The Mind- Nocebo Effect and the Self-fulfilling Prophecy

Nocebo Effect – I shall harm

The mind is powerful and pessimism can block healing treatment. The nocebo effect (in Latin, placebo means “I shall please,” and nocebo, “I shall harm”) is not known as well known as the placebo effect, which is the direct opposite. The placebo effect has been well researched. The physician will give the patient a narcotic to reduce pain on one occasion, and then he will give a placebo the next time and more often than not patient receives relief both times. This is a simple example.

Supernatural Beliefs

source Enuncognita
source Enuncognita

Deadly Curses

Anthropologist have examined reports of witch doctors who issue deathly curses and what they've learned is once the person receives the curse they believe it, and the families no longer give the" walking dead" any food, so the cursed individual will literally die of starvation.

In another example, in the1970’s, doctors diagnosed a man with end stage liver cancer and told him he had just a few months to live. The patient died during that time frame but when they did the autopsy they found out the man only had a tiny tumor that had not spread and yet the man died. This is an example of the nocebo effect.

Phenomenon of the Nocebo Effect

The self-fulfilling prophecy of negative thinking has not been researched very well, but it would seem it's time for doctors to start paying a lot more attention to their patient's outlook. Doctors have seen that many treatments work for most people but not others. There is every reason to believe a person's attitude is very influential in recovery. Even when the doctor prescribes a placebo about 25% of the people complain of headaches, fatigue, insomnia, stomach aches, nausea, dizziness, weakness and other symptoms which are side effects that were not there before the placebo. These ailments are not only real but they can be disabling. This is a puzzling phenomena of the nocebo effect.

Brain- Healthy versus Chronic Pain

These scans were performed at the Mayo Clinic. source Mayo Clinic
These scans were performed at the Mayo Clinic. source Mayo Clinic

Nocebo Research

Recently some British and German researchers performed the most sophisticated study so far to prove the nocebo effect. They had 22 healthy volunteers for this study. They strapped a heat beaming device to the legs of the volunteers, zapping it until people rated their pain at nearly 70 on a scale of 1 to 100. The researchers hooked up an IV to give them the powerful morphine like painkiller, (remifentanil). This is a medication typically used for surgical patients and it is metabolized rapidly, so researchers can alternate between giving the drug and switching to plain fluid with a quick response from the patients.

As the volunteers described how much pain and pain relief they felt, their brains were being scanned. The researchers induced the burn and turned on the drug, the volunteers stated their pain improved. The researchers next told the volunteers they were about to inject more of the painkiller, even though they kept it the same. The pain ratings of the volunteers dropped even more, meaning the expectation of relief doubled the drugs painkilling benefit.

Finally, the researchers told the volunteers they were stopping the drug and the pain would probably increase, although they kept the drug running. The volunteers pain levels soared back up to almost their pretreated level as their grim expectations muted the effect of a proven and potent painkiller, plus anxiety levels fluctuated similarly.

Neural Pain Pathways

The brain cells show changes in neural pain networks that prove the people really did experience the changes in pain that they reported. In addition, expecting more pain fired up sections of the brain that control mood and anxiety, researchers recently reported in the journal Science Translational Medicine. Anticipated pain relief fired up different regions previously found active in people given placebos. The JAMA paper states a patient who expects to suffer painful symptoms is more likely to do so. Patients who are depressed also feel more bodily distress. Women report more disturbing initial symptoms more often than men.

The Placebo Effect

It is imperative to learn how anxiety influences pain to understand that nocebo affect, and to understand the precise mechanisms behind nocebo. How is it that you get the pain that you expect when you're is no physical reason for it? Clinically this is very important as the nocebo affect certainly contaminates research trials, it is costly, and patients who going all their symptoms on the pill they're taking may give up very quickly on a potentially beneficial treatment.

This is not just in the mind but it's also about physical effects. The stress created by the nocebo effect can have long-lasting impact on the heart, for instance, possibly serious enough to cause fatal damage.

In Conclusion- Mind over Matter

This is not just in the mind but it's also about physical effects. The stress created by the nocebo effect can have long-lasting impact on the heart, for instance, possibly serious enough to cause fatal damage.

Physicians may be able to lessen nocebo reactions by building trust with their patients. Doctors and nurses need to identify any chronic symptoms that their patients may suffer before beginning any course of new treatment, and they should discuss the new nocebo phenomena with their patients. Educating the patient can go a long way towards a more positive outcome. In other words, mind over matter.

Placebo and Nocebo Effect

Do you believe you can control pain or other physical symptoms with your mind?

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Comments 42 comments

Mentalist acer profile image

Mentalist acer 5 years ago from A Voice in your Mind!

I try to wrap my head around something as simple as a cold mug of water into something all encompassing of pain relief and sedativly calming force,I also do it with music and just about everything.;)


Pamela99 profile image

Pamela99 5 years ago from United States Author

Mentalist acer, This doesn't surprise me at all as I would think you, of all people would have a handle on this. Thanks so much for your comment.


rpalulis profile image

rpalulis 5 years ago from NY

Very int interesting Pamela, I am going to give this a try next time I am in some pain. I believe that it must have an effect.


Pamela99 profile image

Pamela99 5 years ago from United States Author

rpalulis, I hope it works for you. Thanks for your comment.


drbj profile image

drbj 5 years ago from south Florida

The self-fulfilling prophecy, Pamela, is a powerful force whether positive (placebo) or negative (nocebo). More and more medical schools are focusing on the mind/body connection when training new physicians. It's about time!


Joyus Crynoid profile image

Joyus Crynoid 5 years ago from Eden

Excellent article. It seems to me that Eastern philosophy has been aware of this for a long time. The concept of 'karma' comes to mind...


Pamela99 profile image

Pamela99 5 years ago from United States Author

drbj, I absolutely agree it's about time. I appreciate your comments.

Joyus Crynoid, I think you're probably right about that. I appreciate your comments.


Candelish 5 years ago

Fantastic Article! Western doctors prescribe medication after medication for pain, depression and anxiety without getting to the root of the problem. I am VERY happy to see research now being conducted in regards to how much thought and belief affect us, it's about time. Thank you Pamela for bringing this further out in the open! (Plus I now get to say "I told you so", to a few family members! I love when research backs me up!)


BlissfulWriter profile image

BlissfulWriter 5 years ago

Mind and body are intimately connected and one affects the other -- they call it the mind-body connection.


akirchner profile image

akirchner 5 years ago from Central Oregon

I know some folks don't believe it but I do because the mind is a very powerful thing. However, I think when it comes to chronic pain, there are people that it can work for and people it can't help. Obviously, it depends on the person and how strong they are mentally I guess.


always exploring profile image

always exploring 5 years ago from Southern Illinois

Pamela, This is very interesting. I once had a patient who was paralyzed from the waist down, ( He was in his early 20's ) His order was to have a Talwin q4/hrs,alternating with a placebo. He would wheel himself up to the nurse's station and say, I know this is not the good one. The next one will stop this D pain. He was really the only person who knew what was going on. The other patiens who received a placebe always reacted with a sense of relief. It reminds me of the time i went to the Dentist with a tooth ache, of course it completely vanished when i got in the door. Thank you for a very informative article.

Cheers


Pamela99 profile image

Pamela99 5 years ago from United States Author

Candlish, I'm glad this article work out for you in several ways. I agree that it is about time the Western civilization took a look at our perception of pain. Thanks so much for your comments.

BlissfulWriter, Yes, the mind-body connection is exactly what this hub is about. I appreciate your comments.

Audrey, I know chronic pain is difficult to live with and I don't think the article is saying that your mind can overcome this pain without medication. I took it more like if you decided ahead of time than a medicine or procedure probably wouldn't work then it probably wouldn't. However, if you had a positive attitude ahead of time that your chances were greater than the medicine or procedure would work. I appreciate your comments.

Always exploring, I wonder if some people are more in tune with your body and mind and others which would explain the young man that knew when he was getting the placebo. Our beliefs can be very powerful in a negative or positive way. Thanks so much for sharing your experience and for your comments.


anglnwu profile image

anglnwu 5 years ago

Interesting topic--mind over matter, like you say--is a very power thing to use. Self-fulfilling prophecy can also apply to one's self-esteem. Thanks for sharing and rated up.


Pamela99 profile image

Pamela99 5 years ago from United States Author

Anginwu, Thanks so much for sharing your comments.


A.A. Zavala profile image

A.A. Zavala 5 years ago from Texas

Fascianting hub. It seems that some people who are stuck in a seld fulfilling prophecy circuit also suffer from learned helplessness. Maybe there's a link. Thanks again for sharing.


Pamela99 profile image

Pamela99 5 years ago from United States Author

A. A. Zavala, You may be exactly right. This is certainly an area that needs a lot more research. I very much appreciate your comments.


prasetio30 profile image

prasetio30 5 years ago from malang-indonesia

Thank your very much for writing this. I always find something new from you and know how you care with health. I am proud being your fans. I hope you always healthy....amen. Rated up. God bless you. Take care!

Prasetio


Kindacrazy profile image

Kindacrazy 5 years ago from Tennessee

Pamela, You do such a great job with your hubs. You are very talented, but mostly you Take you time and do your research, and it comes through with your work. I truly admire you for those qualities. Up & useful

BTW, IF I had a MIND to work with.........well, you know what I'm saying


Pamela99 profile image

Pamela99 5 years ago from United States Author

prasetio, I'm glad you enjoyed the hub. I am also proud to be your fan since you're such an excellent writer. Thank you so much for your comments. God bless you.

Kindacrazy, Thank you so much for your kind comments and I'm glad you enjoyed the hub. Don't underestimate yourself as I love to read your hubs.


toknowinfo profile image

toknowinfo 5 years ago

Hi Pamela,

This is an excellent hub. You covered the information in depth and explained it so intelligently. Thanks for sharing. Rated up and useful.


Pamela99 profile image

Pamela99 5 years ago from United States Author

toknowinfo, I'm so glad that you enjoyed the hub and I very much appreciate your comments.


Peggy W profile image

Peggy W 5 years ago from Houston, Texas

The mind body connection is powerful indeed. Very informative hub about the Nocebo effect. Like you said, most people have heard about how placebos work, but probably not as many people (except in other cultures) know about the nocebo effect. Thanks for raising awareness. Up and useful ratings!


katiem2 profile image

katiem2 5 years ago from I'm outta here

Oh Yes, I believe, I had a tumor once removed with no pain medication in my IV as I was pregnant at the time and while the tumor was growing at a very alarming rate and the doctors felt it a life threatening situation that needed to be removed as soon possible, I refused to expose my unborn baby to pain medication, as it was something I did not beleive in.

They gave me the option to go under the knife with a local, I did and my mind def hand to be in the right state and at peace as I layed on that operating table awake the empact of what I was about to experience became very real.

I just maintained a constant peacefull meditation on my sleeping and peaceful child. It was a breeze and left me with both a battle scar and a great story. It can be done. Medication is over used in my opinion.

Great Report on Mind Nocebo the self fulfilling prophecy.

People are afflected with negative thought and lack of belief in their inner strength and ability to use positive energy and meditation in their favor.

Another amazing body of work by you dearest Pamela, amazing!

:) Katie


Pamela99 profile image

Pamela99 5 years ago from United States Author

Peggy, I very much appreciate your comments.

Katie, Thank you so much for sharing your personal story. I agree that medicine is overused in our society and I have been able to put my mind in that state for a coupe of procedures, and at the dentist office. Positive energy is so important to a good state of health and as I've worked harder at positive energy many of my previous symptoms of disease are gone. Even this surgery is going better than it did on my left hand. Thanks so much for sharing your comments.


Micky Dee profile image

Micky Dee 5 years ago

But Pamela, my doctor keeps giving me the wrong placebos!


Pamela99 profile image

Pamela99 5 years ago from United States Author

Mickey Dee, You just can't trust all those doctors. ;-}

Thanks for the comment.


katiem2 profile image

katiem2 5 years ago from I'm outta here

Good to hear that Pamela, I will maintain the most positive thoughts of you growing more and more healthy and strong, plus keeping that positive thought working hard every day to keep you happy and balanced! :) Katie


Pamela99 profile image

Pamela99 5 years ago from United States Author

Katie, Thank you so much. I appreciate your positive thoughts and your comments.


Hello, hello, profile image

Hello, hello, 5 years ago from London, UK

Wow, that is some mind blowing information. Very interesting. Thank you, Pamela.


Pamela99 profile image

Pamela99 5 years ago from United States Author

Hello, I'm glad you liked the hub. ^Thanks for your comment.


Treasuresofheaven profile image

Treasuresofheaven 5 years ago from Michigan

Thanks Pamela99, I had never heard of Nocebo! Very interesting article and ensightful too. Our Minds are in control more than we know.


Pamela99 profile image

Pamela99 5 years ago from United States Author

Treasureofheaven, This was new to me also until I started doing some research and my conclusion was the same as yours. Our minds are more in control than we realized. Thank you so much for your comments.


Money Glitch profile image

Money Glitch 5 years ago from Texas

Excellent hub Pamela! Had never heard of the term nacobo effect, but I do agree 100 percent. The mind really is powerful and a person's positive or negative thinking definitely does affect one's health among other things. Personally know of an individual that, although healthy, for years believed she would die prior to reaching the age of 72. Needless to say, on her 72nd birthday, she had a massive heart attack and died. Doctors definitely do need to do more research on the nocebo effect.


Pamela99 profile image

Pamela99 5 years ago from United States Author

Money Glitch, I have heard some stories like that before and I think we don't have a clue just how amazing our minds are. Personally I have found that if I can avoid stress my lupus symptoms are much improved. Now I just need to think myself well! I appreciate your comments.


CMHypno profile image

CMHypno 5 years ago from Other Side of the Sun

Interesting hub Pamela, we are all so suggestible that the worst thing that you can do to someone is to strip them of hope. This is a challenge for medical professionals as they have to balance being honest about a patient's condition and potentially saying something that may tip them into giving up.


Pamela99 profile image

Pamela99 5 years ago from United States Author

CMHypno, You make a really good point about the position of the medical professional. Since it is so important to maintain a positive outlook with regards to health medical professionals need to be acutely aware of the importance of their patients mental state. Thank you so much for contributing this aspect and I appreciate your comments.


cheaptrick profile image

cheaptrick 5 years ago from the bridge of sighs

Hi again P.I'd like to introduce the Third component which you seem to have missed,the"Gazebo"effect!That's when you mentally take your self to a warm wonderful gazebo and have a beautiful experience with your loved ones regardless of their location or mortality:)Works every time,I promise!Your writing is as professional as it gets.Well done.

Dean


Pamela99 profile image

Pamela99 5 years ago from United States Author

Dean, I think the gazebo effect sounds great. What a wonderful idea! Thanks so much for your comments.


KenWu profile image

KenWu 5 years ago from Malaysia

This is an excellent article. The first time I came across the word nocebo! Well, it all goes back to how we manage our thoughts!


Pamela99 profile image

Pamela99 5 years ago from United States Author

Kenwu, Thank you so much for sharing your comment.


jeugenejohn profile image

jeugenejohn 4 years ago from Kerala

The article is really thought provoking. I did know about the Placebo effect, but not the Nocebo effect. I believe self hypnosis is also a powerful potent through which a person can either endure or relieve persistent pain.


Pamela99 profile image

Pamela99 4 years ago from United States Author

jeugenejohn, I agree with you about self hypnosis. I think we still have so much to learn about the mind. I appreciate your comments.

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