Like antidepressants, a substantial part of the benefit of psychotherapy depends on a placebo effect, or as Moerman calls it, the meaning response. At least part of the improvement that is produced by these treatments is due to the relationship between the therapist and the client and to the client's expectancy of getting better. That is a problem for antidepressant treatment. It is a problem because drugs are supposed to work because of their chemistry, not because of the psychological factors. But it is not a problem for psychotherapy. Psychotherapists are trained to provide a warm and caring environment in which therapeutic change can take place. Their intention is to replace the hopelessness of depression with a sense of hope and faith in the future. These tasks are part of the essence of psychotherapy. The fact that psychotherapy can mobilize the meaning response - and that it can do so without deception - is one of its strengths, no one of its weaknesses. Because hopelessness is a fundamental characteristic of depression, instilling hope is a specific treatment for it it. Invoking the meaning response is essential for the effective treatment of depression, and the best treatments are those that can do this most effectively and that can do without deception.
Author: Irving Kirsch
