The Nocebo Effect: How your negative belief can increase 4 times the likelihood of death


The Nocebo Effect: How your negative belief can increase 4 times the likelihood of death

Previously published as Scared to death: Beware your negative self-fulfilling prophecy may come true
Health: beware negative self-fulfilling prophecy

Everyone has heard the expression “scared to death. ” But can the mind actually influence life and death — or at least our well-being. Medical science is asking the same question.

Consider the case of Sam Londe. In 1974, Dr. Clifton Meador, a Nashville physician, treated him for cancer of the esophagus, considered fatal back then. Londe died a few weeks later, but an autopsy revealed that his esophagus was fine. He had a few cancerous spots on his liver and one on his lung, but not enough to kill him. So what killed Sam Londe?

Three decades later Meador told the Discovery Health Channel: “He died with cancer, but not from cancer. … I thought he had cancer. He thought he had cancer. Everybody around him thought he had cancer. Did I remove hope in some way?

Though we’ll never know for sure, Londe could have fallen victim to the nocebo phenomenon. Coined in 1961, “it’s sort of a nasty counterpart of the placebo phenomenon,” says Robert Hahn, a senior scientist at the Centers for Disease Control and Prevention.

With a placebo, a harmless substance is given to patients in medical studies to test the efficacy of a drug. Patients normally expect a positive outcome. With the nocebo effect, people expect something bad to occur, developing symptoms after learning about painful side effects of medication.

“People get worse because they believe they’ll get worse,” says Dr. Julio Licinio, chairman of the Department of Psychiatry and Behavioral Sciences at the University of Miami. “It’s almost like a negative self-fulfilling prophecy.”

There are few documented studies on the nocebo effect because “it’s usually hard to get any study approved that could make people sicker than they are,” Licinio says. Nocebo, after all, is Latin for “I will harm,” whereas placebo is Latin for “I shall please.”

One example of the nocebo effect was extracted from the ongoing Framingham Heart Study, which began in 1948 to identify common factors that contribute to cardiovascular disease. It began with 2,873 women and 2,336 men. Women who believed they were prone to heart disease were nearly 4 times as likely to die as women with similar risk factors — high blood pressure, excessive weight, high cholesterol — who didn’t believe.

In a classic nocebo experiment conducted in the early 1980s volunteers were told that a mild electrical current would pass through their head, and although no electrical current was used, two-thirds of the volunteers complained of a headache after the experiment.

Daniel Moerman, professor emeritus of anthropology at the University of Michigan-Dearborn, who was not involved in that study, would call the headaches a “meaning response.”
“One thing we can be certain of is if a person changes it’s not because of the placebo. What is it? It’s because of what the placebo means.”

Take the number four. David Phillips, professor of sociology at the University of California at San Diego, looked at mortality rates of 200,000 Chinese- and Japanese-Americans and 47 million white Americans from 1973-1998. He found deaths from heart disease were 27% higher on the 4th day of months for people of Asian descent. There was no such pattern among white Americans.

Could this have anything to do with the words “four” and “death” having similar pronunciations in Cantonese, Mandarin and Japanese?

“The effect was quite striking,” Moerman says. “Four is just a number … but if a four is meaningful in some particular way, it’s not the four, it’s the meaning of the four.”

Phillips notes that “most occasions that stimulate fear also disrupt medical services.” For example, hurricanes cause heart rates to increase, and they disrupt ambulance travel, which leads to fatalities.

“I wanted to find an occasion that stimulates fear but had no effect on ambulance travel.” He got the idea for the study after he realized the number 9 in Chinese sounds similar to something meaning “fortunate.” He checked to see if any numbers had negative connotations. Number 4 popped up and thus began his study.
When you expect bad things to happen, Licinio says, stress hormones rise, your heart beats faster and your immune system becomes suppressed. “It’s similar to the feeling you’d get if you saw a car rushing toward you. It’s good in an acute situation when you need to run away. It’s not good when you’re having surgery.”

Neither is it good, apparently, when a priest administers last rites. In the 1997 report, “Nocebo: The Power of Suggestibility,” Dr. Herbert Spiegel of Columbia University writes about a case in which a priest was summoned to administer last rites at a large American Roman Catholic hospital. “With an impressive air of authority and a brusque voice,” Spiegel said, the priest gave last rites to the wrong patient. Within 15 minutes, that patient died, but the other one lived a few more days.

So, is it possible to be scared to death? “I think so,” Licinio says. “Specifically if you have other diseases. For a healthy young man it would be rare.”

Phillips agrees to a point. “Our data are consistent with this, but you wouldn’t want to bet your life on it.”

By Desonta Holder
Originally published January 2, 2008 at 12:00 am



Robert’s View

We use the Sam Londe story in our life-changing workshop called “Creating a High CQ-EQ Performance Culture”, and The Power of The Mind. CQ-EQ stands for change-emotional quotient.

One participant, a lawyer, recently shared a true story how an acquaintance in UK was diagnosed with 4th degree cancer with a life expectancy of a few weeks. The doctor kept the secret from the patient and she continued living after that. After 2 years, the doctor was so impressed with her survival that he admitted to her that her case was indeed a miracle. 2 weeks later she died. So what killed this patient?

Another participant, a factory general manager, shared that her mother was diagnosed with terminal cancer and have only a few months to live. His family did not reveal to her and she is still alive until today – 25 years later.

Yet another participant shared that her mother knew about her terminal cancer but she had a strong character and positive mindset and lived a further 25 years.

What truth do you tell a patient?
Do you tell the BAD NEWS TRUTH that 70% of patients with this disease will die within 6 months?
Or, do you tell the GOOD NEWS TRUTH that 30% of patients actually live more than 5 years?

Q. Do you have a good story to share about how the power of mind can overcome sickness or prolong life?

Published by

Robert Chaen

Global CEO-Founder of ChangeU and Movsha Movers & Shakers, Hero-CEO Whisperer, Writer, The #1 Alpha Change Expert, Father of Asian FireWalking Robert Chaen is an International Keynote Speaker, writer, researcher, and corp games designer. He is famously known to be the “Hero-CEO Whisperer”, 1-on1 coaching with many CEOs and Celebrities for corporate strategies, staff & office political issues, personal branding, and even public figure OSHA safety drilling called Drager Defense. He has transformed CEOs and managers in Coca-Cola China, TVB Hong Kong, Cathay Pacific, Hong Kong Airport Services, VADS, TM, Public Bank, Auditor General's Office Maldives, etc. He is the prolific creator and online Author of innovative management tools such as DragonCEO, Diamond Leader, Papillon Personal Effectiveness, OSHA Drager Defense, KPI Bank, etc. He is also the Founder of Movsha, an international networking with monthly mingles with MOVers & SHAkers, Angels, Entrepreneurs, CEOs, Celebrities, HR-PR-CSR, HODs, and the Most Influential IDEA people. ​Chaen is widely considered as one of the top International Platform Keynote Speakers for Resorts World Genting Senior Management Conference (Manila), 7-Eleven HK, Samsung, Coca-Cola China Mini-MBA @Tsing Hua University, Cathay Pacific, Hong Kong Jockey Club, The Story Conference where he interviewed Datuk Kamarudin (Chairman of AirAsia) and Siti Nurhaliza. He has been widely featured in TVB, AWSJ, CNBC, SCMP, The Star, and Sin Chew. As “The Father of Asian FireWalking”, he coached TVB celebrities (Ekin Cheng Yee-Kin) to walk on 650°C fire; and raised HK$68M in the world’s 1st and only live TV Charity FireWalk (TVB Tung Wah Charity Show), before Tony Robbins even came to Asia. If Robert can get you to walk on 650⁰C fire, he can inspire you to be THE BEST. He champions CN-HK-EU-US Tycoons to be philanthropic, and to be angel investors to support the next generation of Jack Mas, Steve Jobs, Richard Bransons, Steven Spielbergs, or Barrack Obamas. With some slick motivational speakers with fake doctorates out there, graduates often describe Robert to be "the most credible, empowering, truthful Coach" who believe in his graduates to believe in themselves. ​However, clients have described Robert as "The #1 Cool Badass Alpha Change Expert". He has the coolest first class stature, rapport and trust from clients. He will not hesitate to tell the badass truth ever so gently because clients are paying him big bucks to reveal the truth, find solutions, persuade the hostile HODs, and align cross-teams within the organization. Originally based in Hong Kong for 20+ years, he had worked with top Branding/Ad agencies at J Walter Thompson and Leo Burnett, and was a certified FranklinCovey (7 Habits) in USA, and NLP MasterCoach (USA). His warmth is known to soften the most hardened, resistant sceptics. He will inspire your team to Go for Top 1, or to be a Dragon CEO. With boundless energies, Robert owns 15+ successful business Joint-Ventures, and created unique products under his global VC network called Chaen's Angels VC. He is deeply passionate about ChangeUTH Youth CSR, Science-Based Medicine (vs. quackery), short films and Reality TV. Touched by a personal tragedy through the loss of his HK-born Portuguese wife, co-coach and business partner, Brenda José of 18 years, Robert explores the many ways in which the spirit world is communicating with the living with real scientific studies and evidence. He gives inspiring conferences on The Secret Afterlife.

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