Reconsidering the Placebo Response from a Broad Anthropological Perspective

Department of Anthropology, University of Arizona, Tucson, AZ 85721-0030, USA.
Culture Medicine and Psychiatry (Impact Factor: 1.29). 03/2009; 33(1):112-52. DOI: 10.1007/s11013-008-9122-2
Source: PubMed


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.

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    • "Based on this analysis, a model of Q'eqchi' healing may be the inverse of a " symbolic " perspective: sensorial processes which directly affect the lived experience at the existential immediacy of the body can, in turn, impact the mind and " thinking too much " of a person, producing a plethora of illness narratives that accompany these embodied alterations as the preobjective is made objective. Indeed, " what is initially embodied and sensorial may, over time, become cognitive, as narrative, explanation and meaning become attached to the experience " (Thompson et al., 2009, p. 114). It is the body, then, and a rich conceptualization of how sensorial processes can induce alterations in illness experiences that have been marginal or limited in previous models of " symbolic healing. "
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    • "It is also clear that in all societies healing modalities have developed to maximize the placebo response in an attempt to overcome assaults to well being. This raises the question as to whether the placebo response, like other self-healing mechanisms, may be an evolutionary adaptation.’1 "
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