The nocebo effect… MIND OVER MATTER?

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22 July, 2015 Dr. Linda Friedland Performance

Simon*, a young man assigned to my care, was fit and healthy apart from his back problem. After many years of chronic pain, he finally decided to undergo the recommended back operation for his disc problems. On admission and in the ensuing days prior to surgery, Simon had expressed enormous anxiety about dying under anaesthetic.

The senior surgeons reassured him that all would be okay. After all, he was young, fit and healthy. The inexplicable death of Simon, due to anaesthetic complications during a routine back operation, is something I will never forget.

This memory was stirred up recently when I read an article on the ‘nocebo effect’. I’ve constantly encouraged my patients to take advantage of the power of the mind-body connection. But, the power of the mind over body is a double-edged sword – it has the capacity to harm, just as it has the capacity heal. Rigorous trials have established that the mind has a dramatic effect on your physiology.

Even the most hard core medical sceptic accepts the ‘placebo effect’, which describes how an inert sugar pill can produce measurable physical effects simply by telling the user it works. The converse is also true; the placebo effect has an evil twin – the nocebo effect – in which inert dummy pills and negative expectations can produce harmful outcomes. Many patients who suffer harmful side effects may do so only because they’ve been told to expect them; or telling patients that a medical procedure will be extremely painful means they may experience more pain than if you had kept the information to yourself.

What is becoming clear is that these apparently psychological phenomena have very real consequences in the brain. Using PET scans to peer into the brains of people given a placebo or nocebo, Jon-Kar Zubieta of the University of Michigan in the US, showed that nocebo effects were linked to changes in brain chemistry and neurotransmitters.

“The ultimate cause of the nocebo effect, however, is not neurochemistry but belief,” explains Dr Hahn of the Center for Disease Control in Atlanta, USA. He adds that surgeons are often wary ofoperating on people who think they will die – because such patients often do.  Bad news promotes bad physiology. This means doctors need to choose their words carefully and highlights, for all of us, the power of what we choose to believe about our lives, our bodies and our destiny.

What’s your EQ?

Growing attention has been paid to the power of emotions over the past decade, with particular focus on two key areas: the first being that your emotions are intricately connected with your health; the second suggesting that your Emotional Quotient (EQ) is probably more important than your Intellectual Quotient (IQ) in predicting your future happiness, success and personal health. And the good news is that it’s never too late to enhance your EQ.

Top Australian life coach Matt Catling has worked with thousands of people to help increase their EQ. He believes that personal development exercises can help people manage and improve emotional change and challenges. The key to emotional intelligence is understanding your emotions and acting appropriately. It’s about expressing your opinions and standing up for who you are – in a respectful and tactful manner. Healthy EQ helps you set personal boundaries, make wise decisions and communicate effectively.

In his book Emotional Intelligence: Why it can matter more than IQ (Bantam), Daniel Goleman suggests that IQ tests account for only 20 percent of the equation, whereas the EQ factor accounts for 80 percent when it comes to success and wellbeing. Many very successful entrepreneurs have average IQ scores, yet very high EQs, according to Goleman. And the best thing about your emotional quotient is that you can increase it by learning to identify and take responsibility for your emotions.

Boost your EQ by following these four steps

Manage your mood

A person with a low EQ is one who flies off the handle at the first provocation. Learning to control your anger, thinking before you respond and trying to see all perspectives to make a balanced decision are essential methods for this step.

Impulse control

We live in the ‘instant gratification’ and ‘quick fix’ era. Instead of being driven by your emotions to satisfy yourself immediately, work at controlling your impulses. Attempt to move past your immediate needs and desires towards a conscious decision to work out what is best for all in the long term.

Develop sensitivity to other people’s feelings and needs

People find it really easy to talk with and share their thoughts and feelings with someone who has a high EQ.

Responding to challenging situations

You can boost your EQ by turning challenges into opportunities instead of giving up quickly when confronted by a difficult situation.