Placebo hype: Do the facts match the headlines?

Over at SEEDMAGAZINE.COM, my column discusses the recent flurry of blog posts and media reporting on the placebo effect. Here's a snippet:

This is the primary misconception about placebos: that the placebo itself is somehow "working" to treat a medical condition. You can see it even in the headline for an otherwise well-crafted article that appeared in Wired last August: "Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why." As internist and medical professor Peter Lipson noted on the Science-Based Medicine blog, placebos by definition have no medical effect. The "placebo effect" is due to the subject's (and sometimes, the experimenter's) expectation that a treatment will work. And, of course, a patient sometimes recovers simply due to chance or because his or her immune response handled the problem. Researchers observe an improvement, and this gets attributed to the placebo. In the case of the Wired article, the misconception in the headline is cleared up by the text of the report: The placebo effect may be getting stronger for reasons that are unclear to researchers. Placebos themselves, as ever, remain ineffective.

The anonymous blogger and UK-based neuroscientist Neuroskeptic also addresses the Wired report in a post entitled "Deconstructing the Placebo." Neuroskeptic points out that many of the issues we have with placebos are more properly directed at the medical conditions a placebo could supposedly address. If a placebo is just as effective at reducing anxiety as a drug designed for that purpose, what does that tell us about the nature of anxiety? Is participation in a research study motivating people to do other ostensibly anxiety-reducing activities? How exactly are these additional activities helping the problem? Even if placebos aren't cures, we should be able to learn more about real medical conditions by investigating how people respond to a fictional "treatment."

Also, in case you missed it, here are my picks from neuroscience and psychology posts this past week on ResearchBlogging.org:

One more thing: The Depression Bipolar Support Alliance is sponsoring a video contest, with a prize of $1,000 for the best video. How cool would it be if the winner incorporated some discussion of peer-reviewed research?

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The placebo itself does not work by means to make direct biochemical changes in one's organism, but by making the organism's omnipotent nervous system to take action in curing the condition,
The fact that we do not have a systematic and well accepted knowledge of the CNS control over the so called "autonomic" functions of the body does not, however, mean that this is not the case.
A well powered studies in placebo effect would IMHO do a great good for all of us and the medicine.