The Placebo and Nocebo Effect
Continued……Read Part 1 here.
The Placebo and Nocebo Effect
The power of the mind to affect health has been known to the medical community for a long time and goes under the guise of “placebo effect” and the “nocebo effect”. The placebo effect is any beneficial change to a person’s health as a result of their belief in a treatment, irrespective of the efficiency of that treatment. Yet ironically, it is often seen as a nuisance, particularly in clinical trials, rather than a powerful tool. Despite this, it has been observed in many areas of medicine – from mental health, where it was recently estimated that the effect of a large majority of anti-depressants is mainly due to positive patient beliefs about treatment [2], to relief of arthritic pain in the knee where a sham surgery resulted in similar levels of pain relief as the real surgery [3]. This is not to say that belief will cure all. Instead it seems that a significant placebo response is generally observed in about 35% of all patients. However, the placebo effect clearly demonstrates the ability of our mind to improve our health and therefore should be an important part to our tool kit to health.
A tool can be used for good or evil. Our mind is a tool and is no exception to this rule. Negative beliefs can be detrimental to our health, in what is termed the “nocebo effect”. There have been several well documented cases to the power of the nocebo. The majority of these cases involve a person in a position of perceived power, such as a medical doctor or spiritual leader, giving a negative message to a patient who then incorporates it into their belief and live out message. One such case was recorded in a cardiac ward at a large catholic hospital in USA, where a cardiologist observed that one of his patients had taken a turn for the worse and was about to die. A priest was called to administer last rites, but by mistake he went to stable patient next to the dying man. With an impressive air of authority he gave the last rites to the wrong man, who promptly died within 15min. The dying man survived for another 4 days [4].
Those in authority are not solely responsible for our health, as it is our own belief in their prognosis that gives power to the placebo/nocebo. Indeed, research has shown that we have the same ability to cause a placebo or nocebo response with our own health. Chemotherapy has a dreadful reputation and will often make patients feel violently nauseous. However, it seems that those who expected to be sick before starting treatment experienced the worst nausea during treatment[5]. Furthermore, nausea often starts before the treatment is given; a clear sign of nocebo.
In all these situations of placebo and nocebo the only cause was a change in belief, a change in both our unconscious and conscious minds. Indeed, the stronger your belief the greater the effect.
Your mind and Your health
Understanding that our mind has an effect on our body is one thing, but it is our health that is our concern. So what can you do?
Firstly, be aware of the effect that others have on you. Having a doctor telling you that you have 6 months to live may be creating a self-fulfilling prophecy. If your clinical support is overly negative or didactic, then find other doctors who support you. Similarly, be aware of friends and family and how you feel around them. If you find yourself increasingly negative around them, then try to surround yourself with those that uplift and support you.
Secondly, be aware of your own thoughts and feelings. They can have a huge effect on our physiology. If you are like most of us and your mind is constantly digging up past experiences or painting a horrific future, then do not despair. Instead try a guided meditation or some of the more physical meditative practices like yoga or Chi Gong. These will help quieten your conscious mind so you can direct it towards healthy thoughts.
Remember that the conscious mind trains the subconscious mind, and the subconscious instructs the body. With regular practice you will be able to consciously direct your body towards a healthier path.
May peace, love and health be with you on your journey.
Astley Friend
References:
1. Ranganathan, V.K., et al., From mental power to muscle power–gaining strength by using the mind. Neuropsychologia, 2004. 42(7): p. 944-56.
2. Kirsch, I., et al., Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration. PLoS Med, 2008. 5(2): p. e45.
3. Moseley, J.B., et al., A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med, 2002. 347(2): p. 81-8.
4. Spiegel, H., Nocebo: the power of suggestibility. Preventive Medicine, 1997. 26(5 Pt 1): p. 616-21.
5. Colagiuri, B., et al., How do patient expectancies, quality of life, and postchemotherapy nausea interrelate? Cancer, 2008. 113(3): p. 654-61.
Astley Friend
Astley Friend is both a traveller on his own cancer journey and a medical scientist with a keen interest in the relationship between our self, our mind, our body and our health.
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