Nocebo

There is an equal and opposite version of that.

It's called the nocebo effect, and far fewer women have ever heard of it.

Nocebo is when a negative expectation produces a real negative physical result.

Same mechanism, just flipped.

In research where people are given something that can't actually harm them, but they are warned it might cause side effects, they go on to report those exact same side effects.

So how does your brain manage to do this? And how do you keep it from happening to you? Helen Pilcher is a science writer and former scientist with a PhD in neuroscience from London's Institute of Psychiatry.

And she has some fascinating and frankly unsettling examples of just how powerful the nocebo effect can be.

She's author of a book called This Book May Cause Side Effects, The Curious and Dangerous Power of the Nocebo Effect, Placebo's Evil Twin.

Hi, Helen.

Welcome to Something You Should Know.

I mean, how many times have you gotten a vaccine or a, some sort of medication and heard about other people getting sick from it, s- side effects and all, and, and, and then you got sick from it? Well, was it really the medication or the expectation that you were gonna get sick, so you got sick? This has been very eye-opening.

I've been talking to Helen Pilcher.

She is a science writer and author of the book This Book May Cause Side Effects: The Curious and Dangerous Power of the Nocebo Effect, Placebo's Evil Twin, and there's a link to her book in the show notes.

Then the occultist Blavatsky on the will as a projectile, Besant and Ledbetter on thought that travels and bounces, and Dion Fortune, who wrote the standard Western manual on defending yourself and spent most of it talking people out of the diagnosis.

Finally, the laboratory Nocebo research, the neuroscience of being looked at, and a 2010 paper out of a Dutch psychology department titled, in those words, warding off the evil eye.

Some of this is personal.

I carry a Greek eye.

The effect has a name.

Placebo describes benefit produced by expectation.

Nocebo describes harm produced by expectation and the research on it has become precise.

Fabrizio Benedetti's group at the University of Turin published a key study in the Journal of Neuroscience in 2006.

Dr. Shelley Adler wrote a book that connects seeing shadow people to sleep paralysis.

In Sleep Paralysis, Nightmares, Nocebos, and the Mind-Body Connection, she explains that people who suffer from sleep paralysis may perceive a shadowy or indistinct shape approaching or standing over them during an episode.

This suggests that these visions might not be supernatural but could be perceptions within the brain.

Neuroscientists Balint Jalal and V.S. Ramachandran also believe these hallucinations might have neurological explanations.

Is it nocebo? Yeah, so

placebo is where something makes you feel better.

Nocebo is where it makes you feel worse.

And the thing is, I think with...

So first of all, let's just be clear that placebo effects are real.

I understand the really tight schedule.

So the kind of last question then to follow on from that with the Nacebo effect, does that kind of then lead into a possible selection bias of who feels they do or don't have it? And then when you actually lead into studies around this as well?

So, I mean, I think there's definitely an element looking at these criteria that if you think that you may have this pathology, right? I think it's easy to look at these criteria given sort of the nonspecific nature of the clinical features and put yourself into a bucket.

And I think that's why it's important to try to encourage folks, don't do self-diagnosis.

The second word is less familiar, and it's one I really want you to know.

Nocebo.

It's placebo's shadow.

The nocebo effect is when a negative expectation creates a negative outcome.