It is that time of year. For teachers, parents and students there exists a shadow calendar where the year takes off, not in January, but in late summer/early autumn. We are at a particularly intense juncture in our house, seeing two children off to university and one off to sixth-form college. You don’t have to be neurotic to feel the unsettling breeze blow through these crossroads, and I have been fielding regular outbursts of alarm: ‘What if I don’t like it there? Maybe I’ve chosen the wrong course, I might not understand any of it!’

But afterwards, having removed the ‘reassuring dad’ hat, and looking at my own course folders (closed), the voices still persist; because we too have been away from university for the long holiday – ample time for doubts, and memory loss to take hold. I found myself the other day in a momentary panic when not only could I not reel off Egan’s three stages, I couldn’t even remember his name!

Nursing these uncertainties about the course and my place on it, I picked up Ben Goldacre’s book Bad Science. He talks eloquently about the placebo effect – about the power of suggestion. I was struck by what the book says about both the negative and positive potential of suggestion and how this might play in the world of the counsellor. In time honoured doctor fashion, I am minded to start with the ‘bad news’.

There is evidence firstly which reflects our readiness to accept explanations or labels, especially if they are framed using technical vocabulary. Goldacre vents his spleen at nutritionists who offer poorly researched and reductive arguments which suggest, for example, that schoolchildren who underperform are deficient in key vitamins and minerals, rather than good parenting or an aspirational culture, and that omega-3 fish oils can be a magic potion that alone will increase intelligence. It is not that simple, he concludes, and it does us a disservice to suggest that it is.

The same warning against simple, reductive but attractively ‘sciency’ labels seems applicable to the psychological/ emotional landscape inhabited by counsellors. In my placement where I deal with young people, I have access to documents which describe children as ‘suffering from’: Attention Deficit Hyperactive Disorder (ADHD), Auditory Processing Disorder, Obsessive Oppositional Disorder and Foetal Anti-convulsant Syndrome. In layman’s terms these are children who cannot pay attention, cannot listen, are prone to argue and who were subjected to their mother’s epilepsy medicine whilst in the womb. Historically, these ‘diagnoses’ were well intentioned, made to move away from labelling all children who find difficulty in conforming as ‘naughty’ or ‘bad’ but the corollary is sometimes to offer these individuals what becomes a static condition. In this age of transparency and openness, the young people themselves are armed with these labels and can become stuck with them. In therapeutic terms, it can provide a difficult obstacle – I have counselled an individual and heard him say, ‘It’s not me, I’m O.O.D.’ The perceived gravitas of the label, having a ‘disorder’, felt to this individual like a burden he could never shake. The ‘good news’ is about the awesome power of positive suggestion. Placebos – often characterised as empty or even underhand in the popular consciousness – turn out to be some of the strongest medicines we have. Goldacre cites numerous examples of the placebo effect, including in surgery where patients believed they were receiving morphine or anaesthetic and so felt little or no pain, and dosage where patients recovered quicker given four pills at a time rather than two (the doses were pharmaceutically identical).

A phrase that stuck out in this research was ‘the power of ceremony’, a clear acknowledgement of the importance of presentation and perception. It reminded me of research into counselling efficacy which identifies ‘quality of relationship’ as the dominant factor in successful outcome, and that what we, as counselling students, are engaged in, is powerful, meaningful and demands very close attention. Goldacre’s writing on the placebo effect is ample testimony to the power of positive thought and feeling and makes it easier to take his more pragmatic advice; know that new term anxiety will pass, to get on with life and get better!

Some details have been changed to protect identities.