Musician. Trumpet player. Composer
The philosopher of science Thomas Kuhn advised in his seminal text The Structure of Scientific Revolutions that 'normal science' could not occur until disputes about fundamental issues (including how to define key terms) were resolved. Against Kuhn's picture of science, within the relatively nascent field of placebo studies empirical research has burgeoned, but disputes about how to define the terms 'placebo' and 'placebo effect' still remain (some philosophers argue abandoning the terms altogether).
Indeed, among healthcare practitioners there is still much confusion. Placebos are frequently considered to be 'fake' or 'dummy' treatments. In placebo studies, the placebo effect is considered to be a genuine psychobiological effect that occurs when patients expect a treatment or an intervention to be therapeutic. The placebo effect will not cure cancer but it is considered to be therapeutically effective in the treatment of many common symptoms including mild to moderate pain and depression. These are among the top ten most common complaints presented to primary care physicians.
The Placebo Effect & Psychotherapy
For over eighty years there has been sporadic debate in philosophy and psychology that psychotherapy can be conceived as a 'placebo'. Clearly how we define the terms 'placebo' and 'placebo effect' is of utmost importance in how we understand the important therapeutic benefits of psychotherapy.
The application of the terms placebo and placebo effect in psychotherapy is complicated by the prominence of 'common factors' research in psychotherapy. Common factors are those factors that may occur across a range of different kinds of psychological treatments; they include: positive regard towards the patient, patient and therapists' expectations that therapy will be effective, the alliance between therapist and patients, and therapist empathy for the patient. Should these common or non-specific factors be conceived as 'placebos'? On some definitions of the placebo effect, this is the case. Perhaps even more importantly, promininent research in psychotherapy demonstrates that these kinds of factors are of major significance in therapeutic outcome. So, how we define the terms 'placebo' and 'placebo effect' is of real importance in how we understand these therapies - including what we tell patients about how they work.
As a field of scholarship placebo studies is interdiscplinary and comprises psychologists, philosophers, neuroscientists, anthropologists, and historians. It seems uncontroversial, however, that with greater scientific agreement about how to define 'placebo' and 'placebo effect' future research would be more systematic, and fruitful.