Irving Kirsch

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 professor emeritus of psychology at the Universities of Hull and Plymouth in the 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. He is the author of the 2009 book, The Emperor's New Drugs.

The son of Jewish immigrants from Poland and Russia, Kirsch was born in New York City on March 7, 1943. 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.

Response expectancy theory

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 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. Kirsch challenges the chemical-imbalance theory of depression, writing "It now seems beyond question that the traditional account of depression as a chemical imbalance in the brain is simply wrong."In 2014, in the British Psychological Society's Research Digest, Christian Jarrett included Kirsch's 2008 antidepressant placebo effect study in a list of the 10 most controversial psychology studies ever published.

Research on hypnosis

Kirsch has focused some of his research on the topic of hypnosis. The basis of his hypnosis theory is that placebo effects and hypnosis share a common mechanism: response expectancy. Kirsch's idea on this topic is that the effects of both hypnosis and placebos are based upon the beliefs of the participant. He has characterized clinical hypnosis as a "nondeceptive placebo."

• • Kirsch, I (2009). The Emperor's New Drugs: Exploding the Antidepressant Myth. London: The Bodley Head. ISBN 1-84792-083-7. 
  • Kirsch, I.; Deacon, B. J.; Huedo-Medina, T. B.; Scoboria, A.; Moore, T. J. & Johnson, B. T (February 2008). "Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration". PLoS Medicine. 5 (2): e45. doi:10.1371/journal.pmed.0050045. PMC 2253608. PMID 18303940. 
  • Kirsch, I. & Moncrieff, J (July 2007). "Clinical trials and the response rate illusion". Contemporary Clinical Trials. 28 (4): 348–51. doi:10.1016/j.cct.2006.10.012. PMID 17182286. 
  • Lynn, S. J. & Kirsch, I (2005). Essentials of Clinical Hypnosis: An Evidence-based Approach. Washington, DC: American Psychological Association (APA). ISBN 1-59147-344-6. 
  • Kirsch, I.; Moore, T. J.; Scoboria, A. & Nicholls, S. S (July 2002). "The emperor's new drugs: An analysis of antidepressant medication data" (pdf). Prevention and Treatment. 5: Article 23. doi:10.1037/1522-3736.5.1.523a. 
  • Kirsch, I. & Braffman, W (2001). "Imaginative Suggestibility and Hypnotizability". Current Directions in Psychological Science. 10 (2): 57–61. doi:10.1111/1467-8721.00115. 
  • Kirsch, I. & Lynn, S. J (July 1999). "Automaticity in clinical psychology". American Psychologist. 54 (7): 504–15. doi:10.1037/0003-066x.54.7.504. PMID 10424156. 
  • Kirsch, I., ed. (1999). How expectancies shape experience. Washington DC: American Psychological Association. ISBN 1-55798-586-3. 
  • Kirsch, I. & Sapirstein, G (1998-06-26). "Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention and Treatment". Prevention and Treatment. 1 (2): Article 0002a. doi:10.1037/1522-3736.1.1.12a. Archived from the original on 1998-07-15. 
  • Kirsch, I. & Lynn, S. J (January 1998). "Dissociation theories of hypnosis". Psychological Bulletin. 123 (1): 100–15. doi:10.1037/0033-2909.123.1.100. PMID 9461855. 
  • Kirsch, I. & Lynn, S. J (1998). "Social-cognitive alternatives to dissociation theories of hypnotic involuntariness". Review of General Psychology. 2 (1): 66–80. doi:10.1037/1089-2680.2.1.66. 
  • Montgomery, G. H. & Kirsch, I (1996). "Mechanisms of placebo pain reductio: An Empirical Investigation". Psychological Science. 7 (3): 174–176. doi:10.1111/j.1467-9280.1996.tb00352.x. 
  • Kirsch, I. & Lynn, S. J (1995). "Altered state of hypnosis: Changes in the theoretical landscape". American Psychologist. 50 (10): 846–858. doi:10.1037/0003-066X.50.10.846. 
  • Kirsch, I (1990). Changing expectations : A key to effective psychotherapy. Pacific Grove, CA: Brooks/Cole. ISBN 0-534-12648-0. 
  • Kirsch, I (1985). "Response expectancy as a determinant of experience and behavior". American Psychologist. 40 (11): 1189–1202. doi:10.1037/0003-066X.40.11.1189.