What Does the Placebo and Nocebo Effect Have to Do With Autoimmunity?

If you have read my article entitled: “Why should I optimise my mindset if I have an autoimmune disease?”, you already know that disruptive emotions, if they persist for long enough, can disturb the delicate chemical balance in our bodies producing physiological changes and symptoms. You also know that we CAN counteract the effects of the negative emotional states if we develop a nurturing, positive mindset.

Belief becomes biology

Just to follow up on that, at the end of 19th century an American psychologist William James said: “No mental modification ever occurs, which is not accompanied or followed by a bodily change”. Later on Norman Cousins summarised this statement with three words: “belief becomes biology”. What they both meant was that the body’s physical reality can be altered by the more powerful reality of the mind, i.e. what is expected tends to be realised.

So if you have an autoimmune disorder, you should be asking yourself: “what am I currently believing about this condition, myself, my life, my relationships, etc. that is stopping me from reversing it?” This is particularly important if you have had the condition for while, you have changed your diet, dealt with toxicity, healed your gut, and yet you still have it. Why? What else is going on?

And before you say: "it is my genetics", you must know that you are definitely NOT your genes! I am not going to give you endless examples of epigenetic studies that tell us about how we change are genetic expression every single day. This article would be ridiculously long if I did. If you want the background research on this, there many great books you can refer to, including “Molecules of Emotion, ““The Psychobiology of Mind-body Healing”, and the amazing “The Biology of Belief” (check references below).

The bottom line is that if optimise our mindset for healing and get all the dietary and environmental factors right, we have an incredible level of control over our health that makes the relatively small genetic component much less significant. I do realise that certain autoimmune conditions have a greater genetic contribution than others but my point still stands.

The power of placebo

Expectation of symptom improvement is what the placebo effect is all about. As you probably know, placebo trials provide information whether a tested drug has any effect beyond that occurring when people take the actual drug.  It is patients’ BELIEF in a chemically inactive medicine that activates their body’s healing potential.

There are endless examples in medical literature of the high effectiveness of placebo compared to actual drugs, and even surgical procedures. Back in the 1950′s a sham surgery was used for patients with angina pectoris (recurrent pain due to decreased blood flow to the heart). Rather interestingly, the patients who received a sham surgery reported as much improvement in their symptoms as the patients who had the actual surgical procedure. Similarly, in the case of a sham therapy for back pain, an improvement of 40% was reported by the placebo group.

Other conditions and areas, in which placebo treatments had a high rate of activity include: analgesia (pain relief), insomnia, diabetes, anxiety, high cholesterol, cough, asthma, sarcoma, dermatitis, headaches, rheumatoid arthritis, radiation sickness, Multiple Sclerosis and Parkinson’s. But perhaps the most striking is the report published by Professor Irving Kirsch in the American Psychological Association’s Prevention & Treatment (2002) stating that a whopping 80% of the effect of antidepressants, as measured in clinical trials, could be attributed to the placebo effect!

Placebo effect is a growing area of research, with imaging studies continually contributing to our understanding of the mechanisms of this phenomenon in various medical conditions. The interesting thing is that even people’s expectations about the effects of drinking can be more powerful in terms of predicting behaviour than the actual impact of alcohol. In other words, drinking a placebo can produce all the physiological effects associated with drinking alcohol provided that the expectation is present. The same has been observed with drugs, such as LSD.

Placebo’s evil twin: the nocebo effect

Nocebo is nothing else but the mirror-phenomenon to the placebo effect. This occurs when the expectation of a negative outcome produces the corresponding symptom or makes the symptom worse. In one study evaluating the effects of a new form of chemotherapy, 30% of people in the placebo group lost their hair, as they had an expectation that hair loss would occur.

Another interesting example is obtaining informed consent from patients before administering treatment. Obtaining informed consent means disclosure of information regarding potential complications or side effects of a treatment. If handled badly, this may trigger a nocebo effect. In other words, patients’ awareness of the potential side effects may create an expectation, which in turn may produce the corresponding symptoms.

Another issue that is frequently overlooked is the way in which patients are given diagnoses and how that impacts their ability to overcome illness. Unfortunately, some medical professionals still demonstrate a complete lack of awareness of just how much power they hold over their patients’ well-being. Depending on how that information is communicated, it can either empower the person and make them believe they can overcome their illness, or it can take away all their hope and consequently make them give in to the illness.

So what does the placebo effect mean for you?

Just pause and think about it for a moment. Isn’t it just incredible? Our neurology is so powerful that a simple belief can produce a healing effect but if that belief is negative it can make us worse. Think about your situation. How were you told that you had an autoimmune disease? Was it presented as: “you have this condition but you can reverse it with the right approach”, or ”unfortunately, this is not treatable so you have to live with it (there is nothing anybody can do)”. Think about how that affected your belief about the condition, about your ability to overcome it, and whether you felt empowered or victimised. Maybe you discovered that you had an autoimmune disorder on your own whilst researching your symptoms on the internet. The same applies. How did you feel reading the information? Positive or defeated?

Irrespective of what others believe or present us with, it is vitally important that we take responsibility for influencing our own health in the way that we want to. Sending the right messages to our subconscious mind regarding how we feel about ourselves, our lives, our health, and our potential for healing our bodies is the first step to take.

Remember that our subconscious mind controls and regulates the involuntary functions of the body (e.g. digestion, circulation, breathing, cell renewal, etc.). If we do not take control and “program” our minds, other people will do it for us. Only then, the chances are it will not be to our liking. So we have to make sure we “program” our minds for healing. The truth is that the most powerful resource we all have is our mind so why not use it to our advantage?

The best mind tools I can personally recommend

There are a number of tools we can use to optimise our mind for healing. You may want to try meditation, hypnosis, relaxation, Mindfulness, visualisations, or whatever other mind-expanding techniques you think may work for you. Some other great approaches include: BrainWorking Recursive Therapy®, Havening TechniquesTM (Amygdala Depotentiation Techniques), EFT, psychoanalysis, Dialectical Behavioural Therapy, and NLP.

Some people may need help dealing with emotional blockages and limiting beliefs that have the potential to sabotage their efforts of keeping positive and well. If you think you may need some support to put yourself on the path to healing, getting help is absolutely the right thing to do and the best thing you can ever do for yourself. Many years ago, I did exactly that and it inspired me to help other people with their mind struggles.

So here it is. Persistent negative thoughts and emotions make us unhappy and sick while a positive, nurturing mindset is the key to being happy, healthy and full of energy. It is our choice which path we choose to follow. It may take some work but it is definitely worth it!

If you have an autoimmune disease and would like a personalised approach to optimising your mindset, check out my PsychoHealthology Programme.

References:

Pert CB (1997) Molecules of Emotion. Why You Feel the Way You Feel. Scribner, New York.

Kirsch et al. (2002) “The Emperor’s New Drugs: An Analysis of Antidepressants Medication Data Submitted to the U.S. Food and Drug Administration” Prevention & Treatment (American Psychological Association) 5: Article 23

Radin D (2009) The Noetic Universe. The Scientific Evidence for Psychic Phenomena. Transworld Publishers, London.

Lipton, B (2005) The Biology of Belief. Hay House Inc.

Rossi, EL (1994) The Psychobiology of Mind-Body Healing. New Concepts of Therapeutic Hypnosis. W.W. Norton & Co., New York.