Dr. Tor Wager & Laura Seago
This interview is from the Like Mind, Like Body podcast.
How do you explain what you do to your 9 year old?[Laughs] Ok. My 9 year old is very interested in brain science by the way, he wants to know all the parts of the brain, how things work. [laughs] Sometimes he wants to be a scientist like his dad.We use brain imaging. So we record images from a living human brain and I study what the effects are of thoughts, feelings and emotions on the body. Especially on pain and health related outcomes.I’ve been interested for years on “What does it matter what you think?”And what’s the biggest revelation you’ve had in your study of brain imaging, does it matter what we think?
Yes. [laughs] I think one of the revelation for me, is we do a lot of studies on placebo effects. So one of the first controlled studies of what happens when you get a fake medication and you believe it’s real, especially to your brain. When I got into doing this work, I really didn’t know whether placebo treatments were going to be effective at all. People are pretty reliable on how they rate pain, its experience. I didn’t think it was going to work. But, it did work in the sense that getting a sham treatment relieved people’s pain. Sometimes substantially. We saw a number of changes that go along with that in the brain systems that seem to encode pain and emotions and decisions around pain. So the idea of placebo treatments, just the idea of being treated and engaging in treatment can actually be effective has been one of the biggest revelations for me. Because I am naturally a skeptic, I’m always looking for evidence for when they work, how, for whom, and why.
What’s the most shocking example that you have seen through out your research of the placebo effect taking place in someone?
Most of our studies are really focused on the basic mechanisms and not on improving people’s clinical conditions right now. Although the new study we are starting is aimed at that. So maybe I’ll have more to say about that later on. But I think that some of the most dramatic results that we’ve seen in our lab is if you take a sham medication, you release opioids in the brain. So the brain has its own internal pharmacy. We take morphine, or Fentanyl, or Remifentanil, or any of those different things, Codone, Oxycodone, Hydromorphone, etc. and those drugs are external drugs that act on receptors in our brain that are intimately linked with pain relief, but also with feeling good and engaging in a positive way in life events. The reason we have those receptors is because your brain makes its own.
So the brain has its own internal pharmacy so to speak that you can engage, and the reason that that internal pharmacy exist is to translate your knowledge about where you are and what’s happening to you and the bigger picture into lower level changes in your brain. Where you brain is saying, “How much pain should I be feeling now? Should it be more or should it be less? Given what I have to do and where I am.” So opioids help to implement that. And so getting sham treatments can cause endogenous opioid release.