The ‘Nocebo’ Effect

& how it might affect your health experience

Did you see the title and think ‘Do you mean ‘Placebo’ Effect, Katherine?’ 

If yes, then you’re starting on the same page as I was when I first heard this term. 

If you haven’t heard of the placebo effect: 

The placebo effect is when someone gets a positive outcome from a non-treatment (like a sugar pill or saline) because the person believes it will work. 

If a group of people are given a sugar pill and told it’s medicine, a percentage of that group will get better because they BELIEVE the pill will help them – even though it doesn’t have any actual medicine in it.

Most people have heard of the placebo effect. 

While it is definitely a real thing – you can feel better when nothing has actually been introduced to the body – it’s also sometimes used to explain away the perceived efficacy of treatments that don’t have clear scientific explanations yet (like energy work or kinesiology).  

Now that we’ve covered placebo, let’s talk about what we’re here to talk about –  

The Nocebo Effect

The Nocebo Effect is essentially the opposite of the placebo effect. 

It’s talking about belief, but instead of belief that a medicine will work or something good will happen to your body, 

It’s a belief that either you’ll get a terrible side effect from your treatment and/or that the treatment won’t work/ will have a negative effect on you. 

If you search it up in medical literature, you’ll see studies where a patient is told that a specific treatment may have x, y, or z negative side effect. 

They’re then given the equivalent of a sugar pill (e.g. saline with no medicine) to see how many people have that negative side effect. 

One psychiatric journal said it’s estimated up to 97% of negative pharmaceutical side effects could be caused by the nocebo effect. (Although, I think we can all agree that there may be a vested interest in the percentage being that high – but I’ve included some links below if you’d like to check it out further for yourself). 

The nocebo affect also applies if a patient believes that the treatment they’re receiving won’t work. In that case, the treatment is more likely not to work.

What does this mean? 

Well, it means that if you BELIEVE that a specific course of treatment will have a negative side effect, you’re significantly increasing your chances that you WILL have a negative side effect from that treatment. 

(For example, if you believe you’re likely to get sick from a vaccine, or feel nauseous from a particular drug). 

It’s the other side of the placebo coin.

If you believe something will work, will be beneficial, or won’t cause you any problems, it’s more likely to be true. 

If you believe something won’t work, or that you’ll have a negative reaction to it, it’s more likely to turn out that way. 

Of course, a positive attitude is no guarantee that you’ll get a positive outcome, and not-believing something will work doesn’t mean it won’t (like with me, when I first started getting reiki).

How to Use This in Your Own Healthcare

Now that you know about nocebo (and have been reminded about placebo), how can you use this in your own health journey?  

For one, can you notice what your existing beliefs are about anything you’re about to try or do by way of treatment?

Do you have total faith it will work? You may be placebo-ing it.

Do you think it’s going to cause you injury or that it won’t help your condition at all? You may be setting yourself up for nocebo.

What I’m not saying here is to take something you believe won’t work and try to make yourself believe in it. 

Rather, you may find yourself in situations where you don’t have a choice but to try a specific course of treatment (like chemotherapy). 

When you’re told the possible side effects, try to remind yourself that the more you believe they’ll happen, the more likely you are to experience them. 

You may want to use placebo and see if you can get a better outcome. 

If there’s a treatment you’re feeling instinctively pulled to – like, acupuncture, or an energy treatment, or something else that you don’t understand how it works, 

Try to get your mind as close to neutral as possible – it might work, it might not. 

Let’s Avoid Self-Gaslighting

The one place this can get tricky is if we tell ourselves our mind / belief has control over our outcome, it’s a bit of a slippery slope to self-gaslighting. 

If you’re feeling nauseous after a treatment, don’t sit there and say ‘I don’t believe I’ll be nauseous’ – i.e. don’t try to ‘belief’ your symptom away

Also don’t see your experiencing of a negative side effect as proof that you didn’t ‘believe hard enough.‘ 

The way I see it, there’s placebo on one side, nocebo on the other, and in the middle is the actual experience your body has of any given intervention

Don’t place expectations on yourself that if your ‘mind’ was stronger you wouldn’t feel worse, or you’d definitely feel better. 

Just let your body tell you what’s going on with it, and believe yourself. 

Hopefully, though, this concept has helped remind you the importance of trying to keep a neutral mind, keeping expectations as close to medium as possible, so your body has all the space it needs to tell you what it’s actually experiencing, without the impact of your mind trying to control it. 

Do you think you’ve ever nocebo’ed yourself, or been nocebo’d by someone else? I’d love to hear your thoughts. 

And if you’d like to read more about it, here are a few links that talk about the nocebo effect in healthcare: 

From Oxford University News: Nocebo Effect – How Informed Consent Can Cause Unnecessary Harm

From National Library Of Medicine: Nocebo Phenomena in Medicine, Their Relevance in Everyday Clinical Practice

From WebMD: Is the Nocebo Effect Hurting Your Health? 

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