In the last decade, the study of placebo has moved from the backwaters of medical research to nearer the mainstream. There is now a Program in Placebo Studies at Harvard. NIH and nonprofits like the Robert Wood Johnson Foundation fund placebo work. Journals publish papers. What used to be dismissed is now taken increasingly seriously.

It’s fair to say this shift wouldn’t have happened without Ted Kaptchuk, who heads Harvard’s placebo program. Over 35 years, he’s been investigating placebos, which are medical interventions without active drug ingredients, in various contexts and expanding the scope of the field–including, for a time, to his own acupuncture practice.

The placebo effect is brought about by much more than sugar pills and saline injections. It’s about the whole “drama” or “theater” of medicine.



To Kaptchuk, the placebo effect is brought about by much more than sugar pills and saline injections. It’s about the whole “drama” or “theater” of medicine–essentially the context of the encounter between patient and physician–as much as treatment itself. “The placebo effect is the effect of everything surrounding the fake pill, or the real pill,” he says. “It’s the compassion, trust, and care. It’s the ritual and symbols. It’s the doctor-patient interaction.”

Kaptchuk has published several papers that have gotten wider attention beyond the world of academic journals and conferences. For example, he got a big response for a study with irritable bowel syndrome patients, where he showed that placebo could be effective even when patients knew the treatment was fake. (The drug bottle had a big “placebo” label on it.) Though the study only included 80 volunteers, the results seemed to indicate something profound: When patients want to get better, and believe that doctors are there to help them, good things happen.

Kaptchuk credits the growing respectability of studying placebos down to the wider availability of neuro-imaging techniques. By demonstrating physiological impact in the brain when a patient takes a placebo treatment, researchers can move beyond conjecture about how the effect works. “The discovery of neurobiology has made physicians in the medical community more comfortable that something is going on that they have to pay attention to,” he says. “Before it was just the imagination. Now, the imagination has a real neurobiology.”

Researchers can begin to see inside the brain, helping to gauge what works and when. Neuro-imaging has allowed researchers to look at whether there’s a genetic basis for why some people seem more susceptible to placebo treatments than others.

The recent research findings do beg a serious question, though. Are we going to see actual treatments based on pills that are no more than sugar as alternatives to active drugs? How might medicine incorporate the work that Kaptchuk and other placebo researchers are bringing to the world?