Prof Kirsch 02a-1

Irving Kirsch
Associate Director of the Program in Placebo Studies & Lecturer in medicine, Harvard Medical School.  

Response Expectancy and Automaticity

Response expectancies are anticipations of one’s own automatic responses and can generate expected responses in the form of self-fulfilling prophecies. At the time of their influence on conscious experience, they can themselves be conscious, but once acquired, they can also operate quickly and automatically, without conscious awareness. Stimulus expectancies (i.e., expectancies about the external world) can also be self-confirming, although to a lesser degree. The degree to which an expectancy affects experience varies with the ambiguity of the stimulus and the confidence with which the expectancy is held. There are various dimensions of response expectancy that can be manipulated and measured. One is the magnitude of the expected change; another is the confidence with which the expectancy is held. Expectancies are fluid rather than static and have a reciprocal relationship with subjective outcomes. Best outcomes may be obtained by promoting very confident expectancies for initially small changes, thereby setting in motion a benign cycle. Conditioning and expectancy are not opposing processes. Instead, both classical and operant conditioning can function by influencing expectancies. This has been demonstrated both in humans and in other animals. Classical conditioning can also produce responses that are not mediated by expectancies, as has been shown with very primitive organisms and in humans with responses that are not consciously introspectable. The adaptive value of consciousness is that it provides flexibility in considering other sources of information and allowing the organism to override automatic conditioned responses.


Irving Kirsch is Associate Director of the Program in Placebo Studies and a lecturer in medicine at the Harvard Medical School.  He is also Emeritus Professor of Psychology at Plymouth University (UK), University of Hull (UK) and University of Connecticut (USA).  He has published 10 books and more than 250 scientific journal articles and book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion.  He originated the concept of response expectancy.  His 2008 meta-analyses on the efficacy of antidepressants was covered extensively in the international media and listed by the British Psychological Society as one of the “10 most controversial psychology studies ever published.” His book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, has been published in English, French, Italian, Japanese, Turkish, and Polish Newsweek. In 2015, the University of Basel (Switzerland) awarded Irving Kirsch an Honorary Doctorate in Psychology.