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Ilan Kirsch
Binghamton University
SEE PROFILE
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University of Connecticut
State University of New York at Binghamton
Placebo Effects
In a study reported by Ikemi and Nakagawa (1962), 13
students were touched on one arm with leaves from a
harmless tree, but were told that the leaves were from a
lacquer or wax tree (Japanese trees that produce effects
similar to poison ivy and to which the boys had reported
being hypersensitive). On the other arm, the students were
touched with poisonous leaves, which they were led to
believe were from a harmless tree. All 13 participants
displayed a skin reaction to the harmless leaves, but only
two reacted to the poisonous leaves. In this study, the effect
of the harmless leaves was not only dramatic, it was also
greater than the effect of the active substance.
July 1999 American Psychologist
Steven Jay
Lynn
that are consistent with treatment goals and that gains are
generalized beyond the treatment setting.
Another way of altering the accessibility of facts or
events in memory is to ask people to think about or imagine
likely outcomes. This can increase the salience of particular
outcome expectations and bring to mind concepts and ideas
consistent with positive outcomes and inconsistent with
negative outcomes. When making subsequent judgments or
decisions, these ideas will then be most accessible and will
serve as a basis for action (S. J. Sherman, Skov, Hervitz, &
Stock, 1981). For example, imagining negative outcomes
of smoking and overeating and positive outcomes of not
doing so can make it easier to resist those urges. Similarly,
R. T. Sherman and Anderson (1987) asked first-time clients
to imagine staying in therapy for at least four sessions and
to explain why they were able to do this. For these clients,
premature termination was substantially less than termination by clients who did not imagine remaining in treatment.
By guiding clients' imagery and the kinds of outcomes they
think about, it may be possible to affect how clients behave
when relevant situations arise. Solution-focused therapists
make use of similar strategies (de Shazer, 1985; Fish,
1996). Rather than stressing problems and their causes,
these therapists direct the client's attention to exceptions to
the problem, thereby priming adaptive thoughts and behaviors. Posing questions to clients such as, "How would your
life change if you did XT' or "What would have to change
in your life in order for you to relinquish your fear of public
speaking?" might serve a similar function.
Conclusions
A variety of different therapeutic approaches, either implicitly or explicitly, harness the power of expectancies to
establish, shape, and fulfill treatment goals. Similarly, the
experimental literatures on priming and on ironic processes
are paralleled by strategies developed by therapists from
diverse schools of therapy. Given this overlap, it seems
likely that attention to the experimental literature could
lead to further improvements in therapeutic technique. At
the same time, additional research is needed to validate the
use of these automatic processes in psychotherapy.
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