Why doctors should look for ways to prescribe hope

Researchers are still trying to understand the connection between body and mind, and how our thoughts can influence our physiology. In the meantime, many are developing ways to harness it in hospital settings. Is it possible for a doctor to prescribe hope?

Alexander Montasem, a lecturer in psychology at the University of Liverpool, is trying to find an answer to that question. In his latest study, Montasem and his colleagues focused on people with cardiovascular disease.

The team reviewed all published research into the link between hope and heart health outcomes in such individuals. Hope is a pretty tricky thing to nail down, but these studies use questionnaires to try to do that. In one popular questionnaire, hope is defined as “a positive motivational state” based on having agency and plans to meet personal goals.

Montasem’s team found 12 studies that fit the bill. All told, these studies included over 5,000 people. And together, they found that high hopefulness was associated with better health outcomes: less angina, less post-stroke fatigue, a higher quality of life, and a lower risk of death. The team presented its work at the British Cardiovascular Society meeting in Manchester earlier this week.

When I read the results, it immediately got me thinking about the placebo effect. A placebo is a “sham” treatment—an inert substance like a sugar pill or saline injection that does not contain any medicine. And yet hundreds of studies have shown that such treatments can have remarkable effects.

They can ease the symptoms of pain, migraine, Parkinson’s disease, depression, anxiety, and a host of other disorders. The way a placebo is delivered can influence its effectiveness, and so can its color, shape, and price. Expensive placebos seem to be more effective. And placebos can even work when people know they are just placebos.

And then there’s the nocebo effect. If you expect to feel worse after taking something, you are much more likely to. The nocebo effect can increase the risk of pain, gastrointestinal symptoms, flu-like symptoms, and more.