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Fortschr Neurol Psychiatr 2019; 87(07): 347-354
DOI: 10.1055/a-0637-1940
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Ein kurzes Essay über die Spiritualität von Placebo aus (evolutionär) psychiatrischer Sicht

A short essay on the spirituality of placebo from an (evolutionary) psychiatric perspective
Udo Bonnet
1   Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Evangelischen Krankenhaus Castrop-Rauxel, Castrop-Rauxel, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Deutschland
2   LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Duisburg-Essen, Essen, Deutschland
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Publikationsverlauf

eingereicht 04. April 2018

akzeptiert 27. Mai 2018

Publikationsdatum:
12. Dezember 2018 (online)

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Zusammenfassung

Anders als Spiritualität ist der Placebo-Effekt bestens operationalisiert. Vor diesem Hintergrund wird versucht, eine phänomenologische Verwandtschaft zwischen der therapeutischen Wirksamkeit von Spiritualität und Placebo zu finden. Ähnliche Kontexteinflüsse sowie die mögliche gemeinsame Nutzung einer phylogenetisch gut konservierten protektiven Route über das mesolimbisch dopaminerge Belohnungssystem werden herausgestellt. Die klinische Wirksamkeit beider Phänomene scheint ubiquitär zu sein, wobei die Effektivität des Placebo-Effektes wissenschaftlich viel valider abgesichert ist als dieses bezüglich eines „Spiritualität-Effektes“ aktuell methodologisch möglich wäre. Die Vorhersagbarkeit für beide Effekte ist unsicher und beide sind Janus-köpfig (z. B. Placebo vs. Nocebo-Effekt). Aktuell wird sowohl für Placebo als auch für spiritualitäts-orientierte Verfahren versucht, deren klinische Wirksamkeit durch Modulation der therapeutischen Rahmenbedingungen und Gesprächsinhalte zu maximieren. Die Diskussion endet mit der reflexiven Frage, ob der Placebo-Effekt im Wesentlichen Züge von „Spiritualität-light“ besitzen könnte.

Abstract

Different to spirituality, the placebo-effect is well operationalized. Against this background, an attempt is made to look at a possible phenomenological relationship between the therapeutic effectiveness of spirituality and placebo. Similar context influences as well as the possible common use of a phylogenetically well conserved protective route via the mesolimbic dopaminergic reward system are highlighted. For both phenomena, the clinical effectiveness seems to be ubiquitous, with that of the placebo effect being scientifically much more verified than this currently would be methodologically possible with the “spirituality effect”. Both effects share their uncertain predictability and are Janus-headed (e. g., placebo effect vs. nocebo effect). Currently, for both, the placebo and spirituality-oriented approaches, there are attempts underway to maximize their clinical effectiveness by modulating the therapeutic framework and conversational content. The discussion ends with the reflexive question of whether the placebo effect could have in essence “spirituality-light” traits.

Schlüsselwörter

Placebo - Nocebo - Spiritualität - Transzendenz - Glauben - Resilienz - Phylogenese - neuronale Netzwerke

Key words

placebo - nocebo - spirituality - transcendence - beliefs - resilience - phylogenesis - neuronal brain networks
 

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