The Nocebo Effect
If you believe a treatment won't help you, it probably won't -- and vice versa.
Are you familiar with the placebo effect? I'm sure you are. This occurs when patients think they're getting a fancy new drug, but what they're receiving is just a sugar pill. People who receive a placebo often recover from an ailment like they'd been taking the prescribed medicine.
The placebo effect has a dark side, too—a negative placebo effect called the nocebo effect. The nocebo effect is a phenomenon in which the mere expectation of experiencing a negative outcome or side effect from a treatment or medication can cause adverse outcomes. This is the opposite of the placebo effect, in which the expectation of a positive result can improve symptoms.
An example of a nocebo effect is when a patient is given a sugar pill and is told it's a drug with terrible side effects, and the patient begins exhibiting those exact symptoms. The nocebo effect also occurs when a doctor tells a patient that a future surgery or procedure could have negative results, knowing the risks could negatively impact their recovery, and the patient exhibits the results they are told, primarily due to the power of suggestion.
The nocebo effect has been demonstrated in numerous studies and is thought to be influenced by several factors, including an individual's beliefs, expectations, and past experiences. Suppose someone has had negative experiences with a particular type of medication. In that case, they may expect to experience adverse side effects when taking that medication again, and this expectation can then lead to the experience of those side effects.
The nocebo effect can have significant consequences. If a patient expects to experience negative side effects from treatment, they may be less likely to adhere to the treatment regimen, which can lead to a worse outcome. Additionally, the nocebo effect can affect the results of clinical trials, as the expectation of adverse side effects in the control group (who are not receiving the active treatment being studied) can lead to an overestimation of the side effects of the treatment.
There are many ways in which the nocebo effect can be mitigated. One approach is carefully managing patient expectations by providing precise and accurate information about treatment's potential risks and benefits. It is also important for healthcare providers to be aware of their biases and avoid inadvertently communicating negative expectations to their patients.
Believing in a placebo may not necessarily heal broken bones or reduce a cancerous tumor, but it may work with more subjective outcomes, like the degree to which you feel pain, nausea, or depression.
If we think positively about the medicine and treatments we receive and believe that the benefits will far outweigh the risks, we'll increase our chances of having a good outcome.
There is a close relationship between an individual's mental and physical health. This connection is vital because it highlights that our thoughts, feelings, and behaviors can significantly impact our physical well-being.
Stress and negative emotions can physically affect the body, increasing the risk of developing conditions like heart disease, high blood pressure, and depression. On the other hand, positive thoughts and behaviors, such as engaging in regular physical activity and having a healthy diet, can positively affect mental and physical health.
Understanding the mind and body connection is crucial because it can help us better care for our overall health and well-being by paying attention to our mental and physical needs. It can also help us recognize our thoughts and behaviors' impact on our physical health and take steps to manage stress and other negative emotions to promote overall well-being.
The nocebo effect highlights the importance of the mind-body connection and the role that expectations and beliefs can play in our health. Negative thoughts can contribute to developing negative emotions such as stress, anxiety, and depression, which can have severe consequences for overall health and well-being. Negative thinking can lead to behaviors that are harmful to physical health, create a cycle of negative thoughts and behaviors that is difficult to break, lead to a downward spiral of negative emotions and behaviors, lead to negative interactions with others, and can strain relationships.
The nocebo effect is a natural phenomenon extensively studied in psychology and medicine. There is a growing body of research on the nocebo effect, which has been observed in a wide range of contexts, including clinical trials, medical procedures, and psychological interventions.
I've learned to avoid the nocebo effect by paying attention to my expectations and beliefs about a particular treatment or intervention and keeping an open mind. I often avoid jumping to conclusions or allowing negative thoughts to shape my expectations. Although it's difficult to do today in a city like New York, I constantly surround myself with supportive and positive people.
Clayton is the founder and publisher of the social and political commentary newsletter Think Things Through and the host of the Think Things Through Podcast.