Effet Placebo

Et si il était possible de se soigner par le simple pouvoir de la pensée ? Nous avons entre 45 000 et 60 000 pensées par jours, imaginez que chacune d’elles puissent jouer un rôle sur la guérison, le bien être….  le placebo vous connaissez ?….

Et si il était possible de se soigner par le simple pouvoir de la pensée ? Nous avons entre 45 000 et 60 000 pensées par jours, imaginez que chacune d’elles puissent jouer un rôle sur la guérison, le bien être….  le placebo vous connaissez ?….

  • L’Icroyable Histoire DE MR WRIGHT

Nous sommes dans les années 50, Mr Wright est atteint d’un cancer en phase terminale des ganglions lymphatiques (lymphosarcome). D’énormes masses tumorales  l’envahissent et résistent aux traitements prolongés. Hospitalisé en unité de soins intensifs, le patient subit des ponctions et se voit administrer de puissants sédatifs pour le soulager. Ses différents organes et son système respiratoire souffrent de la maladie et des traitements qu’ils subissent. Son médecin n’a que peu d’espoirs de le voir guérir et lui donne un maximum de deux semaines à vivre. Mr Wright ne désespère pas, un nouveau médicament, le « Krébiozène » est en phase expérimentale et les articles de presse spécialisés laissent entendre qu’il sera particulièrement efficace pour le traitement du cancer. Le malade à convaincre son médecin de lui administrer ce médicament lorsqu’il sera livré pour les phases de test dans la clinique où il se trouve…

…Le vendredi, Mr Wright reçoit une première injection, le lundi il se ballade dans les couloirs de la clinique et propose ses encouragements à qui veut bien les entendre. Au grand étonnement du médecin, une semaine seulement après les premières injections, les masses tumorales se résorbent et une dizaine de jours plus tard, M. Wright quitte l’hôpital. Quelques jours avant la première injection ce malade était fiévreux et mourant et alors que le traitement n’a aucun effet sur les autres cancéreux, voici que Mr Wright rentre chez lui tout revigoré ! C’est ainsi que durant plus de deux mois il retrouve peu à peu la santé, le cancer est en rémission et le médecin bien que très étonné est particulièrement confiant, les masses tumorales disparaissent…

…Les résultats de l’étude sur le nouveau traitement dont a bénéficié Mr Wright sont publiés, révélant au monde qu’il n’est pas à proprement dit efficace. Mr Wright est alors très affecté par la nouvelle et devant l’insistance des médias, finit par perdre confiance et espoir, en peu de temps  tous les symptômes de son cancer se développent à nouveau avec encore plus de virulence.

Le médecin tente alors le tout pour le tout et décide de réanimer l’optimisme dont jadis son patient avait fait preuve. Il travestit la vérité et lui explique que les précédents produits n’avaient pas été correctement conditionnés et en avoir commandé de nouveaux bien plus puissant. Il précise également que contrairement à ce que disent les journalistes le médicament est très prometteur et que la rémission dont il avait profité ces deux derniers mois était bien le résultat de ces premières injections. Mr Wright voit renaitre de l’espoir et acceptele médecin prépare lui même l’injection (une eau pure sans aucun principe actif) et l’administre à son patient tout heureux de se voir bientôt guérit.

De façon encore plus spectaculaire après quelques injections d’eau (seul le corps médical était au courant) le patient voit les masses tumorales fondre comme neige au soleil,  M. Wright est à nouveau sur pieds en quelques jours. Encore une fois, deux mois passent permettant à cet homme de s’auto-guérir sans en avoir jamais conscience. Le cancer est en rémission et le patient se porte de mieux en mieux chaque jour un peu plus. Malheureusement, les médias s’en mêlent à nouveau et annoncent que les tests conduits dans l’ensemble du pays démontrent que le médicament n’a décidément aucun effet dans le traitement du cancer. Quelques jours après cette annonce, M. Wright est hospitalisé dans un état désespéré. Cette fois , il n’y croit plus et meurt en moins de 2 jours.

Cette histoire illustre parfaitement, le pouvoir de notre esprit et notre capacité d’auto-guérison plus connu sous le terme d’effet placébo.

PLACÉBO ?effet placebo

Placébo signifie « Je plairai » en latin, cette traduction est intéressante car nous comprenons alors la notion de flatterie et le raccourcis qui mène parfois un peu vite au charlatanisme, terme lui même associé souvent à tort à l’escroquerie.  Comme le souligne Michel Le Van Quyen chercheur à l’INSERM (dirigeant d’un groupe de recherche à l’institut du cerveau et la moelle épinière à l’hôpital de la Pitié-Salpétrière) dans son livre Les pouvoirs de l’esprit, « L’effet placébo est souvent connoté négativement. Cela s’explique sans doute par le fait que les médecins tendent à douter de la réalité de l’effet placebo, car admettre son importance met en danger leur image et leur pouvoir » . La première définition officielle remonte selon l’auteur Patrick Lemoine à 1811 dans un dictionnaire médical anglais. L’effet placebo ou, pourrait on dire, « la réponse placebo » est une réaction physiologique à une cause psychologique (pensée, croyance, auto suggestion, suggestion…). En 1955 une étude de l’anesthésiste Henry K Beecher de l’université de Havard faisait savoir que 35% des patients souffrant de douleur étaient soulagés par la simple prise d’un comprimé de sucre ou d’une injection de sérum physiologique. Des études plus récentes révèlent que l’effet placébo est plus important encore car on parle de 70 à 100% et on sait aujourd’hui que le placebo est équivalent à une dose de 5mg de morphine intraveineuse pour traiter la douleur.

Le futur professeur Henry K Beecher, avait été directement concerné par l’effet placebo lors de la seconde guerre mondiale dans son hôpital de campagne, il devait soigner les atroces souffrances de soldats pris sous le feu allemand. A court de morphine il entreprit d’injecter à ces malheureux une simple dose de solution saline en leur disant que la douleur allait très vite s’en aller… et ce fût le cas. Nous savons que l’effet placebo est constaté chez 30% des patients toutes pathologies confondues ceci étant, en fonction du trouble dont souffre la personne il peut y avoir de fortes variations allant de 10 à 70% et même 90% pour l’arthrite. Mais alors qu’est-ce qui fait qu’il puisse y avoir de nombreuses variation lors de la prise d’un placebo ?

CE QUI FAIT LE PLACEBO

Il est intéressant de noter que l’efficacité du placebo est multi factorielle. Ainsi les études montrent que la méthode d’administration, la posologie, le cadre dans lequel il est administré et même l’intention du praticien qui prescrit jouent un rôle déterminant. La réputation du thérapeute ou du médecin, sa capacité d’écoute, d’empathie et sa bienveillance  vont avoir une incidence non négligeable sur l’efficacité du traitementdonc de la guérison. Nous savons également que deux cachets (même sans principe actif) seront plus efficaces qu’un seul, que la couleur, la taille et le mode d’administration ont aussi une importance déterminante.  Enfin comme le raconte l’histoire de M Wright la croyance du patient en l’efficacité de son traitement sera déterminante. Par exemple l’effet du placebo est quasi nul dans les cas de cancers car il se heurte à une croyance très forte, celle que cette maladie est mortelle et il y a fort à parier que si cette croyance était défaite les cas de guérisons du cancer seraient beaucoup plus nombreux. Dans son excellent ouvrage, Le pouvoir de l’esprit, Michel le Van Quyen nous explique à son tour  :

L’injection est plus efficace que la gélule, qui est plus efficace que la pilule, qui fonctionne mieux qu’une simple potion, etc. De plus la couleur blanche du médicament fonctionne mieux pour la douleur, le rouge fonctionne comme un stimulant, le bleu comme un bon remède apaisant…. Mieux encore, un placebo qui coûte cher est plus efficace qu’un placebo bon marché.

Encore plus fort, la croyance de l’efficacité d’un traitement par les personnes qui l’administrent va avoir un impact conséquent, ainsi la conviction du thérapeute est un élément essentiel pour l’obtention d’un bon résultat. Une revue de pharmacologie « The pharmacology of placebo » Wolf Stewart (1959) rapporte de façon très claire cette influence :

Le docteur Stewart traitait depuis de nombreuses années un patient asthmatique en proie à des crises quasi permanentes. Il demanda à un laboratoire pharmaceutique de lui livrer un nouveau médicament réputé très efficace. Il le fit prendre à son patient , dont l’état s’améliora rapidement; suspectant un effet purement psychologique le médecin commanda un placebo de ce médicament bientôt donné au patient à son insu : Rechute immédiate. Aussi répéta-t-il plusieurs fois l’expérience : chaque fois que le patient prenait le médicament, il s’en trouvait fort mieux pour rechuter à chaque nouvelle prise du placebo. Wolf finit alors par être convaincu de l’efficacité du médicament et en informa le laboratoire. Cependant à sa grande stupeur, il comprit que dès le début, son patient n’avait reçu que du placebo ! D’une certaine façon le docteur avait influencé l’état du malade par sa propre conviction vis-à-vis de l’efficacité de son traitement.

Les auteurs précédemment cités remarquent également que l’effet placebo est comme une sorte de cailloux dans la chaussure. Pour les chercheurs, les laboratoires et les médecins, il peut être perçu comme un empêcheur de tourner en rond. Selon eux cela peut être du à la culture de performance. Pour Thierry Janssen dans son excellent ouvrage, la solution Intérieure« le médecin doit faire preuve de ses compétences et les rôles seraient donc attribués : Le patient subit, le médecin soigne et guérit » et de rajouter : « Une participation active du malade au processus de guérison remettrait en cause l’efficacité et l’utilité du soignant ». Il en serait alors de même de l’industrie pharmaceutique qui pour des raisons évidentes de profit aurait tout intérêt de minimiser autant que possible l’effet placebo« L’effet placebo constitue une véritable blessure narcissique pour le médecin » nous dit également les auteurs du livre, Guérisons remarquables. Pour beaucoup malgré le fait que l’effet placebo joue un rôle essentiel dans le processus de guérison il est très souvent réduit à un phénomène « psychologique » autrement dit sans vrai consistance, il n’existerait que dans la tête des patients… En réalité on ne croit pas si bien dire.

C’EST DANS LA TÊTE !

placebo

Il est prouvé que les placebos ont d’incontestables propriétés neurologiques. En effet, selon les différentes études menées sur la douleur, l’hypothèse est faite en 1978 que la prise d’un placebo déclenche une sécrétion d’endorphines produites par le cerveau  (hypothalamus et hypophyse), il en résulte un effet analgésique.

L’endorphine est une hormone naturelle qui peut être comparée à la morphine, elle apporte un sentiment de bien être, on dit qu’elle est l’hormone du bonheur et elle est bien connue des sportifs. Lors de cette étude, et pour confirmer son observation, le chercheur Jon Levine administre à ses patients souffrants de douleurs dentaires de la « nolaxone », un produit qui bloque l’action des endorphines. Il observe alors que la douleur revient immédiatement ce qui valide ainsi son hypothèse. Ces observations sont confirmées des années plus tard par l’imagerie cérébrale fonctionnelle et vont même plus loin. En effet, Dans les années 1990, le chercheur Martin Igvar (Institut Korolinska à Stockholm) démontre que les zones cérébrales qui s’activent lors de la prise d’un placebo sont exactement les mêmes que celle qui s’activent lors de la prise de morphine.

Nous savons également que la douleur a une dimension sensorielle et émotionnelle (la douleur peut être amplifiée par la dimension émotionnelle) et il a été constaté que l’action du placebo se fait essentiellement sur le cortex cingulaire antérieur qui gère la dimension émotionnelle de la douleur. Nous comprenons alors qu’à la simple idée d’avoir un médicament efficace – donc d’être bientôt soulagé – le sujet de façon inconsciente va réduire la douleur par l’activité du cortex cingulaire antérieur grâce au neurotransmetteur du plaisir et de la récompense que l’on appelle dopamine. Ceci démontre que l‘effet placebo est associé à l’attente ou à la croyance d’un soulagement par celui qui le reçoit. Certaines études ont même montré que les personnes souffrants de la maladie de Parkinson, résultant d’une dégénérescence de neurones cérébraux producteurs de dopamine, pouvaient bénéficier d’une réduction de leurs symptômes moteur grâce au placebo lui même générant par son effet de la dopamine. Voici à nouveau ce que rapporte Michel Le Van Quyen dans son livre « le pouvoir de l’esprit » :

Des chercheurs de l’université du Colorado ont traité 39 patients volontaires par des greffes de neurones dopaminergiques. L’objectif était ici de remplacer des neurones perdus chez le malade par la transplantation de nouveaux tissus, dans le but de restaurer durablement les mouvements normaux chez les patients. Comme dans tout essai thérapeutique, les patients savaient que seuls certains d’entre eux seraient réellement opérés, tandis que les autres subiraient une opération factice, donc placebo. Un total de 19 malades se sont vus implanter de nouveaux neurones dans leur cerveau, tandis que les 20 autres patients ont également été emmenés au bloc opératoire et préparés, mais les médecins ont seulement fait semblant de les opérer, aucune transplantation de tissus n’étant réellement effectuée…. Quelques mois plus tard, les chercheurs ont évalués la qualité de vie de tous les participants à l’étude, parmi d’autres paramètres cliniques. résultat ? Une amélioration comparable de la qualité de vie a été constatée chez les deux groupes…. Lorsque les patients s’attendent à bénéficier d’un traitement, ils libèrent de la dopamine, le neurotransmetteur qui fait précisément défaut dans la maladie de Parkinson

De nombreuses études comme celle-ci ont été menées et démontrent l’incroyable pouvoir de la pensée, l’une d’elle, menée par une neurologue de Toronto nous apprend que le placebo a eu sur les patients autant d’effet que la prise de Prozac ! Autrement dit, le placebo avait agit de la même manière que l’antidépresseur dans les même zones du cerveau. On comprend mieux que les laboratoires ne soient pas emballés lorsque l’on parle de placebo ;). À plus large échelle (3000 patients) toujours concernant les antidépresseurs, des psychologues ont conclu que 75% des bénéfices thérapeutiques venaient de l’effet placebo  contre 25 % attribué à l’action du médicament ! Quand on connait les effets secondaires de ce genre de médicaments ne faudrait il pas se poser les bonnes questions ? surtout si l’on joint à cela le fait que la plupart des prescriptions d’antidépresseurs sont faites pour des « déprimes » passagères et les « sentiments de mal être » comme nous l’expliquent les psychiatres dans l’émission « mort sur ordonnance » diffusée sur France 5. Si le pouvoir de la pensée, de la croyance, de la suggestion sont si puissants et peuvent soulager des patients, qu’en est il de la pensée ou de la croyance négative ? Il m’arrive assez souvent d’évoquer le fait que nous faisons souvent de l’auto-hypnose négative et que cela fonctionne très bien, voilà qui nous mène à nous intéresser au revers de la médaille.

Nocebo

EN CONCLUSION

Le pouvoir d’autoguérison, bien qu’il ne fasse pas l’affaire de tous n’en demeure pas moins réel et parfois très impressionnant. N’aurions nous pas tous à y gagner si dans l’accompagnement des maladies qu’elles soient physiques ou psychologiques l’effet placebo était utilisé au maximum ?  Nous pouvons toujours espérer que dans un avenir pas si lointain, l’effet placebo soit utilisé au maximum et que l’on rende à chacun son propre pouvoir de guérison limitant ainsi une médication qui, bien qu’elle soit parfois indispensable, peut aussi s’avérer être inutile et non sans effets secondaires. Je vous propose dans l’article « Efftet Nocebo le pouvoir des pensées négatives » de nous pencher un peu plus sur l’effet nocebo moins connu que le placebo mais tout autant puissant pour notre plus grand malheur !

Alors les amis, aviez vous conscience des immenses pouvoir de votre pensée ? Avez-vous des anecdotes à partager ? Si oui et si bien sûr vous souhaitez raconter votre histoire et réagir à cet article cela me fera terriblement plaisir ! Alors j’attends vos commentaires avec impatience et en attendant, n’oubliez pas de partager avec vos amis, il est urgent que chacun soit informé des super pouvoirs de la pensée surtout ceux dont les pensées sont négatives.

 

Source: Philosovie

Comments

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