The Human Truth Foundation

The Nocebo Effect
Negative Psychological Effects of the Mind on the Body

By Vexen Crabtree 2022

#curses #disease #mental_health #nocebo_effect #Nocebo_Effects #Placebo_Effect #psychology #Psychosomosis

Nocebo Effects are negative effects borne from purely psychological factors, causing symptoms where there need be none. It's the negative form of Psychosomosis (the Placebo Effect being the positive form). Nocebo is normally used when a particular perceived threat vector causes distress in a person, which can then cause some kinds of symptoms whether or not the perception of the threat was rational or not. Linked terms such as psychoneurosis, conversion hysteria and somatoform disorders all describe the destructive effect that the mind can have on the body.1,2

Only some physiological symptoms can be made worse by mental states, or induced purely them. They include nausea, headaches, dizziness, skin rashes, breathing difficulties, stomach ulcers, eating disorders and changes in heart rate. Psychoneurosis accounts for 37% of cases of asthma3. Modern fears of things like mobile phone signals are psychosomatic, and in history, so are curses4. Belief can be passed on, in worst-case scenarios becoming psychogenic mass hysteria5.

'Cures' for the nocebo effects are often imagined to be calm reassurance and the presentation of medical facts by someone the sufferer trusts, but, the best long-term preventative measures are a good education, stability at home and general improvements in mental health. Unfortunately these fixes are difficult to attain once things are amiss, but without them it is uncommon that the mere presentation of facts will placate nocebo effects; a variety of social and psychological changes must first occur and the precise combination required is wildly different between individuals.

1. An Introduction to Psychosomosis

#health #hypnotism #meditation #nocebo_effect #placebo_effect #psychology #psychosomosis #self_development

Subconscious psychological factors can lessen or worsen some symptoms of disease, as our immune system and other bodily functions are effected by our moods and expectations, sometimes with greater effects than you might imagine possible6. 'Psychosomosis' is sometimes used to mean medical symptoms that derive from purely (subconscious) psychological factors; such as ulcers caused by stress7, but in its wider sense it includes positive effects (e.g., meditation) as well negative. The "placebo effect" describes how suggestion and expectation can have positive results, but the "nocebo effect" is when our mental states can create and worsen symptoms needlessly.

Some good practices can increase the health of individuals (and of entire nations). "Therapists of all persuasions agree that reducing anxiety or anger is the best way to alleviate suffering from psychophysiological disorders"8 and good reactions to stress facilitate long-term health9,10. Maintaining strong willpower, a fighting spirit, and a positive attitude towards your own body help against diseases, including cancer11, because our immune system and our body's maintenance are linked to our nervous system12, and can be affected by emotional factors. Many psychosomatic diseases and somatoform disorders can be avoided (and sometimes cured) through education5. The promotion of critical thinking and hysteria-awareness can prevent symptoms appearing in the first place, although there are many forms of biological disease that cannot be meaningfully effected without medical intervention13.

For more, see:

2. The Negative Effects of Suggestion and Expectation

#expectation #psychology #psychosomosis #USA

Our expectations about life cause certain experiences14, both in how we interpret events, to how we consciously put the world together, and affect our very senses such as sight and hearing14. Suggestion and expectation are brothers-in-arms, and many psychosomatic diseases result from our expectations about our own reactions based on what we think is real. A childish person who person dislikes a certain food can wind themselves up about to the extent that eating it food will make them sick. So far so harmless, but, similar negative effects of anticipation can be serious, interfering with medicine and research.

Around 60 per cent of patients undergoing chemotherapy start feeling sick before their treatment. "It can happen days before, or on the journey on the way in," says clinical psychologist Guy Montgomery from Mount Sinai School of Medicine in New York. Sometimes the mere thought of treatment or the doctor's voice is enough to make patients feel unwell. This "anticipatory nausea" may be partly due to conditioning - when patients subconsciously link some part of their experience with nausea - and partly due to expectation.[...]

New Scientist (2009)15

The Researchers asked a group of students to inhale a sample of normal air, which all participants were told contained "a suspected environmental toxin" linked to headache, nausea, itchy skin and drowsiness. Although they were actually inhaling normal air, many of them developed the suggested symptoms. The effect was greater in women who had seen others suffer from the alleged symptoms (one group of subjects saw a woman inhale the air and develop these symptoms). This can serve to make entire nations ill; if (for example) a detergent manufacturer plays up the risk of bacteria, suggestible people will indeed become ill from it. The solution is to remain skeptical about threats and cures promoted by industry.

Although psychosomosis sounds like a modern medical term, the same effects have been discussed throughout human history. Kaiten Nukariya, sounding like the philosopher Friedrich Nietzsche in his negativity, describes it thusly:

As the miser sets his heart on worthless dross and accumulates it, so an unenlightened person clings to worthless mental dross and spiritual rubbish, and makes his mind a dust-heap. Some people constantly dwell on the minute details of their unfortunate circumstances, to make themselves more unfortunate than they really are; some go over and over again the symptoms of their disease to think themselves into serious illness; and some actually bring evils on them by having them constantly in view and waiting for them.

"Zen - The Religion of the Samurai" by Kaiten Nukariya (1913)16

Another famous case involves a patient who was diagnosed with end-stage liver cancer in the 1970s. He died within the timeframe predicted by doctors. A later investigation showed that the doctor's prediction was actually wrong - the man was not due to die from the physical effects of his cancer. The patient's expectation led to his demise. The New Scientist article debates the benefits and risks associated with the extensive "side effects" warning of medicines, nothing that:

Many patients who suffer harmful side effects, for instance, may do so only because they have been told to expect them. [...] The severity of these side effects sometimes matches those associated with real drugs.

New Scientist (2009)15

Expectation can have real psychosomatic effects on the body. Take Derek, who was depressed and took all of his anti-depressants as a suicide attempt. He was taken to hospital where he collapsed. His blood pressure floored. He had also been taking part in a trial of a new experimental antidepressant. But a doctor arrived who was involved in the trial and revealed that Derek was in the control group, and that the pills were completely inert - they were placebos, containing no drugs. All of Derek's symptoms were created by expectation that if you take too many pills, you might die. Upon learning the truth Derek was tearily relieved, and his symptoms disappeared within 15 minutes. Anthropologist Robert Hahn of the US Centers for Disease Control and Prevention in Atlanta, Georgia, USA, confirms that "the mere belief that one is susceptible to a heart attack is itself a risk factor. One study found that women who believed they are particularly prone to heart attack are nearly four times as likely to die from coronary conditions as other women with the same risk factors". Derek's belief about his pills, and people's fears about their condition, contributes to their own demise.4

The cure to psychosomatic illness is often correct information delivered by a relevant professional - once the patient learns that there is no poison, disease, or threat, their body stops generating the psychosomatic reaction as their mental state returns to normal. The brain controls all of our immune systems, glands, etc, so that mental states can have pronounced effects on the normal operation of the body. Calm the mind and you can dispel diseases that were caused by the mind.

3. Somatoform Disorders and Conversion Hysteria

The Oxford Companion to the Mind's entry on psychosomosis includes the older medical term conversion hysteria as a form of psychoneurosis wherein "the physical symptoms are not accompanied by demonstratable physiological disturbances"1.

In somatoform disorders, the individual complains of bodily symptoms that suggest a physical defect or dysfunction - sometimes rather dramatic in nature - but for which no physiological basis can be found.

"Abnormal Psychology" by Davison and Neale (1997)2

In psychosomatic disease, the symptoms include physical components (often visible), whereas in somatoform disorders the physical symptoms are missing. For example, hypochondria, anorexia nervosa and mass hysteria are somatoform disorders, but, asthma attacks brought on by emotional disturbances are psychosomatic (accounting for 37% of cases of asthma)3.

An old case can be seen to sit in a grey area, where it is hard to distinguish between forms of hallucination, and, forms of somatoform disorders:

A poor lunatic fancied his body increased to such a size, that he dared not attempt to pass through the door of his room. He declared he saw himself that his body was far too large to make it at all possible to go through such an opening. The physician attending him believed that nothing could more effectually cure this error of the imagination, than to show that the thing dreaded could be actually and easily accomplished. He caused the patient to be thrust forcibly through it. The poor fellow, struck with abject horror at the expectant idea, to his mind, of his certain fate, shrieked that he was in agony, that he was being crushed to death, and almost at once expired!

"The Supernatural?" by Lionel A. Weatherley (1891)17

It would be interesting to note what neurologists such as Oliver Sachs make of such cases.

4. Mass Hysteria

The nocebo effect can even be catching. Cases where symptoms without an identifiable cause spread through groups of people have been around for centuries, a phenomenon known as mass psychogenic illness. [...] If you hear of or observe a possible side effect, you are more likely to develop it yourself.

New Scientist (2009)15

It is easy to see that hysterical symptoms result from mental processes. Mass hysteria is especially common amongst schoolchildren. For example, in a school in Shelkovsk, Chechnya "symptoms included convulsions, nausea and breathing difficulties. The illness spread to neighbouring schools. Local doctors suspected mass poisoning, but when a delegation of medics arrived from Moscow, they attributed it to mass hysteria"5. Even when there is no actual virus, poison, or physical cause, children can "pass on" symptoms that are in line with how the patients expect to suffer. "Mass hysteria, or medically unexplained epidemic illness, has been documented since medieval times. Simon Wessely, a director of the King's Centre for Military Health Research at King's College London, says such outbreaks tend to reflect a society's beliefs". Importantly, Dr Wessely states that the most effective way to stop the epidemic and stop the symptoms is to explain that rumour and suggestion are causing them. [...] Once this has happened, "symptoms vanish within days"5.

What we see here is that, like this page recommends, explaining to people that mental outlook has an effect on physical health can allow people to exercise more control against illness. Schoolchildren's symptoms disappear when it is explained that no poison was found; and, hysterical symptoms disappear when the true causes are empathetically explained by a trusted professional. (Beware that just telling people that the symptoms are their own 'fault' is wrong and does not make things better).

Another example that blurs the boundary between psychosomosis and hysteria is that many aspects of alcoholic drunken behaviour is cultural and caused by social upbringing rather than biology, meaning that the apparent symptoms are brainal rather than purely somatic.

5. Curses, Hexes and The Evil Eye: The Psychology Behind Magical Evil

#cameroon #curses #dominica #magic #Nocebo_Effect #psychology #psychosomosis #supernatural #the_evil_eye

In communities where they believe in magic and the supernatural, fear of curses and the evil eye can have real psychological effects, sometimes even leading to physical symptoms of illness and malaise18. In the medical world, therefore, the effects fall within the realm of psychosomosis, in particular, the Nocebo Effect. This is an area of neurogenerative disease in which belief and expectation can worsen symptoms4, and within limits, even create symptoms where there's no need for them.

Although some people believe in curses and intentionally try to enact them upon others - even in the modern world - in most cases those accused of witchery, evil and magic are generally innocent victims, and often already members of disliked minorities or are perceived as an outsider in some way; it is often a case of national development that authorities, scientists and rationalists must convince large numbers of people that it's nonsense before the perceived effects abate.

In face of the evidence of the psyhological nature of curses, believing peoples have had to declare that "Westerners are immune"; for example, the Fang people of Cameroon19 and the Caribs of Dominica20 have both concluded so. But, wrong again - it's not that Westerners are immune - but, that good education21 grants immunity to superstition and makes life more sensible in general, negating the need to explain things in terms of curses and hexes.

For more, see:

6. The Risk of Mobile Phones: A Psychological Quagmire for Some

#electromagnetic_radiation #health #mobile_phones #neophobia #photons #physics #psychosomosis #radiation #science #technology

The earth is awash in electro-magnetic fields. In addition to the Earth's natural suite of fields, we are surrounded by mobile phones, phone masts, power lines, wireless networks, Bluetooth bubbles, radar, radio broadcasts, motor engines in cars and uncountable other sources of electromagnetic activity (EMA). All these fields, and all energy, exists as electromagnetic radiation (EMR) somewhere on the same electromagnetic spectrum, including dangerous high-energy gamma radiation. Light, both natural and man-made, is also part of the electromagnetic spectrum. The question of which effects are harmful to the human body is a matter of power, frequency and focus.

An irrational fear of EMA can result from misunderstanding of the basic nature of EMR, and typical culprits include those influenced by new age woo, anti-modernist agitators and pseudoscientific reports. There has been a huge amount of study into what is safe, or not, in terms of EMA, and over a hundred international bodies of scientists around the world routinely and comprehensively test technology.22. One point to note is that radio broadcasts are orders of magnitude greater in power than mobile phone technology and have been flooding the planet for centuries: modern gadgets use much less output power.

For more, see:

Although there is widespread, there is no health risk from mobile phone radiation23. In experiments investigators have found that some people are sensitive to the idea of radiation from mobile phones use. When scientists scan their brains, they find that pain receptors flare up when the patients are told they are being subjected to the same electromagnetic fields that mobile phones use. Most people, however, are not affected. These electro-sensitives were, however, not actually subjected to any mobile phone radiation (or any other kind). As they lay there, the investigators told the subjects that they were turning on the mobile phone radiation. The patients who thought they were sensitive to it registered pain responses. Those who didn't think they were affected by it felt no pain. This episode was reported in The Economist (2008)24. No subjects were exposed to anything at all, yet, some had psychologically programmed themselves into pain responses through self-identifying as people who were sensitive to mobile phones. This is a mixture between hysteria and psychosomosis.

If people can cause themselves to be sensitive to certain stimuli even when the stimuli isn't real and doesn't really present any risk at all, it can makes things awkward for society as a whole. Protests against mobile phones and calls for regulation, further investigation and tests have cost money, but the cause of the problem is personal paranoia, not radiation. This paranoia translates, as it does in psychosomatics, into measurable symptoms. Quack remedies, supported by opportunistic salespeople, offer products that rely solely on the placebo effect to 'cure' those affected by such psychosomatic illnesses:

A growing industry of fraud artists is taking advantage of the fact that many of the supposed symptoms of EMF appear to be psychosomatic. They are offering a broad variety of quack remedies that will absorb 'harmful' EMF or otherwise shield the user. These products range from pendants worn around the neck to a patented $727.50 'i-H2O activator' that 'structures all the water you use.'

Skeptical Inquirer (2019)25

This story should be told wide and far because it goes to show what is possible: I bet that self-sensitising in this way is the cause of many minor complaints. We have seen that such psychological effects can go as far to cause ulcers, skin rashes, etc, but it makes sense that lower down on the scale is a whole portion of society afflicted by lesser nuisances that they have convinced themselves into. Education that such psychological clumsiness is possible has helped cure cases of mass hysteria, and general education on psychosomosis would likely help large numbers of people.