Think Sick, Get Sick: The Power of the 'Nocebo'
By MICHAEL WOODS
The Toledo Blade March 10, 2004

Researchers told college students to expect a headache after an experiment in which a mild electric current passed through their heads. The experiment was fake, with no electricity. Two out of 3 students got a headache.

Two groups of women in another study had about the same blood pressure, cholesterol levels, and other risk factors for a heart attack. The only difference: Women in one group believed they would get heart disease.

Over the years, women with the negative mindset were 4 times more likely to die from heart attacks than women without the bad expectations.

Volunteers sensitive to a poison ivy-like plant were blindfolded. Researchers announced that they were brushing one arm with leaves from the poisonous plant. They lied. It was a harmless material. Within minutes, however, the volunteers developed an itchy red rash.

Think sick, get sick.

Expect the worst for your health, and you may get it.

Those old ideas about being "worried sick" or even "scared to death" may be more than folklore.

Research on a new medical idea - the "nocebo effect" - suggests that negative expectations can be self-fulfilling prophecies.

Most people know about the "placebo effect."

Latin for "I will please," a placebo is a fake pill that contains no medicine. Give a placebo to a group of people who think it is medicine, and more than 25 per cent will feel better.

The nocebo is its opposite. A nocebo is a fake pill that causes bad effects. Nocebo is Latin for "I will harm." Do something that makes people expect bad effects, and some will feel bad.

Scientists have been trying to understand the placebo effect for decades. Placebo has been part of medical lingo since the late 1700s. Nocebo is a modern word, coined in the 1960s.

Since the 1990s, however, researchers have grown more aware of nocebo effects and the need to account for negative factors that might affect treatments.

In one study, more than 70 per cent of patients experienced side effects from taking a pill that contained no medicine. Is a drug side effect occurring because of what the medicine does to the body? Or does it occur because of what the size, shape, and color of the pill does to the mind?

A pill's color does count. Many people expect light blues and greens to have a calming effect, and bright reds and oranges to be stimulating.

Both nocebo and placebo effects involve more than pills. Many other factors can affect a person's medical beliefs and expectations.

A doctor, for example, can phrase bad news in positive terms, making a patient expect to beat a serious disease. Negative phrasing can have the opposite effect. One textbook advises doctors to write prescriptions with flourish to make patients believe in the medicine.

Research on the two "cebos" may reveal that a doctor's office furniture, way of dressing, talking, and giving information all have powerful drug-like effects.