UNDERSTANDING THE PLACEBO EFFECT IN COMPLEMENTARY MEDICINE

Who can we trust these days in alternative medicine? What are we to believe? We think we know that something different goes on in complementary medicine than in conventional medicine, something useful and helpful but difficult to prove. One way to try to answer these questions and to gather evidence of effectiveness is to look at the 'Placebo Effect' as it applies to the whole field of medical research, and then examine the particular impact that it can have in complementary medicine. Put bluntly, the 'Placebo Effect' is a fake treatment, something given to please the patient. It is widely recognised in traditional medical research and is important because the results of research show that it is responsible for about a 33% of the total improvement in a patient's health. Of course, in most medical trials the point of the research is to exclude out the 'Placebo Effect' so as to allow the real effect of the drugs, surgery, psychological or other interventions that are being tested to show through. In fact, this can create a bias against the 'Placebo Effect' both because the 'Placebo Effect' feels like a nuisance to researchers and difficult to understand in any sense as being real or take seriously [since we know that it is really a 'fake']. However, what happens if we take the opposite or alternative viewpoint? Since the 33% average placebo response is such an enormous influence, what about actually looking at and researching the difference that it is making, and asking specifically what enhances this effect and what reduces it? This book examines these questions particularly as applied to complementary medicine. It is a thorough summary of the state of present day theory, practice and research, and includes original contributions from many of the leading holistic researchers, doctors and therapists interested in this field. It will be especially useful to practitioners. Thinking about how to enhance one's own placebo effects in any caring context, if a book provides one with just one useful tool, it is worth it, and this one lays out a whole range of techniques and approaches. Equally, deciding how best to integrate conventional and complementary medicines in a clinical setting requires all kinds of decisions about the design and delivery of care, and it is very useful to be able to refer to the best current evidence that shows how to make the placebo response work as well as it possibly can. Finally, practitioners considering doing their own research, will find the book helpful both in their research planning and choice of methodology. This a good technician's book and good enough for that. In summary… One could say that understanding the 'Placebo Effect' teaches one to apply fake treatment as if they are real, and the better one does this the more real the effects become… Hold on! Going back to my opening questions about who to trust and what to believe, the above statement appears to open the door for any quack, mountebank or fool to set up in clinical practice. Trust anyone, they might help you! Believe in anything, it might work! Put another way, the best hocus-pocus magic is good for you! Such a viewpoint is clearly madness and potentially very dangerous if applied to healthcare! Is perhaps the only solution to look for Authenticity? If it is, this moves us into a very different areas; that of truth and truthfulness and medical researchers, whose focus is on more practical concerns, generally avoid such areas! This book is a perfect example of what most medical books do by default, that is to bypass the question of what is authentic. Here at least the difficulty is acknowledged, and the transcript of David Reilly's 'Some reflections on creating therapeutic consultations' opens the possibility of crossing the threshold, but the investigation is not pursued elsewhere in the book. Instead deep down the biomedical model for defining the real and non-real is still the written material ground used to buttress the 'Placebo Effect' argument, and the language of the writers on placebo response remains overwhelmingly a mix of old and new scientism [new words and languages invented for the purposes]. One might say, 'It is necessary to protect against the unacceptable spectre of magic and delusion!' However, the more the book goes on, the more is the feeling that something is missing. What is it? To say the book lacks 'inspiration' would be one way of putting it, which is not to criticise the prose style of the writers [not bad on the whole!] but to focus on the impoverishment of their interpretations, the skills of the 'as if'. Words do things. What words truly inspire 'as if' they are real? Surely, to answer this is to reach the heart of the placebo response. A Radical Healing hangs on the authenticity of the answer; testaments, those patient stories with factoid and verifiable witness, and those that go beyond, chronicles, dangerous narratives, ravishing spectacles and possessions, even those that reach the essence of things.