Have you ever heard of the placebo effect? Well, the nocebo effect is the exact opposite, and unfortunately, it’s much more prevalent in our lives. If we believe we’re hurting or sick, we’re much more likely to stay in this paralyzed-like state. What’s worse is that the majority of us are unaware of this effect, even including the likes of doctors and physical therapists.
The nocebo effect: A negative expectation of a phenomenon causing it to have a more negative effect than it otherwise would.
To give a brief example of nocebo, let’s look at a study. Volunteers were told that a mild electrical current would be passed through their heads and might cause a headache. No electrical current was actually passed, but two-thirds of participants still developed a headache. This is just one example of many, but it illustrates just how potent your brain is in governing your health. When we begin ‘pain catastrophizing’, it can quickly turn into a self-fulfilling prophecy.
Although we’ve let the nocebo effect have too much power in the past, we have the ability to attenuate the signal. Building awareness around this phenomenon can be just as powerful as the ‘pill’ itself. When you realize that you can train your thoughts to expedite healing, there is great freedom. Better yet, there are practical steps you can take right now to work towards this state.
The pill may be inactive, but the side effects are real. Has the nocebo effect taken a grip on your health and recovery?
How To Use Your Thoughts To Promote Healing
While the journey to reversing negative psychology will be different for every individual, I’m confident that there is something here for everyone. Whether you suffer from headaches or chronic back pain, you can access your thoughts and emotions to work for and not against you. To help kickstart this process, here are 3 practical tips to overcoming the nocebo effect.
Before we get started, be aware that I’m not a professional in the psychology field. I’m certainly not claiming that I know the depths and intricacies of this complex phenomenon. I’m also aware that there are populations diagnosed with depression, anxiety, etc… that can complicate recovery and management of the nocebo effect. Those groups are outside of my scope of practice.
What I can offer, however, is a ton of first-hand experience in the health care world. Not only have these tips transformed my client’s recoveries, but I’ve had personal success utilizing them as well. At the end of the day, the overarching theme is really quite simple…
Mental states such as beliefs, expectations, and anticipations can strongly influence the outcome of pain experience. Fortunately, you have the power to change your destiny (to some degree) simply by promoting healthy thoughts.
When we begin pain catastrophizing it can quickly turn into a self-fulfilling prophecy…but it doesn’t have to be this way.
3 Tips To Counteract The Nocebo Effect
As a quick note, I’m a kinesiologist so this will be focused on recovery from musculoskeletal injuries (strains, sprains, aches, etc…). While the effects of nocebo go far beyond these bounds, this is the area in which I have the most experience so we will park here.
#1 — Don’t obsess over images or diagnoses. When we hear a diagnosis, we tend to hang on to it for dear life. While I’m not saying you shouldn’t trust your provider, you also mustn’t assume every word they’re saying is absolute. For example, receiving a diagnosis of a ‘bulging disc’ may have nothing to do with the back pain you’re experiencing, but it will certainly further your pain if you believe it is.
Whether you’re receiving news about a slipped disc or a broken leg, never get too overwhelmed. As ugly as your images or results may seem, you’re still in control of your thoughts. You can let this dreadful new label lead to a spiral of fear, shame, and avoidance behavior, or you can remind yourself of the beautiful, robust, self-healing bodies that we occupy. Yes, this is easier said than done, but it’s absolutely possible.
#2 — Monitor the conversations you have with yourself. The bigger battles arrive when you come home from the clinic or hospital. Physical injuries undoubtedly affect your emotional and mental well-being. This is not about being in denial about your current situation, but simply reeling in your thoughts when they get away from you.
How is this done? Be curious. Next time you experience a trigger (stress, overwhelm, negative self-talk), take a moment and just be inquisitive. Why are you feeling this way? What’s really going on? More often than not, this pause will be enough to alter the trajectory of your negative thoughts and spur on the adaption of new and improved behaviors. You begin to realize that there is hope. You can recover. You are in control. This simple act of curiosity will work wonders to improve your recovery outcomes and keep you level-headed.
#3 — Take action. When we get injured, our first response can be to rest and sit around. Perhaps you’ve had back pain and tried to shake it off by spending the day in bed. Unfortunately, we now know that sedentary behavior will only make your condition worse. While this may be appropriate in very specific circumstances, the majority of acute injuries will be far better improved through you taking action. As soon as it’s possible, you need to be thinking about a return to activities that will promote strengthening at the injured site.
My best advice is to participate in strength and mobility training as soon as you can. The combination of moving through a pain-free range of motion and exposing the body to weight-bearing stimuli will be more effective than nearly every medication. If you’re new to the gym or are hesitant about exercise, please seek out a health professional. They’ll be able to assess your situation and prescribe appropriate exercises to expedite your healing and get you feeling like yourself again.
It may seem counterintuitive, but exercise is the best medicine for nearly every musculoskeletal injury
As much as we need to respect the prevalence of the nocebo effect, we must also work tirelessly to re-write the script of health care. There is a large population of patients who are suffering more than they have to, and they don’t even know it. If you’re a health care provider, please chose your words wisely. Don’t focus on negative imaging and diagnoses, but rather promote self-governance and hope for your patients.
For the rest of us, simply be in-tuned with the dialogue you’re having with yourself. Push fear to the side and take hold of your healing through active rehabilitation. Don’t stop there, however. It’s time we spread awareness in our communities for just how transformative thoughts can be in the journey to recovery and pain management. The nocebo effect only has power if we let it, and it’s never too late to turn this ship around.
Focus on what you can control, it’s often far more than you think.