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The Nocebo Effect

By Cathy Daub, PT, CCE and CD(BWI)
I remember once talking with a pregnant woman in the hospital who had just been tested for gestational diabetes. She looked up at me confused saying, “I eat healthfully and there is no history of diabetes in my family.” She had a look of despair in her eyes and I could tell any confidence she had had in her body to give birth had suddenly been diminished. I saw her later and found out that the test was a false positive and that she didn’t have gestational diabetes after all, but the lingering effect that something could go wrong in her body remained and affected her deeply. A woman giving birth needs to have a lot of confidence in her body for the work of labor for it may be one of the hardest but most rewarding things she has ever done.
The word Nocebo comes from the Latin word “noceo” which means “to harm” whereas the word “placebo” means “to please.” More simply put, nocebo means words that are said that cause harm. The nocebo effect is basically the effects of the power of suggestion. For example if a doctor tells a woman that she has a small uterus, and then as her belly grows, if she believes what he said is true, she may not believe she can birth her baby and a cesarean may be the outcome.

The nocebo can also have the effect of taking an inert harmless substance that ends up causing a harmful effect, simply because someone believes or expects it will harm him/her.  The power of suggestion and our beliefs are very strong and can actually alter and control physiology by simply changing a thought.  Therefore, results of the placebo or nocebo are actually a mind plus body effect. “Changing thoughts can actually create a brand-new reality.”1 “Considering that the latest scientific research in psychology estimates that about 70% of our thoughts are negative and redundant, the number of unconsciously created nocebo-like illnesses might be much higher than we realize.”2

Joe Dispenza in his book “You Are the Placebo” writes:  In other words, in exactly the same environment, those with a positive mind-set tend to create positive situations, while those with a negative mind-set tend to create negative situations.  This is the miracle of our own free-willed, individual, biological engineering.”3  These are the reasons that in BirthWorks certification programs, we focus a great deal on identifying beliefs related to birth and work to change those not perceived to be helpful.

At a recent BirthWorks Childbirth Education Workshop, Krista shared the following story of her birth, one full of the nocebo effect, but also of her power as a woman to rise above it.  This, itself, takes much courage and determination to make the best out of any situation.  But just imagine after reading it how different her experience would have been had she received the respect she deserved during her labor.

References:

  1. Dispenza, Joe, You Are the Placebo: Making Your Mind Matter, published and distributed in the United Kingdom by Hay House Hay House Inc., 2014. p.31.
  2. p.45.
  3. p.45.