Robert Ader is the forefather of the whole area of study known as psychoneuroimmunology (PNI). It amazes me that so few current graduates of medical schools have even heard of the term. Although it’s quite a mouthful, it is, simply, the study of the inter-relationships between the mind, the nervous system and the immune system. Together with psychoneuroendocrinology (the study of the mind, nervous system and endocrine system links), these areas of scientific study begin to help us to understand how the human being functions as a whole organism and how it’s pointless to consider the body and the mind as two distinct, separate entities.
He’s just published an interesting study on the clinical use of placebo. Starting from the understanding of the placebo effect as being, at least in part, akin to psychological, behavioural conditioning, and that such conditioning can exert physical changes in the body, he and his colleagues studied a group of patients with psoriasis.
They split the patients into three groups. One group applied a specified amount of steroid cream daily to their lesions, a second applied 25 to 50% of the strength of the steroid cream daily, and a third group applied cream which 25 to 50% of the time contained the full strength steroid and the rest of the time was a placebo (no steroid present).
The results are interesting, showing in particular that the group which received the placebo some of the time did as well as those receiving the full strength cream all the time, and better than the group receiving the lesser strength cream daily.
So what? Well, Ader and his colleagues point out that using placebo in this way could significantly reduce the amount of a drug required to have a desired outcome. Less drug means less side effects and less cost.
This is a novel study. Can the same phenomenon be found when applied to patients with other conditions? And for those who are concerned about the ethics, this was a fully informed, fully consented trial. There’s no reason why patients clinically couldn’t be given the choice to have treatments in this way……especially if further research confirms that the clinical outcomes are as good as using higher doses of drug more frequently.
Heroes Not Zombies 
Bob, firstly festive greetings and although the weather has caused chaos for many I love the still,dry cold.This weather and this topic resonate with me greatly! Another big word– ‘iatroplacebogenesis’ . I like the idea of studying the stimulation of the placebo/meaning/’healing’ response within another person.
It doesn’t amaze me that the ‘PNI’ term is unknown . I did a talk to a few Dr’s and nobody had heard of the pain gate theory or Melzack and Wall . As a rule of thumb, surely many many people present with ‘mixed’ problems where pain and inflammatory/immune problems are a feature?
All the best for the year ahead and keep the ideas flowing. I value your thoughts,discoveries and creativity greatly.
Ian