Abstract:Does it work? This question lies at the very heart of the kinds of controversies that have surrounded complementary and alternative medicines (such as herbal medicine) in recent decades. In this paper, I argue that medical anthropology has played a pivotal and largely overlooked role in taking the sham out of the placebo effect with important implications for what it means to say a therapy or drug 'works'. If pharmacologists and clinicians have corporeally located the concept of efficacy in terms of bio-availa… Show more
“…The sociological scrutiny of both ‘sides’ of this argument has been limited, but there are some promising developments that deserve further research. To quote Wahlberg, an anthropologist: If pharmacologists and clinicians have corporeally located the concept of efficacy in terms of bio‐availability, pharmacodynamics and pharmacokinetics, and herbalists in terms of a herbal revitalizing of the body's own vis medicatrix naturae, from the early 20th century onwards medical anthropologists (especially those who became interested in the ‘savage mind’) have built up an equally rigorous theory of symbolic efficacy in terms of narratives, symbols and a kind of cognitive homeostasis (Wahlberg :177).…”
Complementary and alternative medicine (CAM) and traditional medicine (TM) are important social phenomena. This article reviews the sociological literature on the topic. First, it addresses the question of terminology, arguing that the naming process is a glimpse into the complexities of power and history that characterize the field. Second, focusing on the last 15 years of scholarship, it considers how sociological research on users and practitioners of TM/CAM has developed in that time. Third, it addresses two newer strands of work termed here the ‘big picture’ and the ‘big question’. The big picture includes concepts that offer interpretation of what is happening at a societal level to constrain and enable observed patterns of social practice (pluralism, integration, hybridity and activism). The big question, ‘Does it work?’, is one of epistemology and focuses on two developing fields of critical enquiry – first, social critiques of medical science knowledge production and, second, attempts to explain the nature of interventions, i.e. how they work. Finally, the article examines the role of sociology moving forward.
“…The sociological scrutiny of both ‘sides’ of this argument has been limited, but there are some promising developments that deserve further research. To quote Wahlberg, an anthropologist: If pharmacologists and clinicians have corporeally located the concept of efficacy in terms of bio‐availability, pharmacodynamics and pharmacokinetics, and herbalists in terms of a herbal revitalizing of the body's own vis medicatrix naturae, from the early 20th century onwards medical anthropologists (especially those who became interested in the ‘savage mind’) have built up an equally rigorous theory of symbolic efficacy in terms of narratives, symbols and a kind of cognitive homeostasis (Wahlberg :177).…”
Complementary and alternative medicine (CAM) and traditional medicine (TM) are important social phenomena. This article reviews the sociological literature on the topic. First, it addresses the question of terminology, arguing that the naming process is a glimpse into the complexities of power and history that characterize the field. Second, focusing on the last 15 years of scholarship, it considers how sociological research on users and practitioners of TM/CAM has developed in that time. Third, it addresses two newer strands of work termed here the ‘big picture’ and the ‘big question’. The big picture includes concepts that offer interpretation of what is happening at a societal level to constrain and enable observed patterns of social practice (pluralism, integration, hybridity and activism). The big question, ‘Does it work?’, is one of epistemology and focuses on two developing fields of critical enquiry – first, social critiques of medical science knowledge production and, second, attempts to explain the nature of interventions, i.e. how they work. Finally, the article examines the role of sociology moving forward.
“…One of the difficulties raised by the systematic selection of individuals at the less severe end of a disorder or a disease for participation in clinical trials is, as Healy has stressed, the likelihood of a disconnect between a treatment's performance during a trial, and its performance when distributed clinically (Healy, 2001). Complicating things further is the fact that, in the placebo-controlled trials that have taken place despite increasingly strict ethical constraints, placebo response has been, as both Goodwin and Kirsch noted at the Maudsley debate, surprisingly high (see Wahlberg, 2008;Wilson, 2008).…”
Section: Recruitment Demands: Selecting Out Severely Depressed Patientsmentioning
Drawing on an analysis of Irving Kirsch and colleagues' controversial 2008 article in PLoS [Public Library of Science] Medicine on the efficacy of SSRI antidepressant drugs such as Prozac, I examine flaws within the methodologies of randomized controlled trials (RCTs) that have made it difficult for regulators, clinicians and patients to determine the therapeutic value of this class of drug. I then argue, drawing analogies to work by Pierre Bourdieu and Michael Power, that it is the very limitations of RCTs -their inadequacies in producing reliable evidence of clinical effects -that help to strengthen assumptions of their superiority as methodological tools. Finally, I suggest that the case of RCTs helps to explore the question of why failure is often useful in consolidating the authority of those who have presided over that failure, and why systems widely recognized to be ineffective tend to assume greater authority at the very moment when people speak of their malfunction.
“…In discussing the role of placebo in WHM, Wahlberg (2008a) draws on the work of early 20 th century medical anthropologists on 'symbolic efficacy' and the role of 'suggestion' in the West , and describes how 'the "sham" was taken out of placebo', as the term ceased being a synonym for fraud in medical treatment. As the role of the mind has been shown to play a significant role in any medical treatment, the placebo effect can no longer be seen as the province only of the trickster but is part of all medical treatment.…”
Section: Incorporation Of Whm Into Mainstream Healthcarementioning
confidence: 99%
“…Wahlberg (2007;2008a;2008b; has identified particular societal changes which have facilitated the acceptance of WHM. Wahlberg terms this acceptance the 'normalisation' of WHM, a process by which, he argues, WHM has been accepted as a legitimate form of healing.…”
Section: Incorporation Of Whm Into Mainstream Healthcarementioning
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