The Nocebo effect
I was recently interviewed by the wonderful Stacey Colino for an article she wrote for US News and World Report on the placebo effect’s evil twin, the nocebo effect. So here’s the deal: the placebo effect, once seen by the medical industry as a negative, because people being given sugar pills instead of real stuff in medical trials often experience an improvement in symptoms, for no good reason. Well, no good reason other than the power of the mind healing them.
The problem is that the reverse is also true. Believing that something will harm you is likely to increase the odds of it happening (sources in the US News article above and below). I’ve struggled with this for a long time. At some point over the years I became terrified of doctors and medication. Not surprising given the mis-prescribed endless years of medication, really strong stuff including anti-psychotics and painkillers, as well as misdiagnoses. Here’s a fun one: I was naive and a doctor told me that a chronic “yeast” infection (which I now know was not yeast but rather chronic low level inflammation of the cervix due to oxalic acid in plants) was most likely due to HIV and insisted I get tested because of a tattoo I had just acquired in San Francisco. This was in the days when results took eight weeks. I was 18 and spent the net two months in hell. After intensive research, I developed night sweats, bowel issues and a low grade fever, all symptoms associated with the possible diagnosis. The negative result came at a huge price to my health: by the time it arrived I was a complete stress ball and the memory haunted me for years.
That would be an example of the nocebo effect. This incident set a dangerous precedent. I lost my faith in doctors and so began a few decades of tumultuous relationships and an inability to accept their diagnoses and medical scripts. I took all of them of course, because I was a pill junky, but they did little for me. I could now argue that the nocebo effect was to blame, but there was also a healthy dose of them really just not knowing anything about mast cell activation or histamine intolerance. This all worries me greatly because I developed a tendency to attribute everything to mast cell disorder, heck it’s hard not to when we know there’s over 50 symptoms.
And there, in a nutshell is the most interesting piece of news I’ve read in years. Worrying that stress is bad for you can actually kill you. But not believing that stress can kill you means it doesn’t affect you as badly.
Welcome to nocebo world.
This is what I believe is the number 1 impediment to healing in our world: the belief that food hurts us. It’s hard to argue with that belief because hey, foods do often hurt! They also have the power to heal but most of us spend very little time focusing on reframing the problem so that we use the power of the brain to intensify the healing power of the food rather than the flip side. I’ve experienced first hand how expecting to react is a self-fulfilling prophecy.
And now we have some more science to back it up.
I reported a while back that scientists have been able to use pavlovian conditioning to induce a nasal tryptase increase (one of the mast cell mediators involved in allergic response and anaphylaxis) in people whose subconscious was triggered into believing they were being exposed to an allergen. You can read the full “Fearful of food? The brain is to blame but also the cure.” post here.
But I also highly recommend listening to this inspiring TED talk “How to make stress your friend.” by Dr. Kelly McGonical in which she mentions a study showing that those who believe stress is bad for them will suffer negative health effects from it, while those who don’t, don’t.
You can also check out David Hamilton’s post on how he realised that increasing his knowledge of nutrition led to weight loss, but also to an increase in negative reactions to it.
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