Hello, everyone. Today, I want to dive deeper into a fascinating topic within psychotherapy: the placebo effect. It’s one of the so-called external common factors of therapy and one that sparks both curiosity and controversy. While often misunderstood, the placebo effect plays a significant role in shaping the outcomes of therapeutic practices. Let’s explore how it works, why it’s so impactful, and how some professionals—both ethical and not—use it to their advantage.

The Power of Belief

When we talk about the placebo effect in therapy, we’re really talking about perception versus reality. The placebo effect doesn’t mean a person is truly healed; instead, it means they feel healed, often without any real therapeutic mechanism at play. This distinction is important because it reveals both the potential and the pitfalls of this phenomenon. Whether we like it or not, belief can be a powerful ally—or a deceptive enemy—in psychotherapy.

Creating Expectations: The Foundation of Placebo

The placebo effect begins long before therapy even starts, with the creation of expectations. People often enter therapy with preconceived notions about what will happen and how it will help them. A skilled therapist knows how to leverage these expectations. For example, emphasizing the effectiveness of certain techniques or pointing out success stories can significantly boost a client’s confidence in the process.

But it’s not just about words. Body language, tone of voice, and even the office environment contribute to this. A professional, polished image can instill confidence and foster trust. It’s no coincidence that many therapists pay close attention to how they present themselves, from their credentials on the wall to the soothing atmosphere of their workspace.

The Image of the Therapist

This brings us to the therapist’s image and personality. Clients often project their own ideas of success onto their therapists. A therapist who appears confident, accomplished, and knowledgeable is more likely to inspire trust and commitment. People are naturally drawn to leaders—those who seem to have their lives together. This perception creates a subtle dynamic where clients feel they can rely on the therapist, making them more receptive to therapeutic interventions.

Interestingly, some therapists go to great lengths to maintain this image. They project success in every aspect of their lives, even when it might not be entirely accurate. The logic is simple: if clients see the therapist as someone they aspire to emulate, they’ll feel more motivated to follow their guidance.

Rituals and Meaning

One of the most curious aspects of the placebo effect is how rituals can amplify its power. In therapy, rituals don’t have to be elaborate or esoteric; they can be as simple as a structured routine or specific therapeutic exercises. These rituals, regardless of their scientific validity, gain meaning because the client believes in them.

For instance, metaphorical techniques or visualization exercises might seem strange at first glance. However, they work because they invite the client to assign personal meaning to the process. The more meaning they find, the stronger the placebo effect becomes. This is why even the most unconventional approaches can sometimes yield surprising results—they tap into the client’s ability to justify and create significance.

The Role of Investment

Let’s not forget the psychological principle of investment. Whether it’s time, money, or emotional effort, clients are more likely to value and commit to therapy when they’ve invested in it. It’s human nature to want to protect what we’ve spent our resources on. This is why higher-priced therapy sessions or long-term commitments often seem to yield better outcomes—not because the therapy itself is better, but because clients are motivated to make it worthwhile.

This also applies to non-monetary investments. Clients who must travel great distances for therapy or complete challenging preparatory exercises often develop a stronger attachment to the process. The effort they put in creates a sense of ownership and accountability, which fuels their belief in therapy’s success.

Emotions and Engagement

Another crucial factor is emotional engagement. People are more likely to feel satisfied with therapy when they experience strong emotions during the sessions. Whether it’s laughter, tears, or even frustration, emotional intensity helps create a sense of progress. This is why interactive and experiential techniques often resonate more with clients than purely analytical ones. The more involved the client feels, the more they believe in the value of the therapy.

Expecting Success

It’s also important to consider the client’s expectations of the therapy process itself. Clients often come with specific ideas about how therapy should unfold. Some expect deep, introspective conversations, while others hope for quick, tangible solutions. A mismatch between expectations and reality can lead to disappointment, even if the therapy is effective.

For therapists, this means striking a balance. It’s essential to guide the client without completely disregarding their expectations. In some cases, meeting the client’s expectations—even with methods that seem less effective—can strengthen their belief in the process and enhance the placebo effect. After all, belief is a critical ingredient in therapeutic success.

The Thin Line Between Use and Abuse

Here’s the tricky part: the placebo effect is a double-edged sword. Used ethically, it can boost therapy outcomes and motivate clients. However, it can also be exploited by those who prioritize appearance over substance. This is why some so-called therapists or self-help gurus achieve seemingly miraculous results through little more than charisma and theatrics. While these approaches may leave clients feeling good temporarily, they often lack the depth needed for lasting change.

The key is to use the placebo effect as a supporting tool, not a standalone strategy. It can complement genuine therapeutic work by fostering trust, engagement, and motivation, but it should never replace real psychological interventions.

A Balanced Approach

In the end, the placebo effect is neither inherently good nor bad—it’s simply a psychological phenomenon that can be harnessed in different ways. For therapists, the challenge lies in using it ethically and effectively. By understanding its mechanisms and incorporating it thoughtfully into the therapeutic process, we can enhance the client’s experience and pave the way for meaningful growth.

Psychotherapy isn’t just about methods and techniques; it’s about belief, connection, and the human capacity for change. By respecting the power of these factors, we can create a more impactful and rewarding therapeutic journey.