How to Boost Brain Chemistry: Your Doctor's Good Bedside Manner Helps

Patients crave a deep relationship, full of empathy and trust, with their doctor or health care provider. Even during the brief visits that are, unfortunately, forced on our providers by profit-conscious administrators, we can still benefit from a few moments of emotional sincerity and contact. Recent studies have demonstrated that the positive influence of these ephemeral relationships extends beyond simple emotional rapport to influence our long-term physical-health outcomes. This intangible benefit is called the placebo effect.

The placebo effect has always played an important role in medical practice. In the past, healers, shamans, and mediums relied on their showmanship to induce a placebo effect. Today, naturopaths, homeopaths, and chiropractors rely on the placebo effect to sell their services.

Unfortunately, our understanding of the neural mechanisms that underlie the placebo effect is incomplete. Clinical and laboratory studies demonstrate that the placebo effect influences our symptoms as well as the outcome of medical treatments. Randomized double-blind trials have demonstrated that the placebo effect induces genuine improvements in health that can be corroborated by specific physiological changes. Converging evidence across diverse medical conditions suggests that clinically relevant benefits from placebo treatment are facilitated by clinicians who demonstrate warmth and proficiency during interactions with patients.

A recent study considered the role of the health care provider’s self-confidence and warmth in patient-provider interactions to better understand how providers can boost the placebo effects alongside active medications (i.e., with known medical ingredients) and treatment in a typical clinical care environment. The researchers investigated whether intranasal oxytocin could influence acceptance of advice given on resolving health concerns by either an individual expert (their physician) or a non-expert advisor with or without influencing their perceived likeability or trustworthiness. The study concluded that oxytocin is a key mediator of treatment success across a wide spectrum of interventions that increase social connectedness between patient and doctor.

Their discovery is consistent with current theories that oxytocin regulates many aspects of parental nurturing as well as other social behaviors in both sexes. Oxytocin may also play a role in stimulating bonding between mother and child. Humans who sniff oxytocin via a nasal spray become more trusting. Other studies have linked exposure to oxytocin with reduced social anxiety. It may also increase social cohesion by making us more willing to trust others and or to conform to their opinions.

Fortunately, medical schools now realize the importance of teaching their students to communicate better with their patients, demonstrate confidence and empathy, and take the necessary steps to make patients feel comfortable. Researchers are now uncovering the neurobiological mechanisms that might underlie the health benefits of a caring bedside manner.