Sometimes I can’t believe that it’s been twelve years since Mind Over Medicine hit the New York Times bestseller list right out of the publication gate and five years since I had the chance to completely rewrite a revised edition in 2020. (Buy the revised edition here.) My life has gone on, I’ve written five more books since that one, we’ve survived a global pandemic, and that book keeps selling like hotcakes, thanks to many of you who make it a regular gift whenever someone you love gets a scary diagnosis, often alongside my partner Jeff Rediger’s book CURED and my friend Kelly Turner’s book Radical Remission. (Thank you to those of you who continue to purchase and recommend my book!)
Then sometimes I get these reminders about how that book actually changed how many people think about medicine, how relationships impact your health, how the rituals of connection and healing affect health outcomes, how healing your trauma can sometimes lead to better health, how doing work you love affects your body, and how spirituality that doesn’t bypass your trauma can actually help you heal. Like when professors from medical schools reach out to ask me if they can have consent to use the Whole Health Cairn wellness model in their medical school lecture. Or when I found out that the Canadian public health care system had embraced health equity programming to bring the concepts of Mind Over Medicine and the Whole Health Cairn into a Canadian public health clinic. Or when I was asked to teach surgeons at Kaiser how to pray with their spiritually-inclined patients before surgery.
So I was delighted when I received an email from a sixth-year student at Richmond Montessori School in Richmond, VA, who is conducting an independent research project on the power of the mind over the body. He wanted to ask me some questions about placebos and nocebos, and I was touched that my work might impact the next generation of thought leaders. Just like I built my work on the shoulders of mind-body medicine giants like Rachel Naomi Remen and Bernie Siegel, it’s my hope that the children of today might one day take this body of work and expand it towards whatever’s next in the movement towards a more holistic, trauma-informed, comprehensive kind of Whole Health Medicine than what most doctor’s offices and hospitals currently offer.
I thought some of you might be curious to read my answers.
1. In your opinion, what is the actual concept of “mind over medicine”?
When I talk about Mind Over Medicine, I’m not saying the mind can magically cure everything or that people should blame themselves for being sick or think positive instead of going to the doctor. What I am saying is that our thoughts, beliefs, emotions, and nervous system states (which includes not just your brain but the nerves in your whole body) profoundly influence the body’s innate self-repair mechanisms.
Your body is wired with natural healing processes—immune function, hormonal balance, wound repair, cellular regeneration. These systems work best when the nervous system feels safe. Practices that bring us into that relaxed, socially connected “ventral vagal” parasympathetic state, whether that’s through meditation, love, meaning, healthy relationships, creativity, a therapeutic relationship with someone you trust, like a good doctor or therapist, or hope, can amplify the body’s healing abilities.
So “mind over medicine” is really mind with medicine: a partnership between what your doctor can offer and what your inner healer can do. I don’t recommend ignoring your doctor’s orders. I just believe we have to tend to our thoughts, beliefs, feelings, and nervous system states with as much attention as what we eat, whether we exercise, and which medications we take.
2. How did/does Mind Over Medicine help the world around us?
When people understand how deeply the mind, nervous system, and body are connected, we expand the way we think about health and healing. We stop seeing ourselves as passive recipients of medical interventions and start becoming active participants in our own well-being.
This helps the world because:
- It empowers people to cultivate healthier lifestyles, relationships, and emotional habits.
- It inspires people to seek healing for their traumas as part of a comprehensive medical treatment plan.
- It reduces stress, which is one of the biggest drivers of modern illness.
- It encourages doctors and scientists to study compassion, connection, and hope as real therapeutic tools.
- It promotes a more humane, whole-person approach to healthcare.
In other words, it brings more humanity, empathy, empowerment, and personal agency into medicine, and that serves everyone.
3. Do people still use placebos in medicine? Why or why not?
In clinical research, placebos are used all the time. Researchers rely on placebo-controlled trials to figure out whether a medical intervention or drug works better than a sugar pill, saline injection, or fake surgery. Without placebos, we can’t separate the biochemical effect of a medication from the power of expectation and belief.
In everyday medical practice, doctors don’t generally give “fake pills,” because that would be deceptive and unethical, and trust between doctors and patients is tantamount. In the 1990’s, Harvard once led a multidisciplinary conference about placebos. The transcripts for that conference were published by Anne Harrington in a book called The Placebo Effect, which is a super interesting read.
One of the case studies they discussed, which I found very intriguing, revolved around whether nurses should be given permission to inject ICU patients with saline when they said they were in pain but had already taken the maximum dose of pain medication, beyond which it might suppress their breathing. Pain is one of the most placebo-responsive conditions. Many types of pain get better if someone in a white coat administers a placebo that the patient believes is meant to help their pain.
Ethicists argued over this case study and determined that no, nurses should not give saline injections and pretend they’re giving pain medication. I struggled with that one, because it seems so benevolent to do so. But medical ethics often trump doing what might actually help patients. I wrote a whole chapter in MInd Over Medicine about potential clinical applications of the placebo effect, but it wound up getting cut because the book was too long.
What we can do is take advantage of certain rituals of medicine- white coats, compassionate conversations, thorough explanations, the sense that your doctor really cares, giving hope to someone hopeless- these rituals are all placebo-like activators. They’re not fake; they simply harness the mind-body-nervous system’s natural healing pathways and help us optimize health outcomes through the relational aspects of healing. While positive belief in a healing effect seems to have something to do with it, the therapeutic healing relationship is probably one of the most potent parts of the placebo effect.
Interestingly, we now know that open-label placebos, placebos given with full honesty- wherein a doctor says “I’m going to give you a placebo pill that I truly believe will help you”- can still work. That tells us the healing response isn’t about tricking people; it’s about activating meaning, trust, and the body’s own repair mechanisms.
4. What are the most significant events throughout the research of the placebo and nocebo effect?
A few milestones stand out:
- 1955 – Henry Beecher’s famous paper, “The Powerful Placebo.”
This was the first major scientific recognition that belief can affect healing, based on observations from World War II. - 1970s–1980s – The discovery of endorphins and endogenous opioids. Researchers found that placebos work partly because the brain releases its own natural painkillers.
- 1980s Psychoneuroimmunology (PNI) was discovered and popularized in Candace Pert’s book The Molecules of Emotion
- 1990s – Neuroimaging breakthroughs. MRI and PET scans showed that placebos change real brain activity, not just “imagination.”
- 2000s–Present – The rise of nocebo research.
We’ve learned that fear, mistrust, and negative expectations can produce real symptoms, which means the mind can harm as well as heal. For example, when people are given a list of possible adverse effects to a drug or vaccine, they often develop those adverse effects, even if they’re given a sugar pill or saline injection.
Recent years – Open-label placebo studies, many of which were performed by acupuncturist and Harvard researcher Ted Kaptchuk, who founded the Program for Placebo Studies & The Therapeutic Encounter (PiPS) at Harvard. People get better even when they know they’re taking a placebo. This is one of the most paradigm-shifting discoveries in modern mind–body medicine.
5. How have placebos changed over time? If not, why?
Physically, the placebo itself, whether a pill, injection, or ritual, hasn’t changed much. What has changed is our understanding of the placebo response.
We now know:
- It’s not about “fooling” people.
- It’s a measurable psychobiological phenomenon.
- It involves brain chemistry, immune function, hormones, and the nervous system.
- It varies depending on culture, medical rituals, and the doctor–patient relationship.
So the placebo itself is ancient. Snake oil was working long before we had real medications that had been proven to be more effective than placebos. But our awareness of how powerful it is has expanded dramatically.
6. Does the form of placebo affect the outcome?
Absolutely. The more “dramatic” the placebo, the stronger the effect. Research shows:
- Injections produce stronger placebo responses than pills.
- Big pills work better than small pills.
- Colored pills work differently depending on the color (e.g., blue is calming, red is energizing).
- Two pills work better than one.
- Sham surgeries (fake surgeries) produce some of the most powerful placebo effects ever recorded, as demonstrated best by Bruce Moseley, the Houston orthopedic surgeon who conducted the landmark VA study showing that patients who received only an incision and no actual surgical repair improved just as much as those who received the full arthroscopic procedure.
This doesn’t mean people are imagining the improvement. It means the ritual itself influences the brain and nervous system, just like the ritual of prayer, meditation, or being lovingly cared for might.
7. When was the discovery of the placebo effect?
The term “placebo” was first used in medicine in the 1700s, but the effect itself was discovered gradually. The first major scientific documentation was during World War II, when anesthesiologist Henry Beecher ran out of morphine and watched soldiers’ pain decrease after being injected with saline. But humans have been experiencing placebo responses for thousands of years, long before we had the language for it. Healing rituals, shamanic ceremonies, prayer, and community care all tap into the same mind–body pathways.
8. How long does it take for the placebo response to occur?
It can be surprisingly fast. Studies show placebos can produce measurable physiological changes in minutes (pain relief, blood pressure shifts), hours (changes in hormone levels or inflammation markers), and days to weeks (when belief and expectation build over time). The timing depends on the condition, the person, and the context. But the body responds to meaning and expectation far more quickly than most people realize.
If you haven’t read Mind Over Medicine and you’re interested in learning more, you can find Mind Over Medicine anywhere you shop for books. Please order from your local independent bookstore if you can!
Order Mind Over Medicine for a holiday gift or for yourself.
If you’ve read Mind Over Medicine and want a deeper dive, try my online program The Six Steps To Radical Self-Healing.
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