Understanding the Placebo Effect in Complementary Medicine: Theory, Practice, and Research

By David Peters | Go to book overview

1
Placebos and nocebos: the cultural
construction of belief
Cecil G. Helman
The role of context in placebo and nocebo phenomenona
The 'total drug effect'
The context of ritual healing
Contexts of ritual healing: some examples
Traditional healers
Western medicine
Cultural differences
The psychoanalyst
Anton Mesmer
The macrocontext of Western medicine
The cultural construction of belief
The nocebo effect
Conclusion

Editor's note

Cecil Helman's book 'Culture, health and illness' made me aware that our 'obvious' ways of doing medicine actually depend on a hidden world view, a framework of unexamined assumptions that holds our thinking in place. When looked at through the anthropologist's eye, many deeply rooted certainties (including mind—body dualism and a bias towards reductionism) can be seen for what they are: beliefs. I wanted Hellman's anthropological gaze to liberate us from the notion of real and unreal elements in treatment. One wrong assumption we make is that placebos are 'things' that fool us into feeling better. In this chapter he persuades us that the greater part of any treatment outcome has to do with factors that are anything but biological. Even apparently unequivocal clinical facts actually depend on culture and custom; in fact, even within the practice of conventional medicine in Europe, diagnoses, treatments and symptom patterns vary from nation to nation. He helps us see that the way we think about health and healthcare is culture bound—making it obvious for instance that, at a time when beliefs and social relationships are changing, people will seek out new ways of putting together their healing encounters, and making it seem less strange that effectiveness and beliefs should be so intricately bound together. Hellman not only gives us a framework for asking how and why complementary therapies have taken such a hold, but also calls into question whether treatment, relationships and outcomes can ever be fully understood if plucked out of their cultural landscape.

-3-

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