The placebo effect is a well know phenomenon in which a fake treatment still leads to improvement in the illness. However, for some people, these placebo treatments work, and for others, they do not. This difference in responsiveness has lead researchers to search for a “placebo personality” – stable individual characteristics that could predict a person’s responsiveness to a placebo treatment. Years of research found multiple different characteristics related to the placebo effect, but the overall finding was that a single personality trait would not predict placebo responsiveness. Rather, a much more nuanced view was needed.
To begin, there is an overall conceptual framework into which the personality characteristics related to placebo responsiveness can be organized. This framework breaks people into two different categories: inward orientation and outward orientation. Inward orientation is characterized by a tendency to focus on internal states and outward orientation by a desire to interact with the environment and attain positive, external goals and rewards. Inwardly oriented people who are compliant, suggestible (both perceptually and hypnotically), and absorbed in their own inner world, and outwardly oriented people who are extraverted, optimistic, reward seeking, and ego-resilient tend to be the most responsive to placebos.
Next, the relationship between the patient and the environment must be considered. The responsiveness to the placebo treatment may be most likely to occur when there is a match between the patient’s personality characteristics and the context in which the patient receives the treatment. So inwardly oriented people might be most responsive to a placebo when the treatment is given in an authoritative manner, in a non-threatening environment, and where they are instructed to focus on how they feel internally. Outwardly oriented people however, might be more responsive when they receive the treatment from a friendly or empathetic practitioner, or in an exciting or novel way.
Now, not everyone is convinced that the “placebo personality” is a valid thing, and certainly more research needs to be done in the area. But, there is definitely reason to keep looking into it. Being able to predict a patient’s responsiveness to a placebo treatment could be helpful in making decisions for treatment and dosage amount. Additionally, this knowledge would be useful for treating patients with psychosomatic complaints (complaints about physical issues that are caused or worsened by mental factors) and illnesses without medical explanations. Especially for illnesses that have no known biological source, being able to identify or create conditions in which a placebo treatment would be effective would be able to save time, money, and possible harm to the patient due to side effects of real drugs.
Darragh, M., Booth, R.J., & Consedine, N.S. (2015). Who responds to placebos? Considering the “placebo personality” via the transactional model. Psychology, Health, and Medicine, 20(3), 287-295.