Interview with the IPS Principal Investigators: Henriët van Middendorp
Who are you and how you did you become involved with IPS?
I am Henriët van Middendorp and I am an associate professor of Health Psychology at Leiden University as of 2014. I have been working with Andrea Evers since 2010 and have been highly involved in the placebo and nocebo research that she has received different grants on since 2011. Resultantly, as being one of the senior members of the placebo research group at Leiden University, I have been involved in the founding of the Center for Interdisciplinary Placebo Studies Leiden.
What is the focus of your current research, and why is this important?
My specific research focus is currently on placebo effects in children and adolescents, specifically aimed at applying our (mechanistic) knowledge on placebo and nocebo effects to optimize clinical care within medical settings. Not many researchers are studying children and adolescents, but especially in these age groups placebo effects are shown to be stronger and thus could have an even larger impact on their health and functioning than in adults. By changing our thinking about placebo effects from being a replacement of ‘real’ treatment and requires deception of the patient to something that is always part of any treatment context, placebo effects can be translated into easily applicable and ethical ways to improve healthcare, medical or hospital experiences, and treatment outcomes.
Next to my research in children and adolescents, I am also conducting research on placebo and nocebo effects in adults, which is mostly focused on examining the effects and mechanisms of different placebo and nocebo learning techniques, such as verbal suggestions, classical conditioning, and observational learning, in both healthy and medical populations, with a specific focus on (chronic) pain. This research varies from lab-based to applied, examining interventions such as pharmacological conditioning and nocebo counterconditioning in patients with fibromyalgia, for example.
What inspired you to pursue this research topic?
For me, working with one of the most inspirational and bright persons (Andrea Evers) who really saw the huge potential of placebo research to have a real impact on healthcare from a psychological point of view as well as the intriguing results of early placebo studies has evoked my sincere enthusiasm for this topic. I think it is really amazing to see what contextual factors such as healthcare provider-patient communication and previous treatment experiences that bring about placebo or nocebo effects can do, explaining such a large part of treatment effects, which could even be comparable to the effects of medications or surgeries. I really believe that using this knowledge in clinical care could make a difference, for example in preventing healthcare anxieties in children that could have a lifelong impact on healthcare use.
How does your research align with the mission and goals of IPS?
The research that I am involved in contributes to our understanding of placebo and nocebo effects, their underlying mechanisms, and their potential applications in clinical practice, which are all part of the mission of IPS. I collaborate with interdisciplinary research teams and patients to enable a good fit of our research to practice, enabling easy implementation of the research findings to clinical practice. Next to that, I regularly present about our research on conferences and healthcare provider meetings/symposia.
What impact do you hope your research will have, both in science and in society?
My highest hope would be that our research could really make a difference in regular clinical care. For me specifically, I hope my research in children and adolescents will first of all lead to more awareness of the impact of small things, such as the use of words or knowing about previous experiences and helpful tips of a child or adolescent, within the medical setting. On a larger scale, I hope that our research will eventually lead to the incorporation of low-level placebo applications within medical care, leading to better medical/hospital experiences, fewer medical traumas in children/adolescents, and resultantly optimized healthcare throughout the life span.
What are the next steps or future ambitions for your research?
I would really like to give a boost to the still rather limited research on placebo effects in children and adolescents, particularly regarding applying placebo effects in an ethical way within daily clinical care. A specific research project that I am really enthusiastic about is a study conducted together with the Willem-Alexander Children’s Hospital of the Leiden University Medical Center. This study examines the effects and mechanisms of magic as a potential easily-implementable evidence-based addition to pediatric healthcare, which might decrease distress and boost children’s feeling of control and empowerment. Additionally, we will be starting up a great study in collaboration with Make-A-Wish to examine the short- and long-term effects of wish granting on children and their families, which I’m really excited about.
