Dr David Hamilton Home Page

The Nocebo Effect
(www.drdavidhamilton.com)

I have always believed that it is ‘nice to be nice’. Recent research into the nocebo effect, which is the opposite of the placebo effect, has shown that saying negative things to people with regards to their illness can have a negative effect on their health.

It is well known that a positive suggestion to someone can have important biochemical effects in their body...that’s the placebo effect.....but a negative suggestion can have the opposite effect. Recent research published in the Journal of Neuroscience (F. Benedetti et al, J. Neuroscience 2006 , 26(46), 12014-22) looked at the experience of pain when a person received a negative suggestion.

It caused an intensification of pain by activating a peptide hormone called CCK (cholecystokinin). This activation was caused by anxiety. Negative suggestions can cause anxiety because they can make a person focus on the pain or illness, or to believe that they are more sick, or if the patient is secretly determined to get better they will internally resist what they hear. Positive suggestions, on the other hand, have been shown in other studies to reduce the pain and cure or reduce the symptoms of a whole host of illnesses.

Thus, it suggests that we should try to be positive around our friends and family members when they are sick, giving them positive suggestions. This lessens anxiety around their condition. There is also the belief that we need to be real too; that giving hope where there’s apparently none might cause more harm. But that’s a judgement each of us need to make, to find a balance, and this will depend upon the severity of the illness and the personality of the person who’s sick or in pain.

But in general, when things aren’t quite so serious, which is most health and life situations for most people, it is important to be positive and supportive, not only with regards to people’s health but also in their life goals. Just as a placebo effect can cause someone to recover when you give them a positive suggestion, so the same occurs in life as people pursue their goals. A positive suggestion can help them to believe in themselves more and help them achieve. A negative suggestion can hold them back, stripping them of their faith and internal motivation.

As an ex-athletics coach for a top UK club I saw this type of thing first hand. Helping athletes to believe in themselves was by far the most efficient way of helping them to achieve their goals. Of course, some athletes, just as some people in daily life, do respond better to criticism and we should try to recognise who this is appropriate for, but the majority of people work and perform better when you help them to believe that their hopes and dreams are possible.