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Are You a Nocebo?

Long regarded as a nuisance hurdle in pharmaceutical drug testing, the placebo effect is actually a powerful tool that can be harnessed and amplified. In the same way, a nocebo effect (that is, the expectation of a negative result) can ignite uncertainty or fear into dis-ease. In many ways, the Body follows the Mind.

A key implication of this truth? How we communicate with our clients is perhaps just as important as what we are communicating.

Are we promoting strong Belief in the body’s ability to heal itself? Faith? Patience? Comfort with the natural ups’n’down of progressive healing? Optimism? Empowerment? Or are we promoting fear by simply failing to promote hope?

Using fear to motivate a patient to comply with directions can be an enticing trap. Ouch. We’ve all done it at times. Our motivation may feel somehow positive. But what if that fear leads them to take lots of compliant “healthy” actions that are much less effective simply because their expectation stays in a place of weakness, vulnerability, or waiting for the other shoe to drop? What if that fear actually takes them out of true empowerment and into a belief in their dependence on you for their wellness?

This has actually been studied!  And, I hope, gives you some inspiration to consider carefully how you

  1. prepare *yourself* and your mindset prior to your client appointments.
  2. prepare *your words and actions* in specifically how you will educate, inspire, and empower them.

Consider this study   Out of 200 patients, in those who were given a specific diagnosis and told they would feel better in a few days, 64% did. In those who were told their diagnosis was uncertain and the physician wasn’t sure what would happen, only 39% felt better four days later.  This is a greater than 50% improvement based on practitioner confidence and clarity.  The authors stated, “The doctor himself is a powerful therapeutic agent; he is the placebo, and his influence is felt to a greater or lesser extent at every consultation.”

Consider a report that those who received a lengthy, warm visit (vs. a short, brusque one) from an anesthesiologist the night before surgery required less than half as much painkiller post-surgery than the latter group.  You’ll find many more fascinating examples here.

Setting negative expectations regarding the likelihood of pain increases the incidence of perceived pain. Setting expectations for likelihood of side effects from drugs increases the experience of those side effects.   Check it out!

Do these results surprise you?

We are focused on building interventional skills and knowledge; it’s important! But as part of that focus, let’s all embrace the overarching power of how we show up as practitioners, how we communicate with our patients, and (most of all) how much we believe confidently in their ability to be well.  Depending on your history, this may require some “unlearning” from the healthcare culture you’ve experienced to date and that offered your foundational training.

Perhaps Dr. Lissa Rankin’s words can shine a bright line on a growth opportunity for All of us – patients and practitioner alike.

In gratitude to you for sharing your gifts with so many others –

 

 

 

 

P.S.  If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.

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