“Depression is partly a nocebo effect, in the sense that it can be produced by negative exceptions about oneself and the world. The way in which these negative expectations develop and produce their negative effects provides some clues as to how they can be reversed. Expectancy effects grow, feeding upon themselves. One reason this happens is that our subjective states - our feelings, our moods and sensations - are in constant flux, changing from day to day and from moment to moment. The effects of these fluctuations depend on how we interpret them, and our interpretations depend on our beliefs and expectations. When we expect to feel worse, we tend to notice random small negative changes and interpret them as evidence that we are in fact getting worse. This interpretation makes us actually feel worse, and it strengthens the belief that we are getting worse, leading to a vicious cycle in which our expectations and negative emotions feed on each other, cascading into a full-blown depressive episode. .. Positive expectancies have the opposite effect. They can set in motion a begin cycle, in which random fluctuations in mood and well being are interpreted as evidence of treatment effectiveness, thereby instilling a further sense of hope and countering the feeling of hopelessness that are so central to clinical depression.”

“Like antidepressants, a substantial part of the benefit of psychotherapy depends on a placebo effect, or as Moerman calls it, the meaning response. At least part of the improvement that is produced by these treatments is due to the relationship between the therapist and the client and to the client's expectancy of getting better. That is a problem for antidepressant treatment. It is a problem because drugs are supposed to work because of their chemistry, not because of the psychological factors. But it is not a problem for psychotherapy. Psychotherapists are trained to provide a warm and caring environment in which therapeutic change can take place. Their intention is to replace the hopelessness of depression with a sense of hope and faith in the future. These tasks are part of the essence of psychotherapy. The fact that psychotherapy can mobilize the meaning response - and that it can do so without deception - is one of its strengths, no one of its weaknesses. Because hopelessness is a fundamental characteristic of depression, instilling hope is a specific treatment for it it. Invoking the meaning response is essential for the effective treatment of depression, and the best treatments are those that can do this most effectively and that can do without deception.”

“Eventually it became clear that our emotions, attitudes, and thoughts profoundly affect our bodies, sometimes to the degree of life or death. Soon mind-body effects were recognized to have positive as well as negative impacts on the body. This realization came largely from research on the placebo effect—the beneficial results of suggestion, expectation, and positive thinking.”

“We are not our feelings. We are not our moods. We are not even our thoughts. The very fact that we can think about these things separates us from them and from the animal world. Self-awareness enables us to stand apart and examine even the way we “see” ourselves—our self-paradigm, the most fundamental paradigm of effectiveness. It affects not only our attitudes and behaviors, but also how we see other people.”

“But it seems to me to be an imperfection in things of beauty, and a weakness in man, if an explanation from the shallow-side has a destructive effect. The horror which we feel for Freudian interpretations is entirely due to our own barbaric or childish naivete, which believes that there can be heights without corresponding depths, and which blinds us to the really "final" truth that, when carried to extremes, opposites meet.”

“Everything in this world is based on interpretation, how we as people interpret the people and events and feelings around us. Then our interpretation defines us. Who we are is usually based on how we react to circumstances.”