending time with his family. “Materialistic goals aren’t as beneficial for your wellbeing,” he adds.

Since we spoke, I’ve been thinking over my own goals. I’ve realized that my first is to come up with a list of goals. And I plan to do it soon. “The minute we give up [on pursuing] our goals, we start falling into hopelessness,” he says.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

The findings build upon decades of fascinating research into the phenomenon of the placebo effect. Our beliefs and expectations about a medicine (or a sham treatment) can change the way it works. The placebo effect’s “evil twin,” the nocebo effect, is just as powerful—negative thinking has been linked to real symptoms.

Researchers are still trying to understand the connection between body and mind, and how our thoughts can influence our physiology. In the meantime, many are developing ways to harness it in hospital settings. Is it possible for a doctor to prescribe hope?

Alexander Montasem, a lecturer in psychology at the University of Liverpool, is trying to find an answer to that question. In his latest study, Montasem and his colleagues focused on people with cardiovascular disease.

The team reviewed all published research into the link between hope and heart health outcomes in such individuals. Hope is a pretty tricky thing to nail down, but these studies use questionnaires to try to do that. In one popular questionnaire, hope is defined as “a positive motivational state” based on having agency and plans to meet personal goals.

Montasem’s team found 12 studies that fit the bill. All told, these studies included over 5,000 people. And together, they found that high hopefulness was associated with better health outcomes: less angina, less post-stroke fatigue, a higher quality of life, and a lower risk of death. The team presented its work at the British Cardiovascular Society meeting in Manchester earlier this week.

When I read the results, it immediately got me thinking about the placebo effect. A placebo is a “sham” treatment—an inert substance like a sugar pill or saline injection that does not contain any medicine. And yet hundreds of studies have shown that such treatments can have remarkable effects.

They can ease the symptoms of pain, migraine, Parkinson’s disease, depression, anxiety, and a host of other disorders. The way a placebo is delivered can influence its effectiveness, and so can its color, shape, and price. Expensive placebos seem to be more effective. And placebos can even work when people know they are just placebos.

And then there’s the nocebo effect. If you expect to feel worse after taking something, you are much more likely to. The nocebo effect can increase the risk of pain, gastrointestinal symptoms, flu-like symptoms, and more.  

It’s obvious our thoughts and beliefs can play an enormous role in our health and well-being. What’s less clear is exactly how it happens. Scientists have made some progress—there’s evidence that a range of brain chemicals, including the body’s own opioids, are involved in both the placebo and nocebo effects. But the exact mechanisms remain something of a mystery.

In the meantime, researchers are working on ways to harness the power of positive thinking. There have been long-running debates over whether it is ever ethical for a doctor to deceive patients to make them feel better. But I’m firmly of the belief that doctors have a duty to be honest with their patients.

A more ethical approach might be to find ways to build patients’ hope, says Montasem. Not by exaggerating the likely benefit of a drug or by sugar-coating a prognosis, but perhaps by helping them work on their goals, agency, and general outlook on life.

Some early research suggests that this approach can help. Laurie McLouth at the University of Kentucky and her colleagues found that a series of discussions about values, goals, and strategies to achieve those goals improved hope among people being treated for advanced lung cancer.

Montasem now plans to review all the published work in this area and design a new approach to increasing hope. Any approach might have to be tailored to an individual, he adds. Some people might be more responsive to a more spiritual or religious way of thinking about their lives, for example.

These approaches could also be helpful for all of us, even outside clinical settings. I asked Montasem if he had any advice for people who want to have a positive outlook on life more generally. He told me that it’s important to have personal goals, along with a plan to achieve them. His own goals center on advancing his research, helping patients, and spending time with his family. “Materialistic goals aren’t as beneficial for your wellbeing,” he adds.

Since we spoke, I’ve been thinking over my own goals. I’ve realized that my first is to come up with a list of goals. And I plan to do it soon. “The minute we give up [on pursuing] our goals, we start falling into hopelessness,” he says.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.