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26
explaint the following mechanisms for placebo effect
Anxiety reduction;
Expectation;
Transference;
Meaning effects;
Conditioning.
Anxiety reduction;
Expectation;
Transference;
Meaning effects;
Conditioning.
Anxiety reduction – some evidence that placebo pain-relief reduces affective but not sensory pain. However, anxiety may actually alleviate pain.
Expectation – essentially about self-efficacy such that if a patient thinks that and prepare themselves to be in control and have good outcomes from an intervention this tends to happen. Can be so powerful that can seemingly counter drug effects. (i.e. Buckman and Sabbagh (1993) who gave pregnant women an emetic having told them it was an anti-emetic for morning sickness - they reportedly felt less sick!)
Transference – a psychodynamic process of identification of the patient with the doctor and transfer of their anxiety. In some psychoanalytic models this is followed by counter-transfer in which the doctor gives the anxiety back but in manageable form
Meaning effects – combines conscious, unconscious and socio-cultural effects on expectations. Helman (2001:5) ‘The doctor’s office, hospital ward, holy shrine or house of a traditional healer can be compared to a theatre set complete with scenery, props, costumes and script. This script, derived from the culture itself
… tells them how to behave, how to experience the event and what !!to expect from it. It helps to validate the healer, and the power of their methods of healing’
Conditioning – in its classical form the linking of a stimulus, action and response such that in due course the action can be removed and the stimulus alone provokes the response.
Expectation – essentially about self-efficacy such that if a patient thinks that and prepare themselves to be in control and have good outcomes from an intervention this tends to happen. Can be so powerful that can seemingly counter drug effects. (i.e. Buckman and Sabbagh (1993) who gave pregnant women an emetic having told them it was an anti-emetic for morning sickness - they reportedly felt less sick!)
Transference – a psychodynamic process of identification of the patient with the doctor and transfer of their anxiety. In some psychoanalytic models this is followed by counter-transfer in which the doctor gives the anxiety back but in manageable form
Meaning effects – combines conscious, unconscious and socio-cultural effects on expectations. Helman (2001:5) ‘The doctor’s office, hospital ward, holy shrine or house of a traditional healer can be compared to a theatre set complete with scenery, props, costumes and script. This script, derived from the culture itself
… tells them how to behave, how to experience the event and what !!to expect from it. It helps to validate the healer, and the power of their methods of healing’
Conditioning – in its classical form the linking of a stimulus, action and response such that in due course the action can be removed and the stimulus alone provokes the response.
