The NOCEBO Phenomenon: How Thoughts Create Illness

The NOCEBO Phenomenon: How Thoughts Create Illness

Everyone knows what the placebo effect is - you take a pill without an active chemical, and you feel better. Alas, the placebo has an antipode - the nocebo effect. This concept means that if we expect illness, we can get sick without objective reasons. Psychologist Nurgul Nurtayeva told about this phenomenon to the journalist of portal.

The term "nocebo" (in Latin - "I will harm") appeared in 1961 to denote phenomena opposite to the placebo effect. The easiest way to understand the essence of the nocebo effect is through examples.

In Bulgakov's The Master and Margarita there is a scene where Woland predicts Sokolov, the barman, "death in nine months from liver cancer in the Moscow State University clinic, in the fourth ward." You can be sure that it was after the predicted nine months that Sokov would die, because he believed very strongly in his illness.

Perhaps the most striking example of the nocebo effect described in fiction is the reaction of the protagonist of Jerome K. Jerome's book "Three Men in a Boat Not Counting the Dog" to a medical reference book in the British Museum library. “So I conscientiously went through all the letters of the alphabet, and the only disease that I did not find in myself was puerperal fever ... I entered this reading room a happy, healthy person. I crawled out of there like a miserable wreck,” the author describes the experience of his hero, a master of negative self-hypnosis.

One classic example is the story of Derek Adams, who was involved in a trial of a new antidepressant. It so happened that he broke up with the girl and took the pills out of grief ... After a while, he realized what he had done and asked his neighbor to take him to the hospital as soon as possible, where a real collapse happened to him. Doctors observed a whole bunch of symptoms: tachycardia, low blood pressure, shortness of breath...

However, experts were surprised that the results of laboratory tests and toxicological tests showed a healthy clinical picture. Derek was prescribed specific therapy, but this did not improve his condition. Fortunately, a doctor arrived at the hospital, who was one of the organizers of the clinical trials of the antidepressant. The specialist told Derek that he was in the control group and that all of his pills were placebos (pacifiers). Hearing this, our friend instantly recovered, all indicators returned to normal.

British scientists believe that the practice of voodoo is largely based on the nocebo effect. For the island natives, the word of their priest, who has divine power and all sorts of distinctions and superiority, is sacred and irrevocable.

Robert Hahn, an anthropologist at the US Centers for Disease Control and Prevention in Atlanta, Georgia, who studies the nocebo effect, had a very interesting idea: “Voodoo death, if it exists, may represent an extreme form of the nocebo phenomenon.”

The thought is material
Any doctor will tell you, and I completely agree with this, that it is much more difficult to treat a person who does not believe in his recovery or, even worse, predicts the most terrible outcomes. It has long been noticed, and doctors themselves often say that

a positive attitude is half the path to recovery, and a negative attitude is half the path to ineffective treatment.

Anxiety in the form of a nocebo effect in women is more common than in men who drive their fears inside themselves, do not discuss their suspicions with a doctor. Also, in men, the development of the nocebo effect is more influenced by the expectation of the disease than by life experience and information about the disease.

For women, the opposite is true. They rely more on past experience, while men, when analyzing a specific situation, are very reluctant to take the past into account. In addition, it has been observed that people who are well informed about the possible side effects of drugs are three times more likely to complain about these unpleasant symptoms, which (they say) are due to the action of these drugs.

Suspicious people who read instructions for drugs from beginning to end are much more likely to feel all the side effects. And for them they are absolutely real.

Recipe treatment
Unfortunately, the nocebo effect is still poorly understood. Scientists from the University of Michigan believe that this phenomenon is associated with dopamine and opioid receptors. In their research, they are based on the results of positron emission tomography (PET). On the other hand, a group of scientists from the University of Turin found that the pain caused by the nocebo effect can be suppressed by blocking the receptors for the hormone cholecystokinin.

Anticipation of pain tends to cause anxiety in a person, which in turn activates cholecystokinin receptors, increasing pain. Placebo and nocebo are two sides of the same coin. Which of them will manifest itself in each particular case depends on the patient's expectations, i.e. on what kind of forecast he makes for himself. And the nature of this prognosis largely depends on the literacy of the doctor.

Based on this data, I have only one effective advice: lower your threshold for suspiciousness.