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The nocebo effect [link]

1 Post author: Kevin 14 November 2011 12:59PM

Comments (9)

Comment author: SilasBarta 14 November 2011 10:02:56PM 1 point [-]

Bad summary.

Comment author: Jayson_Virissimo 15 November 2011 02:34:21PM 0 points [-]


Comment author: SilasBarta 15 November 2011 03:49:52PM 3 points [-]

No summary is bad summary, opposite from the rule for news.

Comment author: Kevin 16 November 2011 05:07:00PM 0 points [-]

What? One of the entire points of the discussion section as it exists is for posting links.

Comment author: SilasBarta 16 November 2011 05:41:00PM *  2 points [-]

Yes, with a summary, to avoid making people have to read the entire article to know if it's worth their time, and to validate that you understand the content well enough to endorse it.

Maybe you're just more accustomed to the Hacker News standards?

Edit: Didn't mean to imply Hacker News standards are bad, just that standard practice there seems to be just posting the link and article title, while users here have a much different expectation, which you have been informed of several times and continue to violate.

Comment author: [deleted] 15 November 2011 05:29:55PM 1 point [-]

Here's a summary:

the "nocebo effect" - the flip-side to the better-known placebo effect. While an inert sugar pill (placebo) can make you feel better, warnings of fictional side-effects (nocebo) can make you feel those too... This poses an ethical quandary: should doctors warn patients about side-effects if doing so makes them more likely to arise?

Examples given include- A man died shortly after being told he had cancer, even though autopsy showed the cancer hadn't grown, and didn't show any other reason for his death. Another example is mass psychogenic illnesses such as when 62 factory workers got very sick due to an "insect" that was never found. This spreads most rapidly to female individuals who have seen someone else suffering from the condition. Finally, telling someone that a pain-killing drug has worn off (even if it hasn't yet) is enough to return them to pre-drug levels of pain.

when volunteers feel nocebo pain, corresponding brain activity is detectable in an MRI scanner. This shows that, at the neurological level at least, these volunteers really are responding to actual, non-imaginary, pain

one of the neurochemicals responsible for converting the expectation of pain into this genuine pain perception... is called cholecystokinin and carries messages between nerve cells. When drugs are used to block cholecystokinin from functioning, patients feel no nocebo pain, despite being just as anxious...Benedetti's work on blocking cholecystokinin could pave the way for techniques that remove nocebo outcomes from medical procedures, as well as hinting at more general treatments for both pain and anxiety.

Doctors often stress possible side-effects to avoid getting sued, but lowering a patient's confidence in a treatment is counter-productive.

Comment author: [deleted] 14 November 2011 09:01:28PM *  1 point [-]

Now that we know about this effect, how can we apply it rationally to our lives? In general, it's hard/impossible to make a rational decision to internally believe something. But I can see how this can apply in things like exposure therapy.

For example, I used to teach a lot of performance fire art (lighting yourself on fire for the fun and amusement of others), and when working with new students I explicitly made sure that we started with skills that did not hurt at all (i.e. briefly lighting your jeans).

I did this due to my personal observations that a lot of the pain in these sorts of situation comes from fear. There is already a "nocebo" effect going on in that people expect being on fire to hurt, and so it does...much more than it would if the nocebo effect weren't there. By starting with things that caused just mild discomfort, and slowly working your way up, you can pretty much negate the nocebo effect.

Of course, then there is the next stage, where you are doing things that cause pain (leaving any exposed body part lit for a significant amount of time). Then there is some mind hacking type stuff going on.... You purposefully dispassionately distance yourself from your body. Believe "I know this will hurt. I am ok with that. It is just pain receptors telling my brain that my arm/tongue/whatever is on fire. I am already aware of this. I don't care." You have to have done it enough to have internalized the fact that the pain you are experiencing is greatly disproportionate to the actual damage inflicted on your body.

There's a bit more to it than that, but it's an interesting state of mind.

Comment author: Logos01 15 November 2011 05:38:15AM 0 points [-]

For example, I used to teach a lot of performance fire art (lighting yourself on fire for the fun and amusement of others),

... says the user "daenerys". Totally didn't see that coming.

By starting with things that caused just mild discomfort, and slowly working your way up, you can pretty much negate the nocebo effect.

Acclimatization can achieve very interesting results, especially with subjective responses to things such as pain and nausea, definitely. I'm not certain, however, that this would still qualify as adjusting for a 'nocebo' effect.

It seems that "nocebo" has more to do with the perception of malady or pain being resultant from an event rather than what you're describing. Something like informing someone you've injected them with a needle without actually doing so, and thereby witnessing their pain response. Or the article's example of the man whose cancer 'killed' him.

A similar phenomnon, certainly, but the same? I don't know.

Comment author: Kevin 14 November 2011 01:03:44PM 0 points [-]

If anyone can find the non-edited version, I'd appreciate it.