The placebo effect is well known in therapy, but what about its less known twin the nocebo effect?
low with a virus, feeling exhausted, or even feeling like we could vomit. Hearing these words, however, may make us feel even more ghastly — quite literally. In my and my co-authors' new book,, clinicians, psychologists, neuroscientists, anthropologists, philosophers, and ethicists delve into one the most fascinating but overshadowed phenomena in healthcare — the nocebo effect.. The latter refers to those positive health benefits that can arise when we expect to feel better and do.
Dr. Dirk Varelmann is a specialist in anesthesia at Beth Israel Deaconess Medical Center in Boston who explored whether the way in which a local anesthetic injection was described might influence experiences of pain. In a, one group was informed, “You will feel a big bee sting; this is the worst part;” while the other group was advised, “We are going to give you a local anesthetic that will numb the area, and you will be comfortable during the procedure.
It seems that the truth may sometimes be a bitter pill to swallow. If words worsen our symptoms via nocebo effects this invites an ethical dilemma: when is too much information a bad thing? Should doctors restrict what they tell us if it prevents them doing harm? Or should they fully respect our need to know, and divulge all the nasty side effects even if we feel worse as a result?
Of course, when our friends or family say these things they don’t set out to make us feel worse. But in healthcare contexts, what clinicians tell us — or even what they write in our— really could have implications for our symptoms, and this in turn may have ramifications for whether we adhere to medications, or even drop out of care.
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