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Journal of Medicine and Philosophy 2008 33(1):58-79; doi:10.1093/jmp/jhm005
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© The Author 2008. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

A Phenomenology of the ‘Placebo Effect’: Taking Meaning from the Mind to the Body

Oron Frenkel

University of California, Berkeley/University of California, San Francisco, Berkeley, CA, USA

Address correspondence to: Oron Frenkel, M.S., Joint Medical Program, University of California, Berkeley, Division of Health and Medical Sciences, 570 University Hall #1190, Berkeley, CA 94720-1190, USA. E-mail: oronito{at}gmail.com


   Abstract

Most mainstream attempts to understand the "placebo effect" invoke expectancy theory, arguing that expecting certain outcomes from a treatment or intervention can manifest those outcomes. Expectancy theory is incompatible with the phenomena of placebo responses, more appropriately named "meaning responses." The expectancy account utilizes reflexive consciousness to connect a world of conceptual representations to mechanical physiology. An alternative account based upon Merleau-Ponty's motor intentionality argues that the body understands and is capable of responding to meanings without the need for any conceptual or linguistic content. A motor intentional framework of meaning poses dramatic implications for the interpretation of clinical trials and in the clinical practice of medicine. Most strongly, it argues that the empathic physician can facilitate the physiologic effects of treatments through skillful participation and manipulation of the meaning response.

Keywords: meaning, phenomenology, placebo effect


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