Placebos and nocebos are two side of the same coin. Research suggests that if we believe something about our health there is a reasonable possibility that in some of us that will come true.
The role of placebos is so well established that any research in new medication has to be compared to the effect of a placebo. For example if I believe a herb tea will help me feel better there is a good chance I will feel better once I drink the tea. The belief alone is enough to bring about some kind of healing. This mind over matter scenario is well documented with reports of incredible cures.
Nocebos are similar placebos but work in the opposite way. If I believe that I suffer from indigestion then there is a reasonable chance that I will. We can believe ourselves into poor health. The New Scientist (13 May 2009) even reported on a man who was diagnosed with liver cancer and given a few months to live. He died on schedule only for the autopsy to reveal his liver condition had been misdiagnosed. The man had died of the diagnosis.
Arthur Barsky, a psychiatrist at Boston’s Brigham and Women’s Hospital published an article in the Journal of the American Medical Association describing how women who believe they are prone to heart disease are nearly four times as likely to die of the disease than women with similar risk factors but who do not share such fatalistic beliefs.
The message is that if we believe in ourselves and our ability to heal, that alone will increase the chance of being healthy. Once we start to allow thoughts of poor health to invade that state we compromise our health.
For me this brings into question the many forms of nocebos that we encounter. This is often rampant in the world of natural healing, complimentary medicine and traditional therapies where it is common to come away from any encounter with a list of nocebos. I use acupuncture from time to time but every treatment involves a negative description of the condition of my kidneys or spleen or whether I am too damp or hot. Similarly practices like feng shui can be practiced in a way that is so negative that every home is full of doom and gloom for the occupants. If someone believes there home will lead to divorce perhaps it will. The negativity becomes a self fulfilling prophecy and serves to fuel stronger negative beliefs in the future.
I choose not believe any nocebos but I am amazed how many of my clients come with a list of nocebos that they believe about themselves based on acupuncture, kinesiology, shiatsu, astrology and other forms of subjective diagnosis.
Unfortunately fear is one of our deepest and most powerful emotions. It is the emotion that serves to keep us from danger and keep us alive. At the same time it is a powerful emotive force that can be used to encourage change. I imagine everyone can relate to times we have taken on something out of fear for our health. Healthy eating would be an example. Fear of poor health might encourage someone to avoid certain foods and yet a belief in poor health potentially compromises that person’s health. Much healthier would be to believe that we are healthy and that eating well will just make us even healthier.
My own ethics have for many years been to support people in thinking positively and creating placebos through greater self belief. When you are next confronted with a nocebo remember you have a choice as to whether to believe it and by exercising that choice you may improve your health.
Simon G. Brown
22 Belsize Square
London NW3 4HT
+44 (0) 20 7431 9897