安慰剂效应中的方法论挑战与身心关系

安慰剂和安慰剂效应是现代科学研究方法论的重要组成部分。对安慰剂效应的新的科学研究表明,安慰剂效应是真实存在的生理现象,且表现出主体性和情境性,这给科学研究对医疗有效性的检验带来了方法论上的挑战,给关于自我实现的信念、预期与反思意识中的身心关系等问题带来知识论上的挑战。文章提出,意义响应为回应这些挑战提供了可能的视角。从意义响应出发,从病人的主体性和社会文化体验来考查医疗过程,沟通了文化、心理和生理的身体,可以解决安慰剂效应在定义、方法与机制解释方面的模糊和混杂,避免条件反射、预期理论等在安慰剂效应的解释中对身体和心理非此即彼的强调带来的矛盾,并启发生物医学研究在证据判断上关注实践者。

Methodological Problems and the Relationship Between Mind and Body in Placebo Effect

Placebo and placebo effect used in clinical research and practice are considered as a critical component of modern medical research methodology. However, endless confusion has arisen because the definitions of the placebo effect are as diverse and the placebo itself obviously cannot be what causes the physiological changes. Neither belief, expectancy theory or classical conditioning accounts could fully interpret the placebo effect. Placebo effect could be more appropriately named as meaning responses, which cover the multi-agent clinical context of health. Meaning responses include everything outside of specific therapy and spontaneous healing. This approach highlights the patients’ medical experience and the doctors’ engaging in therapy, and avoids the simplistic dualism of mind vs. body.