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Performance and the Placebo Effect

Henry Beecher, a young doctor from Harvard, was serving in the US military in Italy in 1944, treating injured American soldiers. After a disastrous offensive at Anzio casualties were high and Beecher was working out of a makeshift field hospital near the beach. Such were the number of casualties that he soon ran out of anaesthetic. Instead of telling the next soldier that there was no morphine he instructed the nurse to inject him with salt water. Believing that he had been administered an anaesthetic the soldier lay down and endured surgery on his serious wounds without any apparent suffering. Beecher repeated this ground breaking result with dozens of soldiers over the coming days and weeks.

This story comes from a fascinating book called 'Bounce' by Matthew Syed a journalist, author and former international table tennis player. In it he explores the essence of high performance and sets out to dispel the talent myth; the idea that achievement and excellence in sport, art or any endeavour are based on inherited capabilities and hard work alone.

In the book, Syed explores a number of well known concepts in high performance: 10 000 hrs of purposeful practice, the need for great coaching, high levels of intrinsic motivation and a growth mindset. What really surprised me was the chapter on the placebo effect (containing the story above). I knew and understood the importance of beliefs in affecting behaviour but was shocked at how powerful the effects of deeply held beliefs can be.

You may already know about the placebo effect, most commonly understood as patients gaining health benefits from taking a pill that has no medicinal component (usually simply a sugar pill.) After Beecher popularised the idea, during the 60's and 70's the medical world sought to more fully understand the placebo effect. It was found that red and orange pills were more effective colours for stimulants (ever wondered why your Berocca is orange?) and blue and green for depressants (If you're now thinking "But Viagra is blue!" it was first developed to reduce blood pressure - it's stimulating side effects were only discovered during trials!). If the placebo process was more lengthy and complicated it was more effective, headache pills that were more expensive had more effect and so on - it has even been proven that those with devout religious beliefs have significantly better health outcomes and lower mortality rates (this is however not evidence for the divinity of God as the effects transcends denominational boundaries.) The conclusion that we draw from all this is that the placebo effect works because of the strength of conviction in the belief, not because there is any objective truth in it.

So how does this apply to performance and the world of work? In the moments that we want to perform at our best (give a great speech, have a difficult conversation with a colleague, win a big contract or negotiation) it is not just our ability that matters it is our ability to access that ability. The major access blockers to our best self in the moment are fear and doubt. As Tim Gallway (author of the 'inner game' series of books) puts it the power of doubt is that it's self fulfilling. As we entertain doubts we focus on what might go wrong, we get tense, our natural ability is inhibited, we tighten up and fail to perform as we would like, proving our doubts to have been well founded, which only goes to strengthen them next time we are in a similar situation. We need to dispel doubts and fears in the moment by focusing on a strongly held belief that we will perform as we want to or by reducing the importance of the moment - "it's just another speech, this sale really isn't that important, etc" It's not about what is true but what is useful in the moment.

Hard work, purposeful practice, coaching and mentoring are the things that enable top performers in any field to develop the capabilities to be the best. Being able to manipulate our beliefs, to switch off fear and doubt and replace it with something more useful in the moment is what allows those with great ability to translate those abilities into outstanding performance when they need to; when under great pressure and when it matters most.

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