TY - JOUR
T1 - Reconsidering the placebo response from a broad anthropological perspective
AU - Thompson, Jennifer Jo
AU - Ritenbaugh, Cheryl
AU - Nichter, Mark
N1 - Funding Information:
Acknowledgments The writing of this paper was partially supported by NIH/NCCAM Grant T32AT001287-06. J.J.T. is a predoctoral fellow; M.N. and C.R. are faculty. Some of the research cited in this paper was supported by NSF Grant DDIG 0718313, received by M.N. and J.J.T.
PY - 2009/3
Y1 - 2009/3
N2 - This paper considers how the full range of human experience may catalyze a placebo response. The placebo effect has been characterized as something to control in clinical research, something to cultivate in clinical practice and something present in all healing encounters. We examine domains in which the term 'placebo' is used in discourse: clinical research, clinical practice, media representations of treatment efficacy and lay interpretations of placebo-an underresearched topic. We briefly review major theoretical frameworks proposed to explain the placebo effect: classical conditioning, expectancy, the therapeutic relationship and sociocultural 'meaning.' As a corrective to what we see as an overemphasis on conscious cognitive approaches to understanding placebo, we reorient the discussion to argue that direct embodied experience may take precedence over meaning-making in the healing encounter. As an example, we examine the neurobiology of rehearsing or visualizing wellness as a mode of directly (performatively) producing an outcome often dismissed as a 'placebo response.' Given body/mind/emotional resonance, we suggest that the placebo response is an evolutionarily adaptive trait and part of healing mechanisms operating across many levels-from genetic and cellular to social and cultural.
AB - This paper considers how the full range of human experience may catalyze a placebo response. The placebo effect has been characterized as something to control in clinical research, something to cultivate in clinical practice and something present in all healing encounters. We examine domains in which the term 'placebo' is used in discourse: clinical research, clinical practice, media representations of treatment efficacy and lay interpretations of placebo-an underresearched topic. We briefly review major theoretical frameworks proposed to explain the placebo effect: classical conditioning, expectancy, the therapeutic relationship and sociocultural 'meaning.' As a corrective to what we see as an overemphasis on conscious cognitive approaches to understanding placebo, we reorient the discussion to argue that direct embodied experience may take precedence over meaning-making in the healing encounter. As an example, we examine the neurobiology of rehearsing or visualizing wellness as a mode of directly (performatively) producing an outcome often dismissed as a 'placebo response.' Given body/mind/emotional resonance, we suggest that the placebo response is an evolutionarily adaptive trait and part of healing mechanisms operating across many levels-from genetic and cellular to social and cultural.
KW - Embodiment
KW - Evolutionary medicine
KW - Healing
KW - Local biology
KW - Performance
KW - Placebo
UR - http://www.scopus.com/inward/record.url?scp=58849109760&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58849109760&partnerID=8YFLogxK
U2 - 10.1007/s11013-008-9122-2
DO - 10.1007/s11013-008-9122-2
M3 - Article
C2 - 19107582
AN - SCOPUS:58849109760
SN - 0165-005X
VL - 33
SP - 112
EP - 152
JO - Culture, Medicine and Psychiatry
JF - Culture, Medicine and Psychiatry
IS - 1
ER -