Synopses & Reviews
A mere "symbol" of medicine--the sugar pill, saline injection, doctor in a white lab coat--the placebo nonetheless sometimes produces "real" results. Medical science has largely managed its discomfort with this phenomenon by discounting the placebo effect, subtracting it as an impurity in its data through double-blind tests of new treatments and drugs. This book is committed to a different perspective--namely, that the placebo effect is a "real" entity in its own right, one that has much to teach us about how symbols, settings, and human relationships literally get under our skin.
Anne Harrington's introduction and a historical overview by Elaine Shapiro and the late Arthur Shapiro, which open the book, review the place of placebos in the history of medicine, investigate the current surge in interest in them, and probe the methodological difficulties of saying scientifically just what placebos can and cannot do. Combining individual essays with a dialogue among writers from fields as far-flung as cultural anthropology and religion, pharmacology and molecular biology, the book aims to expand our ideas about what the placebo effect is and how it should be seen and studied. At the same time, the book uses the challenges and questions raised by placebo phenomena to initiate a broader interdisciplinary discussion about our nature as cultural animals: animals with minds, brains, and bodies that somehow manage to integrate "biology" and "culture," "mechanism" and "meaning," into a seamless whole.
Review
"To understand the placebo effect is to grasp simultaneously the success and the failure of medicine. This yin-yang comes through clearly in The Placebo Effect, which is based on the proceedings of a conference at Harvard University in late 1994. The speakers and discussants were all experts. Their charge at the conference, according to one participant, was 'to create some destabilization of current thinking with respect to placebo effects.' In this the text succeeds admirably...The power and the prevalence of placebo effects should interest any healer, and so should this book. From it one will learn that ultimately the placebo effect cannot be understood, for once we discover some detail of its mechanism, that knowledge will no longer be considered a placebo effect."
--The Lancet [UK]"This book, drawing on contributions from fields as diverse as cultural anthropology, religion, pharmacology and molecular biology, reviews the roles of placebos in history and discusses the difficulties in making sense of them. At a time when quackery costs the nation an estimated $30 billion a year, such research couldn't be more timely."
--Peter Gorner, Chicago Tribune"This book is based on a conference at Harvard University in December 1994, sponsored by the Harvard Mind, Brain, Behavior Interfaculty Initiative. It brought under one roof some of the leading authorities on placebo and placebo effects, giving many of the chapters the unique quality of coming straight from the 'the horse's mouth.' The placebo has become a familiar concept among biomedical researchers and practitioners since it became a prerequisite in randomized, controlled trials in the middle of this century. Yet the state of knowledge about the placebo effect in phenomenological terms...and as a neurobiologic construct...is still inadequate...This book highlights and aims at interdisciplinary dialogue...It will make fascinating reading for clinicians, neurobiologists, and students, as well as for philosophers and ethicists. More specifically, the book should be considered by those involved in all aspects of clinical pharmacology and therapeutics."
--Gideon Koren, M.D., New England Journal of Medicine"The Placebo Effect helps to explain why medicine appears to be some way off relinquishing the certainty of faith for the uncertainty of science...This edited collection of reviews...repays reading for the nuggets of insight it gives into health care and its as yet not-so scientific underpinnings."
--John Galloway, Nature"This book sets out to show that the placebo effect is a 'real' entity in its own right, one that has much to teach us about how symbols, settings, and human relationships literally get under our skin."
--The Therapist [UK]"The concluding section [of The Placebo Effect] is almost too rich with ideas to be digested in a single session...As Anne Harrington states in her well-written introduction, the conference [on which The Placebo Effect was based] ended with no consensus, but it had given scientists and humanists the opportunity 'to stretch in ways that promised to leave none of the parties involved in the undertaking unchanged.' [The Placebo Effect] may offer [its] readers a similar opportunity."
--Marcia Meldrum, Isis"Medical science has traditionally been uncomfortable with the paradox of placebos: 'sham' treatments that can produce real, even dramatic, effects on healing. This insightful collection of essays and dialogues confronts the dilemma--and the discomfort--head on. Looking at placebos from viewpoints as diverse as neuropharmacology and anthropology, molecular biology and religion, the contributors place placebos at the intersection of biology and culture, with much to teach us about the interaction of our minds and bodies."
--Cerebrum"The book is well worth reading for those with an interest in the subject. It is thought provoking and in many respects extraordinary."
--E. Ernst, Fact: Focus on Alternative and Complementary Therapies"The Placebo Effect...brings together some of the leading authorities to describe the state of the field, as it appears from their several disciplinary perspectives, and to outline future directions for research."
--David Harley, Medical HistoryReview
This book, drawing on contributions from fields as diverse as cultural anthropology, religion, pharmacology and molecular biology, reviews the roles of placebos in history and discusses the difficulties in making sense of them. At a time when quackery costs the nation an estimated $30 billion a year, such research couldn't be more timely. Peter Gorner
Review
The Placebo Effect...brings together some of the leading authorities to describe the state of the field, as it appears from their several disciplinary perspectives, and to outline future directions for research. E. Ernst - Fact: Focus on Alternative and Complementary Therapies
Review
To understand the placebo effect is to grasp simultaneously the success and the failure of medicine. This yin-yang comes through clearly in The Placebo Effect, which is based on the proceedings of a conference at Harvard University in late 1994. The speakers and discussants were all experts. Their charge at the conference, according to one participant, was "to create some destabilization of current thinking with respect to placebo effects." In this the text succeeds admirably...The power and the prevalence of placebo effects should interest any healer, and so should this book. From it one will learn that ultimately the placebo effect cannot be understood, for once we discover some detail of its mechanism, that knowledge will no longer be considered a placebo effect. The Lancet
Review
This book is based on a conference at Harvard University in December 1994, sponsored by the Harvard Mind, Brain, Behavior Interfaculty Initiative. It brought under one roof some of the leading authorities on placebo and placebo effects, giving many of the chapters the unique quality of coming straight from the "the horse's mouth." The placebo has become a familiar concept among biomedical researchers and practitioners since it became a prerequisite in randomized, controlled trials in the middle of this century. Yet the state of knowledge about the placebo effect in phenomenological terms...and as a neurobiologic construct...is still inadequate...This book highlights and aims at interdisciplinary dialogue...It will make fascinating reading for clinicians, neurobiologists, and students, as well as for philosophers and ethicists. More specifically, the book should be considered by those involved in all aspects of clinical pharmacology and therapeutics. Chicago Tribune
Review
The Placebo Effect helps to explain why medicine appears to be some way off relinquishing the certainty of faith for the uncertainty of science...This edited collection of reviews...repays reading for the nuggets of insight it gives into health care and its as yet not-so scientific underpinnings. Gideon Koren - New England Journal of Medicine
Review
This book sets out to show that the placebo effect is a "real" entity in its own right, one that has much to teach us about how symbols, settings, and human relationships literally get under our skin. John Galloway - Nature
Review
The concluding section [of The Placebo Effect] is almost too rich with ideas to be digested in a single session...As Anne Harrington states in her well-written introduction, the conference [on which The Placebo Effect was based] ended with no consensus, but it had given scientists and humanists the opportunity "to stretch in ways that promised to leave none of the parties involved in the undertaking unchanged." [The Placebo Effect] may offer [its] readers a similar opportunity. The Therapist
Review
The book is well worth reading for those with an interest in the subject. It is thought provoking and in many respects extraordinary. Marcia Meldrum - Isis
Synopsis
A mere "symbol" of medicine the placebo nonetheless sometimes produces "real" results. Medical science has largely managed its discomfort with this phenomenon by discounting the placebo effect. This book is committed to a different perspective--namely, that the placebo effect is a "real" entity in its own right, one that has much to teach us about how symbols, settings, and human relationships literally get under our skin.
About the Author
Anne Harrington is Loeb Harvard College Professor and Professor for the History of Science at Harvard University.
Harvard University
Table of Contents
Introduction
The Placebo: Is It Much Ado about Nothing?
Arthur K. Shapiro and Elaine Shapiro
Clinical Reflections on the Placebo Phenomenon
Howard Spiro
The Nocebo Phenomenon: Scope and Foundations
Robert A. Hahn
The Doctor as Therapeutic Agent: A Placebo Effect Research Agenda
Howard Brody
Toward a Neurobiology of Placebo Analgesia
Howard L. Fields and Donald D. Price
The Contribution of Desire and Expectation to Placebo Analgesia: Implications for New Research Strategies
Donald D. Price And Howard L. Fields
The Role of Conditioning in Pharmacotherapy
Robert Ader
Specifying Nonspecifics: Psychological Mechanisms of Placebo Effects
Irving Kirsch
Placebo, Pain, and Belief: A Biocultural Model
David B. Morris
Placebo: Conversations at the Disciplinary Borders
Edited by Anne Harrington
Contributors
Index