18 02, 2015

Do You Get What You Expect?

What comes to mind when you think of the dentist’s office? Do you picture a neutral colored waiting room with months old magazines sitting on a table? Can you hear the drill making contact with a tooth? Do you see the needle?   Whatever you imagine you’re probably not looking forward to your next visit. Why? There may be a multitude of reasons but one of the biggest drivers is most likely pain – either real or imagined. A study into the relationship between pain and the placebo effect used the dentist’s office as a testing ground. The findings provide further [...]

11 12, 2014

There Was Nothing magical about the Band-Aid. Or Was There?

I’m sure all of us cut ourselves at some point during our childhood and the first thing we did was to rush directly to our mothers for help. She may have addressed this seemingly devastating trauma at the time with all of her attention, a small detailed examination followed by soap and water, some calm reassuring words, a warm embrace, and then a Band-Aid. At that moment, the pain very likely went away…and you ‘felt’ better. What you experienced was likely your first conscious experience of the placebo response. Here is why. The moment you correlated a change in your [...]

21 11, 2014

The Nocebo Response

A few years ago a woman we’ll call Mrs. S went to the hospital for some routine tests. Mrs. S. had a heart valve condition called tricuspid stenosis. She also suffered from a milder form of congestive heart failure. Neither condition was considered life threatening. The treating physician, Dr. Bernard Lown, examined Mrs. S. and found nothing out of the ordinary. Later, another doctor accompanied by a host of residents doing routine medical rounds with final year students and interns, examined Mrs. S. At the end of the visit this same doctor announced in front of everyone – including Mrs. S. – that the patient had TS. Medically speaking, TS is an abbreviation for tricuspid stenosis – but Mrs. S. really believed that it stood for “terminal situation.” Soon after the second doctor’s declaration, Mrs. S. developed symptoms that mirrored a more advanced form of congestive heart failure. It was as if she accepted, believed, and surrendered to the idea without any analysis that she was dying. Dr. Lown tried to explain the mix up but Mrs. S. wouldn’t listen. It was impossible for Mrs. S to hear anything else. Within hours, she got progressively sicker and died later that same day. The story of Mrs. S. actually happened and is a good example of the nocebo response. Nocebo (“I shall harm”) is the idea that negative thoughts, feelings and emotions can produce negative outcomes. Mrs. S. was a reasonably healthy person. There was no evidence of any fundamental change in her heart condition and yet she still died. What happened? Is it possible that Mrs. S. created the conditions she ultimately died from just by thought alone? […]