Nocebo effect: when thoughts breed illness. Placebo, nocebo and pain: theoretical aspects and practical application What is the name of the reverse placebo effect
We are more familiar with such names as placebo and iatrogenic. Not so long ago, I also read with pleasure about the “nocebo”, about which, I confess, I did not know anything, or simply the word “nocebo” was not remembered.
All these definitions relate to the field of psychiatry, since placebo, iatrogenic and nocebo are associated with influence on mental activity of the brain, through the secondary signaling system, that is, through our speech.
Placebo is a self-hypnosis effect. At first, the action of a certain medicine was explained to the person in the most detailed way, which fantastically quickly and without complications removes the symptom of the disease that the patient has at that moment.
Then, instead of a medicine, they gave me, as we say, a “pacifier”, which does not contain any chemically significant substances. The patient, believing in the miraculous properties of the false medicine, began to take it and the symptom that bothered him disappeared.
It turns out that the patient mentally launched and supported the healing process. Of course, a change in the rhythm of life, the nature of nutrition and fluid intake, adequate physical activity, and other factors that relate to the factors of a “healthy lifestyle”, which doctors usually recommend to their patients, played a role here.
This has been successfully used by distributors of Western companies that have flooded our country (Herbalife, Newways, In-rich, etc. - I already wrote on this topic at the Forum), with their dietary supplements - pacifiers.
Naturally, “specialists” were hired for such work, far from medicine, but with well-suspended tongues. Yes, and doctors cheated by selling dietary supplements at an appointment at a clinic or in a hospital, who received an amount per month that significantly exceeded their salary. Unfortunately, there are many dubious "clinics" selling dietary supplements, and nothing has changed so far.
You may ask: how to treat a placebo? I will answer calmly, but with caution. After all, there is no obvious harm to the body. The man got better. This "experience" is remembered by the body, and, in the future, it will work faster.
However, this is true only if the violation in the work of the organism concerns only the deviation of some function. If the disease has passed into the stage of organic changes, then flirting with a placebo will lead to the erasure of symptoms that are very important for the diagnosis, and, more importantly, the loss of time for organizing a true and targeted treatment.
That's when the moment of truth comes, when even the services of a surgeon will be useless.
iatrogeny- this is a slightly different kind of external influence on the patient. It is associated with a careless, and sometimes deliberate message to the patient about the severity (often doubtful) of the pathology that he has. These words sometimes sink into the soul of the patient so deeply that he constantly remembers them.
And in this case, as in placebo, the effect of suggestion begins to act, but only in reverse order, with a negative factor, further undermining the already weakened by the disease organism.
However, this is not all about iatrogenic. It often happens that a healthy person, having received this kind of news, begins to experience symptoms of a non-existent disease. What to talk about, if I myself have often found myself in such situations, but I will talk about them another time.
To make it clear about the seriousness of the pathological influence of words on a person, especially a patient who, as a rule, is 100% suggestible, I will give one phrase that I always say at the first seminar of the School.
Think about it, and you will understand how important and significant it is, what we say:
“Just a few words, spoken quietly, you can say - in your ear, can make a person either very happy or infinitely unhappy, up to suicide.”
What affected the person?
Not the intonation, and not the volume, but the INFORMATION that entered the body through the ears and acted on the psycho-emotional center of the brain.
Isn’t that why people say: “The word is silver, silence is gold”, “The word is not a sparrow, it will fly out - you won’t catch it”, hinting to us that we need to think before speaking, and it’s better to remain silent than to say, and then repent (and sometimes pay) for what was said.
Especially this important in raising children. He brings up well, who talks with the child and is patient in communicating with him.
Now it's time to find out about NOCEBO.
Nocebo effect.
“It has long been proven that the expectation of an illness can be as dangerous as the illness itself. For example, followers of the Voodoo cult often resort to suggestion if they need to harm someone.
Voodooist makes a person believe in the disease, as a result, various symptoms appear, in some cases the victim literally kills herself. This phenomenon is known as the "nocebo effect" (lat. nocebo - "I will hurt").
Scientists claim that health-threatening beliefs can be passed from person to person and spread through the media.
To feel the nocebo effect on yourself, it is not necessary to provoke some voodoo priest - just leaf through a couple of newspapers or exchange gossip with work colleagues.
Remember - some time ago there was a rumor that cell phones have a detrimental effect on the brain, and although no one has yet provided scientific evidence for this, thousands of people around the world said that the mobile phone has become a source of headache for them, in the literal sense of the word.
Once, doctors set up an experiment to identify the connection between headaches and cell phones, while some of its participants complained of malaise, even if instead of real phones they were “influenced” by dummies.
The nocebo effect can be so pronounced that it can turn a not-too-successful joke into a real tragedy. As a striking example of pernicious self-hypnosis, the famous German psychiatrist Erich Menninger von Lerhenthal cited the following story that happened to his students in Vienna. Wishing to teach a lesson to one of the university staff, the students dragged him into a pre-arranged room, blindfolded him and announced that he was about to be beheaded. The unfortunate man's head was placed on a wooden block, and then the pranksters hit him on the neck with a wet, cold towel. At the same moment, the victim of the cruel prank passed away.
Nocebo is able to influence not only the well-being of a person, but also physiological parameters. In medical circles, a case that occurred in 2007 is widely known. A patient undergoing treatment for depression decided to take his own life and swallowed several dozen prescribed pills. The man collapsed lifeless right in the corridor of the clinic, his blood pressure dropped sharply and if it were not for the urgent measures taken by the doctors who arrived in time, he would not be alive.
The most surprising thing is that a blood test did not reveal any potent substances in the body of a failed suicide. The doctors who “pumped out” him puzzled over the mysterious incident for some time, and only a few hours later, the patient’s attending physician explained that he had participated in an experiment to study the “placebo effect”, and almost died from an “overdose” of sweet “pacifiers”.
Of course, all this looks somewhat comical, but, according to Fabrizio Benedetti, a neurophysiologist from the Medical School at the University of Turin, the nocebo can really kill a person.
Expectation and fear of malaise most directly affect the hypothalamus, pituitary gland and adrenal medulla, provoking a powerful hormonal explosion. By and large, the body doesn’t care if the danger is real or the brain “created” it - if the fear of the threat is strong enough, there is a risk of death.
As discussed earlier, the nocebo effect can be transmitted through gossip and rumors. The same Benedetti last year arranged the following experiment. He invited a group of more than a hundred students to take a hike in the mountains, to an altitude of about 3000 m and, a few days before the trip, told one of them that the rarefied mountain air could cause migraines. The “initiate” passed the news on to his comrades, and by the day of the campaign, about a quarter of its participants complained of a severe headache. Moreover, their analyzes showed that the boys and girls had just returned from a mountain hike, where they breathed air with a low oxygen content. “In those “infected” with rumors, the biochemistry of the blood has changed,” the neurophysiologist notes.
In other words, the nocebo effect can spread like a kind of epidemic and cover quite large groups of people. At the same time, a person sometimes does not even understand what caused the malaise - according to some reports, the nocebo acts and is transmitted at the level of subconscious signals.
A few more examples of mysterious mass ailments, which can be explained, perhaps, only by flashes of the nocebo effect.
In July 1518, in the French city of Strasbourg, a woman was noticed on the street performing a strange dance that lasted several days. Other townspeople joined it and gradually the "flash mob" grew to almost 400 participants. By the end of the summer, several dozen participants in the "dance marathon" had died from heart attacks or from exhaustion. This tragic episode went down in history as the "Dance Plague".
In 1962, an unknown disease struck dozens of workers at an American textile factory. Among the symptoms were nausea, numbness of the extremities, dizziness, but the doctors could not diagnose any of the patients. The official version says that the blame for everything is mass hysteria associated with the closure of the factory and the loss of work.
At the end of the 19th century, many users of the fashionable gadget called the "telephone" complained that after telephone conversations they felt dizzy and had a headache.
In general, the fear of technological progress often creates a nocebo effect. For example, in Canada, the so-called "wind turbine syndrome" is quite common - Canadians living near wind farms claim that they suffer from insomnia and weakness and, of course, wind turbines are to blame for this.
Recently, in many countries of the world, complaints of vision problems due to watching 3D TVs have become more frequent - doctors believe that the nocebo effect may also be to blame, but the study of the impact of 3D technologies on people's health is only gaining momentum.
How to stop epidemics of deadly rumors and beliefs? One of the measures could be to increase control over the activities of unscrupulous media that disseminate information that can provoke outbreaks of nocebos. In addition, it is important to raise people's level of education in every possible way, to explain to them that their gullibility can pose a threat to their well-being.
“We have to make it clear to patients what inner fear is and how to deal with it,” says Dimos Mitsikostas. He recognizes that with all the achievements of modern medical science, the connection between thinking and physical HEALTH cannot be ignored. For thousands of years, medicine has used the will of people to treat them.
Of course, one desire to recover is not enough to defeat the disease, but one cannot do without it, ”adds the doctor.
Attention! the information on the site is not a medical diagnosis, or a guide to action and is for informational purposes only.
The nocebo effect or response is the deterioration of the patient's condition resulting from the administration of an inert substance (nocebo, or negative placebo) to him and the simultaneous belief that his condition will worsen after that.
However, similar nocebo effects have now been described without the use of inert substances. We encounter nocebo and/or nocebo-like effects all the time both in life and in clinical practice. For example, when a diagnosis of a serious illness is made, the patient's condition may worsen due to his negative expectations about the disappointing further prognosis. Also, these effects can occur with a loss of confidence in the treating doctor, medical staff. Another example would be the heightened concern of Western society about their health, in which case persistent media warnings have a significant impact on the occurrence of symptoms of a particular disease in many people. Thus, the results of a recent study of headaches that occur when using mobile phones showed that electromagnetic radiation from mobile phones has no effect on the occurrence of this symptom. And the authors concluded that this headache arose solely due to the nocebo effect (Oftedal G., Straume A., Johnsson A., Stovner L. J., 2007). It has been shown that in diseases in the pathogenesis of which a psychological component is of great importance, for example, irritable bowel syndrome, nocebo effects are quite common (Price D. D., Craggs J., Nicholas Verne G. et al., 2007). Finally, pain avoidance can be seen as a nocebo-like effect because fear of pain may itself lead to its occurrence or worsening CVlaeyen J. W., Linton S. J., 2000; Leeuw M., Goossens M. E., Linton S. J., 2007).
The study of the neurobiological mechanisms of the nocebo effect is difficult for ethical reasons, because the patient's belief that he will get worse leads to a real worsening of his condition. Using an experimental approach, scientists conducted a neuroimaging study, the results of which led to the conclusion that negative expectations potentiate pain sensations by activating specific areas of the brain (prefrontal cortex, insula, anterior cingulate cortex) (Ploghaus A., Tracey I., Gati J. S. et al., 1999; Sawamoto N., Honda M., Okada T. et al., 2000; Porro C. A., Baraldi P., Pagnoni G., et al., 2002; Koyama T., McHaffie J. G., Laurienti P. J., Coghill R. S., 2005; Lorenz J., Hauck M., Paur R. C. et al., 2005; Keltner J. R., Furst A., Fan C. et al., 2006). In another recent study, it was shown that the expectation of a certain level of pain intensity can change the degree of perceived pain intensity through the activation of various areas in the brain. The researchers, using 2 visual stimuli, each accompanied by one of two delivered thermal stimuli (48C and 47C), found that participants reported more pain when the thermal stimulus was preceded by a high-intensity visual stimulus. Participants' brain scans also identified statistically significant differences in neuronal activation in the ipsilateral caudal anterior cingulate cortex, caudate head, cerebellum, and contralateral sphenoid nucleus.
Thus, these neuroimaging studies showed that the expectation of pain stimuli, both low and high intensity, strongly influenced the intensity of perceived pain and the activation of specific areas of the brain. These studies dealt only with negative expectations (no neutral substances were prescribed), and the effects obtained should be classified as nocebo-like.
As noted above, the outcome of treatment may vary depending on the expectations of the patient. For example, in anesthesia practice, it has been shown that verbal persuasion can reverse the effect of nitric oxide, i.e. from an anesthetic, it can turn into a painkiller. Here we are confronted with the phenomenon of nocebo-hyperalgesia, which is essentially the opposite of placebo analgesia and in which the expectation of increased pain plays a key role. To obtain the effect of nocebo-hyperalgesia, one must prescribe a neutral treatment, accompanied by a verbal belief about increased pain. In one study (Benedetti F., Amanzio M., 1997), patients were prescribed proglumide, a non-selective cholecystokinin receptor antagonist, to relieve the symptoms of nocebo-hyperalgesia after surgical manipulations. Proglumide has been shown to be able to prevent the symptoms of nocebo-hyperalgesia by acting on cholecystokinin receptors, and this effect is dose-dependent. While a low dose of the substance (0.05 mg) was ineffective, increasing it to 0.5 and 5 mg caused an analgesic effect. Since cholecystokinin receptors are involved in the mechanism of anxiety, it has been suggested that proglumide can influence anxious thoughts about the onset of pain (Benedetti F., Amanzio M., 1997; Benedetti F., Amanzio M., Casadio C. et al., 1997). This effect was not eliminated by naloxone, i.e. was not associated with effects on opioid receptors. In another experimental study, scientists found that the administration of a neutral drug with simultaneous verbal belief of increased pain caused hyperalgesia and hyperactivity of the hypothalamic-pituitary-adrenal axis. Both nocebo-induced hyperalgesia and hypothalamic-pituitary-adrenal activity were stopped by the administration of diazepam, a benzodiazepine receptor agonist, which suggests the involvement of anxiety in this mechanism. On the contrary, the administration of a non-selective cholecystokinin receptor antagonist, proglumide, made it possible to stop the symptoms of nocebo-hyperalgesia completely, but had no effect on the activity of the hypothalamic-pituitary-adrenal axis. This led to the conclusion about the specificity of cholecystokinin in the mechanism of occurrence of the hyperalgesia component in the nocebo response. Both diazepam and proglumide had no effect on baseline pain due to their effect solely on nocebo-induced hyperalgesia. These data reveal a close interaction between the components of nocebo-hyperalgesia and anxiety, and also show that proglumide does not affect anxiety in the process of anticipating upcoming pain, as previously postulated (Benedetti F. , Amanzio M., 1997; Benedetti F., Amanzio M., CasadioC. et al., 1997), only interrupts the cholecystokinergic relationship between anxiety and pain (Colloca L., Benedetti F., 2007).
Today, scientists have already come to the conclusion that the phenomenon of placebo analgesia is mediated by the release of endogenous opioids under certain conditions (Amanzio M., Benedetti F., 1999; Zubieta J. K., Bueller J. A., Jackson L. R. et al., 2005). The data obtained on the involvement of cholecystokinin in the mechanism of nocebo-hyperalgesia suggest that the rpioidergic and cholecystokinergic systems can be activated due to opposite expectations, analgesia and hyperalgesia, respectively. Such a view of the neurochemistry of the phenomena of placebo and nocebo, in which two opposite mediator systems are activated by opposite expectations about pain, is also confirmed by other studies (Hebb A. L. 0., Poulin J-F., Roach S. P. et al., 2005; Benedetti F., 1997 ).
Interestingly, the pronociceptive and anti-opioid effects of the cholecystokinergic system were also found in the brainstem. For example, it has been shown that cholecystokinin is able to block the effect of opioid analgesia, acting at the level of the rostral ventromedial sections of the medulla oblongata, a zone that plays a key role in pain modulation (Mitchell J. M., Lowe D., Fields H. L., 1998; Heinricher M. M., McGaraughty S., Tortorici V., 2001). It was also found that cholecystokinin can activate neurons that facilitate the transmission of pain signals in the same area of the medulla oblongata (Heinricher M. M., Neubert M. J., 2004). These data may serve as a guide to further study of the mechanisms underlying nocebo-induced and anxiety-induced hyperalgesia.
The results of one study showed that the nocebo belief about increased pain can cause both hyperalgesia and allodynia in response. Using already accumulated knowledge about the placebo effect, a group of scientists (Colloca L., Sigaudo M., Benedetti F., 2008) conducted a study of the role of learning in the formation of the nocebo effect through the development of conditioned reflexes. To accomplish this, healthy subjects were subjected to verbal persuasion of increased pain prior to the application of tactile and low-intensity pain stimuli. This nocebo procedure was also carried out after preliminary training of conditioned reflexes, during which two different conditioned visual stimuli were associated with either the presence or absence of pain. Pain perception was assessed using a scale from 0 to 10, where 0 meant no pain and 10 meant unbearable pain. The results of the study showed that when verbal persuasion was used without preliminary development of conditioned reflexes, tactile stimuli were perceived as painful, and pain stimuli of low intensity were perceived as the same higher intensity. After the development of conditioned reflexes, the same effect was observed.
Thus, in contrast to placebo analgesia, in which after the development of conditioned reflexes, a more pronounced effect is observed compared to that with verbal persuasion, with nocebo hyperalgesia, learning is less significant. Summarizing the results obtained, the scientists concluded that the nocebo response can cause both hyperalgesia (increased sensitivity to pain) and allodynia (feeling of pain in response to non-painful stimulation). Education in nocebo hyperalgesia is less significant compared to its role in the effect of placebo analgesia (Colloca L., Sigaudo M., Benedetti F., 2008).
The concept of nocebo and nocebo-like effects is associated with negative expectations of treatment outcome. It has been shown that the anxiety associated with the expectation of impending pain in nocebo-hyperalgesia activates cholecystokinergic systems, which in turn facilitate the transmission of pain signals in the brain. Summarizing the data obtained, it can be concluded that the placebo-nocebophenomenon is an example of how positive and negative expectations about pain affect different neurochemical systems: in the first case, this is the endogenous opioid system, and in the second, the cholecystokinergic system. The balance between these two systems determines whether the patient will tolerate painful procedures well or poorly, and also allows predicting his response to treatment (Colloca L., Benedetti F., 2007).
A PHOTO Getty Images
Alexandra felt well until she heard a terrible verdict from the doctors: “You have cancer, you have a few months left to live.” After the death of the girl, it turned out that the doctors were wrong: the tumor was benign and did not develop. There was a nocebo effect (from the Latin "harmful"). “The woman died because she was in a negative emotional state,” says hypnopsychologist Vladimir Kucherenko. - The emotional sphere of a person affects the development of almost any disease. So, for example, the root cause of peptic ulcer is Helicobacter pylori, which is present in 90% of people. But those who, as a result of emotional experiences in the body, have the conditions for the successful reproduction of bacteria, get sick.
Imaginary sick
“The suspiciousness of some patients itself leads them to a deterioration in well-being,- states the neurologist Zinaida Kolesnikova. ‒ Recently, a patient came to me, who was just coughing, but she worked herself up so much that she literally believed that she had a fatal illness. The woman went to do expensive tests, and only then believed that she did not have oncology.
Kolesnikova knows from her medical experience that some of us only feel worse after reading the package leaflet for a drug that details the side effects. And even if there are no visible manifestations of side effects, after taking medications, it often seems to us that we feel worse.
And those who consider themselves at high risk for a disease are much more likely to get it than those who, being at the same risk, do not know about it.
A strong imagination creates an event
According to Zinaida Kolesnikova, word of mouth has a nocebo effect. “It is worth a person who is not related to professional medicine to spread a rumor that a certain medicine has a negative effect, as everyone immediately refuses it,” the neurologist notes. ‒ Although they were often treated with it for many years and were satisfied with the result.
Sometimes television plays the role of word of mouth. For example, once information was spread on TV that one French antidepressant was used by drug addicts. Immediately, a wave of refusals began, although the drug had excellent performance and is used by all of Europe.”
The French writer and philosopher of the Renaissance, Michel Montaigne, made famous the saying of the ancient Latins: Fortis imaginatio generat casum - "a strong imagination gives rise to an event." Montaigne did not mean sickness, but the materialization of every strong faith. He seemed to be warning: do not waste it on the expectation of trouble.
Everything is material, even anxiety
Placebo and nocebo effects have very real manifestations in the human brain and are explained by material causes. They were identified by Jon-Kar Zubieta 1 of the University of Michigan using positron emission tomography (PET). The scientist demonstrated that the nocebo effect is associated with a decrease in the production of the hormone dopamine, which is involved in the production of opioid peptides that have analgesic effects. This explains why the nocebo exacerbates the pain. Simultaneously, Fabrizio Benedetti 2 of the Faculty of Medicine at the University of Turin in Italy discovered that the pain caused by the nocebo effect can be suppressed with the help of proglumide, a drug that blocks the receptors of a hormone called cholecystokinin (CCK). After all, the expectation of pain causes anxiety, and it activates the CCK receptors, increasing pain.
Nocebo effect in men and women
Who is more susceptible to the nocebo effect - the stronger or the weaker sex? “Anxiety in the form of a nocebo effect is more common in women than in men. But men can also be anxious, and their problem is that they drive their anxiety inside themselves, do not discuss suspicions with the doctor, ”Zinaida Kolesnikova states.
In men, the development of the nocebo effect is more influenced by the expectation of the disease than by life experience and information about the disease. For women, the opposite is true. “Women rely more on past experience, while men are very reluctant to take the past into account when analyzing a specific situation,” says Paul Enck, a psychologist at the University Hospital of the University of Tübingen (Germany) 3 .
contagious psychosis
Perhaps the most striking example of the nocebo effect described in fiction is the reaction of the protagonist of Jerome K. Jerome's book "Three Men in a Boat Not Counting the Dog" to a medical reference book in the British Museum library. “So I conscientiously went through all the letters of the alphabet, and the only disease that I did not find in myself was puerperal fever ... I entered this reading room a happy, healthy person. I crawled out of there like a miserable wreck,” the author describes the experience of his hero, a master of negative self-hypnosis.
Hypnosis helps with the nocebo effect
Unfortunately, in real life, the nocebo effect is not so harmless. Sometimes it takes on the character of a mass psychosis. So, in December 2005, one after another, students of several schools in the Shelkovskiy district of Chechnya began to complain of headaches and suffocation, some were tormented by seizures and muscle spasms. Chemicals capable of causing poisoning with similar symptoms have not been identified. And such outbreaks happened more than once. In Jordan in the 1990s, 800 children developed side effects after being vaccinated. At the same time, nothing was found in the vaccine itself that could cause a similar effect.
Hypnosis helps with the nocebo effect. “This is the most powerful method of bringing a person out of a negative psycho-emotional state,” Vladimir Kucherenko believes. - The drugs have a temporary effect, they give you the opportunity to pull yourself together. But then the person returns to the previous state. Hypnosis sessions provide systemic deliverance, since hypnosis affects not only the psyche, but various biochemical processes occurring in the body.
Love of life.“My advice is to trust less articles in the non-professional press in order to avoid the nocebo effect,” suggests Zinaida Kolesnikova. “Think that a new fine day is coming, you are surrounded by relatives and friends, there is an interesting job, and you will meet friends on the weekend.”
Change of outlook.“A person always has a choice - how to act, what to think and feel. He can “drown” in negative emotions and, as a result of the nocebo effect, be drawn into an illness that he might not have had at all. In this case, it is necessary to radically change the worldview and lifestyle,” says Vladimir Kucherenko.
1 20 Symposium on Mechanisms of Placebo/Nocebo Responses, November 2007, Tutzing (Germany).
2 "Placebo and nocebo effects", The Point, 2007.
3 “Understanding the Mechanism of Placebo Responses: the Role of Expectation and Conditioning across diseases and treatments”, placebo-vw.unito.it
Dr. Lissa Rankin at TEDx, it's never too late to quietly and carefully listen/watch/read this text now. It describes from the point of view of science the mechanisms of miraculous self-healing from any disease (including cancer at the last stage) or sudden death from the “evil eye”.
Zozhnik provides the text of this important speech by Lissa (with subtitles, editing, links and pictures).
Can the mind heal the body? And if so, is there evidence to convince skeptical doctors like me? These questions have driven my research in recent years. And I discovered that the scientific community, the medical institutions, over the past 50 years have proven that the mind can heal the body. This is called the "placebo effect".
Science is about self-healing
We've been trying to outsmart him for decades. The placebo effect is a thorn in the side of medical practice. It's the ugly truth that stands between implementation
new types of treatment, new surgical methods in medical practice.
But I think it's rather good news because it's ironclad proof that the body contains internal repair mechanisms that cause the unthinkable to happen to the body.
If this sounds amazing to you and you find it hard to believe in self-healing,
you should check out The Spontaneous Remission Project, a database compiled by the Institute of Noetic Sciences. This is more than 3,500 cases described in the medical literature, patients who recovered from the so-called "incurable" diseases.
You will be shocked if you take a look at this database. Everything is in it: the fourth stage of cancer disappeared without treatment, HIV-positive patients became HIV-negative, heart and kidney failure, diabetes, hypertension, thyroid diseases, autoimmune diseases disappeared.
The case of "Mr. Wright"
This is a famous case, studied in 1957, which you may have come across on the Russian Internet. The sick so-called "Mr. Wright" ( judging by the sources, the patient's name is conditional, - approx. Zozhnik) was an advanced form of lymphosarcoma. Things were not going well for the patient, and he had little time left: orange-sized tumors in the armpits, on the neck, in the chest and abdominal cavities. His liver and spleen were enlarged, and his lungs accumulated 2 liters of cloudy fluid every day and needed to be drained so he could breathe.
But Mr. Wright did not lose hope. He found out about the wonderful drug "Krebiozen" and begged his doctor: "Please give me Krebiozen and everything will be fine."
His attending physician, Dr. West, could not do this due to the novelty and insufficient study of the new drug. But Mr. Wright was persistent and did not give up, he continued to beg for medicine until the doctor agreed to prescribe Krebiozen.
Demonstration for the speedy distribution of a new wonderful cure for cancer - Krebiozen, which turned out to be a dummy after testing.
He scheduled a dose for Friday next week. Hoping Mr. Wright doesn't make it to Monday. But by the appointed hour, he was on his feet and even walked around the ward. I had to give him medicine.
After 10 days, Wright's tumors had shrunk to half their original size. A couple more weeks passed after the start of taking Krebiosen and they completely disappeared. Wright danced with joy like crazy and believed that Krebiozen was a miraculous medicine that cured him!
This went on for two whole months until a full medical report on Krebiozen came out, which stated that the therapeutic effect of this drug was not proven. Mr. Wright became depressed and the cancer returned.
Dr. West decided to cheat and explained to his patient: “That Krebiozen was not cleaned well enough. It was of poor quality. But now we have ultra-pure, concentrated Krebiozen. And that's what you need!"
Wright was then given a placebo injection. And his tumors disappeared again, and the fluid from his lungs was gone. The patient began to have fun again. All 2 months until the Medical Association of America messed things up by publishing a nationwide report that definitely proved Krebiozen to be worthless.
Two days after Wright heard the news, he died. He died, despite the fact that a week before his death he himself flew his own light aircraft!
Nocebo is the opposite of placebo
Here is another case known to medicine that looks like a fairy tale. Three girls were born. The birth was taken by a midwife, on Friday the 13th, and she began to assert that all children born on this day are subject to spoilage. “The first,” she said, “will die before her 16th birthday. The second - up to 21 years. The third - up to 23 years.
And, as it turned out later, the first girl died the day before her 16th birthday, the second - before the age of 21. And the third, knowing what happened to the previous two, the day before her 23rd birthday, she was admitted to the hospital with hyperventilation syndrome and asked the doctors: “Am I going to survive?” That very night she died.
These two cases from the medical literature are excellent examples of the placebo effect and its opposite, the nocebo.
When Mr. Wright was cured with distilled water, this is a good example of the placebo effect. You are offered an inert therapy - and it somehow works, although no one can explain it.
The nocebo effect is the opposite. These three girls who were "jinxed" are a prime example of this. When the mind believes that something bad can happen, it becomes a reality.
Measurable placebo effects
Medical publications, journals, the New English Journal of Medicine, the Journal of the Medical Association of America, they are all full of evidence of the placebo effect.
When people are told they are being given an effective drug, but are given saline injections or regular sugar pills instead, it is often even more effective than actual surgery. In 18-80% of cases, people recover!
And it's not just that they think they feel better. They actually feel better and it's measurable. With the help of modern devices, we can observe what happens in the bodies of patients who have taken a placebo. Their ulcers heal, the symptoms of intestinal inflammation decrease, the bronchioles expand, and the cells begin to look different under a microscope. That this is happening is easy to confirm.
I love Rogaine's research. There's a group of bald guys, you give them a placebo and they start growing hair.
Or the opposite effect. You give them a placebo, you call it chemo, and people vomit, their hair falls out!
The doctor and the nurses are also a placebo (or nocebo)
But is it really just the power of positive thinking that leads to these results? No, according to Harvard scientist Ted Kaptchuk. He believes that the most important thing is that the care and attention provided by a health worker is more influential than positive thinking. Some studies say that the doctor is actually a placebo.
Ted Kapchuk observed patients who received a placebo as a curative therapy. And he told them: "This is a placebo and there is nothing in it, there is no active substance." But they still got better. Most, as Kaptchuk admitted, thanks to the care and care, they wanted and they did something and felt that they were taken care of.
The body has a natural internal repair mechanism, but the scientific basis proves that the care and attention of a health worker, such as a healer, is needed to facilitate the process.
It is not easy to cope with the disease alone and there is a big difference when someone maintains this confidence. But the problem is that a doctor can be both a placebo and a nocebo.
What do patients want from us healthcare workers? They need us to be a force for healing, not fear or pessimism. So when the doctor says, "You have an incurable disease, you are doomed to take these drugs for the rest of your life." Or “You have cancer. You have 5 years left to live. It's like that midwife telling those three newborns that they were jinxed.
As doctors, we want to be realistic, you know? When we give people information that we think they should know, but in reality we can do harm.
Instead, doctors should be like Dr. West - we give distilled water. "Mr. Wright, I promise this will help you."
health pyramid
What are placebo and nocebo effects in their purest form? Can we do something without clinical trials?
My hypothesis says that in order to heal ourselves, to be optimally healthy, we need more than just a good diet, regular exercise, sleep, vitamins, follow the doctor's orders. This is all good, critical and important.
But I also became convinced that we need healthy relationships, a healthy work environment and creative life, a healthy spiritual life, a healthy sex life, financial health, the environment. Finally, we need a healthy mind.
I was so eager to prove this that I found literature and extensive data that proved that all this is significant and changed my opinion. I've compiled them in my upcoming book, Mind Over Medicine: Scientists Prove You Can Heal Yourself.
I want to present to you the key aspects of this. As you can see from this whole pyramid of health, all faces are built on a foundation, which I called the inner wick.
What is important to me is your authentic part, which knows what is true for you. This desire to bring the truth to you may not touch your life, and the stones in your health pyramid may not be balanced.
I placed the body and physical health on top of the pyramid. Because it is the most fragile, the most shaky, the most easily destroyed if something in your life goes badly. I have found from the medical data that relationships matter. People with strong social circles have half as much heart disease as those who are single.
Married couples are twice as likely to live longer than unmarried. Healing your loneliness is the single most important preventive measure you can take for your body. This is more effective than quitting smoking or exercising.
Spiritual life matters. Parishioners of churches live an average of 14 years more.
Work Matters. You can work yourself to death. In Japan it is called karoshi. Death from overwork. Survivors of karoshi can sue for damages. And not only in Japan, it happens very often in the US, but we don't get compensated for it. According to the study, people who do not take vacations are 3 times more likely to suffer from heart disease.
Happy people live 7-10 years longer than unhappy, and the likelihood of heart disease for an optimist is 77% less than for an optimist.
How it works?
What happens in the brain that changes the body? This is what amazes me. I discovered that the brain communicates with the cells of the body through hormones and neurotransmitters. For example, the brain defines negative thoughts and beliefs as a threat.
You are lonely or a pessimist, something is wrong at work, a relationship is in trouble and the amygdala screams: “Threat! The threat!" The hypothalamus turns on, then the pituitary gland, which communicates with the adrenal glands, which begin to splash out stress hormones - cortisol, norepinephrine, adrenaline. Turns on, as Walter Kenneth of Harvard calls it, the stress response. Which turns on the sympathetic nervous system, puts you in a fight-or-flight state that protects you if you're running from a mountain lion.
But in everyday life, in the event of a threat, that quick stress reaction arises, which should be turned off when the danger has passed. But in our case this does not happen.
Fortunately, there is a counterbalance in the relaxation mechanism that Herbert Benson of Harvard University has described. And when the direction changes, the stress response turns off and the parasympathetic nervous system turns on, healing hormones such as oxytocin, dopamine, nitric oxide, endorphins fill the body and cleanse every cell.
Most surprisingly, the natural self-healing mechanism only kicks in when the nervous system is relaxed. Therefore, in a stressful situation, all self-defense mechanisms are not included. The body is too busy trying to fight or run instead of healing.
When you think about it, you ask yourself: how can I change the balance of my body?
One report shows that on average we have over 50 stressful situations every day. If you are lonely, depressed, unhappy with your job, or have a bad relationship with your partner, the number at least doubles.
Therefore, the relaxation response, according to the researchers, explains the placebo effect. So when you take a new miracle drug, you don't know if it's a placebo or not. The tablet starts the relaxation mechanism, the combination of a positive attitude and due care of the health worker relaxes the nervous system.
And then that natural mechanism of self-healing turns on. Luckily, you don't have to participate in a clinical trial to turn on the relaxation process. There are many simple and enjoyable ways to start the relaxation mechanism. And this has been proven by research.
- meditate
- express yourself creatively
- get a massage,
- do yoga or tai chi
- go out for a walk with friends
- do what you love,
- sex
- you can laugh
- do exercises,
- play with animals.
I ask you to consider your own health pyramid. What bricks are not balanced in it? Each of the bricks can be a factor that creates a stressful situation or relaxation. How to increase the amount of relaxation in your body?
And most importantly, what does your body need to heal itself? What prescription do you need? Do you have the courage to face the truth that your inner source already knows?
I think our healthcare system is in a terrible state, mostly because we have forgotten about the body's ability to heal. Medical institutions are too arrogant. We used to think that with all the modern technologies, all the knowledge of the past centuries, we have mastered nature and refuse to think that nature can sometimes be better than our medicine.
We must take responsibility for our body, your consciousness has great power, interact with the body and heal it. Everything starts with you.
Be the love you want to see in healthcare.
And I believe miracles will happen. As soon as you did this, oxytocin, dopamine was released, self-healing began.
nocebo effect - this is a manifestation of a non-ga-tive reaction in response to non-ga-tive expectations. That is, it is the reverse effect of the placebo effect. When a person thinks that he is ill with something or does not believe in the effectiveness of the le-karst, in the result of which, his not-ha- tive expectations and sales. And if the placebo effect can in some cases even determine the effectiveness homeo-pa-ti-ches-kih pre-pa-ra-tov , then the nocebo effect can, in some cases, manifest itself in a very strange way. In particular, recently pro-in-di-moose researched-after-before-va-ing the influence of knowledge of human-lo-ve-ka sob-s-t-ven-nyh gene some especially ben-nos-tey on the feeling and mountains-mo-nal-ny background. As a result, it turned out that knowledge affects the sensations and the mountainous background to a greater extent than self-mu-ta-tion.
Lately, in general, it’s been very popular with gene-not-ti-chess tests. What has become possible, but thanks to the development of DNA se-ve-ni-ro-va-niya technologies. And such tests are carried out not only on embryos, but also on adults. Although the practical benefit so far can only be brought by em-bree-o-new tests. That with art-kus-st-ven-nom op-lo-dot-in-re-nii pos-in-la-et to select em-b-ri-o-na with ten-qi-al-but the most high IQ. And it may be immoral, but at least useful. But the genetic tests of adults are not just demon-useful, they directly do harm. Although, it would seem that knowledge of pre-races-lo-women-nos-ty to one or another for-le-va-niya can help a person to speed-re-ti-ro-vat its own way.
Impact of DNA tests
The whole problem is that people are ir-ra-qi-o-nal-na and emo-qi-o-nal-na. Therefore, when a person finds out that he has some kind of genetic non-dos-tat-ki, then instead of comp-pen-si-ro-vat them with his in-ve-de-ni-em, he, on-o-bo-mouth, waves his hand at everything, “hurt-m-e-s-s-sya” and believes that “let everything then burn blue flame-me-nem. Ko-nech-but, so pos-tu-pa-yut is not all! But on average, it’s just such a reaction. For example, when people are told that they have a pre-dis-pos-lo-feminine-ness to diabetes, then instead of sitting on di-e-tu with di-a-be-te and make time co-from-vet-s-t-vu-yu-schey fi-zi-ches-koy active-tiv-nos-tee , they either did not change their way of life, or, on-o-bo-mouth, even his mustache-lip-la-whether.
And you yourself could observe such a peculiar nocebo effect. For example, in the tre-on-zher-room. When people think that they have a “bad gene-no-tee”, and so-and-so, instead of putting in more effort, they, for example, ro-tiv, na-chi-na-yut try less. And, es-test-ven-but, that re-zul-ta-you decrease even more. Moreover, this belief of theirs in their own-s-t-vein-non-dos-tat-ki can have a more powerful impact on their results than you the fact of the presence of additional non-dos-tat-kov. And even if there are no fact-ti-ches-ki such non-dos-tat-kov. Because the or-ga-nism of a person who believes that he has not-dos-tat-ki, re-a-gi-ru-et on this belief is more powerful than or-ga- bottom-ma of a person, fak-ti-ches-ki them about-la-da-yu-sche-go.
The genetic nocebo effect
On December 10, 2018, in the journal Nature, it was published-whether-to-va-but research-after-before-va-tion of the influence of knowledge about the presence of mutations in genes on sensations and mountains-mo-nal- ny background che-lo-ve-ka. It was blind. That is, neither the is-py-tu-e-we, nor the research-before-you-those-whether knew the factual results of your DNA tests. But is-sled-to-va-te-whether co-general-is-py-tu-e-mym that they have a-day-with-t-vu-yut or from-day-with- t-vu-yut op-re-de-lyon mutations. In the re-zul-ta-those of which follow-di-li for the re-ac-tion of is-py-tu-e-myh. Total pro-vo-di-li 2 ex-pe-ri-men-ta. In the first is-py-tu-e-myh tes-ti-ro-va-li on a treadmill, and in the second - tes-ti-ro-va-li at the table. After that, in the first ex-pe-ri-men-te pro-si-li, evaluate the feeling of mustache, and in the second - the feeling of hunger. In addition, in the second case, there is also a mountain-mo-nal background.
Naturally, before co-generalizing the is-py-tu-e-my re-zul-ta-you of their genetic tests, they pro-ho-di-whether the first stages of the ex -pe-ri-men-tov. After that, and evaluate the feeling of mustache and hunger. And also they are for-me-rya-whether a mountain-mo-nal background. Then they from-dy-ha-li, they shared the results of DNA tests and asked to go through the ex-re-ri-men-you again. Like an eye-for-elk, people, someone-eye co-generally-whether that they have a gene-not-ti-ches-kaya pre-race-by-lo-femininity to you -shen-noy tired-la-e-mos-ti, na-chi-na-whether to get tired faster on a treadmill. Moreover, the influence of their knowledge was more powerful than the presence of a factual mutation. That is, people who simply believe that they have such a mutation, mustache-ta-wa-whether faster than people, someone else had it.
But in the second experiment, the nocebo effect was not observed in the second experiment. But the placebo effect was observed. Thus, people who somehow reported that they don’t have pre-races-by-lo-women-nos-ty to re-re-e-da-ny, on-sy- were faster than people who thought they had such a mutation. At the same time, this belief even influenced the mountainous background of is-py-tu-e-myh. That is, they are not just subject-ek-tiv-but assess-no-wa-whether their feeling of hunger, but also their or-ga-nism dey-s-t-vi-tel-but less pro-in-qi-ro -Val them want to eat. And, again, the influence of faith in the presence or from-day-with-t-vie of mutations has a greater influence than factually given -nye.
