The Placebo Effect: Illness and Interpersonal Healing

We suggest the hypothesis that the placebo effect operates predominantly by producing symptomatic relief of illness, such as pain, anxiety, and fatigue, rather than by modifying the pathophysiology of disease

Franklin G. Miller; Luana Colloca; Ted J. Kaptchuk

2012

Scholarcy highlights

  • The placebo effect has been a source of fascination, irritation, and confusion within biomedicine over the past 60 years
  • We suggest that lack of adequate attention to theory has hindered scientific investigation of the placebo effect and translation of scientific research into improved clinical practice
  • We suggest that progress in conceptualizing the placebo effect and probing its clinical significance can be promoted by seeing it as a set of related causal processes within “interpersonal healing,” by means of which the context of the clinical encounter and the relationship between a healer and a patient produce therapeutic benefit
  • The distinctive features of seeing the placebo effect as a mode of interpersonal healing are that it locates this phenomenon within the context of the clinician-patient relationship; it denotes a causal connection between this context and therapeutic outcomes; and this theory hypothesizes that the predominant, if not exclusive, impact of the placebo effect is to relieve illness, rather than to modify disease beyond symptomatic relief
  • In addition to promoting conceptual clarity regarding the placebo effect, we have noted the limited rigorous evidence relating to its clinical significance and recommended experimental inquiry aimed at translating the scientific understanding of the placebo effect into improved patient care
  • We have highlighted ethical issues that need to be addressed in optimizing placebo effects and minimizing nocebo effects within clinical practice and in conducting justifiable research on placebo effects

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