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Implications for dualism
Page 324 Black blue 324 HEALTH PSYCHOLOGY lifestyle, then a placebo in the form of a medical intervention may not work, as the doctor’s expectation of failure may be communicated to the patient. Furthermore, theories of health professionals’ health beliefs and their role in doctor–patient communication illustrate a useful emphasis on interaction rather than individual characteristics. Health-related behaviours A placebo may function via changes in health-related behaviour. If an individual believes that they have taken something or behaved in a way that may promote good health, they may also change other health-related behaviours (e.g. smoking, drinking, exercise), which may also improve their health. Furthermore, the choice to take a medication may itself be seen as a health-related behaviour, and may be predicted by theories of behaviour and behaviour change. Stress Placebos also have implications for understanding responses to stress. If placebos have an effect either directly (physiological change) or indirectly (behaviour change) then this is in parallel with theories of stress. In addition, placebos may function by reducing any stress caused by illness. The belief that an individual has taken control of their illness (perceived control) may reduce the stress response reducing any effects this stress may have on the illness. Pain Placebo-induced pain reduction may be mediated either by physiological changes, such as opiate release, or by anxiety reduction. Both of these changes can be explained in terms of the gate control theory of pain, which suggests that the experience of pain is a result of an interaction between psychological (beliefs, anxiety) and physiological (opiates) processes. Previous experience and expectation are also implicated in pain reduction. Perhaps, placebo-induced pain reduction may also be mediated by patient expectations and previous experience about the efficacy of the treatment intervention. Implications for dualism Placebos indicate that an individual’s symptoms and health status may be influenced by their expectations, beliefs and previous experience. These factors are central to health psychology in its attempt to challenge the traditional biomedical approach to health and illness. If an individual’s psychological state can influence their health, then perhaps the mind and body should not be seen as separate entities but as interacting. This is, in part, in contradiction to dualistic models of the individual. However, this interaction still assumes that the mind and body are distinct; to interact with each other, they still need to be defined as being separate. Page 324 Black blue