Irving Kirsch (born March 7, 1943) 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 of psychology at Plymouth University in the United Kingdom, and 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.

Biography[link]

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 Californiain 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.^[1] 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.

Theories and research[link]

Response Expectancy Theory[link]

Kirsch’s response expectancy theory is based on the idea that what people experience depends partly on what they expect to experience.^[2] 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.^[3] The theory is also backed up by the 2008 meta-analysis that Kirsch conducted on the effects of antidepressants on 2,318 people who suffered from depression. The results of this study showed that while many people may benefit from antidepressant treatment (although most of them to a degree that is not clinically significant), about 1 in 4 are made worse.^[4] The theory has been applied to understanding pain, depression, anxiety disorders, asthma, addictions, and psychogenic illnesses.

Research on Antidepressants[link]

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.^[5] 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 data from published trials. Kirsch’s analyses of the FDA data showed that the difference between antidepressant drugs and placebos was 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.^[6] Kirsch has taken his theories to the point of questioning the well-known belief of the depression being caused by a chemical imbalance. ^[7]

Research on Hypnosis[link]

Kirsch has focused some of his research on the topic of hypnosis. The basis of his hypnosis theory is that placebo effects and hypnosis effects share a common mechanism: expectancy theory. Kirsch's idea on this topic is that the reasoning behind the effectiveness of both of these instances is based upon the beliefs of the participant involved.^[8]

References[link]

1. ^ "Irving Kirsch Biography." Integrative Medicine & Health 2012. Web. 26 Mar. 2012. <http://imconsortium-congress2012.org/biography-irving-kirsch.html>.
2. ^ Kirsch I (1985) Response Expectancy as a Determinant of Experience and Behavior. American Psychologist 40: 1189-1202.
3. ^ Kirsch I, editor (1999) How expectancies shape experience. Washington DC,: American Psychological Association. 431 p.
4. ^ Kirsch I, Sapirstein G (1998) Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention and Treatment.
5. ^ Kirsch I, Sapirstein G (1998) Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention and Treatment.
6. ^ Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et al. (2008) Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine.
7. ^ Kirsch I (2009) The Emperor's New Drugs: Exploding the Antidepressant Myth. London: The Bodley Head
8. ^ Kirsch, Irving. "Hypnosis and Placebo: Response Expectancy as a Mediator of Suggested Effects." 15 (1999): 99-110.

Selected bibliography[link]

• • 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[link]

Meta-analysis of data submitted to the Food and Drug Administration [1]

Listening to Prozac but hearing placebo [2]

• Program in Placebo Studies and the Therapeutic Encounter website

CBS News 60 Minutes - Treating Depression: Is there a placebo effect? February 19, 2012 4:22 PM (Irving Kirsch interview) [3]