Page 1032 - medicina-integrativa_compress

1058 PARTE III, SECCIÓN 2 MENTE-CUERPO

• Se considera que el efecto placebo surge
REVISIÓN TERAPÉUTICA principalmente de elementos incidentales
y preliminares del tratamiento. El efecto
• El efecto del placebo se basa en la depende de la interacción de médico,
capacidad innata del cuerpo de curarse a sí proceso de tratamiento y paciente.
mismo espontáneamente. La percepción del paciente de esta
interacción a menudo activa el proceso
• El cuidado óptimo requiere que el efecto de curación/placebo.
placebo se maximice.
• La experiencia de la relación terapéutica
• Los pacientes no son receptores pasivos ha demostrado facilitar el cambio.
del tratamiento, sino que deben Es esta relación, y no la persona
considerarse como socios igualitarios. individual, la que ofrece el marco del
cambio.
• El efecto placebo es contextual, un
fenómeno situacional más que el resultado • No sólo son elementos importantes
de un rasgo de personalidad permanente. del efecto placebo la expectativa, el
significado y la maestría, sino también
• La capacidad de evidenciar el efecto es llevar al paciente a una capacidad que
probablemente inherente a todas las desemboca en mejores resultados para
personas. la salud.

Agradecimiento 16. Grencavage LM, Norcross JC: Where are the commonalities among
the therapeutic common factors? Profess Psychol Res Pract 21:
Quiero expresar mi agradecimiento a Richard R. Bootzin, PhD, 372-378, 1990.
por su ayuda a la ahora de conceptualizar muchas de las ideas 17. Barfod TS: Placebo therapy in dermatology. Clin Dermatol
incluidas en este capítulo. 17:69-76, 1999.
18. Brody H: “My story is broken; can you help me fix it?” Medical
ethics and joint construction of narrative. Lit Med 13:79-92, 1994.
19. Brody H, Waters DB: Diagnosis is treatment. J Fam Pract
BIBLIOGRAFÍA 10:445-449, 1980.
20. Oh VM: The placebo effect: Can we use it better? BMJ
1. Di Blasi Z, Harkness E, Ernst E, et al: Influence of context effects on 309:69-70, 1994.
health outcomes: A systematic review. Lancet 357:757-762, 2001. 21. Thomas KB: General practice consultations: Is there any point in
2. Spiro H: Clinical reflections on the placebo phenomenon. In being positive? BMJ 294:1200-1202, 1987.
Harrington A (ed): The Placebo Effect: An Interdisciplinary 22. Houston WR: The doctor himself as a therapeutic agent. Ann Intern
Exploration. Cambridge, Mass., Harvard University Press, 1997. Med 11:1416-1425, 1938.
3. Bennet P: Placebo and healing. In Pizzorno JE, Murray MT (eds): 23. Findley T: The placebo and the physician. Med Clin North Am
Textbook of Natural Medicine. New York, Churchill 37:1821-1826, 1953.
Livingstone, 1999. 24. Thomas KB: The placebo in general practice. Lancet 344:
4. Weil A. Spontaneous Healing. New York, Fawcett Columbine, 1995. 1066-1067, 1994.
5. Cassell EJ: The Healer’s Art. Philadelphia, JB Lippincott, 1978. 25. Evans FJ: The placebo response in pain reduction. In Bonica JJ (ed):
6. Maizes V, Caspi O: The principles and challenges of integrative Advances in Neurololgy, vol 4: Pain. New York, Raven Press, 1974.
medicine. West J Med 171:148-149, 1999. 26. Gracely RH, Dunbar R, Deeter WR, Wolskee PJ: Clinician’s
7. Ernst E, Herxheimer A: The power of placebo: Let’s use it to help as expectations influence placebo analgesia [letter]. Lancet 1(8419):
much as possible. BMJ 313:1569-1570, 1996. 43, 1985.
8. Benson H, Friedman R: Harnessing the power of the placebo 27. Leopold N, Cooper J, Clancy C: Sustain partnership in primary care.
effect and renaming it “remembered wellness.” Annu Rev Med J Fam Pract 42:129-137, 1996.
47:193-199, 1996. 28. Brody H: The placebo response: Recent research and implications
9. Mitchell A, Cormack M: The Therapeutic Relationship in for family medicine. J Fam Pract 49:649-654, 2000.
Complementary Health Care. Edinburgh, Churchill 29. Benson H, Epstein MD: The placebo effect: A neglected asset in the
Livingstone, 1998. care of patients. JAMA 232:1225-1227, 1975.
10. Kaptchuk TJ: Powerful placebo: The dark side of the randomized 30. Bernstein CN: Placebos in medicine. Semin Gastrointest Dis 10:
controlled trial. Lancet 351:1722-1725, 1998. 3-7, 1999.
11. Amanzio M, Pollo A, Maggi G, Benedetti F: Response variability to 31. Miller WR, Brown JM, Simpson TL, et al: What works? A
analgesics: A role for nonspecific activation of endogenous opioids. methodological analysis of the alcohol treatment outcome
Pain 90:201-215, 2001. literature. In Hester RK, Miller WR (eds): Handbook of Alcoholism
12. Moerman DE: General medical effectiveness and human biology: Treatment Approaches: Effective Alternatives, 2nd ed. Boston, Allyn
Placebo effects in the treatment of ulcer disease. Med Anthropol Q & Bacon, 1995.
14:3-16, 1983. 32. Miller WR, Andrews NR, Wilbourne P, Bennett ME: A wealth of
13. Luparello TJ, Leist N, Lourie CH, Sweet P: The interaction of alternatives: Effective treatments for alcohol problems. In Miller
psychologic stimuli and pharmacologic agents on airway reactivity in WR, Heather N (eds): Treating Addictive Behaviors, 2nd ed. New
asthmatic subjects. Psychosom Med 32:509-513, 1970. York, Plenum Press, 1998.
14. Arkowitz H: Integrative theories of therapy. In Wachtel PL, Messer 33. Brown J, Stewart M, Tessier S: Assessing Communication between
SB (eds): Theories of Psychotherapy: Origins and Evolution. Patients and Doctors: A Manual for Scoring Patient-Centered
Washington, DC, American Psychological Association, 1997. Communication. (Working Paper Series 95-2). London, Thames
15. Grünbaum A: Explication and implications of the placebo concept. Valley Family Practice Research Unit, 1995.
In White L, Schwartz GE, Tursky B (eds): Placebo: Theory, Research 34. Gaudet TW: Integrative medicine: The evolution of a new approach
and Mechanisms. New York, Guilford Press, 1985. to medicine and to medical education. Integr Med 1:67-73, 1998.