The Many Meanings of Placebo

Physicians throughout medical history knew three possible ways to explain the association between treatment and cure: 1. the beneficial effect of the treatment itself, 2. the healing power of nature, and 3. the placebo effect. In the modern definition by Grünbaum, a treatment is a placebo when the effect cannot be explained by the theory that describes its activity. In clinical practice the placebo phenomenon is commonly misunderstood. Placebos are given to prove the patient wrong or to punish him. Nevertheless, most clinical pain can be reduced to at least half of its intensity by placebos. Also cough, headaches, asthma and other ailments can thus be relieved. Explanatory theories are often much narrower in focus than the phenomenon they seek to explain. A Meaning Model could offer new possibilities, as it includes the doctor-patient relationship, belief systems, social support, and feelings of mastery over the symptoms. One way to make such a model visible is the exploration of the deep-seated cultural assumptions about illness in different countries.