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Placebo reduces feelings of guilt

Summary: Placebos can help reduce feelings of guilt, even when the placebo is given overtly, reports a new study.

Source: University of Basel

People don’t always behave impeccably towards others. When we realize that this has inadvertently caused harm, we often feel guilty. This is an uncomfortable feeling and motivates us to take corrective action, such as apologizing or confessing.

This is why guilt is considered an important moral emotion, as long as it is adaptive, that is, appropriate and proportionate to the situation.

“It can improve interpersonal relationships and is therefore valuable for social cohesion,” says Dilan Sezer, a researcher at the Division of Clinical Psychology and Psychotherapy at the University of Basel.

Whether feelings of guilt can be reduced by taking placebos is something that researchers at the Faculty of Psychology at the University of Basel have been exploring.

Their findings were published in the journal Scientific Reports.

open placebos work

In order to arouse feelings of guilt, study participants were asked to write about a time when they broke important rules of conduct or treated someone close to them unfairly, hurt, or even harmed them. The idea was that the study participants would still feel bad about the chosen situation.

Participants were then randomized to three conditions: participants in one group were given placebo pills with the misleading information that it was a real medication, while participants in the other group were given a placebo. Both groups were told that what they received would be effective against feelings of guilt.

The control group received no treatment. Results showed that feelings of guilt were significantly reduced in both placebo groups compared to those without medication.

This was also the case when subjects knew they had received a placebo.

“Our study therefore supports the intriguing finding that placebos work even when they are administered overtly, and that explanation of the treatment is the key to their effectiveness,” says lead author Dilan Sezer. The participants in this study were all healthy, did not have psychiatric disorders and were not being treated with psychotropic drugs.

Clinical applicability not yet proven

When guilt feelings are irrational and persist for long periods of time, they are considered maladaptive – in other words, disproportionate. These emotions can affect people’s health and are also, among other things, a common symptom of depression.

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When guilt feelings are irrational and persist for long periods of time, they are considered maladaptive – in other words, disproportionate. The image is in the public domain

Scientific studies have shown that placebo effects can be powerful in treating depression. But the discovery that open-label placebos might also be helpful for strong emotions like guilt is new. It stands to reason, says Dilan Sezer, that we should try to take advantage of these effects to help those affected.

“The administration of open-label placebos, in particular, is a promising approach as it preserves patient autonomy, allowing patients to be fully aware of how the intervention works.”

The study results are a promising first step toward symptom-specific and more ethical treatments for psychological complaints using open-label placebos, continues Sezer.

More research will need to be done to see whether maladaptive guilt can be treated with placebos. And it remains to be seen whether similar effects are also possible with other feeling states. For Dilan Sezer, one thing is certain: “The use of open-label placebos would be a cheap and direct treatment option for many psychological and physical complaints”.

About this psychology research news

Author: Noemi Kern
Source: University of Basel
Contact: Noemi Kern – University of Basel
Image: The image is in the public domain

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Original search: Free access.
“Oblivious and overt placebo effects in experimentally induced guilt: a randomized controlled trial in healthy subjects” by Dilan Sezer et al. Scientific Reports


Deceptive and overt placebo effects in experimentally induced guilt: a randomized controlled trial in healthy subjects

Placebos are known to produce significant effects in many conditions. We examined overt and misleading placebo effects on guilt, which is important for self-regulation and a symptom of mental disorders.

After an experimental guilt induction, healthy subjects were randomized to a sham placebo (DP; n= 35), open-label placebo (OLP; n= 35), or no treatment (NT; n= 39). The primary outcome was guilt responses assessed in the area under the curve (AUC). Secondary outcomes were shame, guilt, and affection.

Our hypothesis is that DP and OLP would reduce guilt compared to NT. Blame responses were greater in the NT group than in the placebo groups (estimate = 2.03, 95% CI = 0.24–3.82, d= 0.53), while AUC guilt did not differ significantly between placebo groups (estimate = −0.38, 95% CI = −2.52–1.76, d= −0.09).

Placebos are effective in reducing acute guilt responses regardless of placebo administration (ie, overt versus misleading).

Furthermore, we observed narrative-specific effects with significant shifts in guilt but not in shame, pride, or affection.

These results indicate not only that guilt is amenable to placebos, but also that placebos can be administered in ethical and potentially emotion-specific ways.