Science Flash: The Nocebo Effect

I know that everyone's heard of the placebo effect: two groups are given a pill, they are both told that it is the real thing, but one group is actually given a sugar pill. The sugar pill group feels better for some reason, which we call the placebo effect. However, there appears to be a reverse for this: the Nocebo Effect.

The Flip Side of Placebos: The Nocebo Effect

By John Cloud

http://www.time.com/time/health/article/0,8599,1929869,00.html

The placebo effect is when something happens, like taking medicine, and we think that we will get better, and we do, even if the medicine wasn't real. It's like fooling yourself into getting better. In fact, placebo in Latin means, "I shall please," as the article says. However, the opposite of this is the nocebo effect, or "to do harm" in Latin.

The article says that "A nocebo response occurs when the suggestion of a negative effect of an intervention leads to an actual negative outcome." In other words, when someone says something negative, like "That flu shot is going to hurt really badly," then the flu shot will seem to hurt really badly. Also, the negative effects will usually be related to the drug taken, like if the "doctor" says it's likely to cause nausea, then a lot of people will say, "I'm feeling sick." Basically, it's mind over matter in a negative way.

Nobody really knows why the placebo and nocebo effect works. There are probably dozens of theories, but any of them could be right- or wrong. One explanation that the article mentions is that perhaps the worry caused by all the warnings causes the brain to issue certain commands, causing, for instance, pains in the stomach. Another explanation of the (positive) placebo effect is that it evokes certain chemicals, starting the body's own "health-care system," as they say. I think that perhaps the real explanation will be a combination of the two. After all, our thoughts do influence our body. For example, there was a documentary about stress that explained how it can cause numerous health problems. For instance, stomach ulcers were originally thought to be caused by stress. However, they later discovered that it was actually a type of bacteria that caused it, to the great relief of many doctors (an amusing clip goes something like this: "Doc, my stomach really hurts." After diagnosing the patient with stomach ulcers, the doctor, faced with the fact that stress caused them, says, "How's your attitude lately?.... You need to work on your attitude." The patient replies, "I should work on finding a new doctor.") After more research many years later, though, they find that stress causes the body to halt or slow down certain functions, since stress was originally the "flee for your life!" response. One of those functions is repairing the stomach wall (after all, if a lion is after you, you don't really care about your stomach lining at the moment) and chronic stress would, in turn, greatly weaken the stomach wall, causing it to be vulnerable to bacteria and ulcers. So, mind over body really is a genuine thing that we should consider.

Mind over matter is an interesting topic, but what do we do when we don't want our "mind" to rule over our body? The article offers a simple solution: placebo and nocebo is simply a trick of the mind. To outwit it, we must be aware of the effects: in other words, it's "mind over mind."