The phrase "mind-body connection" has many connotations. For some, it's shorthand for New Age quackery. For others, it's a source of hope and a way to reconcile the spiritual life with modern science.
For Dr. Tor Wager, it's just another day at the office.
Wager is a psychology professor at the University of Colorado who specializes in neuroscience and brain imaging. But his passion is the placebo effect. He uses functional magnetic resonance imaging, a specialized scan that measures changes in blood flow, to link specific brain activation to people experiencing a placebo effect. He is a leading figure in the new generation of placebo researchers.
Increasingly, placebo effects are being viewed as real and tangible, if mysterious. In various surveys, 45 percent to 85 percent of American and European practitioners say they have used placebos in clinical practice, and 96 percent of academic physicians in the United States say they think placebos have therapeutic effects.
Even so, many scientists mistrust them.
"When I started grad school I felt like it was kind of taboo to study the placebo," Wager said. The research at the time was spotty, "and then there were whole sections of society that were ready to jump on that and say, 'Oh, look how powerful the mind is!'"
But placebo research has gained respectability in recent years, thanks largely to the work of Dr. Fabrizio Benedetti, an Italian neuroscientist.
Benedetti argues that there is not a single placebo effect, but many. One common effect involves the assumption that a particular pill is responsible for easing pain or discomfort that is actually subsiding naturally. Another is classic Pavlovian conditioning, in which a patient is so accustomed to feeling better after a shot that it works no matter what is in it. Another is the relief a patient feels when a doctor offers a concrete solution.
The persistent question - why some people are more responsive to placebos than others - has long frustrated scientists. "There's decades of research that has more or less failed," Wager said. "New methods are going to let us get a lot more out of it."
Solving the mystery would potentially unlock whole new areas for therapy. Wager recently attended a meeting sponsored by the National Institutes of Health about enlisting multiple institutions in an effort to understand placebos. Several drug companies were present; some have begun their own research into the mystery.
Wager (who receives financing from the NIH, the National Science Foundation and the Michael J. Fox Foundation) says drug companies are cautious about bringing too much attention to placebos, but recognize a potential for better therapies.
But for him it is a deeper question.
"What is the placebo effect?" he asked. "It's not some weird magical thing that just kind of happened out of the blue. I think it's connected to systems that generate emotional responses. It's a window into ways in which psychological factors can affect brain and body factors that are related to health."
