Overview

A lucid and stimulating explanation of how the body’s natural healing mechanisms work – and how they can be triggered in non-chemical ways via the ‘placebo effect’. Can we really cure ourselves of disease by the power of thought alone? Faith healers and alternative therapists are convinced that we can, but what does science say? Contrary to public perception, orthodox medical opinion is remarkably confident about the healing powers of the mind. For the past fifty years, doctors have been taught that placebos such as sugar pills and water injections can relieve virtually any kind of medical condition. Yet placebos only work if you believe they work, so the medical confidence in the power of the placebo effect has provided scientific legitimacy to popular claims about the healing powers of the mind. In this intriguing exploration, Dylan Evans exposes the flaws in the scientific research into the placebo effect and reveals the limits of what can and cannot be cured by thought alone. Drawing on new ideas in immunology and evolutionary biology, Evans proposes a new theory about how placebos work, and asks some searching questions about our concepts of health and disease.

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9780007126132

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Reviews

'Should prove fascinating and stimulating to expert and ordinary readers alike' Marek Kohn, Evening Standard 'Persuasive, elegant and challenging.' Michael Bywater, Daily Telegraph 'The placebo effect is fundamental to medical treatment, and this book brilliantly explores the scientific evidence in an accessible and gripping manner.' Lewis Wolpert 'The placebo effect, of such huge importance in our lives, is an effect which according to conventional scientific wisdom ought not to exist. Now, out of left field, springs a modern-day philosopher with challenging -- and persuasive -- ideas about what the effect amounts to and why.' Nicholas Humphrey

What are placebos and how do they work? How can a substance act as a placebo for one person and not another? Drawing on a wide range of scientific research, Dylan Evans sifts the evidence and examines the placebo's chequered history. Many studies testing the effect of placebos have been inconclusive, partly due to the difficulty of carrying out double-blind medical trials and partly due to semantics. Researchers have couched the placebo response in both neurological and psychological terms. Evans suggests that we don't need to invent a new term to make the picture clearer. We already have a very simple one. 'Belief' is the secret ingredient in the placebo response. Placebos won't help you unless you believe they will. The response itself is characterized as a rapid re-adjustment of the body's own natural healing mechanisms to a 'surge of hope'. It isn't a single chemical event but a chain of such events. But there are limits to what these mechanisms can do. What is it that determines whether or not a medical condition responds to a placebo? In a stunningly simple idea, the author lists the medical conditions known to be responsive to placebos and looks for a single biological mechanism common to all. If this mechanism is activated in all of the cases, it follows that the placebo might work by turning the mechanism off. There is ample evidence that pain, ulcers, depression and anxiety are responsive to placebo cures. All of these invoke the 'acute phase response' - lethargy, apathy, loss of appetite and increased sensitivity to pain. If placebos really work by suppressing the 'acute phase response' it would explain why the placebo fails to relieve other conditions such as heart disease and cancer. This convincing theory is developed at some length before Evans moves on to court controversy with his suggestion that the majority of alternative medicines (some 30 different disciplines) are simply placebos. The high levels of consumer satisfaction amongst users of alternative medicine may just prove that alternative therapists are better at evoking trust in patients and better able to mobilise the placebo response than conventional medical practitioners are. This is a fascinating introduction to a concept that is still baffling in many ways; readers of all medical backgrounds and none will find it gives them plenty to think about. (Kirkus UK)

Author Information

Dylan Evans is currently research officer in Evolutionary Robotics at the University of Bath. Previously he was a research fellow in the Philosophy Department at King’s College London, where he was involved in a project on the evolution of the emotions. His previous books include Emotion: the Science of Sentiment and Introducing Evolutionary Psychology. He contributes regularly to the Guardian, and broadcasts frequently.

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