The Nocebo Effect: Can You Be Tricked Into Thinking Yourself To Death?

"I will please" is the literal meaning of the word "placebo" — and indeed, that's exactly what the placebo effect can do. Research has demonstrated, over and over again, that the administration of medications or procedures that shouldn't have the power to do anything at all do, in fact, lead to very real and measurable psychological and physical changes. Placebos can reduce pain, affect chemical reactions in the brain, change a person's heart rate and blood pressure, heal ulcers, and even help patients with asthma, depression and fatigue experience positive changes. 

Dating back to the 18th century when sham medications without active ingredients were first used to demonstrate that supposed real treatments were ineffective, the concept was widely investigated during the 20th century, with new research still emerging on a regular basis. A 2010 study titled Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome even demonstrated that placebos can also work when patients are fully aware that they are taking placebos. 

Meet the "nocebo". While "placebo" means "I will please", "nocebo" can be translated as "I will harm". The nocebo represents a terrifying concept, given the amount of research placebos have going for them. Unlike the placebo, the nocebo has barely been touched by scientific research.

Nocebo As A Deviant Murder Method

India, 1930. Prison. A man condemned to death is offered the chance to spare his family from the socially stigmatizing ritual of public excution by hanging, if only he'd agree to participate in an experiment. Should he consent, a doctor explained to the "dead man walking", he would be the test subject for a new execution method, a method in which the man would slowly be made to bleed to death. This execution would be carried out in private on prison grounds and, the doctor assured the condemned man, the method would not inflict pain. Knowing he was going to die in either case, the prisoner agreed. 

The man was blindfolded and taken to a private room. Once there, he was chained to an operation table. A pouch of water was tied to each of the table's four corners, and the doctor proceeded to make small, surface incisions in the man's wrists and feet. Gradually, he allowed water to seep out of the pouches. 

READ Can Placebos Work On Skeptics?

The experiment was a "success": the man was under the impression that he could feel his own blood, slowly leaving his body. The fact that those present in the room had previously agreed to speak in an ever lower tone amplified the man's impression that he was fading away. Eventually, the medical team ceased to talk altogether and the only remaining sound was the "blood", dripping, and dripping, and dripping. 

The case, which American researcher N.S. Yawger described in his 1936 piece entitled Emotions as the cause of rapid and sudden death, may just contain one of the most terrifying concepts you will ever encounter — whether in real life, history books, or a horror movie. 

Is The Nocebo Effect Real?

What Is The Nocebo Effect?

Coined by Walter Kennedy in 1961, the term "nocebo reaction" was chosen to mean the exact opposite of "placebo". The nocebo effect refers to a patient response to a sham treatment that shouldn't realistically have the potential to inflict harm — the harmful response is, in other words, generated within the patient themselves as a direct result of the belief that they underwent a treatment or received a medictaion that would cause a certain reaction. As Kennedy put it, the nocebo reaction is due to "a quality inherent in the patient rather than in the remedy". 

The case described above, in which an Indian man already sentenced to be executed "thought himself to death" remains an isolated example — in this day and age, it is all too clear that experimenting with procedures that may literally trick people into dying isn't an ethically-sound venture. It's for this reason that we can't expect much research into the scientific merits of nocebo-ing yourself to death. 

There are, however, a few examples of the nocebo effect that we do know about:

• Research shows that those people who are treated with placebos do experience side effects associated with the actual, real counterparts of the medication they are supposedly getting: people taking sugar pills have experienced nausea, vomiting, muscle weakness, memory disturbances, alterations of taste, and fatigue. 
• In a study of chronic back pain sufferers, those who were told a certain test would cause pain experienced significantly higher levels of discomfort than those who weren't offered this false information.
• Another study involved telling a percentage of patients who received the drug finasteride to ease symptoms of prostate disease that the drug may make them impotent, while others weren't told this. A total of 44 percent of those who expected possible erectile dysfunction did indeed experience it, compared to only 15 percent who weren't expecting impotence.
• Renowned neurologist Martin Samuels found hundreds of little bleedings within the heart of a person who committed suicide. Of course, this isn't what caused the man's death — that was due to the impact of the fall when he jumped off a building. But the extent of the heart damage Samuals found was a mystery, until he learned that the same thing happened in others who committed suicide after a period of doubt. Dubbed "fear lesions", it became clear that fear can cause very real organ damage. Could this explain why the man from India died?

If you're not likely to find yourself in the position of being told you're going to be bled to death in an Indian prison, though, you may still gain a valuable lesson from the existence of the nocebo reaction. Think you're going to experience harm, and you just may — even in the absence of actual harm-causing substances. The opposite may also still hold true: believe you're going to make it through, and you probably have a higher chance of doing exactly that.