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講者:Prof. Przemysław Bąbel (Jagiellonian University, Poland)

講題:The Power of Placebo in Pain Management







Placebo, commonly considered an inert intervention, possesses an extraordinary capacity to elicit significant health effects. Beneficial outcomes are referred to as placebo effects, while negative consequences are termed nocebo effects. Although placebo and nocebo responses are observed in diverse medical conditions, they have been extensively investigated within the realm of pain management. The phenomenon of placebo-induced pain relief is coined as placebo hypoalgesia, while pain exacerbation is termed nocebo hyperalgesia. This enlightening talk delves deep into the intricate mechanisms that render placebos so impactful on health. Central to the discussion is the pivotal role of learning processes in driving both placebo and nocebo effects. Classical conditioning stands out as one such process, wherein a formerly neutral stimulus (the placebo) acquires the ability to evoke a response (e.g., pain relief) akin to that produced by another stimulus (e.g., a painkiller) previously administered. Observational learning also exerts influence, as individuals may replicate responses observed in others who experienced pain relief after taking a placebo. Additionally, operant conditioning plays a crucial role in shaping placebo effects, with behaviors followed by rewards (e.g., attention or pain relief) becoming more likely to recur, while behaviors leading to punishers (e.g., pain or withdrawal of attention) occurring less frequently. The talk presents a comprehensive review of the evidence substantiating the effectiveness of placebos in pain modulation and explores the current state of understanding regarding the underlying learning mechanisms. Moreover, it sheds light on the potential clinical applications of harnessing learning processes to optimize placebo effects and effectively manage nocebo responses.



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