The Placebo Effect: An Interdisciplinary Exploration [Hardcover]

Anne Harrington (Editor)

Book Description

Publication Date: August 1, 1997 | ISBN-10: 0674669843 | ISBN-13: 978-0674669840 | Edition: 1

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.

Editorial Reviews

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 )

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 (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 )

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 )

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 History )

From the Back Cover

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 text refers to the Paperback edition.

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Product Details

• Hardcover: 260 pages
• Publisher: Harvard University Press; 1 edition (August 1, 1997)
• Language: English
• ISBN-10: 0674669843
• ISBN-13: 978-0674669840
• Product Dimensions: 9.2 x 6.4 x 1 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.4 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #2,110,024 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

16 of 19 people found the following review helpful:

5.0 out of 5 stars Best book on placebos yet to be written, November 2, 2005

By 

Mark Waldman "Adj. Faculty, Exec MBA Program,... (Coaching, Research, Training: Malibu/Los Angeles California) - See all my reviews
(REAL NAME)   

This review is from: The Placebo Effect: An Interdisciplinary Exploration (Paperback)

I'm currently working with author and professor Andrew Newberg on the biology of belief and the neurophysiology of spiritual experience, and this book is the gold standard when it comes to understanding how this mysterious process works. Today, the question is not whether placebos work, but how they work. Depending upon the condition being treated, the effectiveness of placebo treatments can range anywhere from 0% to 100%. Pain is the most amenable to placebo treatments, which suggests that pain regulation is closely tied to the same neural mechanisms that control conscious awareness and memory. Suggestibility, expectations, conditioning, emotions, and desires also play essential roles in explaining the analgesic effects of placebo.
For illnesses involving depression and anxiety, the placebo effect accounts for a 25-35% success rate, while anti-depressant drugs only have a 35-45% success rate, according to statistics published by the drug companies themselves. This suggests to me that it is one's optimistic belief that is largely responsible for the alleviation of depressive symptoms. On the other hand, the fact that nearly two-thirds of depressed individuals do not get better may be related to deeply embedded beliefs that reflect a more pessimistic stance about the world. According to David Morris of the University of Virginia, one of the contributors to this anthology, placebos "place belief and meaning at the center of the therapeutic encounter" and that "positive beliefs in the efficacy of medication or treatment are necessary to underwrite a placebo effect, while disbelief actively subverts it."
Positive beliefs had the power to heal, whereas negative beliefs had the power to injure, and this framework can be applied to spiritual beliefs as well. One can even speculate that those who do not inherit a bias towards optimistic beliefs are less likely to survive and pass on their genes to others.
The power of placebo goes a long way to explain a variety of health claims made in the fields of alternative medicine and psychotherapy, for it may be the mutually-agreed-upon belief systems of both the patient and the doctor that accounts for the high degree of success achieved. Unfortunately, this also opens the door to considerable fraud, for a person can market a bottle of water and claim to have a 30% to a 100% success rate in treating an almost endless list of symptoms. In a similar manner, fads are successful because a large amount of people concurrently agree that the object of the fad is beneficial. You not only have the power of belief on your side, but you have the power of consensus as well.

4 of 4 people found the following review helpful:

4.0 out of 5 stars Worth the read, September 9, 2007

By 

B.F. RMT (Ontario, Canada) - See all my reviews

This review is from: The Placebo Effect: An Interdisciplinary Exploration (Paperback)

This collection of essays, while now a bit dated, still has much to offer if you are interested in this topic. The contributors have excellent credentials, varied perspectives and different points of view. This is a fresh change from just hearing the mantra of one author's spin on the placebo effect over and over in their book. If you want to really understand the placebo effect, I believe that you really have to have an open mind. This book can help you in that endeavor.

5.0 out of 5 stars A fascinating study., August 4, 2011

By 

Henry Eberstadt - See all my reviews

This review is from: The Placebo Effect: An Interdisciplinary Exploration (Paperback)

This book is a fascinating account of the placebo effect. Placebos have always been something of a thorn in the side of medical expertise--something to be avoided or dismissed. Anne Harrington's book tackles the issue directly. It is based on a conference that took place at Harvard University, sponsored by the Harvard Mind, Brain, Behavior Interfaculty Initiative. It debunks much of what we commonly believe. The whole notion of what is "real" and what is "not real" is called into question. Placebos work, and they often work as well as pharmaceuticals. Harrington is a historian of science, but the book includes contributions by neurologists, neurobiologists, psychologists and a gastroenterologist. I found the interdisciplinary conversations at the end of the book to be especially fascinating.