The standard neuroscientific account of the placebo effect identifies the neurochemical systems involved but fails to explain the constitutive transition from semantic context to physiological cascade. The dominant explanatory concept—expectation—does not resolve this gap; it merely relabels the explanandum. This paper proposes an alternative framework based on the theory of autocatalytic organization, drawing on the formal work of Rosen, Kauffman, and Montévil/Mossio. In an autocatalytically organized system, there is no translation between “meaning” and “physiology” because both are aspects of the same self-maintaining process. The placebo effect is reconceived as the integration of a perturbation into self-reinforcing cascades, governed by the topology of the autocatalytic network. This framework is applied to four empirical domains: psychoneuroimmunology (conditioned immunosuppression), open-label placebos, network neuroscience, and the placebome. Concrete, testable hypotheses are derived, including the prediction that perturbation-based measures of network non-factorizability should correlate with placebo magnitude. The clinical implications include a reframing of the drug–placebo distinction, a critique of the factorizability assumption underlying RCT design, and a rationale for individualized open-label placebo interventions.