Erik Vance’s Suggestible You, published in 2016, is about the placebo effect and its relatives; the nocebo, the conditioning response, the elaborate and underappreciated machinery by which human beings are influenced by expectation, narrative, and context in ways that produce measurable physiological change. It’s a book I suggest to people at least once a month.
It’s a book about how much of what we experience as reality is actually story. The argument is very specifically not that story is a lesser category of experience, but in the sense that story is one of the primary mechanisms by which the human animal operates in the world. We are extraordinarily suggestible for creatures that pride ourselves so much on our powers of reason. That suggestibility is not a flaw to be overcome, as many assume, gullibility as liability, it’s a predictable dynamic to be taken into account, and ideally, leveraged.
I should mention briefly that I am fully aware that Suggestible You as a text has its limitations. Vance is a journalist, not a researcher, and he occasionally overclaims; dropping too many things into the placebo basket, sometimes at the expense of treatments that have genuine evidence-based efficacy independent of expectation. Some of the psychology research he cites has also had to weather the replication crisis that has swept through behavioral science in the years since the book’s publication. If you decide to check it out, read accordingly: as a compelling and well-reported introduction to a genuine phenomenon, not a comprehensive final scientific account.
What has held up, thankfully, is the core argument, and the compelling weight of the real life examples he provides. The placebo effect is powerful and far reaching. It is neurobiologically grounded; measurable in brain scans, involving the release of actual endorphins, dopamine, serotonin. The research since 2016 has only gotten more robust rather than less. And one of the most interesting findings to be strengthened in that time is the open-label placebo: the discovery that placebos work even when the person taking them knows they are taking a placebo. Not as well as blind placebos, but substantially. Which removes the self-deception objection entirely and opens up a considerably more interesting question: if you don’t have to believe the pill is real for it to work, what exactly is doing the work?
Vance’s answer, an answer I find most useful, is expectation operating through story. The brain is a prediction machine. It runs constantly updated models of what is likely to happen next, based on everything it has previously experienced, and it shapes perception and response around those predictions. He writes in particular about the “theater of medicine;” the white coat, the clinical setting, the ritual of being examined and prescribed, works not because of superstition but because it activates the brain’s existing models of what healing looks and feels like. It is a story the nervous system recognizes and responds to.
I was reading this book during the years I have elsewhere described as my metamorphic goo phase; a long recovery from burnout, the interior excavation work, the period during which I was actively searching for the best tools I could find for the particular project of understanding my own life clearly enough to “do the next right thing” as Anna tearfully sang in Frozen 2 around the same time I read Suggestible You, when my son was a toddler. What I took from Vance, reduced to its most useful form, is: the human nervous system does not respond to goals, it responds to stories about goals.
The difference between a milestone you dread and a milestone you pursue with something approaching genuine excitement is almost never the nature of the milestone itself, it is almost always the story in which that milestone is embedded.
If I have a goal I would like to reach; a piece of work to complete, a practice to establish, a threshold to cross, I can set up a calendar. I can divide the distance between now and the deadline into logical intervals, assign tasks to each interval as suggested by established precedent, and proceed. This works, after a fashion, for some people, (unfortunately, not me, not at all.) What it produces is a relationship with the work characterized primarily by obligation. You do the thing because you said you would because the interval has arrived, because the calendar demands it. The Calvinist satisfaction of a system operating as designed.
But if I add story to my calendar; if I look at what the language of astrology tells me about the particular quality of the coming weeks, the archetypal weather of this moment in relation to my natal chart, and use that language to shape when I do what, something necessary coalesces. The milestones stop being arbitrary divisions of time and become moments with specific character. This week is for laying foundations quietly. This one is for the bold move. This one is for consolidation before the next push. The calendar is still there. The work is the same work. But I am moving through a story rather than a schedule, and the difference in my engagement is not subtle.
I do the work on time not because of anything resembling puritan discipline but because I have crafted a compelling story about why this particular moment is the right moment for this particular work, and I am genuinely excited to take advantage of it, and I feel at times an elating responsibility to honor it. The dread of obligation has been replaced by something that functions much more like purpose. This is an extrapolation of exactly what Vance is describing; the deliberate engagement of the nervous system’s actual operating architecture, using story as the interface.
I was not alone in drawing this conclusion from Vance’s work, or in looking for ways to make it actionable. There is a whole community of people who arrived at roughly the same place and have been developing practices around it for years.
Placebo Magick, the term used in a growing community of secular, skeptical, and nontheistic practitioners, is the deliberate use of ritual, symbolic practice, and intentional meaning-making as a form of applied open label placebo. It is the conscious engagement of the same neurological mechanisms that make the theater of medicine work when deployed in service of the practitioner’s own goals and the patient’s wellbeing. The community sits at the intersection of secular witchcraft, Atheopaganism, and evidence-based approaches to ritual, and it has its own podcast, its own subreddits, its own reading lists, and a substantial overlap with the Atheopagan tradition in which I am ordained.
It was through The Placebo Magick Podcast that I first heard Mark Green, founder of Atheopaganism and author of the book by the same name,interviewed, and discovered it as a specific meaning making structure. The tag line of said podcast, now off the air, but with a fantastic catalog of helpful archive episodes, rings in my mind often, in the calming, lyrically resonant voice of the host: “Remember: magic is a metaphor, and metaphor is magical.” Exactly my point.
What draws people to this framing is precisely the open-label placebo finding. You do not have to believe the ritual is doing something supernatural for it to do something real. You just have to engage with it genuinely, with intention, in a symbolic language that has meaning for you. The effectiveness depends not on metaphysical claims but on the quality of the story, the richness of the symbolic vocabulary, the extent to which the practice engages your nervous system’s existing architecture for meaning-making.
Astrology, in this framing, is an extraordinarily well-developed symbolic language for generating exactly that kind of story. It has been refined over several thousand years of application to human experience. Whatever else it is or isn’t, it is a field-tested system for producing personalized narrative frameworks that feel true to the person receiving them; because they are built from the actual specifics of that person’s chart, their moment, their configuration. The birth chart is not a prediction. It is a story about a specific person, told in a symbolic language precise enough to generate an essentially unlimited number of variations and applications.
Note: None of this requires the stars to be doing anything. Carl Sagan, who stands alongside Ursula LeGuin as another member of my personal pantheon, railed against the pop astrology he saw popularized in newspaper columns, declaring that the light of Mars could not have reached his delivery room, so how could its placement at the moment of his birth impacted his his destiny? In the out of context words of a very mediocre therapist I once saw, “what if it didn’t have to matter?”
The argument does not depend on celestial mechanics having a causal relationship with human psychology. It depends on something considerably better established: that human beings are story-running organisms, that the stories we inhabit shape our cognition and motivation in ways that are real and measurable, and that some symbolic systems are extraordinarily well-developed technologies for generating stories that the nervous system can actually use.
Le Guin would, I think, have found this extremely satisfying. It means that the dismissal of story as a lesser category of knowing, as decoration rather than infrastructure, is not just aesthetically wrong or culturally impoverished.
Le Guin wrote, in one of her essays, that we tend to think of reason as the primary human faculty and story as its decoration; the sugar that helps the medicine of argument go down. She thought this was exactly backwards. Story is how human beings actually process anything that matters. Reason is the tool we use to check our stories for internal consistency, to test them against evidence, to revise them when they fail. The thinking that moves us, that shapes our choices, that makes us capable of acting with conviction rather than merely processing information, that happens in, (jazz hands), narrative!
She was writing as a novelist and a philosopher of fiction. She did not have access to Hugo Mercier and Dan Sperber’s Why do humans reason? Arguments for an argumentative theory, published over a quarter century after her essay, which makes essentially the same argument from cognitive science and evolutionary psychology. Mercier and Sperber’s central claim, arrived at through an exhaustive review of the empirical literature on how human reasoning actually works, is that reason did not evolve to help individuals arrive at better beliefs or make better decisions in isolation. It evolved to help us convince other people and evaluate their arguments. We are, at our cognitive root, not truth-seeking machines but story-telling and story-evaluating ones. The lone rational actor reasoning toward truth in a quiet room is not the real face of human cognition. It is, on their account, a fairly recent and somewhat misleading philosophical invention.
Which means the question of how to actually help a human being navigate their own life, make decisions with conviction, understand their situation clearly, move through transitions with purpose rather than dread, is not answered by giving them better arguments. It is answered by giving them better stories. The tools most suited to that work are not the ones that appeal to reason in isolation. They are the ones that engage the narrative architecture directly, that speak in the symbolic languages the nervous system is programmed to receive.
I believe that astrology, tarot, and the archetypal story work I do are most accurately understood as tools for engaging that narrative capacity deliberately, using the symbolic languages we have access to, or feel compelled by, that have been refined over millennia for exactly this purpose, to help people see the story they’ve been living clearly enough to deliberately choose what will come next.
Whether the stars and planets tug on our fortunes is beside the point.
The story is real. The nervous system that responds to it is real. The work that gets done because of it is real. In a moment when the story of our world feels very bleak and overrun with evil, I am extremely motivated to help more people believe productive, exciting, generative stories about themselves, so they can go out and live them, for the sake of our shared world.
“All of us have to learn how to invent our lives, make them up, imagine them. We need to be taught these skills; we need guides to show us how. If we don’t, our lives get made up for us by other people.” – Ursula K LeGuin