Rehabilitating placebo

Welcome back friends! Today we've got a first for you: our very first audio essay by... not me. I would call it a guest essay, but it's by our longtime Assistant Producer, Urte Laukaityte. If you're a regular listener of the show, you've been indirectly hearing her work across dozens and dozens of episodes, but this is the first time you will be actually hearing her voice.  Urte is a philosopher. She works primarily in the philosophy of psychiatry, but also in the philosophy of mind, the philosophy of biology, the history of medicine, and neighboring fields. She's particularly interested in a colorful constellation of psychiatric phenomena—phenomena like hypnosis, mass hysteria, psychogenic conditions, and (the topic of today's essay) the placebo effect.   There's almost certainly more to placebo than you realize—it's a surprisingly many-layered phenomenon. Here, Urte pulls apart those layers. She talks about what placebo can and cannot do, the mechanisms by which it operates, the ethical dimensions of its use, its evil twin nocebo, how it is woven through the history of medicine, and a lot more. She argues that, though we've learned a lot about the placebo in recent decades, we have not yet harnessed its full potential.  As always, we eagerly welcome your comments about the show. Feel free to find us on social media, or send us a note at [email protected]. We would love to hear your suggestions for future episodes, your constructive criticisms, really your feedback of whatever kind. Alright friends, now on to our audio essay—'Rehabilitating placebo’—written and read by Urte Laukaityte. Enjoy! A text version of this episode will be available soon.   Notes and links  3:30 – A research paper describing the FIDELITY trial. 8:00 – For a neuroscientific overview of placebo research, see this review article. The landmark 1978 study is here. 9:00 – The study using naloxone in rats. 10:30 – A review of placebo effects in Parkinson’s disease. 13:00 – The study showing placebo effects in allergy sufferers. For more on placebo and conditioning in the immune system, see here.  13:30 – An overview of the results on whether placebo “can replace oxygen.”  16:00 – For the “milkshake” study, see here.  20:00 – A perspective piece on open-label placebos. A review of the efficacy of open-label placebos.  22:00 – A review of nocebo-induced side effects within the placebo groups of trials.  24:00 – On the idea of “good placebo responders,” see here. 27:30 – The book Medical Nihilism, by Jacob Stegenga. 28:00 – A review and meta-analysis of the use of placebo by clinicians.  29:30 ­– A paper on complementary and alternative medicine (CAM) and placebo.  30:30 – A review of factors modulating placebo effects. 34:00 – For the “signaling theory of symptoms,” see here.   Many Minds is a project of the Diverse Intelligences Summer Institute, which is made possible by a generous grant from the Templeton World Charity Foundation to UCLA. It is hosted and produced by Kensy Cooperrider, with help from Assistant Producer Urte Laukaityte and with creative support from DISI Directors Erica Cartmill and Jacob Foster. Our artwork is by Ben Oldroyd. Our transcripts are created by Sarah Dopierala. Subscribe to Many Minds on Apple, Stitcher, Spotify, Pocket Casts, Google Play, or wherever you listen to podcasts. You can also now subscribe to the Many Minds newsletter here! We welcome your comments, questions, and suggestions. Feel free to email us at: [email protected].   For updates about the show, visit our website or follow us on Twitter: @ManyMindsPod.