Irving Kirsch
Encyclopedia
Irving Kirsch is Associate Director of the Program in Placebo Studies
and a lecturer in medicine at the Harvard Medical School
and Beth Israel Deaconess Medical Center
. He is also a professor emeritus of psychology at the University of Hull
, United Kingdom
and the University of Connecticut
in the United States
. Kirsch is noted for his research on placebo effects
, antidepressants, expectancy, and hypnosis
. He is the originator of response expectancy theory, and his analyses of clinical trials of antidepressants have influenced official treatment guidelines in the United Kingdom.
The son of Jewish immigrants from Poland
and Russia
, Kirsch was born in New York City
on March 7, 1943. As a young man, he was active in the civil rights
and anti-war movements. In the early 1960s, at the request of Lord Bertrand Russell
, he published a pamphlet consisting of material against the war in Vietnam
that according to Russell had been censored by the New York Times. Before becoming a psychologist
, he worked as a violinist in the Toledo Symphony and in string sections accompanying Aretha Franklin
and others in concerts.
Kirsch received his PhD in psychology from the University of Southern California
in 1975. While a graduate student, he produced, in conjunction with the National Lampoon, a hit single and subsequent record album entitled The Missing White House Tapes, which were crafted by doctoring tape recordings of Richard Nixon
’s speeches and press conferences during the Watergate Hearings. The album was nominated for a Grammy award as Best Comedy Recording in 1974.
In 1975, Kirsch joined the psychology department at the University of Connecticut
, where he worked until 2004, when he became a professor of psychology at the University of Plymouth
. He moved to the University of Hull
in 2007 and joined the faculty of the Harvard Medical School
in 2011. Kirsch has authored or edited 10 books and more than 200 scientific journal articles and book chapters. He is married to Giuliana Mazzoni, a professor of psychology at the University of Hull and an expert on memory and memory distortions. His son, David Tresner-Kirsch, works in Boston as a computer scientist.
Kirsch’s response expectancy theory is based on the idea that what people experience depends partly on what they expect to experience. According to Kirsch, this is the process that lies behind the placebo effect and hypnosis. The theory is supported by research showing that both subjective and physiological responses can be altered by changing people’s expectancies. The theory has been applied to understanding pain, depression, anxiety disorders, asthma, addictions, and psychogenic illnesses.
Research on Antidepressants
Kirsch’s analysis of the effectiveness of antidepressants was an outgrowth of his interest in the placebo effect. His studies in this area are primarily meta-analyses, in which the results of previously conducted clinical trials are aggregated and analyzed statistically. His first meta-analysis was aimed at assessing the size of the placebo effect in the treatment of depression. The results not only showed a sizable placebo effect, but also indicated that the drug effect was surprisingly small. This led Kirsch to shift his interest to evaluating the antidepressant drug effect.
Kirsch’s first meta-analysis was limited to published clinical trials. The controversy surrounding this analysis led him to obtain files from the U.S. Food and Drug Administration (FDA) containing data from trials that had not been published, as well as those from published trials. Kirsch’s analyses of the FDA data showed that the difference between antidepressant drugs and placebos is not clinically significant, according to the criteria used by the National Institute for Health and Clinical Excellence
(NICE), which establishes treatment guidelines for the National Health Service
(NHS) in the United Kingdom.
Kirsch has since argued that the widely-held theory that depression is caused by a chemical imbalance is wrong.
Listening to Prozac but hearing placebo http://psycnet.apa.org/journals/pre/1/2/2a/
Program in Placebo Studies and the Therapeutic Encounter website
Program in Placebo Studies
The Program in Placebo Studies and the Therapeutic Encounter was founded in July 2011, at Beth Israel Deaconess Medical Center and the Harvard Medical School...
and a lecturer in medicine at the Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
and Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center in Boston, Massachusetts is a major flagship teaching hospital of Harvard Medical School. It was formed out of the 1996 merger of Beth Israel Hospital and New England Deaconess Hospital...
. He is also a professor emeritus of psychology at the University of Hull
University of Hull
The University of Hull, known informally as Hull University, is an English university, founded in 1927, located in Hull, a city in the East Riding of Yorkshire...
, United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and the University of Connecticut
University of Connecticut
The admission rate to the University of Connecticut is about 50% and has been steadily decreasing, with about 28,000 prospective students applying for admission to the freshman class in recent years. Approximately 40,000 prospective students tour the main campus in Storrs annually...
in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
. Kirsch is noted for his research on placebo effects
Placebo effect
Placebo effect may refer to:* Placebo effect, the tendency of any medication or treatment, even an inert or ineffective one, to exhibit results simply because the recipient believes that it will work...
, antidepressants, expectancy, and hypnosis
Hypnosis
Hypnosis is "a trance state characterized by extreme suggestibility, relaxation and heightened imagination."It is a mental state or imaginative role-enactment . It is usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary...
. He is the originator of response expectancy theory, and his analyses of clinical trials of antidepressants have influenced official treatment guidelines in the United Kingdom.
The son of Jewish immigrants from Poland
Poland
Poland , officially the Republic of Poland , is a country in Central Europe bordered by Germany to the west; the Czech Republic and Slovakia to the south; Ukraine, Belarus and Lithuania to the east; and the Baltic Sea and Kaliningrad Oblast, a Russian exclave, to the north...
and Russia
Russia
Russia or , officially known as both Russia and the Russian Federation , is a country in northern Eurasia. It is a federal semi-presidential republic, comprising 83 federal subjects...
, Kirsch was born in New York City
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...
on March 7, 1943. As a young man, he was active in the civil rights
Civil rights
Civil and political rights are a class of rights that protect individuals' freedom from unwarranted infringement by governments and private organizations, and ensure one's ability to participate in the civil and political life of the state without discrimination or repression.Civil rights include...
and anti-war movements. In the early 1960s, at the request of Lord Bertrand Russell
Bertrand Russell
Bertrand Arthur William Russell, 3rd Earl Russell, OM, FRS was a British philosopher, logician, mathematician, historian, and social critic. At various points in his life he considered himself a liberal, a socialist, and a pacifist, but he also admitted that he had never been any of these things...
, he published a pamphlet consisting of material against the war in Vietnam
Vietnam
Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...
that according to Russell had been censored by the New York Times. Before becoming a psychologist
Psychologist
Psychologist is a professional or academic title used by individuals who are either:* Clinical professionals who work with patients in a variety of therapeutic contexts .* Scientists conducting psychological research or teaching psychology in a college...
, he worked as a violinist in the Toledo Symphony and in string sections accompanying Aretha Franklin
Aretha Franklin
Aretha Louise Franklin is an American singer, songwriter, and pianist. Although known for her soul recordings and referred to as The Queen of Soul, Franklin is also adept at jazz, blues, R&B, gospel music, and rock. Rolling Stone magazine ranked her atop its list of The Greatest Singers of All...
and others in concerts.
Kirsch received his PhD in psychology from the University of Southern California
University of Southern California
The University of Southern California is a private, not-for-profit, nonsectarian, research university located in Los Angeles, California, United States. USC was founded in 1880, making it California's oldest private research university...
in 1975. While a graduate student, he produced, in conjunction with the National Lampoon, a hit single and subsequent record album entitled The Missing White House Tapes, which were crafted by doctoring tape recordings of Richard Nixon
Richard Nixon
Richard Milhous Nixon was the 37th President of the United States, serving from 1969 to 1974. The only president to resign the office, Nixon had previously served as a US representative and senator from California and as the 36th Vice President of the United States from 1953 to 1961 under...
’s speeches and press conferences during the Watergate Hearings. The album was nominated for a Grammy award as Best Comedy Recording in 1974.
In 1975, Kirsch joined the psychology department at the University of Connecticut
University of Connecticut
The admission rate to the University of Connecticut is about 50% and has been steadily decreasing, with about 28,000 prospective students applying for admission to the freshman class in recent years. Approximately 40,000 prospective students tour the main campus in Storrs annually...
, where he worked until 2004, when he became a professor of psychology at the University of Plymouth
University of Plymouth
Plymouth University is the largest university in the South West of England, with over 30,000 students and is 9th largest in the United Kingdom by total number of students . It has almost 3,000 staff...
. He moved to the University of Hull
University of Hull
The University of Hull, known informally as Hull University, is an English university, founded in 1927, located in Hull, a city in the East Riding of Yorkshire...
in 2007 and joined the faculty of the Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
in 2011. Kirsch has authored or edited 10 books and more than 200 scientific journal articles and book chapters. He is married to Giuliana Mazzoni, a professor of psychology at the University of Hull and an expert on memory and memory distortions. His son, David Tresner-Kirsch, works in Boston as a computer scientist.
Theory and research
Response Expectancy TheoryKirsch’s response expectancy theory is based on the idea that what people experience depends partly on what they expect to experience. According to Kirsch, this is the process that lies behind the placebo effect and hypnosis. The theory is supported by research showing that both subjective and physiological responses can be altered by changing people’s expectancies. The theory has been applied to understanding pain, depression, anxiety disorders, asthma, addictions, and psychogenic illnesses.
Research on Antidepressants
Kirsch’s analysis of the effectiveness of antidepressants was an outgrowth of his interest in the placebo effect. His studies in this area are primarily meta-analyses, in which the results of previously conducted clinical trials are aggregated and analyzed statistically. His first meta-analysis was aimed at assessing the size of the placebo effect in the treatment of depression. The results not only showed a sizable placebo effect, but also indicated that the drug effect was surprisingly small. This led Kirsch to shift his interest to evaluating the antidepressant drug effect.
Kirsch’s first meta-analysis was limited to published clinical trials. The controversy surrounding this analysis led him to obtain files from the U.S. Food and Drug Administration (FDA) containing data from trials that had not been published, as well as those from published trials. Kirsch’s analyses of the FDA data showed that the difference between antidepressant drugs and placebos is not clinically significant, according to the criteria used by the National Institute for Health and Clinical Excellence
National Institute for Health and Clinical Excellence
The National Institute for Health and Clinical Excellence is a special health authority of the English National Health Service , serving both English NHS and the Welsh NHS...
(NICE), which establishes treatment guidelines for the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
(NHS) in the United Kingdom.
Kirsch has since argued that the widely-held theory that depression is caused by a chemical imbalance is wrong.
Selected bibliography
-
- Kirsch, I. (2009). The Emperor's New Drugs: Exploding the Antidepressant Myth. London: The Bodley Head
- Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5(2).
- Kirsch, I., & Moncrieff, J. (2007). Clinical trials and the response rate illusion. Contemporary Clinical Trials, 28(4), 348-351.
- Lynn, S. J., & Kirsch, I. (2006). Essentials of clinical hypnosis: An evidence-based approach. Washington, DC: American Psychological Association.
- Kirsch, I., Moore, T. J., Scoboria, A., & Nicholls, S. S. (2002). The emperor's new drugs: An analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration. Prevention and Treatment, 5(23).
- Kirsch, I., & Braffman, W. (2001). Imaginative suggestibility and hypnotizability. Current Directions in Psychological Science, 10(2), 57-61.
- Kirsch, I., & Lynn, S. J. (1999). Automaticity in clinical psychology. American Psychologist, 54(7), 504-515.
- Kirsch, I. (Ed.). (1999). How expectancies shape experience. Washington DC,: American Psychological Association.
- Kirsch, I., & Sapirstein, G. (1998). Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention and Treatment, 1 (Article 0002a).
- Kirsch, I., & Lynn, S. J. (1998). Dissociation theories of hypnosis. Psychological Bulletin, 123(1), 100-115.
- Kirsch, I., & Lynn, S. J. (1998). Social-cognitive alternatives to dissociation theories of hypnotic involuntariness. Review of General Psychology, 2(1), 66-80.
- Montgomery, G. H., & Kirsch, I. (1996). Mechanisms of placebo pain reduction: An empirical investigation. Psychological Science, 7(3), 174-176.
- Kirsch, I., & Lynn, S. J. (1995). The Altered State of Hypnosis - Changes in the Theoretical Landscape. American Psychologist, 50(10), 846-858.
- Kirsch, I. (1990). Changing expectations: A key to effective psychotherapy. Belmont, CA Brooks/Cole.
- Kirsch, I. (1985). Response Expectancy as a Determinant of Experience and Behavior. American Psychologist, 40(11), 1189-1202.
External links
Meta-analysis of data submitted to the Food and Drug Administration http://dx.doi.org/10.1371/journal.pmed.0050045Listening to Prozac but hearing placebo http://psycnet.apa.org/journals/pre/1/2/2a/
Program in Placebo Studies and the Therapeutic Encounter website