# Reducing Emotional Distress with Open-Label Placebos: Assessing the Role of Motor Engagement in Pill Consumption

## TL;DR

This study explores whether taking a placebo pill is necessary for reducing emotional distress, finding that imagining taking a pill or using cognitive reappraisal can be equally effective.

## Contribution

The study introduces a novel comparison of motor engagement in placebo consumption versus cognitive reappraisal for emotional distress.

## Key findings

- Groups did not differ in emotional distress or physiological arousal measures.
- Imaginary placebo was rated more effective and plausible than usual placebo.
- Cognitive reappraisal was rated more effective than all placebo conditions.

## Abstract

It has been posited that ingesting a pill constitutes a pivotal action that facilitates the effects of open-label placebos (OLPs: placebos honestly prescribed). In the present OLP experiment, the motor components of a placebo treatment were systematically varied. The participants (n = 183) were randomly allocated to one of four groups that all viewed aversive pictures. The ‘active OLP’ group took a placebo pill with specific instructions concerning the sequence of motor actions for the intake. The ‘usual OLP’ group swallowed the pill (without specific motor instructions), while the third group received an ‘imaginary OLP’ (no pill intake). The fourth group applied cognitive reappraisal (CR; active control group) to reduce emotional distress. The participants rated their affective state as well as the efficacy and plausibility of the treatment approach. Moreover, blood pressure and pulse were recorded as indicators of bodily arousal. The four groups did not differ in their valence ratings and physiological measures. The ‘imaginary OLP’ received higher ratings for both effectiveness and plausibility than the ‘usual OLP’. CR was rated as superior relative to all OLP conditions. In conclusion, reducing emotional distress with OLPs does not necessitate the consumption of a placebo pill. In terms of acceptability and ease of implementation, CR stands as a well-established alternative.