A Dispatch from the Cutting Edge of Placebo Studies

Jul 9, 2013, 8:00 AM, Posted by

Courtesy of The Program in Placebo Studies and the Therapeutic Encounter (PiPS) Courtesy of The Program in Placebo Studies and the Therapeutic Encounter (PiPS)

It’s a rare and exciting opportunity to witness a new field of research blossom. Although working on the cutting edge is thrilling for those researchers who operate there, day in and day out—it’s also scary. Every step they take leads them into more uncharted territory.

I recently attended the first of five public forums on the science of placebos, hosted by Pioneer grantee the Program in Placebo Studies and the Therapeutic Encounter (PiPS). This forum series, co-sponsored by the Pioneer Portfolio, offers rare public access to the small but burgeoning field of placebo studies.

More Than a Sugar Pill

At the first forum, some of the world’s leading placebo researchers presented study after study showing how placebos can actually help alleviate pain and reduce symptoms from conditions as serious as Parkinson’s disease. You might be thinking, “Wow! A sugar pill can do all of that?” but sugar pills aren’t the only placebos out there.

Think about your last doctor’s visit. How much of your visit did you spend receiving a prescription, a shot or a procedure? Likely very little. Chances are, most of the visit involved the “rituals of care,” such as recounting a recent medical problem, learning about the promise of a new drug for your disease, or watching the nurse prepare a syringe.

These are just a few examples of the many intangible aspects of health care that can elicit what researchers call the “placebo response.” From a positive doctor-patient interaction to a patient’s faith in a treatment, the placebo response has been shown to elicit measurable physiological responses. It has even been proven to augment the power of some treatments that health professionals already use. And, recent research shows that a placebo can work even when the patient receiving it knows he or she is getting one.

Although health professionals and others have been aware of the power of placebos for decades, the movement to galvanize a scientific field around studying them in such a rigorous, interdisciplinary way is relatively new. Researchers now have so much to draw on—from new neuroimaging technologies to other emerging fields like cognitive neuropsychiatry—that their peers of the past never had.  By harnessing these new tools and knowledge, researchers in PiPS’ Harvard-wide network and beyond hope to quantify and optimize the effects of these often poorly understood aspects of care like never before.

A Field on the Rapid Rise

Like any other emerging field of research, placebo research is still defining itself. What do researchers (or don’t they) study? Why? Under which conditions? In whom? How will their new knowledge help people heal and maintain health?

The pioneering researchers in the field of placebo studies face a unique set of challenges in trying to answer these essential questions. For starters, placebos pose very tricky ethical questions. They also do not affect every person in the same way—and can even affect the same people differently under different circumstances. The field can hardly even agree on what constitutes a placebo. The list goes on.

And so do the placebo researchers. Like PiPS’s fearless director and eminent researcher Ted Kaptchuk, their enthusiasm and thirst for knowledge are unwavering. At a small group discussion prior to the public forum, I saw seasoned researchers and upstart graduate students alike grappling long and hard with nearly every question that arose. No one had all of the answers, but they all were urgently seeking them—and doing so with clever, innovative projects and a rare openness to wide-ranging interdisciplinary collaboration.

It is our hope that this series of public forums will bring more smart minds into this promising field. After all, as placebo research has shown us, a determined mind can unleash amazing results.

The second in this series of five public forums will take place in early December at Massachusetts General Hospital and will focus on clinical applications of placebos. For details, stay tuned to the PiPS website.

This commentary originally appeared on the RWJF Pioneering Ideas blog.