The power of placebos to ameliorate symptoms has been with us for centuries. Western medicine today is finding it increasingly difficult to ignore the efficacy of placebos. In some clinical trials with placebos as controls, inert or sham replicas of active pharmaceutical drugs and even sham surgeries have been found to be as beneficial as the intervention being tested. In this volume in the MIT Press Essential Knowledge series, Kathryn Hall examines the power of placebos, showing how their effects can influence our clinical trials, clinical encounters and, collectively, Hall argues, our public health.
Hall, who has studied the placebo effect for years, reviews the history of the placebo in medicine, tracing its evolution from quackery and patent medicine to its use as a control in clinical trials. She considers the ways that expectations and learning affect our response to placebos; advances in neuroimaging that reveal the inner workings of the placebo effect; the “nocebo” effect; placebo controls in randomized clinical trials; and the use of psychological profiles and genetics to predict individual placebo response. The effects of placebos have been hiding in plain sight; with this book, Hall helps bring them into clearer view.
Kathryn T. Hall is Deputy Executive Director of Boston Public Health Commission and Assistant Professor (part-time) in Medicine at Harvard Medical School and Associate Molecular Biologist in the Division of Preventive Medicine at Brigham and Women's Hospital.
Pain, Parkinson’s, depression, and more have been shown - through numerous clinical studies - to be highly responsive to placebo. This book presents a highly informed look at the history of placebo, current understanding and research, and the future of this powerful “back door” into our health.
The author does an excellent job of summarizing complex concepts and research surrounding this issue, including studies that support a top-down control model for experiences such as pain - how the mind is able to essentially block incoming signals at the brain stem and even further down the spine. Our brains perceive largely through expectation - positive or negative, it shapes the lived experience.
From showing how drugs like naloxone (Narcan) can block the placebo effect to discussion on ethics and current practice (including explicit allowance for placebo treatment by the German Medical Association in 2012), this book is by far the most interesting I have read this year.
A fine short introduction to the academic literature on placebos. The author's own experience motivates a valuable sympathy with the enterprise. But, at the same time, the establishment view of placebos as being of a different category of thing, rather than just treatments with a different sort of causal mechanism, persists in the text, to the detriment of the discussion.
Short and illuminated discourse on the history and future of placebos. Well worth a read to understand how complex we are in our responses to disease and treatment.