Placebo effect, also known as fake drug effect, fake drug effect and substitute effect (English: Placebo Effect, derived from Latin placebo solution "I will comfort"), was put forward by Dr. Bique in 1955, and also understood as "nonspecific effect" or subject expectation effect.
placebo effect
Mbth placebo effect
Also known as 1 counterfeit drug effect
Also known as the counterfeit drug effect.
Also known as the third generation agent effect.
Moderator: Dr. Bick
concept
The "placebo effect" in psychological consultation refers to the psychological phenomenon that psychological counselors provide "placebos" to visitors in consultation, so that visitors can alleviate their psychological obstacles or improve their condition in anticipation. The "placebo" in psychological counseling includes psychopathological drugs, neutral substances in the biological sense, the image of the consultant, the language and non-language skills of the consultant and the construction of the counseling environment. Counselors guide visitors to change and develop themselves through drugs, drug substitution, words and deeds, and environmental hints. The difference between psychological counseling and clinical medicine "placebo" lies in that it emphasizes the image of consultants, the guidance to visitors and the construction of psychological counseling environment. They play a greater role in individual cognitive change, psychological adaptation and development than the drug "placebo" Some people think that this is a remarkable human physiological response, but others think that this is an illusion caused by the design of medical experiments. Whether this phenomenon really exists, scientists have not yet fully understood.
Effect display
Definition of effect
The placebo effect was put forward by Dr. Henry K. Beecher in 1955, which is also understood as "nonspecific effect" or the expected effect of the subjects. At the same time, there is a completely opposite effect-Nosebo effect: patients do not believe that the treatment is effective, which may worsen the condition. Noxiwave effect (Latin Nocebo means "I will hurt") can be detected in the same way as placebo effect. For example, a control group taking ineffective drugs will get worse. This phenomenon is considered to be due to the negative attitude of drug recipients to the efficacy of drugs, thus offsetting the appearance of placebo effect and Noxipo effect. This effect is not caused by the drugs taken, but based on the patient's psychological expectation of rehabilitation.
evaluating indicator
Medical staff can use placebos to stimulate the placebo effect of patients. When you believe in a drug,
placebo effect
It can enhance the curative effect of drugs and improve the quality of medical treatment. When a new drug comes out and its therapeutic value is evaluated, the placebo effect of the drug should be estimated. If there is no significant difference between the efficacy of a new drug and placebo after a double-blind trial, the clinical use value of this new drug is not great. This is why some new drugs are often regarded as a panacea when they first come out, but after a period of use, their popularity disappears and their value declines. In the process of medication, the placebo effect is everywhere. Even for serious organic diseases such as angina pectoris, more than 1/3 patients have improved their symptoms by using placebos, and many analgesics have obvious placebo effect. Some patients may have side effects such as nausea, headache, dizziness and drowsiness when taking placebo, which also belongs to the placebo effect.
Reaction crowd
A person who easily produces corresponding psychological and physiological effects when using a placebo is called a placebo. The personality characteristics of this kind of people are gregarious, dependent, suggestible, lack of self-confidence, concern about various physiological changes and discomfort, hypochondriasis and nervousness.
We should remember that the placebo effect is more likely to appear in patients, about 35% of patients with physical diseases and 40% of patients with mental diseases will have this effect. It is precisely because patients have this psychological characteristic that quacks and witch doctors can have an activity market and display their skills.
Control research
Dr Bi Ke's research (1955)
It is reported that about a quarter of patients who take placebos (such as placebos that claim to cure back pain) say that the pain is relieved. Remarkably, the relief of these pains can be detected by objective methods, not just by patient reports. This improvement in pain did not occur in patients who did not receive placebo.
Because of the discovery of this effect, the government regulatory authorities stipulate that new drugs must pass clinical placebo-controlled trials before they can be recognized. The test results should not only prove that the patient responded to the drug, but also compare the test results with those of the control group taking the placebo, proving that the drug is more effective than the placebo ("effective" means that the following two drugs or 1: 1) can affect more patients than the placebo, and 2) the patient's response to the drug is stronger than the placebo). Because the doctor's perception of the practicality of the course of treatment will affect its performance and also affect the patient's perception of the course of treatment. Therefore, this drug test must be conducted in a double-blind manner: neither doctors nor patients will know whether the drug is a placebo.
Recently, it has been found that a similar phenomenon will occur in simulated surgery, so some surgeons
Placebo drug
Placebo-controlled studies must be conducted (for obvious reasons, double-blind methods are rarely used). In order to support the test, the drug test group will get better treatment than the placebo control group.
Almost all studies conducted in this controlled way show that placebos can improve the condition. For example, Kahn published a meta-analysis of antidepressants and found that the number of people who took placebos or attempted suicide decreased by 30%, while the number of people who took antidepressants decreased by 40%.
However, the general research project does not add a group that does not receive any treatment as a control, so it is difficult to calculate the actual impact of the placebo effect.
Put forward the "placebo effect" and "Noxiwave effect". More than 50 years have passed now, but they still clearly appear in experimental medical situations. The existence of this effect means that the trust between people is very important in the doctor-patient relationship. Therefore, "humanistic care" must not be absent in the communication between doctors and patients, and the medical ecology should operate a "reassuring" block with heart.
Related investigation
The so-called "placebo effect" refers to taking fake drugs that have no curative effect at all without letting patients know, but the patients get the same or even better effect as the real drugs. This specious phenomenon is not uncommon in medical and psychological research. Therefore, many doctors have to consider this "placebo effect" when treating patients.
John Deuce, an American dentist, often encountered this situation in his 27-year medical career: some toothache patients came to Deuce's clinic and said, "I feel much better here." In fact, they are not lying-maybe they feel that someone will take care of their dental disease soon, so they are relaxed; It may also be like attending a religious ceremony, when they touch the doctor's hand, the pain will be relieved ... in fact, this is similar to the effect of a placebo.
As the founder of the National Medical Fraud Committee, Dr. Deuce's interest in placebo research began with his investigation of medical fraud cases. He pointed out that dentists, like other doctors, sometimes mislead or exaggerate medical needs to induce patients to buy medicine or undergo expensive surgery. In order to specifically explain what is the "placebo effect", he quoted the Journal of the American Medical Association.
Placebo effect [1]
Research results of peripheral neuralgia. It is reported that the subjects were divided into four groups: group A took mild painkillers; Group B took counterfeit drugs with similar colors and shapes; Group C received acupuncture treatment; Group D received sham acupuncture treatment. The experimental results show that the pain of the four groups has been alleviated, and there is no significant difference in the analgesic effects of the four different methods. This shows that the effects of painkillers and acupuncture are not necessarily more effective than placebo or comforting behavior.
In fact, humans have been using placebos for a long time. Long before the invention of antibiotics, doctors often prescribed some powder that they knew was useless, and patients thought there was hope. But in the end, some patients really miraculously recovered, and some even passed the "ghost gate" of plague and scarlet fever safely.
Rosa, an expert in placebo research, believes that it is naturally a beautiful thing to give patients a cheap placebo without any side effects, but unfortunately, in most cases, placebos may not have a really lasting effect, but the real treatment has been delayed. Today, the psychological and physiological reasons of the "placebo effect" are still a difficult mystery, and new findings need further in-depth study.
experimental research
Placebo experiment
Scientists create pain for subjects, and then use morphine to control the pain. Do this several times a day for several days until the last day of the experiment, and replace morphine solution with normal saline. Guess what happened? Like morphine, physiological saline also effectively inhibited the pain of the subjects.
This is the so-called placebo effect: sometimes, something ordinary will become powerful for some reason. Fabbrizio Benedetti of the University of Turin added the morphine antagonist allyloxone to normal saline on the last day. What are the amazing results? The ability of physiological saline to inhibit pain disappears.
So what happened in this process? For decades, doctors have known that there is a placebo effect, and the experimental results of allyloxone seem to show that the placebo effect is a biochemical reaction to some extent. But beyond that, humans know nothing about the placebo effect.
Later, Benedetti proved that a placebo made of normal saline can also relieve the symptoms of tremor and muscle stiffness in patients with Parkinson's disease. Benedetti and his team measured the neuronal activity in patients' brains while injecting them with normal saline. They found that with the injection of normal saline, the excitability of nerve nuclei in the hypothalamus of patients decreased, and the number of "stress excitability" of neurons also decreased: normal saline obviously had an effect.
The reason remains to be studied.
Benedetti said that researchers don't know what happened in this process, but one thing is clear: the brain can affect the biochemical activities of the body. He said: "The relationship between the expected therapeutic effect and the actual therapeutic effect is a good model to understand the interaction between the brain and the body." Now, researchers still need to determine when and where placebos can work. Maybe placebos don't work for some diseases; Maybe there is some * * * homologous mechanism between different diseases. These questions have not been answered so far.
action principle
There are two hypotheses about how placebo works: the expected effect of the subject and the conditioned reflex.
Expectation effect
The expectation effect of subjects leads patients to report their improvement consciously or unconsciously, which leads to the appearance of placebo effect. Asbj？ Rn Hróbjartsson and Peter C. G? Tzsche questioned in the article that "most patients politely report the tendency of improvement in order to cater to the experimenters, even if they don't feel improvement." Subjective prejudice may also make patients subconsciously think that their condition has improved because of attention and care.
Restrictive reaction
Classical constraint is a kind of associative learning mode, which enables trainees to make specific responses in specific situations. A famous example is Pavlov's dog experiment: ring the bell before giving every kind of food to the dog. After repeated many times, whenever the bell rings, the dog will automatically secrete saliva, because the dog has learned to associate the bell with food. Therefore, placebo can make patients have similar biological responses to effective drugs, which may be caused by restraint.
Psychological consultation
It depends entirely on the actual effect of psychological counseling, and one of the reliable and effective treatments proved by experiments is the placebo effect. This very powerful phenomenon depends on the belief that our health is getting better, because we believe that our bodies will get better.
People who take placebo "drugs" think they are real drugs, so they can really experience a significant reduction in pain or other symptoms, even though placebos have no biochemical effect. The placebo effect is a very powerful phenomenon, which can
placebo effect
The symptoms of at least 1/3 or even more patients were obviously improved. Placebo medicine and placebo medical process have been proved to be effective for a large number of diseases, including long-term pain, hypertension, angina pectoris, depression, schizophrenia and even cancer. This is the continuation of mysterious magic, witchcraft, leech bloodletting, worship of Yaowang Temple, elixir and other messy therapeutic experiments in the 20th century.
The placebo effect is an obvious example of our psychological expectation that any signal from the body can be manipulated. Placebo is very effective only when patients believe in its effect. If psychologists convince patients that this treatment will improve their physical symptoms, or provide placebos to enhance their psychological effects, the effectiveness of placebo drugs or medical procedures will be greatly improved. For example, injecting a placebo is usually better than taking a placebo because injecting drugs will have a greater psychological impact than swallowing pills. It is found that the color, size and shape of placebo will affect its effect when it is taken in tablet form.
The psychological and physiological mechanism of placebo effect is quite complex and has not been well understood. Some scientists believe that this is the role of morphine-like chemicals such as endorphins released by the brain when it is nervous. Other scientists think this is some form of conditioned reflex. No matter through what mechanism the placebo effect is produced, the psychological effect undoubtedly plays a very key role.
Life application
The "placebo effect" can be seen everywhere in real life. Several city people who have little contact with the rural environment have gone out for an outing. When they reached the mountainside, they were deeply attracted by the clear spring water, green grass and charming scenery.
Related books
During the break, one of them happily took the kettle handed by his companion and took a sip of water. He couldn't help but sigh: The water in the mountains is so sweet, and the water in the city really can't be compared with here. The owner of the kettle smiled. He said that the water in the kettle is the most common water in the city, and it was connected from the tap water pipe at home before departure. This phenomenon shows that when we analyze reality, we are obviously mixed with many personal factors, including our expectations, experiences and beliefs.
A psychological/psychological test
There are three tapes. Someone told me that one tape can ensure you have a better sex life, one tape can help you increase your self-esteem quickly, and the third tape can help you lose weight effectively. How? All you need to do is listen-on the road, in bed, while doing your homework-to the "soothing clear waves on the beach". The experimental group set out to judge whether the tapes aimed at improving self-esteem and memory are really effective.
237 men and women aged 18-60 participated in the experiment. The first is the pretest, in which their initial self-esteem and memory are measured by standard psychological tests and scales, and then the subjects are randomly divided into two scenarios, half of which are given memory tapes and the other half are given self-esteem tapes, so that they can listen to these tapes regularly. Five weeks later, they returned to the laboratory for a post-test and received a memory and self-esteem test. The researchers don't know which subjects received which treatments.
Did these tapes improve self-esteem and memory? The results of this controlled experiment show that there is no obvious improvement in self-esteem or memory in any objective measurement. However, a very strong effect did appear: the placebo effect, which is expected to be helped. Considering the placebo effect, the researchers added an independent variable. Half of the subjects in each group got the self-esteem tape with the wrong label, while the others got the self-esteem tape in the memory box.
Participants believe that if they accept tapes marked as self-esteem, their self-esteem will increase, or if they accept tapes marked as memory, their memory will increase-even if they listen to tapes that they have never received.
Essence and application
The object "placebo effect" is essentially a suggestive effect, which is a synthesis of various psychological counseling methods, including hypnotherapy, cognitive therapy, suggestive therapy, people-centered psychotherapy, and the principles of psychological counseling theories and technologies such as image dialogue technology, self-defense and behavioral therapy. The ultimate goal of psychological counseling is to "help visitors stand on their own feet", so the "placebo" of psychological counseling is not only to use drugs, but also to guide visitors to develop in a positive direction. The placebo of drugs is mainly caused by the visitors' knowledge and feelings about drugs and the psychological-physiological interaction caused by the drug taking behavior itself. Environmental construction and professional ability of consultants should be based on the psychological needs of various visitors, and bring psychological influence to visitors through "first impression effect" and verbal suggestion. The "placebo effect" can be applied to psychological counseling from two aspects: first, the personality characteristics of people who are easily hinted include liking to associate with others, dependence, being easily hinted, lack of self-confidence, and liking to pay attention to their own physiological changes and discomfort; Second, psychological diseases that are easily suggestible, such as hysteria, obsessive-compulsive disorder, some phobias, anxiety, hypochondriacs, nervousness and so on. If both are available at the same time, "placebo" is more likely to produce curative effect.
psychological need
The average age of contemporary college students in China is generally around 20 years old, which belongs to the middle and late adolescence. The psychology of most college students is rapidly maturing, but it is not yet fully mature and has great plasticity. Compared with university education, middle school education in China has great differences in evaluation mechanism, management mode and teaching methods. In addition, college students are paranoid in cognition and tend to go to extremes in emotion, so universities are hotbeds of individual psychological obstacles. Moreover, in recent years, students' psychological problems have become more and more serious. Due to the increase of students' acceptance of information, the increase of employment pressure and their own personality quality, the desire for mental health is more urgent. Contemporary college students hope to have higher cognitive and adjustment ability to their psychological state, and they are also willing to accept help from others. At the same time, the conformity psychology in college students' living environment has a great impetus to students' psychological status quo, so the application of "placebo effect" in colleges and universities will have better results.
Applying the principle of "placebo effect" in college students' psychological counseling
Although the "placebo effect" is of great significance to the psychological growth of college students, if it is not used properly, it is like a double-edged sword. While actively developing individual psychology, it will also produce other negative factors that affect individual psychological growth. Therefore, counselors should follow some basic requirements when using the "placebo effect".
1. Consultants should be familiar with the basic knowledge related to the "placebo effect". Psychological counselors should understand the field of "placebo effect" and its application in the development of psychology, understand its meaning and essence, master its scope of application in psychological counseling, skills used in various forms of counseling and matters needing attention in use, and understand the related counseling methods and related theories and technologies.
2. Applying the psychological effect of "placebo effect" according to the individual differences of visitors is different for everyone. It is closely related to the various conditions of visitors (age, gender, occupation, education status, economic level, etc.). ), personality characteristics, psychological state, mood when receiving counseling, types of psychological obstacles and expectations for counseling itself. In order to improve the timeliness of consultation, counselors should have high judgment, judge the personality characteristics of visitors by listening at the beginning of the meeting, and understand their life background and main obstacle types, so as to adopt the strategy of "placebo effect" in a targeted manner.
3. The application of "placebo effect" should obey the ultimate goal of psychological counseling. As a special psychological function in the process of psychological counseling, it should serve the ultimate goal of psychological counseling. School psychological counseling has the dual goals of education and development, but the development goal is an important part of modern school education. The ultimate goal of counseling is to guide visitors to adjust their cognition, reshape themselves and form a self-reliant personality. And learn some basic skills and techniques of self-psychological adjustment, so the "placebo effect" should not only pay attention to the psychological suggestion in the consultation process, but also inspire visiting students to learn to use self-psychological suggestion in their future lives, and should also pay attention to the following three points:
(1) Avoid relying on drugs or replacing neutral substances.
When instructing patients to use drugs or alternative neutral substances, counselors should take into account a serious psychological impact they may cause, that is, dependence on or addiction to "placebo." The so-called "placebo" dependence or addiction refers to the physical and psychological dependence of visitors on drugs or neutral substances. Once drugs or substitutes are stopped, withdrawal reactions will occur: anxiety, fear, pain, discomfort, weakness, fatigue, insomnia and other symptoms and psychological disorders will recur. In severe cases, delirium tremens may occur: tremor, terror hallucination, auditory hallucination, disturbance of consciousness, excitement, agitation and even collapse and death. Therefore, in order to promote the psychological development of visitors, counselors should attach great importance to the rational use of drugs or substitute substances, strengthen management, and avoid dependence and addiction.
(2) avoid falling into excessive authority.
The existence of authority in school psychological counseling is an important factor in establishing counseling relationship. The authority of consultants helps to gain the trust of visitors and produce positive hints that are helpful to them. However, excessive authority can easily lead both counselors and visitors into misunderstanding: counselors will not pay attention to the words and deeds of visitors, will not measure the words and deeds of visitors with their own values, and will even dominate and control the thoughts of visitors; Visitors will be obedient to the consultants, blindly trusting, and have excessive imitation and even rebellious psychology, so it is necessary to avoid the phenomenon of being too authoritative in consultation.
(3) Avoid excessive empathy. "Empathy" here is a term of psychoanalysis, which means that visitors transfer their emotions and feelings in their lives to counselors. Appropriate emotional transfer helps visitors to expose their psychology, but excessive emotional transfer will emphasize the self-defense mechanism of visitors to psychological counseling, hinder the sincerity of visitors in the interview, and thus can not communicate naturally, affecting the special interpersonal relationship established in the consultation process. In fact, in counseling, both counselors and visitors may have empathy, so counselors should handle their emotions well, not only pay attention to the various attitudes and behaviors revealed by visitors in front of them, but also pay attention not to bring their life experiences and needs into psychological counseling, let alone try to change each other's lives with this emotion, or use this emotion.
Application of "Placebo Effect" Technology in College Students' Psychological Counseling. To create a good consulting environment, we should optimize people and environment, that is, organize the space and decoration of consulting room from the aspects of individual differences, privacy, color and function, handle the consulting room environment well and meet the wishes of visitors. Psychological counseling rooms in colleges and universities should be located in quiet and sparsely populated places on campus, and the floors should not be too high. It is best to set up front and rear doors, and a letter to visitors should be posted at the entrance of the consultation room, indicating the confidentiality commitment and consultation details. The interior design of consulting room should be good at using the sensory characteristics of color. Warm or cool colors will directly make the room feel warm or cold (cool). The psychological consultation room can be equipped with various functional rooms, and the warm house can make visitors feel positive and relaxed; A cool room can make tourists feel safe, quiet and cool. The seats in the consulting room should be soft and comfortable for students to relax. Try to put some potted plants in the consulting room, which can improve the environmental atmosphere, increase the factors of beauty, produce a benign stimulus to people's nerves, make people's skin cool, breathe evenly and relax. In a word, a simple, warm, rich, optimized and unified psychological counseling environment can make students feel warm, relaxed and secure, without worrying about "revealing" secrets, and let students talk about the details of their personal lives with confidence.
2. Establish the authority of consultants. Because China's psychological counseling tends to be suggestion-oriented rather than guidance-oriented, we must attach importance to the authority of counselors. The existence of authority can enhance the dependence and suggestion in the consulting relationship. The consulting reception room shall specify the qualifications of the consultant, such as education, degree, technical title of consulting industry and awards; At the same time, the appearance, manners and manners of consultants should have affinity and influence.
3. Emphasis on the compliance of visitors with "placebo" refers to whether patients take drugs according to the doctor's advice in clinical medicine. There is also compliance in psychological counseling. Compliance refers to whether the visitor listens to the consultant's advice and assigned tasks, which has a great influence on the counseling effect. The effect of "placebo" especially depends on compliance, so the consultant should solemnly inform the visitors that they must do what the consultant asks, and patiently explain to the visitors why they must do so, because failure to do so will cause harm. And respect the reflection and opinions of visitors in the consultation process; Exchange information, strengthen cooperation and understanding, so that visiting students are willing and insist on doing what consultants say, thus improving the timeliness of consultation.
4. The therapeutic effects of drugs and neutral substances suggestive of human diseases are partly related to suggestibility. Therefore, this role can not be ignored in psychological counseling, especially for mental diseases that need drugs or substitute substances for auxiliary treatment. Usually, after a person is sick, he needs more drug treatment, because drugs have physiological effects; It can also cause good feelings in patients' psychology through non-physiological effects, that is, the psychological effects of drugs. It is generally believed that the psychological effect of drugs has nothing to do with its pharmacological effect, but the physiological effect of drugs can be used to strengthen the verbal suggestion effect, which is particularly prominent in suggestive psychotherapy. Counselors, visitors themselves and their partners should make timely and appropriate use of psychological effects to enhance the therapeutic effect of drugs and neutral substances, such as choosing the right time of administration, cooperating with appropriate oral hints, eliminating the influence of adverse reactions, etc., which can achieve good results.
5. Actively paying attention to visitors and encouraging positive attention means that consultants treat visitors with a positive attitude and pay attention to their strengths, that is, selectively highlighting the positive aspects of visitors' words and behaviors and using their own positive factors. The active attention of consultants will broaden the horizons of visitors and help them reopen the door of hope. Through active attention, counselors can constantly look for the advantages and positive aspects of visitors, and at the same time directly and clearly solve their problems and help visitors face up to the world they live in. At the same time, nonverbal clues such as speech, intonation, expression, posture and action are used to express the encouragement of psychological counselors to visitors, so that visitors can feel warm and show themselves to change their psychological state.
6. Guide visitors to actively recognize that "cognition plays a decisive role in the generation of emotions". At the same time, it also affects the individual's attribution to behavior, and then affects his emotional state. Positive cognition will produce positive attitude and objective and correct behavior evaluation, and vice versa will lead to negative attitude and unreasonable behavior evaluation. Therefore, the role of "placebo" is to guide visitors to adjust their self-cognition during the consultation process and in their future life, and to adjust their physical and mental state with positive cognition.
7. The verbal suggestion of psychological counselor has a great influence on the psychological effect of "placebo". Counselors can strengthen their effects through words, and can also eliminate their adverse reactions through words. Sometimes drugs or substitute substances can be used to strengthen the suggestive function of language. For example, patients with hysteria often use intravenous injection of calcium gluconate or bromocaffeine, and the effect is good.
8. Guide tourists and partners to create a good living environment. The living environment of visitors can also serve as a "placebo". Visitors need to create a safe environment for growth, including spiritual environment and material environment. For example, the colors of furniture should not be too bright, but should be varied to convey an aesthetic consciousness. The living environment should be lively, natural and simple, with some inspiring decorations. At the same time, the attitude towards visitors should be equal, respectful, caring and warm, which is conducive to the formation of visitors' optimistic, lively and cheerful personality and modern aesthetic taste. [2] It should be
Standardizing the use of stabilizers is a sign of social civilization.
The so-called "placebo effect" refers to taking drugs that have no corresponding curative effect at all without letting patients know, but patients have achieved good results. "Sedative effect" exists widely in clinical practice. For example, people worship experts and famous doctors and trust so-called good drugs, expensive drugs and imported drugs, which is also the "placebo effect".
We are a mental hospital. In clinical practice, many doctors use placebos to treat patients who are dependent, easy to accept hints, lack self-confidence, pay too much attention to their own physiological changes and discomfort, tend to be hypochondriac, neurotic and mentally ill. It is also a common means and method in the treatment of mental illness, which has achieved good results and is essentially different from ethics.
For example, calcium bromide static massage and No.4 electricity commonly used in our hospital treat patients with neurosis and physical discomfort. The same patient, different medical staff or the same patient, and the same nurse have different attitudes (facial expressions, instructions, emotions, etc. ) will get different therapeutic effects. Therefore, it must be noted that when using placebo, we should strictly follow the operating procedures, observe the patient's condition changes, and cooperate with psychotherapy, and know that about 35% of patients with physical diseases and 40% of patients with mental diseases will have this effect, so as not to delay the illness and cause adverse consequences. It is also necessary to prevent quacks and witch doctors from using the characteristics of patients' placebo effect to display their medical skills.