The Nocebo Effect

You’ve heard of the placebo effect, haven’t you? It’s where you’re given something and told that it will make you feel better. You feel better, but it’s not because of whatever you were given. It’s because you believed that you were going to feel better. That relief you feel is all in your head. It’s real, you do feel better, but it’s not because of what you were given.

The opposite effect is called the nocebo effect. (Placebo, nocebo, get it?) This is when you’re given something and, because you were told that it would hurt you, you feel bad or get sick. The nocebo effect is as real as the placebo effect. People really do feel sick, get rashes, or even go into anaphylactic shock although whatever they were given has nothing to do with it. We saw this with that cheerleader who went dystonic after a flu vaccine. Her symptoms were real. She really was dystonic. It was just that the vaccine was extremely unlikely to be the culprit. The very fact that her symptoms resolved and she was able to drive and go shopping (and then have a British accent when talked to) show that she was not physiologically injured. It was psychogenic.

There was also the case of several girls who developed tics after receiving the HPV vaccine in LeRoy, New York. One by one, the girls followed suit and all became ill after hearing that someone else was ill. Once all the investigations possible were done, there was no real cause to their condition. Just as quick as they all became ill, they all became healthy again. It wasn’t the vaccines. It wasn’t the environment. It was all in their heads… But it was real.

That’s what you have to keep in mind when you see these nocebo effects happening. You can’t judge the person insane and not do anything to help them. That doesn’t help. You calm them down, explain to them that the nocebo is just that, a nocebo, and then wait for their condition to resolve.

The following video explains it very, very well, and it’s worth keeping these points in mind when dealing with people who swear up and down that they were injured by things that are known to have an excellent record of safety. Their “injury” is real to them, and the symptoms can be measured scientifically.

httpvh://www.youtube.com/watch?v=O2hO4_UEe-4

I'm a doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen