P.8.a.003 - Placebo and nocebo phenomena: a survey of knowledge and attitudes among psychiatrists, psychiatry residents, and medical students in Croatia

Abstract

Complementary and alternative medicine (CAM) is frequently conceptualized as ‘nothing but’ placebo. I will argue, and provide the evidence in this chapter, that, apart from potential specific effects, CAM is a clever way of inducing generic self-healing effects. Jerome D Frank's model serves to conceptualize this. CAM practitioners normally establish good relationships and take time to listen to their patients. They have very elaborate rituals to enact those effects. They demonstrate their prowess and they provide alternative explanatory models that make sense, at least to those patients that consult with them. Most important of all, perhaps, is the fact that nearly all CAM modalities require patients to become active, thus serving as a catalyst to mobilize resources and stimulate the experience of self-efficacy. The latter is debatedly one of the most important nonspecific effects of therapy. Hence, it is misleading to conceptualize CAM effects as nonspecific effects. Rather, it seems to be a way of activating a self-healing response that is very specific in itself, and indeed, more specific than purportedly specific pharmacologic effects.