I’ve been doing some interesting reading lately on the mind/body connection in preparation for a presentation I am giving at the annual meeting of the Northwest Society of Plastic Surgeons this month. I have been reading up on the “Nocebo Effect” which is the evil twin of the much studied and celebrated “Placebo Effect.” Any one who has kissed a child’s owie is well acquainted with the placebo effect.
The nocebo effect is a more recently studied phenomenon. One nocebo effect study involved giving a fake lactose solution to a group of participants which included lactose tolerant and lactose intolerant individuals. 44% of the lactose intolerant and 26% of the lactose tolerant reported gastrointestinal distress after ingesting the sham lactose. The study participants were told that the solution was know to cause gastrointestinal symptoms. The nocebo effect can be disruptive when it comes to new drug trials. In some cases almost 10% of the participants in the placebo arms of clinical trials have to drop the study because of adverse effects. I have come to view the nocebo effect as the Power of Negative Thinking. We humans are very susceptible to suggestion.
I had a patient recently who came in for removal of her surgical drains after a breast reduction. She was just a nervous wreck and was clearly bracing herself for the most painful thing ever. I asked her about her anxiety and she told me she had seen a YouTube video of a young man who had had a gynecomastia procedure getting his drains removed. He apparently was howling like an injured wolf. He must have either had a very low pain threshold or maybe he was a drama student? Anyway, while chatting with my patient, I slipped out her first drain in about 3 seconds. Then I slipped out the other one. She was pleasantly surprised at how quick and easy it was. Yes, it stung a little but no need for howling. The howling wolf video she saw was the nocebo effect at work. The nocebo effect is one reason I implore my patient to avoid surgery horror stories before and after their procedures. For every horror story out there are likely 10,000 undocumented stories of uneventful surgery and recovery. But uneventful isn’t nearly as interesting as a howling wolf.
Thanks for reading and beware the nocebo effect. Dr. Lisa Lynn Sowder.