Every Patient's Advocate

The Nocebo Effect: The Potentially Deadly Version of “It’s All in Your Head”

Most of us know the word “placebo.” It’s a Latin word meaning “I shall please.”

Along comes a word I’d never heard before yesterday — but it has application in areas of my work. The word is “Nocebo” — more Latin — meaning “I shall harm.”

I heard the word from a broadcast producer, Stacie, who is actually looking for someone who has suffered the nocebo effect. (See Looking For… )

Let me state up front — I do not believe for one moment that any healthcare professional who treats us for illness is intending to harm us. No way. Not a chance. That’s not what this is about.

Instead, it’s a way our brains fool us. It’s a process that takes place within our heads, convincing us of something that just isn’t true. It is a good and real example of “it’s all in your head.” And it can have serious consequences, including death. Yes, really. The mind-body connection can actually destroy the mind and body. Frightening thought.

Here’s how it works: we are given a prescription for a drug — any drug, even a placebo drug – or we are given some kind of treatment, and told what kinds of side effects are possible with that treatment. Then we suffer from those side effects because of the power of suggestion, and not because we are physically suffering them.

A Harvard study reported in JAMA (Journal of the American Medical Association) showed the strength of this phenomenon. A story last month from the McClatchy newspapers reported on a man’s death — not FROM cancer, but because he THOUGHT he had cancer.

For me, that hits a bit too close to home.

What do wise patients take away from knowledge of the nocebo effect? Our takeaway needs to be that separating our heads from our physical reality can be every important when it comes to being treated. We need to make sure our outcomes truly benefit us, or truly harm us. If a placebo makes you feel better — well, then, so be it. But when a placebo becomes a nocebo? We need to be on guard to make sure that doesn’t happen.

As I think about it — perhaps it’s something I’m very good at. When I was told I had cancer and that two labs had confirmed that diagnosis — I really did feel ill! But I also didn’t “think” it was really cancer. I never bought in. I guess I knew my own mind and my own body.

I hope the same will be true for you.

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