Placebo or nocebo effect? Be careful what you wish for

It is well known that we can think ourselves well. In medicine we call it the placebo effect, meaning the “pleasing effect” in latin. But we can also think ourselves ill. This is called the nocebo effect, meaning the “harming effect.” Both of these are commonplace. They are both powerful. But recent research suggests that the nocebo effect of thinking negatively is more powerful than the placebo effect.⁽¹⁾ If you believe that something is going to hurt, it will hurt a lot more than if you did not expect pain. This has profound implications if you have been used to chronic stiffness or pain. It can allow you to get trapped in a cycle of literally thinking yourself into a cycle of pain and illness.

The biggest systematic review of medical treatments, conducted by Oxford University in the UK concluded that “In trials with continuous outcomes (n = 115) we found no difference between treatment and placebo effects.”⁽²⁾  Included in those trials were pain, anxiety, depression, and insomnia. Yes, medical treatments for these conditions are not statistically better than a pill of sugar. So does that mean that it’s “all in your head”? Does that mean that you are lying, cheating, deluded, or insane? Not at all, for many conditions which can be measured objectively also get better when you take a placebo. For example, placebo is as effective as the most common knee surgery, called knee arthroscopy.⁽³⁾

Placebo effect is Not a Failure

Placebo has long been proven to be as or more effective than MANY prescription medications, but without the side effects. WITHOUT THE DANGEROUS SIDE EFFECTS! The fact that there is so little effort from the medical community to actually research how the placebo effect works shows just how committed they are to the use of surgery, or chemicals manufactured in pharmaceutical factories.

A Harvard commentary states that “For years, a placebo effect was considered a sign of failure.”⁽⁴⁾ Surely, if it is as effective as most medical interventions, it should be considered a sign of resounding success? What toxic culture could overlook this effect and avoid researching it, even turning it into an industry joke?

The Future of Humanity Institute from the University of Oxford observed that much of the $600 billion dollars spent on medical research annually could be better spent elsewhere.⁽⁵⁾ While 1 in every 4 people on planet earth do not have access to clean drinking water, let alone cheap solutions like bed nets to prevent mosquito bites, billions of dollars are poured into fanciful drug trials with relatively little impact on world health. 

Wasting Money to Make Profits

We have reached the point that Global “health” expenditure is 9 trillion dollars, or 11% of global GDP. If placebo has been proven time after time to be similarly effective as many medical treatments, then why is the “research” of placebo left to just a group of alternative practitioners and psychologists? Could it be that researching a free, hugely effective treatment… that is the power of thought, might bite a hole in that 9 trillion dollar “Profit Pie?”

Why not stop all of those medical procedures which produce no benefit over placebo. And reallocate that money into providing clean water to the world. Then the mis-spent research budget could be spent on teaching people how to live healthily and making a conscious choice not to be ill. On learning how to become resilient and happy. On how to use the placebo effect. More health. More happiness. No side effects.

We should be researching how to use our minds to improve our bodies. Dr Dispenza’s work focusses on this.⁽⁶⁾

Harnessing Positive Healing Thoughts

You can see your health beliefs as having a mathematical relationship with your actual health. The worst of the nocebo beliefs are divisive. These divide your body into individual parts which you can blame and hate. If you believe that it is just your low back which stands between you and a round of golf, then this is quite a natural response. You might think “my bloody low back,” as if it was an enemy in your life. Drugging it or cutting it open seem appropriate responses. We also have subtracting beliefs, like “my brother and father always have back pain, so this is just normal for men in my family.” Research shows that this nocebo thought will cause more pain in your low back, even if the injury is only minor. 

On the placebo side, you can add health by being pragmatic and acknowledging that your current health (or lack thereof) is the sum of your prior health habits and history. This lets you take control of your future health. By improving your health choices today, you can add more health and happiness into your future. Pretty obvious. “I can rebuild my spinal health by getting adjusted often, improving posture, and stretching daily.” This works well, but better still is the multiplier effect.

The multiplier effect

To multiply your health involves adopting a real “we can do it” attitude, where you confidently believe that your body, in partnership, has an amazing ability to heal from even serious illness or injury. You are one with your body, this amazing partner, on the same team. This deep trust is hard to come by. Most of us grew up in a medicalised culture, taught that health is something which we lose by bad luck and can only get back from someone in a white coat. Understanding and believing deeply that your body is an amazing healing organism takes work and patience. When we realise and truly believe this, we start to focus on removing interference, and letting our body do the magic. The rewards can be true resilience and happiness.    

Be Careful What You Wish For

Every person who I adjust is changed. Yes, every single one. We can measure this objectively, as your nervous system and posture changes. That does not mean that everyone feels instantly better, but the adjustment always makes a change. For most people this means that pains go away, your body relaxes, and you start to heal. Chiropractic opens the capacity to heal in every body. What you do with that capacity is up to you. 

Chiropractic frees the ability to heal in every body, every adjustment frees your chain.

There are people who choose to be positive, and become a better version of themselves. There are others who choose to focus on the one small thing which has not changed. For example, instead of saying “I can sleep better, I can reach my shoes to get dressed, I can return to sport, and I have stopped shouting at my wife and kids, I know I am healing, and will be strong and happy” someone might choose to say “I still have pain in my buttocks when I drive my car over an hour, my father had back problems, this will never change.” Both statements may be valid, but one encourages more HEALING, while the other encourages more PAIN and SUFFERING. One is placebo-enhancing, and the other is nocebo-enhancing.  

Our health thoughts are mostly polarised. Either I am broken or I am healing. I am a set of parts, or I am whole. And they are repetitive. If we think it once, we think it many times. And they are like wishes. 

Placebo or Nocebo? Be careful what you wish for. 

References

1. Horsfall L. (2016). The Nocebo Effect. SAAD digest, 32, 55–57. 
2. Howick, J., et al. (2013). Are treatments more effective than placebos? A systematic review and meta-analysis. PloS one, 8(5)
3. Moseley, J.B, et al. (2002) A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. New England Journal of Medicine 2002; 347:81-88
4. Harvard Health Publishing (December 13, 2021) The power of the placebo effect, Online publication
5. Dalton, M (December 8, 2014) How valuable is medical research. Future of Humanity Institute, University of Oxford. Online publication 
6. “You Are the Placebo: Making Your Mind Matter” by Dr. Joe Dispenza.