23/01/2026
When research says “placebo,” it often means: “Oops. Something happened that isn’t our pet mechanism.”
That’s like calling gravity a “non-specific effect” because you forgot to include it in your model. 🧠🔬
Here’s the problem: placebo is treated like a binary.
Either a treatment has a “real, specific” effect… or it’s “just placebo.”
But biology doesn’t do binaries. Biology does spectrums.
The Specific ↔ Non-Specific Spectrum
At one end:
✅ Specific ingredients
A drug’s receptor binding. A stimulation parameter. A neurofeedback contingency. A precise protocol target.
At the other end:
✅ Context ingredients
Trust. Expectation. Meaning. Ritual. Credibility. Feeling understood. The therapeutic alliance.
And in the messy, glorious middle—where most healing lives:
🔥 Specific learning amplified by context
Context doesn’t replace mechanisms. It tunes them.
Like turning the gain k**b on an amplifier. Same guitar, different volume.
So when a trial says “the placebo group improved,” the correct scientific response isn’t:
“Ha! Fake!”
It’s:
“Interesting. The brain’s prediction machinery changed the experience. What were the levers?”
Because the brain is a Bayesian engine wearing a lab coat.
It constantly asks: What does this mean? What should I expect next? Am I safe? Can I change?
Why this matters clinically
If we pretend “non-specific” effects are irrelevant, we throw away half the toolkit clinicians use to help people engage long enough for the specific learning to stick.
And if we pretend “placebo explains everything,” we stop doing the hard work of refining protocols, targets, dosing, and personalization.
It’s not either/or. It’s both/and.
A continuum. A spectrum. A dance.
So maybe the next time we say “placebo,” we should be more precise:
➡️ Which context variables moved the needle?
➡️ Which expectations were shaped?
➡️ Which learning mechanisms were recruited?
➡️ What made the brain decide: ‘This will help’?
Because calling it “just placebo” is like calling a rocket launch “just combustion.”
Technically true. Scientifically lazy.
What’s your take: Should clinical research measure context as a mechanism—not a nuisance variable? 👥🧠
Curious? Read my whole take here:
🇬🇧 https://pro.neurologic.academy/blog/v202603
🇫🇷 https://pro.neurologic.fr/blog/v202603
