Free Cracked by James Davies

of the American Dream. He was born to Polish immigrants in New York City in 1943. He’d been heavily involved in the civil rights movements of the 1960s, while also writing pamphlets against the Vietnam War (at the request of Bertrand Russell). Before becoming a psychologist in his early thirties, he’d worked as a violinist, accompanying artists like Aretha Franklin and enjoying a stint in the Toledo Symphony Orchestra. Just before gaining his PhD in psychology in 1975, he was nominated for a Grammy award for an album he’d produced, which included doctored snippets from the Watergate hearings. 39 His journey is, therefore, an interesting one: his life has oscillated between music, psychology, pacifism, and politics—between New York, California, Krakow, Boston, and now Scorborough.
    It seemed ironic to start our interview by asking Kirsch, a devoted pacifist in his youth, about a war he had recently started within the medical community ignited by his scientific research. The war was so turbulent because so much was at stake, not only for the millions of adults and children who now take antidepressants, or for the hundreds of thousands of doctors around the globe who are now prescribing them, but also for the pharmaceutical industry that makes billions a year from antidepressant sales. What I wanted to know from Kirsch was how someone so seemingly peaceful could have created such widespread pandemonium.
    â€œBy complete accident,” answered Kirsch with a boyish smile as he sipped tea from an antique china cup. “I wasn’t really interested in antidepressants when I started out as a psychologist. I was more taken by the power of belief—how our expectations can shape who we are, how we feel, and, more specifically, whether or not we recover from illness. Like everyone else at the time,” continued Kirsch, “I just assumed antidepressants worked because of their chemical ingredients. That’s why I’d occasionally referred depressed patients to psychiatrists for antidepressant medication.”
    Everything would change for Kirsch after a young man called Guy Sapirstein approached him in the mid-1990s. This bright and eager graduate student had become fascinated in the placebo effects of antidepressants. What gripped Sapirstein was how depressed patients could actually feel better by taking a sugar pill if they believed it to be an antidepressant. This led Sapirstein to wonder about the extent to which antidepressants worked through the placebo effect, by creating in patients an expectation of healing so strong that their symptoms actually disappeared.
    Once Sapirstein had outlined his interests, Kirsch knew he wanted to get on board. And so it wasn’t long before both men set about investigating the question together: To what extent did antidepressants work because of their placebo effects?
    â€œInstead of doing a brand-new study ,”said Kirsch, describing the method they employed, “we decided to do what is called a meta-analysis. This worked by gathering all the studies we could find that had compared the effects of antidepressants to the effects of placebos on depressed patients. We then pooled all the results to get an overall figure.”
    In total, Kirsch’s meta-analysis covered thirty-eight clinical trials, the results of which, when taken en masse, led to a startling conclusion. “What we expected to find,” said Kirsch, lowering his teacup, “was that people who took the antidepressant would do far better than those taking the placebo, the sugar pill. We couldn’t have been more wrong.” And if you look at the graph below you’ll see exactly what Kirsch means: 40

    The first thing you’ll notice is that all the groups actually get better on the scale of improvement, even those who had received no treatment at all. This is because many incidences of depression spontaneously reduce by themselves after time without being