Customer Reviews

Placebo: Mind over Matter in Modern Medicine

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In this investigation of the placebo effect, the author asserts that orthodox medical opinion has for decades been convinced about the healing powers of the mind. This confidence in the power of the placebo effect provides scientific legitimacy to the many claims about mental healing.

By exploring recent research in evolutionary biology and immunology, Evans proposes a new theory on how placebos work while investigating and evaluating current ideas of health and disease. He looks at the history of the placebo effect and investigates the efficacy of placebos by sifting the evidence and providing an opinion on which medical problems can be cured by its use.

In chapter 3, The Acute Phase Response, Evans sets out his theory of the function of a single biological mechanism in the placebo phenomenon; he also states that this is not a proven theory and needs much further research. The next chapter looks at the belief effect, the key mental event that triggers physiological processes that result in healing.

Investigating the physical and psychological aspects of health in evolutionary context, he also considers the potential of placebos to harm. In more metaphysical terms, one may say he looks at positive and negative mental energy, the curse and the blessing, but in scientific terms. Various alternative healing modalities are also discussed, as well as psychotherapy, which the author claims may be the purest placebo.

Ethical questions are considered next in the chapter The Witch Doctor's Dilemma. The author concludes that the impressive findings of recent scientific research in mind-body medicine have revealed that the healing power of the mind may not be unlimited, but that it is certainly not insignificant. The mind fights disease in many ways and one of those is to prompt us to take action, whether by the use of allopathic or alternative medicine. The book concludes with copious notes, a bibliography and an index. I have found this an honest and open-minded look at the healing power of the mind, albeit from a strictly scientific respective.

Placebo controls are the unquestioned standard within clinical research methods. But even experienced researchers I've asked were not aware of the shortcomings of the seminal paper about placebos - research which is now canonical in the literature. Dylan Evans has put on trial this key element of all clinical trials.

Evans treats with equal scrutiny the work of Henry Beecher, who claimed broad powers for the placebo, and later detractors who claimed there may be no placebo effect at all. Among the other questions he examines is the paucity of research comparing placebos to no treatment at all. He also expands on the scientific dilemma to the ethical dilemma of whether a doctor should deliberately deceive a patient given the belief in the placebo as treatment apparently has helped some or at least reduced suffering. He asks whether something like psychotherapy may still be a benefit even though they may only, at best, be able to claim a placebo effect. In each case Evans presents meticulous references and reasoning. He simply holds the accepted placebo control to the same level of critical skepticism he applies to homeopathy.

This book reminds us that in order to be truly scientific, we must also apply continued scrutiny even to the most established methods in science.

Placebos are far more specific than commonly believed. For me this book could've benefitted from more technical detail, but that is a matter of taste.