{"id":396,"date":"2017-12-08T09:00:17","date_gmt":"2017-12-07T22:00:17","guid":{"rendered":"http:\/\/blog.amt.org.au\/?p=396"},"modified":"2017-12-08T16:09:00","modified_gmt":"2017-12-08T05:09:00","slug":"review-2017-placebo-symposium-in-sydney","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2017\/12\/08\/review-2017-placebo-symposium-in-sydney\/","title":{"rendered":"Review: 2017 Placebo Symposium in Sydney"},"content":{"rendered":"
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Image: Pixabay<\/p><\/div>\n

by Rebecca Barnett<\/h4>\n

Question: How do you know if you\u2019ve actually attended a Placebo Symposium?<\/p>\n

Answer: Everyone in your acquaintance feels obliged to ask if you got any benefit.<\/p><\/blockquote>\n

But it definitely wasn\u2019t all just in my head. I really did attend a Placebo Symposium<\/a> in November, jointly convened by the Pain Management Research Institute<\/a> at Sydney University and the IASP Placebo Special Interest Group<\/a>.<\/p>\n

And, yes, I genuinely benefited.<\/p>\n

Most formal definitions of the word placebo include the terms \u201cinert\u201d or \u201cchemically inactive\u201d.<\/p>\n

\"\"Damien Finniss, Chair of the IASP placebo special interest group, opened the event by laying down the gauntlet and striking at the very heart of these sorts of classical definitions of placebo. Here is the frame he provided for the whole event (based on Dan Moerman\u2019s book, Meaning, Medicine and the Placebo Effect<\/a>, which is available for FREE download):<\/p>\n

    \n
  1. Placebos are not<\/strong> inert<\/em><\/li>\n
  2. When we give a placebo, we stimulate a therapeutic ritual (psychosocial context)<\/em><\/li>\n
  3. This therapeutic ritual initiates, modulates and maintains multiple endogenous pathways that improve symptoms<\/em><\/li>\n
  4. Therefore, you do not need to give a placebo to elicit a placebo effect (i.e. to turn on placebo mechanisms)<\/em><\/li>\n
  5. Placebo effects are part of routine clinical care (and life).<\/em><\/li>\n<\/ol>\n

    So began a two-day exploration which consistently challenged the classical notion that placebo refers to something inactive or inert, positing an alternate understanding that placebo is not actually about administering an inert substance but rather about maximising the therapeutic ritual which can lead to measurable changes in the patient\u2019s brain (for example, specific neurotransmitter and hormone release).<\/p>\n

    The focus of the symposium was unashamedly clinical: how to harness placebo mechanisms to improve clinical outcomes. This obviously meant that there was also quite a lot of discussion about placebo\u2019s evil step-sibling, nocebo<\/a>, and how to minimise and manage negative expectations.<\/p>\n

    It\u2019s difficult to know how to best encapsulate the stunning range of presentations and perspectives at the Symposium in a brief review. There were sessions on:<\/p>\n