Placebos, Central Sensitization, and Chronic Pain

Ted explains central sensitization and why placebo approaches often help amplified symptoms like chronic pain and fatigue.

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Placebo effects are not about expectation, or positive thinking, and you don’t have to believe you’re taking a real drug to feel better. In fact, they are not in your mind at all, but your body.

This is what self-confessed ‘deviant’ Ted Kaptchuk wants you to know, after conducting decades of research that has shocked the medical establishment and turned upside down conventional thinking about placebos.

I’ve been a fan of Ted’s work ever since we first met in 2014, when I was researching my book Cure: A journey into the science of mind over body. He originally trained in Chinese medicine (one of the first westerners to do so in China), and he is now a professor of medicine at Harvard, where he directs Harvard’s Program in Placebo Studies and the Therapeutic Encounter.

Ted has been doing some wild things there: listening to patients; thinking carefully about what’s really making us better when we receive a treatment; and exploring what happens if you give people medicine without the drugs.

His trials break all the normal rules, but they show us how we might approach medicine differently, particularly for the very conditions that our drugs are usually worst at treating – from depression, fatigue, and anxiety to many skin conditions, gut problems and especially chronic pain. His results also dovetail perfectly with the latest results from neuroscience about how we perceive not just bodily symptoms, but our entire reality.

I asked Ted about his rebellious background, the inspirations for some of his craziest experiments, and how to unlock our inner pharmacy.

Ted Kaptchuk’s home page at Harvard:

https://ghsm.hms.harvard.edu/faculty-staff/ted-jack-kaptchuk

Ted’s website:

https://www.tedkaptchuk.com/

Lecture series I presented for The Great Courses on mind-body links in medicine (the first two are all about placebos, including Ted’s work):

https://www.thegreatcoursesplus.com/the-power-of-mind-over-body

Honest fakery: How placebos can treat chronic pain:

https://www.nature.com/articles/535S14a

Ted’s first 2010 trial on honest placebos:

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015591&

Academic review on placebos for chronic pain (2020):