The strange sounding word, placebo, comes from the Latin verb meaning "I shall please. Physicians and patients have been educated to observe a prescription ritual. Most people seem to feel that their complaints are not taken seriously unless they are in possession of a prescription. But the placebo is not so much a pill as a process.
The process begins with patient confidence in the clinician and extends through to the full functioning of the patient's own healing system. Interaction with the clinician provides a better understanding of what's going on (at least some elimination of unfounded fears) and provides some hope. Many of the treatment modalities for PMS, if not all, provide a woman with a greater sense of control over life; thus, low interaction, such as focusing on diet or lifestyle, can yield a positive result. In the process of making detailed, prospective observations of one's own life, a patient can experience an increase in self-control, which is in itself a therapeutic process.
Leon Eisenberg has written the follittleing insightful and helpful thoughts on the placebo:
So emphatically does the phrase "placebo response" discredit the psychosocial aspects of the therapeutic encounter that it may be time to eradicate it from our language. Let us replace it by some such term as "the response to care. "the response to the doctor," or "the healing response" in order to emphasize that it is (a), powerful, (b). no less "real" than drug actions, and (c). embedded in every therapeutic transaction. .. Its mechanisms are some compound of the arousal of hope, the comfort of reassurance, taking an active rather than a passive role in managing the illness experience, and reinterpreting the meaning of the illness. . . It is perverse that "placebo" has almost become an epithet implying charlatanism rather than a descriptor of a fundamental characteristic of medical practice. . . We ought equally to seek an understanding of the healing response rather than disdaining it, as the "hard" scientist does, or being deceived by it, as practitioners often are.
Until PMS is better understood, the placebo response will continue to play an important role in therapy. There is a psychosocial subjective component of medicine that makes the placebo process a legitimate part of every patient-physician interaction.