The Seba library treats Placebo Effect in 7 passages, across 5 authors (including Damasio, Antonio R., Bosnak, Robert, van der Kolk, Bessel).
We still know very little about the placebo effect, through which patients respond beneficially in excess of what a given medical intervention would lead one to expect.
Damasio presents the placebo effect as symptomatic of medicine’s broader failure to integrate mind and body, cataloguing the precise dimensions of ignorance — who responds, how far the effect extends, and what it means for double-blind methodology.
, Descartes’ Error: Emotion, Reason, and the Human Brain, 1994thesis
It is a powerful expectation of effective healing which causes the placebo effect. On the average, about a third of patients responds favorably to placebo.
Bosnak, via Kradin, argues that the placebo effect is driven by the intensity of the patient’s expectation of healing, supported by clinical trial evidence including sham surgical procedures that matched real surgical outcomes.
, Embodiment: Creative Imagination in Medicine, Art and Travel, 2007thesis
Most treatment studies of PTSD find a significant placebo effect. People who screw up their courage to participate in a study for which they aren’t paid, in which they’re repeatedly poked with needles
Van der Kolk observes that robust placebo responses are a consistent feature of PTSD pharmacotherapy trials, implicating the act of help-seeking and ritual participation as active therapeutic ingredients independent of any pharmacological agent.
, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, 2014supporting
effects attributed to medication may be inflated by expectancy and demand effects. Use of ‘active’ placebos better protects the blind, and the resulting effect sizes are approximately half as large as those otherwise reported.
Shedler argues that antidepressant trial effect sizes are substantially inflated because side effects compromise blinding, meaning much of the apparent drug benefit is actually a placebo-expectancy artifact.
, The Efficacy of Psychodynamic Psychotherapy, 2010supporting
Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome.
Wampold cites Kaptchuk’s decomposition of placebo components in a clinical trial context as evidence for the active therapeutic role of relational and contextual factors common across all psychotherapies.
, How important are the common factors in psychotherapy? An update, 2015supporting
In medicine, expectations can be induced verbally and then physicochemical agents or procedures can be administered or not, making the two components (creation of expectations and the treatment) independent.
Wampold distinguishes the methodological tractability of placebo-expectation research in medicine from its near-impossibility in psychotherapy, where generating expectations is itself inseparable from the treatment being studied.
, How important are the common factors in psychotherapy? An update, 2015supporting
I felt a switch within me, a certainty that th
Bosnak’s autobiographical account of surviving a life-threatening illness by means of an internal shift of conviction functions as a first-person phenomenological parallel to the expectation-driven healing the placebo literature documents.
, Embodiment: Creative Imagination in Medicine, Art and Travel, 2007aside