Enactive and Simondonian reflections on placebo phenomena
Iñigo Arandia-Romero (UPV/EHU)
Tuesday 21 January 2019 at 11:30 (Centro Carlos Santamaria, B14)
Placebo effects have played a key role in the history of medicine, and they are still nowadays extremely useful as the gold standard to test the efficacy of many treatments through Randomized Control Trials (RCT). Despite its importance, they did not receive much research attention until the last two decades or so, and we are still far from a complete understanding of the phenomena related to the umbrella-term placebo. We will show that part of the problems and limitations to understand the placebo effects is related to theoretical assumptions that are often implicit in the current biomedical paradigm: the mind-body dualism, the predominance of individualism, the reductionist tendency to study isolated factors, and neglecting the dynamic nature of human beings (i.e, their history and evolution process). By taking advantage of the distinction between pre-reflective and reflective consciousness employed in the phenomenological tradition, the theoretical framework of the enactive perspective, and the philosophy of individuation developed by Gilbert Simondon, we will propose a novel way to analyze placebo interventions that overcomes some of the limitations of current approaches, and is able to explain part of the huge variability of placebo responses, across subjects and across conditions. Instead of offering a full account of placebo phenomena, we will provide insights to better analyze different experimental paradigms employed in placebo research considering that each subject is an embodied agent situated in a social environment with concrete problems that can be interpreted as a sense-making challenge or a search for meaning. Then, the placebo intervention can be understood as just the last step that triggers a large response but that would be impossible without the history of the subject, all her previous attempts to cope with her condition in her social context, the patient-practitioner interaction and other features that are often neglected or labelled as non-specific in the placebo literature.