How do expectations influence the success of treatment for mental disorders? How do such expectations arise and how can they be changed? And how can practitioners use this knowledge to ensure that patients develop the best possible attitude to treatment and suffer as few side effects as possible? Prof. Winfried Rief at the Philipps University of Marburg deals with questions like these
Prof. Winfried Rief, Head of the Psychotherapy Outpatient Clinic and the Clinical Psychology and Psychotherapy Unit of the Philipps University of Marburg
Our expectations are decisive in determining whether we are happy or unhappy.
Prof. Winfried Rief, Director of the Psychotherapy Outpatient Clinic and the Clinical Psychology and Psychotherapy Unit at the Philipps University of Marburg, spokesperson for the Collaborative Research Centre Treatment Expectation for the University of Marburg.
I am the Director of the Psychotherapy Outpatient Clinic and the Adult Psychotherapy Training Unit at the University of Marburg. As a psychologist and psychotherapist, I mainly treat patients with chronic pain, i.e. pain that persists for several months or keeps returning, but I also treat patients with depression, chronic anxiety and many other things. One focus of the area I lead is the combining of knowledge and treatment approaches at the intersection of medicine and psychology. In my research group, we live and breathe this union of research, teaching/training and clinical application, enabling us to offer help to many people with highly diverse symptoms and diseases. This is one reason why I would call myself a "clinician scientist", someone who combines science and clinical care and is inspired by both.
And there are many intriguing questions that my team and I are interested in:
- How do expectations influence the success of treatment for mental disorders (e.g. depression), but also for physical illnesses (e.g. patients undergoing heart surgery)?
- How do such expectations develop, and how can expectations be changed? And why do expectations sometimes persist despite experiences that contradict them?
- How can doctors’ and psychotherapists’ behaviour help patients develop the best possible attitudes to treatment options while minimising side effects?
At the same time, we never lose sight of individual patients and their problems: How can we use our knowledge to best support our patients, helping them to draw the most benefit from treatments with as few side effects as possible?
I studied psychology at the University of Trier, did my doctorate at the University of Konstanz and the psychiatric state hospital Reichenau, and then worked in different clinics for many years. In 2001, I returned to the university landscape and accepted a professorship for clinical psychology and psychotherapy, having previously also completed by habilitation (postdoctoral studies) at the University of Salzburg alongside my clinical work. This was followed by research placements at Harvard Medical School, USA, Auckland, New Zealand, and San Diego, USA.
Prof. Winfried Rief: at the interface between medicine and psychology
How do mental processes affect physical illnesses and bodily functions?
The interface and connecting links between mind and body have held a great fascination for me since the time of my degree. At the same time, I was also dissatisfied with the approaches that were common doctrine at the time - I didn't want to settle for that. The interfaces between the immune system and mental well-being (Janice Kiecolt-Glaser, USA), the role of subjective assumptions about illness in heart attack patients (Prof. Keith Petrie, New Zealand) or in numerous other physical illnesses (Prof. John Weinman, UK) stimulated new thinking about how psychological factors can significantly influence the course of physical illnesses.
In addition, topics such as unclear physical symptoms or chronic pain conditions were ideal areas in which I could link science with clinical application and treatment.
Why I find placebo research so fascinating
For me, the great fascination of placebo research is that it isn’t just about handing out placebo pills: I see placebo research as the paradigm par excellence, that considers the state of being human in its entirety and its influence on medical interventions. How does stress influence physical well-being? How can doctors behave in a way that is credible to their patients? How can we exploit the great potential of contextual factors, which are often unnoticed or ignored, to make therapies even more effective and tolerable? Every person, every patient, is a not a mere neutral recipient of medical interventions; rather, each person has his or her own attitudes, expectations and individual behaviours in dealing with illness and treatment. By taking this into account, we can contribute not only to more effective treatments, but also to a more humane, personalised medicine and corresponding health system.
What brings me joy in life
Diving into a new topic again and again, exchanging ideas with others and thinking about how to link scientific topics with practical treatment experiences are sources of professional satisfaction for me. I have always found the interdisciplinary cooperation that characterises placebo research in particular to be enriching. The mutual respect for the different areas of expertise has been my driving force, not only for scientific discovery, but also for my personal enjoyment of the work.
Over the years, my team has grown, and supporting scientists to find their way in clinically applied research has increasingly become one of my purposes in life, which can also be a source of joy and affirmation.
In my private life, I take pleasure in the relationships I nurture. Enjoying a good meal and/or some nice wine together, chatting and not always taking life too seriously, exploring new things together mean that boredom is quite foreign to me. On the other hand, I also love the physical experience of exercise, be it in the water, in the mountains or in the snow.