Antecedent reappraisal - why placebos work

Antecedent reappraisal is the concept behind why placebos work. It describes how beliefs shape what we actually experience. Think “this injection is going to hurt,” and it is going to hurt pretty much as expected. Now let the doctor gently apply a cream before the injection, explaining how this is an analgesic product that reduces pain, and you think, “this injection is going to hurt, but this cream will make it hurt much less.” Indeed, that will be your perception of the experience (reframed example from ‘Behave’ by Sapolky).

Neurologically, the amygdala (the fear center, impulsive system) activates in both scenarios. In scenario 2, the amygdala is then overridden by the frontal cortex (the “logical,” composed brain system), which intervenes to shape experience through thoughts.

We are constantly shaping our perceptions through thoughts. We do it to ourselves and to others. We establish limiting beliefs about something, even if unconsciously, and continue living with the brake strongly held down. We do this to each other, too. Due to our social nature, we’re inevitably influenced by the thoughts of the people around us, and we internalize all sorts of stories that may make our existence easier or harder.

The teacher told me I’m a good writer and it’s exam day. This essay topic seems challenging (scary), but the teacher told me I’m a good writer—I can handle this. The teacher told me I’m a bad writer and it’s exam day. This essay topic seems scary; there is identification with fear, and I don’t think I will pass the exam.

You can see how this concept applies to how we make choices and perceive our life. It is one of the most powerful systems to ever exist for humans, because it can shape entire life trajectories and every choice we make.

So, what to do about it? Merely notice the existence of belief effects in each moment during the day, and choose what to do with them. There are choices available at all times. You have the opportunity to be promoted as vice president of the company, being offered more money and status. You think ‘this opportunity is not what i want in life, but it’s good money and i don’t have enough’, so you accept the offer. Alternatively, you think ‘this opportunity is one of many, the status and money offers look great, but it’s not aligned with what i want in life’, so you decline the offer. Behind your choices are underlying beliefs (antecedent reappraisals).