Placebo Response & Response Shift: How the Results of Fast Thinking Differ From Slow Thinking.

An earlier post, “What Is. Can’t Put a Word to It,” introduced you to my newest paper entitled “Implications of the differences between our perceptual and conceptual views.” It takes material from the psychology of behavioral economics, including Daniel Kahneman’s NY Times best seller, “Thinking, Fast and Slow” and Seymour Epstein’s “Cognitive-Experiential Theory” about “two selves theory” examining the world through the view point of the fast thinking system. Here again is a short introductory video on this subject by Dr. Kahneman:

The Riddle of Experience vs Memory

Because we’re all used to thinking with concepts, logic and using memory with “words in the mind,” hallmarks of the slow thinking system, understanding the fast thinking system takes a bit of work because it does not utilize concepts. It processes sensory-perceptual experience directly. In my article, I suggest a rule of thumb … “slow thinking processes concepts; fast thinking processes percepts.” Percepts are the “what is” in the title of my previous post, what we cannot put words to. It’s our world before it’s been conceptualized, put into words. Try answering this question; “What is your subjective experience of the smell of a rose, the sight of blue, the sound of a trumpet, the taste of banana, the touch of a handshake, or the thought of the word ‘boulder’ in your mind?” Don’t tell me what these are similar to; tell me your direct experience of them. Though we can describe associations they have to other sense perceptions, like finding the color blue “refreshing,” sensory-perceptual experience is ungraspable to language. Sensory-perceptual experience, literally every contact we have in the world, is non-conceptual.

Yet, behavioral economics research has shown us that perceptual processing, probably by the right brain, yields informed, intelligent action. Interestingly, the actions and decisions made through perceptual processing differ remarkably from those made through conceptual processing. Many of the so-called “cognitive biases” originate from this difference but many other interesting phenomena also arise because of these two ways we process information. As promised, this post will discuss the placebo response and also touch on a way psychotherapy and meditation may provide relief of symptoms.

Generally speaking, a placebo response occurs when people appear to get better after receiving a treatment, like a pill, that actually had no active ingredient. So how does this relate to percepts, concepts and our two ways of understanding and interacting with the world? More straightforwardly than you may realize; the transform holds the key. Described in this way, the transformation occurs when “what is,” sensory-perceptual experience, is changed into concepts—gets put into words. From the paragraph above, you may remember there is no basis for this; it can’t be done. Yet, we constantly break this rule, and accept distorted information, probably because of our desire to communicate.

Initially, we access the world exclusively through our sense perceptions; our world is perceptual. Then, the world we experience directly also becomes transformed into a conceptual realm. At this point, each of us holds two views; one is transformed and processed by the left brain through the use of concepts, the other is processed by the right brain using percepts. Interestingly, we can only understand something when it’s been conceptualized. It took the efforts of behavioral economics researchers to determine that we also can “know” through sensory-perceptual experience—though we can’t conceptually understand how we know. It seems until recently, conceptual processing has wrongly gotten all the credit for our intelligence.

As for how the placebo response may appear, consider these two simultaneously held but different views; one being perceptual and the other having within it both the conceptual and the perceptual (since the origin of the concept is the percept). In the realm of pain, for example, the sense-perception may be an intense stimulation of the sense of touch. Both views have access to this. Added to this within the conceptual view may be concern or worry (a concept) of some sort. Examples may be “The pain is too great for me to bear!,” “I wonder if I’ll need to take time off from work and lose some pay?,” etc. From the conceptual point of view there are two aspects to this pain, the sensory-perceptual experience plus the conceptual worry. However, from the perceptual point of view there is only the sensory-perceptual experience. The view from the perceptual system always suffers less because it does not contain the additional concept (worry). If one could, and we can, shift from viewing the pain from the conceptual stance to that of the perceptual view, suffering from the pain would decrease. As I have previously written (Pashko, 2014), this shift can be the cause of the placebo response. With this as a theoretical basis, I have proposed a method for patenting to predict for people who will become placebo responders in clinical research trials (Pashko, 2011).

In addition to possibly causing the placebo response, perhaps the mechanism by which we switch from a conceptual view to a perceptual one is the way in which many of the cognitive psychotherapies and the various types of meditations also achieve their success. The cognitive psychotherapies and meditations, through suggestions that thoughts (concepts) often hold no valuable content and so can be disregarded, appear similar in their mechanism. Certain that more research is needed to understand the efficacy of this switch in relation to our physical health and mental well-being, one can only hope it receives a high priority.


Epstein, S. (2014). Cognitive-experiential theory. New York, NY: Oxford.

Kahneman, D. (2012). Thinking, fast and slow. New York, NY: Farrar, Straus & Giroux.

Pashko, S. (2011). Bodily self-image and methods for predicting placebo response or response shift. USPTO application number: PCT/US2012/038014.

Pashko, S. (2014). Conceptual versus perceptual information processing: Implications for subjective reporting. Journal of Neuroscience, Psychology, and Economics, 7, 219–226.

Pashko, S. (2016). Implications of the difference between our perceptual and conceptual views. Psychology & Neuroscience, 9(2), 267-281. Link to paper.


Steven Pashko is a research clinician who studies treatment effectiveness and the value of health and healthcare. With a background in psychology and pharmacology, he conducts research and speaks about well-being. Notably, using behavioral economics theory, he submitted for a patent for way to identify people who respond to placebos.

Website: Steven

Copyright Steven Pashko, PhD (2016).

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