nocebo

Nocebo - Modern Voodoo and how we fall for it en masse


Expectation as a self-fulfilling prophecy

In 2007, American Derek Adams had a proper fight with his girlfriend. The relationship seemed to have gone to pieces. 

As a result, the Adams swallows the entire contents of a month's worth of antidepressants - 29 pills at a time.

A short time later, the neighbor took a shaking Adams to the nearest hospital, where dangerously low blood pressure and dizziness were detected. The blood test revealed: no toxins detectable. Although the patient received 6 liters of IV over the next 4 hours, Adams' condition continued to deteriorate. 

A physician was then consulted who was in charge of a drug trial in which Adams had participated a month earlier. This doctor informed the patient that he was in the placebo group of the study, i.e. he had only received tablets without active ingredients.

Within 15 minutes, the blood pressure and heart rate then normalized, and the patient could be discharged soon after. 

nocebo
The placebo effect is well known, but the nocebo variant is at least as important.

The case is a classic example of the nocebo effect. This was first defined in 1961, when it was discovered that the placebo effect also works in the other direction. That is, that an imagined drug or an imagined external danger can cause extremely real effects - and negative ones at that.

It is only in the last two decades that the nocebo effect has been increasingly researched. The problem here is that it is hardly ethically justifiable to subject healthy persons to a pathogenic effect. 

Nevertheless, we know that about 25% of all subjects in a drug test develop the symptoms described under side effects. These subjects are from the placebo group, i.e. they have not received any active substance.

The expectation alone triggered the symptoms. 

Clifton Meador was a physician at Vanderbilt School of Medicine in Nashville, Tennessee, who documented nocebo cases. He says:

"Bad news promotes bad physiology - Bad news promotes an ailing organism".

DR. Clifton Meador, Nocebo Specialist

Hardly anyone from the Western world would be impressed by a voodoo spell. But how about a person who writes titles like doctor or professor in front of his name, wears a white coat and points to a pile of laboratory findings on which his devastating prognoses are based, which will determine your life from now on?

Even those who are "important" cannot escape this kind of modern voodoo: more and more leaders from business and politics are dutifully undergoing so-called "check-ups". The idea: healthy people are examined in order to detect illnesses at an early stage. The crux of the matter: diseases are seldom discovered, but so-called "deviations from the norm" often are. And precisely these turn healthy people into insecure patients.


"It's not acute, but it's something we should watch" is a phrase heard by many people who came in for a so-called checkup in perfect health and go home as patients.

The Deutsche Apotheker Zeitung addresses this topic under the title "Nocebo - If you believe it, you get sick:" in detail.

Nocebo: Attention risk of infection!

That the Nocebo effect but even contagious can be, was determined by the following Try shown:
A group of students was asked to breathe room air that was supposed to contain toxins. The participants were informed in advance about the symptoms that might occur as a result. Some of the test persons then watched a colleague develop exactly the symptoms that had been mentioned before, e.g. headaches and nausea. In reality, however, it was completely normal air and an actress who acted out the symptoms. The observers of the scene - also exposed only to normal air - then developed to a large extent the same symptoms, and significantly more often and more strongly, than the group that had not observed the play. 

Hans Mohl moderierte von 1964 bis 2004 die Fernsehsendung „Gesundheitsmagazin Praxis“ im ZDF. Jeweils am Tag nach der Sendung wurden viele Arztpraxen regelrecht gestürmt von Menschen, die bei sich jene Symptome aus Mohls aktueller Sendung entdeckt hatten und entsprechend besorgt waren.
The phenomenon was given the name "Mohl's disease," and to this day it serves as an example of the impact that media coverage has on the public's perception of itself.

There are some publications that deal with the phenomenon in detail, such as "Diagnosis of Mohl's disease - a diagnosis of the disease". How TV doctors fill their colleagues' practices". Or: Do the media make you sick?

Here is another example of a "contagious" nocebo effect. In September 2018 - before Corona - Emirates flight 203 takes off from Dubai bound for New York. Over the course of the 14-hour flight, 99 of 427 economy class passengers plus 7 crew members fall ill with flu-like symptoms, diarrhea and fever. Upon arrival, the plane is quarantined and all passengers are examined individually. It turned out that only 10 people really needed treatment, 7 of them crew members! However, if they had been sick at the time of departure, they would hardly have reported for work. On the other hand, contagion and outbreak of flu is impossible even considering the shortest possible incubation periods.

A classic Nocebo effect, vermutlich verstärkt durch das „eingesperrt Sein“ in einem Flugzeug. Können Sie sich vorstellen, was wochenlange Lockdowns in diesem Zusammenhang anrichten?

Areas where outbreaks of baseless mass hysteria are repeatedly observed are the Middle East and also Central America. The science magazine Newscientist reports about an outbreak of mass hysteria in Nicaragua in 2003, in the course of which rows of young women were afflicted by respiratory distress and even suffocation symptoms. The article concludes with the question: "Is there a solution?

Response: the public should be encouraged to adopt a fear-free attitude, while at the same time minimizing media attention to this issue."

Nocebo & Corona

In this context, it cannot fail to consider the nocebo effect in the corona crisis. Mind you, this is not about the evaluation of corona as a disease, but only about the effects that must inevitably take place through the associated media coverage.

Indeed, if one considers the usual rate of 25% of people who "fear themselves sick" through appropriate mass suggestion, this alone could overwhelm the health care system.

Gerald Hagler (im Buch How healing still succeeds)

Die entsprechenden Hinweise und Warnungen von Psychologen, Soziologen, Hirnforschern, Psycho-Neuroimmunologen etc. werden jedoch bestenfalls ignoriert, oft sogar gelöscht.

In a Interview panic researcher Prof. Dirk Helbig is asked, "How do you counter hysteria?"

His answer: "Through education. And by not looking at a problem from which the world will not end under a magnifying glass and thus making it seem much bigger than it is. Other mortality risks are much greater. In a way, the Corona crisis is a maturity test for our modern society and all of us."

Weitere Artikel von Gerald Hagler