Nocebo

Most people are familiar with the concept of a placebo. The word comes from Latin and means “I shall please.” We most frequently hear it used in medical terms. It can be a substance or a treatment that has no known therapeutic value. Common placebos include inert tablets (like sugar pills), and inert injections (like saline).

Sigmund Freud conjectured that since some placebos had a positive effect on what was considered a physical problem, the problem must really be in the mind. In his version of talk therapy providing positive information can improve the perception of well-being.

I have been fascinated with this concept ever since I heard about it in a high school course. But it was only recently that I heard the word nocebo. This is when negative data makes someone feel worse about their own health. Nocebo is Latin for “I shall harm.”

I heard nocebo used in the context of the negative effect that my wearing a fitness tracker on my wrist might have on me. I wear it to track my activities (steps, miles, exercise times). It also monitors my heart rate and my sleep. The device has a positive effect on me when it vibrates to tell me I have hit my steps goal for the day. But what is the effect on me when I spend all day working on the code for a website and discover at dinnertime that I have only taken 1200 steps all day and I have only been active for one of my waking hours? Nocebo effect.

“Placebo” was used in a medicinal context in the late 18th century to describe a “commonplace method or medicine.” In 1811, it was defined as “any medicine adapted more to please than to benefit the patient”.

In the 20th century, studies on the “placebo effect” showed that there could be a positive effect and that it could also have no effect. Inconclusive. However, placebo-controlled studies were used and are still used to evaluate new treatments. Clinical trials control for this effect by including a group of subjects that receives a “sham” treatment. Subjects in such trials don’t know if they received the treatment or a placebo.

I think it is interesting that if a person is given a placebo under one name, and they respond well, they will respond in the same way on a later occasion to that placebo under that name – but not if it is given with another name. Clinical trials are often double-blinded so the researchers also do not know which test subjects are receiving the active or placebo treatment.

I’m no medical authority so I must be careful what I suggest here, but I would think that when someone finds relief from a scientifically questionable treatment (copper bracelets for arthritis, some herbal products, etc.) that relief might be a placebo effect.

What was new to me (and perhaps to you) is the nocebo effect. It seems to apply to more than my fitness watch. What about social media “likes” and reposts and hit counters on your blog or website? They can all have a positive effect on you when you get them, but what about when you don’t get them? I think we might all need to be more conscious of any nocebo effects in out daily lives.

Effects That May Affect You

brainI don’t know why lately I have been coming across a lot of articles about some, mostly psychological, effect on us and our behavior. It must be the places I’m reading online.

Last week, I wrote about the “Barnum effect,” and another article about how being presented with facts doesn’t change our beliefs.

This week I read about the illusory truth effect which says that the amount of times you hear something (frequency) will influence your likelihood to believe it as true.

Experiments are done where subjects are told a series of true and false statements. They are reminded of some of those statements multiple times over a two-week period. At the end, it is found that the statements they were reminded of the most are the ones the subjects are most likely to remember, and they are more likely to mark the statements they were familiar with as true and the ones they were unfamiliar with as false. What does this say about the news we hear over and over? True or false, the frequency of that news not only makes you remember things, but it tends to make you believe those things. “If you say it (or hear it) enough times, you start to believe it.” This can explain why many self-help programs include a kind of mantra of positive messages.

I’m getting older and I’m very, very aware of when my memory seems to be failing me. (At least, my memory of what my memory once was!)  Why do I remember some things and other things are quickly forgotten?  It could be due to the primacy effect.

I read about that effect this past week too, although I used to teach this idea is my writing courses. If a reader is given an essay or article that is five pages long, what parts is she most likely to remember – the beginning, middle or end? That would be important to know as a writer. Where do you put the most important information – and where do you bury the weakest?

The primacy effect (remembering the beginning facts) and recency effect (remembering the last facts) just seems to be the way our brain works. The primacy effect holds that beginning information is more likely to be stored in the long-term memory.

An easy test is trying to memorize a long list, like a shopping list. Chances are excellent that you will remember the first few items (primacy). You will have a good chance of remembering some of the last items (recency). But the items in the middle of the list will likely be lost.

When it comes to studying for an exam, information first read and studied will be stored faster and better remembered.

Knowing about the primacy effect should help you remember things. That’s a good thing, right? Probably, but not necessarily.

It can be a bad thing when it comes to first impressions. If you meet someone, or got to a place or try something for the first time and the first impression is negative, that will stay with you.  I just had someone tell me this past week that the first time in their life they ever ate shrimp they got violently ill. “I’ve never eaten shrimp again,” he said.

What kind of first impressions have you made on others? The primacy effect works both ways and explains why first impressions have lasting impact. The effect is also tied into our emotions. The term “emotional distortion” is used to
describe how a first emotion (happiness or anger) can have primacy and distort those emotions that follow.

In the film business, they say “You’re only as good as your last movie.” That seems to be the recency effect.