There are so many aspects we could develop about the mind body connection. For example, how you can control your thoughts, or how you react to your environment and how you can influence the neurophysiology (Physical Emergency Response).

One of them is the placebo and nocebo effect. The term “placebo” is familiar to doctors and lay people and is often used as a synonym for ineffectiveness, as in the phrase “only a placebo effect”.

Definition of Placebo

The word “placebo” originates from the Latin “placere” and literally means “I will please“. According to the conventional definition, a placebo is a “false drug” with no pharmacologically active substance and is indistinguishable from the outside of a real drug. Placebo cannot in itself cause any effect. If effect there is, it can only be attributed to the action of being given the placebo, i.e. being administered by the doctor to the patient or believing strongly that you are actually taking the real drug.

 Basically, in a medical context, the Placebo or Nocebo effect is what happens when your brain takes care of a problem instead of relying on a drug or external therapy or treatment to do so (but we use the placebo effect all the time during our day in other contexts).

The placebo effect is used as a basis for comparison when we want to determine if a therapy, treatment or surgery is effective.

Patients taking placebos do not only report the desired effects, but also unwanted effects. The phenomenon which means that preparations without active substances can have ill effects which, by analogy with the placebo effect, have been attributed to the “nocebo effect” (where “nocebo” means “I will hurt”). A negative attitude, a pessimistic attitude on the part of patients, bad experiences with previous medications, negative information that the patient has received from the doctor, pharmacist and the press can all cause side effects, as can reading the leaflet and its long list of warnings.

Mechanisms of placebos

According to prevalent common theories, the main mechanisms of the placebo effect are conditioned reflexes and patient expectations. That means: conscious and unconscious phenomena are at work.

Packaged Reflexes

The definition of the conditioned reflex refers to the historical studies of Pavlov. Pavlov observed, in an experimental study with dogs, that the sight of food stimulated their gastric secretions. If the food was presented at the same time as a sound signal, after a short habituation, the sound signal alone was enough to cause the gastric secretions. Most patients have had the experience in their lives of taking medications and finding that they were improving their symptoms. Therefore, if, when they had new symptoms, they were given a medication, they assumed that it would still help them. The consequence of this attitude is that even a placebo can be effective. However, if patients notice that new medications help them less than previous ones or notice a body resistance (because of the new drug or because of an external interaction that they are not aware of), this positive attitude decreases, as does the effect of the next administration of placebo. In other words, the patient becomes “deconditioned”.

Expectations

Unlike the sequence of subconscious events involved in the conditioned reflex, the patient also has a conscious expectation when taking a medication. The doctor’s prescription, pharmacist’s instructions, comments from friends and family, and any knowledge of the patient might have that led him to the conscious assumption that an improvement will follow. The remarkable thing is the robustness of this attitude of hope. In a study using placebos, patients were told openly that they would receive a tablet without any active substance. The only additional comment allowed was to say that “it had helped a lot of people”. Despite objective information about the lack of active ingredient, this positive observation allowed placebo to be effective in 13 of 14 patients and reduced their subjective symptoms by 41%. The influence of expectations on therapeutic effects is very clear when medicines or placebos are studied in an “open-hidden paradigm”, that is, with or without patients being aware of their administration.

Additional Factors

Different factors can modulate a placebo effect. For example, it has been shown that the color, size or shape of oral medicinal products may have an effect. Red, yellow and orange cause a soothing effect. Price also has an influence: expensive medicines work better than cheap ones. This phenomenon can be demonstrated well beyond the example of placebo, in other situations of consumption. In a published study, subjects were offered several wines whose only information given was their prices. In a blind tasting, the same wine did better when it was reported as more expensive. Other factors in the administration of a placebo are associated with the influence of the doctor on the attitude of the patient towards his disease. These can collectively refer to the “context effect“. This includes the physician’s objective medical information, his personal charisma and the atmosphere in which the treatment takes place. A study of 262 patients with irritable bowel syndrome was performed as follows: the first group (I) was only examined, the second group (II) received simulated acupuncture (and therefore false) and the third group (III) ) a simulated acupuncture combined with an empathetic and confidential interview. In group II the symptoms improved significantly compared to group I, and in group III the improvement was greater than in group II, with still a significant difference between groups II and III.

Definition of Nocebo

Much less research has been done on the nocebo effect. The reason given is that it is ethically unjustified to cause disease in healthy people using the nocebo effect. The nocebo effect, as well as the placebo effect, often rests on a conscious attitude of hope or expectation. Both the mental anticipation of a future event and the force of expectation influence the extent of the nocebo response. A patient who is afraid that particular external influences make him ill can develop symptoms (see the article “The backfire effect” on this same blog with the example of the Chinese people). The placebo effect … and noceboThe common term used for this phenomenon is “self-realized prediction“. Non-specific side effects that could be explained by the nocebo phenomenon are often vague and light complaints such as nausea, fatigue, insomnia and stomach pain, or other symptoms underlying the illness itself (pain). With the nocebo effect, too, conditioned reflexes play a role. In a person with psychosomatic stomach aches for example, the hormone cholecystokinin causes a pain reaction in the brain. This is a conditioning, caused by a messenger substance that triggers fear, triggers the side effects expected when taking the drug.

You have plethora of literature regarding placebos but in this site, you can refer to the article posted in this blog February 19, 2017 “The backfire effect” to read and you can go as well on this link.

The Lightning Process, among the tools that it proposes, will help you to fight back unwanted nocebo effects. The structure of the mental exercise offers a strong and secure way to counteract the improper use of your brain and will allow you to re-wire your brain with positive and powerful conditioned reflexes, life enhancing expectations and specific, customized factors.