The Placebo Paradox
The re-vitalization of clinical trials with psychedelics has produced an exciting new array of studies investigating different combinations of therapeutic substances and diagnoses. Beyond the important bureaucratic negotiations that have taken place to gain approval for these studies, this new wave of studies is also negotiating a new methodological landscape of clinical research. When researchers Humphry Osmond and Abram Hoffer were studying the use of hallucinogens in Saskatchewan in the 1950’s, their research was published as case studies. However, today, placebo controlled randomized controlled studies are now the standard for research with psychopharmaceuticals. Because psychedelic therapy seeks to induce a radical change in consciousness—to make a subject feel different from her everyday self—blinding theses studies has emerged as a methodological sticking point. However, this paper argues, that it is also a rich site for interrogating the paradoxes of placebo effects more generally. Anthropology has generally engaged with the placebo as inert: either as an example of the power of symbolic healing within Western medicine, or as ethically fraught territory of non-treatment. In contrast, this paper frames placebos as anything but inert; they are heavily charged with efficacy within the logic of the clinical trial. Drawing upon ethnographic research with clinical researchers from the Multidisciplinary Association for Psychedelic Studies (MAPS) and the history of the use of placebos in medicine and in research, this paper will explore how contemporary studies are negotiating the placebo paradox.
Katherine Hendy is a cultural anthropologist specializing in studies of medicine and science and technology. Her doctoral fieldwork and dissertation studied a small tribe of clinical researchers based out of Santa Cruz, California and their efforts to develop the drug MDMA as a prescription pharmaceutical. Her dissertation draws primarily from participant observation fieldwork with the Multidisciplinary Association for Psychedelic Studies (MAPS) and explores the politics of clinical research. She is currently a Visiting Assistant Professor at The Ohio State University in the Department of Comparative Studies where she teaches several courses on Science Technology and Society.