Placebo effects are not only found in medicine, but also at school, university and wherever we learn. How the placebo effect works outside medicine – and how we can use it to improve learning performance.

Learners can make good use of suitable placebo effects – and avoid nocebo effects.

Placebo effects don’t just happen at the doctor’s. They can also be found at school, in further education and training, or when you’re learning a foreign language, for example. Here, we want to explain how the placebo effect works and how you might utilize it to get good results.

The term placebo effect may not mean anything to you at first, but you’ve most likely already experienced it: When your children were small and fell over a lot, you might have simply kissed the pain away and dried the tears with some comforting words – and then it would be as good as gone. The kissing and consoling were the placebo, acting much like a real painkiller. The word "placebo" comes from Latin and means "I will please".

But how can something work even when no medicine is taken at all? This question has preoccupied scientists for a long time. In medical studies, they have been able to prove that remedies without an active ingredient, or so-called sham treatments, can alleviate patients’ symptoms. A lot of it depends on what the patient expects from the treatment.

If I take a tablet that says "Aspirin" on the packet, I expect that it will alleviate my headache – the throbbing in my head consequently subsides even if the administered tablet does not actually contain any of the corresponding active ingredient at all. This is a typical placebo effect.

By the way, the opposite also applies: When a treatment (e.g., a visit to the dreaded dentist) is associated with negative expectations and therefore leads, for example, to weaker efficacy or undesirable side effects, we speak of the nocebo effect. Latin: "I will harm". A patient’s expectation of pain when visiting the dentist can therefore lead to greater pain during the treatment than if the person had not expected any pain.

There are still many unanswered questions about the placebo effect, such as why it does not work equally for all people. However, we do already know that it doesn’t exclusively occur in medicine. And this is where academic success comes into play.

Specifically, the placebo effect can be utilized when a person is suffering from stress, tension, worry, bad moods, and fatigue during the time leading up to important exams or papers. In an experiment with students, one group was given a substance-free capsule – a sugar pill – twice a day for three weeks, while another group received nothing. The group taking the sugar pill went into an exam with significantly less tension, even though they knew that there was no active ingredient in the pills and that they were just taking some sugar! It was simply the daily ritual and the positive expectation that curbed their stress during the exam preparation, lifted their mood, and made learning easier.

This is why the placebo effect can work for relaxed learning even without pills like in the experiment. For example, you can benefit from a placebo effect if you simply approach an exam optimistically or if it is combined with other positive effects. Anyone who has experienced stress relief from doing sports, for instance, can incorporate regular exercise into preparation for a presentation, paper, or exam. Even an hour of making or listening to music can be useful. Obviously, sports or music have a positive physical effect on our ability to think and learn, but these rituals can additionally act like a "mental anchor", as a placebo effect. For example, if you always drink your favourite tea from a special cup when you’re practicing or learning, your brain associates these positively loaded rituals with the positive expectation of being relaxed and learning well.

You can consciously use such rituals as placebos when they’re associated with positive experiences, in other words, like a kind of vehicle. The great thing about placebos is that they are so flexible: All sorts of things can become a placebo if they are associated with something nice. The brain then releases messenger substances (known as neurotransmitters) that also dull pain and are active in the reward centre when we experience something nice. Try it yourself or recommend it to your children!

The principle of the placebo and nocebo effect also works in schools and other areas of education. Similar to the relationship between a doctor and a patient, there is also a relationship of trust between a teacher and a student. Besides imparting knowledge, teachers' expectations and attitudes, and the degree of attention they give to their students, have a huge influence on how well their students work, or on whether they even work at all. Students who are frequently praised enjoy learning, are more likely to make an effort and will actually perform well in the future. Those who are criticized a lot gradually lose confidence in themselves, their desire to make an effort diminishes, and they consequently do worse at school.

Nikol Rummel, professor of educational psychology at the Ruhr University in Bochum, researches what promotes or hinders the learning process: "We know from a large number of studies in the research field of educational psychology that teachers' expectations and motivation can have a major influence on students' learning and on their learning success."

However, you’ve surely got your own expectations about what you can and want to achieve, and which therefore influence the placebo effect in your own learning. Scientists speak of "self-efficacy” in this regard. The belief that "I can do this" also depends on your faith in your own ability, and this can also determine success or failure. People who are convinced of their own abilities are able to tackle challenging tasks and persevere in pursuing their goals, even in the face of repeated setbacks and crises. A most welcome placebo effect!

Tell us your personal story involving the placebo and nocebo effect! Medicine is also shaped by stories. This is why we are gathering patients’ diverse experiences regarding their own expectations for the Collaborative Research Centre "Treatment Expectation". You can find out more here.