The two dangerous twins: Placebo & Nocebo

  Argus Morningstar is a huge fan of He-man. Being the only child coming from a wealthy family, he developed a feeling that he is something special. Something more than others. In his 20s, he built a great physique and now he was on his way to becoming a super-smart person.

A friend of his recommended a doctor who would concoct these mystical herbs and minerals that would grant him amazing vocabulary. He was tired contributing nothing in crossword puzzles when his friends played. He felt dumb.

One day, he took this concoction as prescribed by the doctor – Dr. Moonwell. One week to have it daily, and he’d have a mind sharper than a finely cut diamond. Argus sat down with his friends in full confidence ready to contribute.

To everyone’s astonishment, he contributed extensively. He knew the spellings, he knew the historical figures, he knew the chemical compounds. His friends wondered – ‘What happened?’ He was suddenly smarter than he was before, way smarter. He didn’t feel any different as such, but he was himself astonished.

What was Argus’ secret? Dr. Moonwell did something great. Or did he?

Meet the Placebo effect. 

When one experiences a positive effect due to something that does not induce any mechanism to produce that effect, a Placebo effect^[1]occurs. The mystical concoction Argus used was nothing special. They were basil leaves mixed with sugar syrup. The object that induces this effect is a placebo. In this case, it was the mystical concoction.

Scientifically speaking, the Placebo effect is a dummy object that creates a psychological effect of inducing the desired change and then that change manifests. The user of the Placebo often believes that the placebo actually caused the change.

While it is partially true, it is a psychological effect, not the effect of the components in the placebo. Tonnes of studies support the existence of this effect and in fact, while testing medicine, drugs, and therapies, the researchers often control their experiments to make sure a Placebo effect does not occur.

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Meet Eliza Morningstar, she is Albus’ twin sister. She is quite a sharp person. In school, she did exceptionally well.

While she is a little lazy, she worked hard to overcome her laziness to be a highly productive person. In her office, she underwent a sales training regime as deemed mandatory by her manager. She didn’t particularly like the manager – Mr. Cross. He offered her this ancient recipe for a soup that would cure her laziness.

She decided to humour him. What could be the worst thing? The soup would taste bad. One evening, she decided to make it and it was just some ordinary clear soup. Nothing special. But there was one advantage. It was warm and during winters, it became a habit. She consumed it for a few days the next month.

Over time, she realised that her productivity was going down. That was surprising because she did well in her sales training. The sales were plummeting and she did not know what she was doing wrong.

She then noticed a pattern. The day after having the soup was a particularly bad day in sales. She couldn’t convert the leads. It seems ridiculous, but that was what she believed. A soup, intended to make her less lazy, was making her sales plummet.

What was happening with Eliza? Mr. Cross surely did something. Or did he?

Meet the Nocebo effect

When one experiences a negative effect due to something that doesn’t contain or induce a mechanism to generate that negative effect, a Nocebo effect^[2]takes place. This one is the Placebos’ evil twin. The nocebo effect is not as widely observed as the placebo effect but nonetheless, exists at an empirical level.

Scientifically speaking, the nocebo effect has nothing to do with the object that causes it. There is no mechanism. Just like the placebo, it’s a dummy & a sham that generates the effect. And once again, mediated psychologically. 

What is common between the Placebo & the Nocebo effects? 

1. Both are caused by a sham object that the user believes (at some level) that a certain effect will manifest. 
2. Both are mediated psychologically. 
3. Varying degrees of belief or disbelief in an object can change the level of how strong the effect is. 

What is different between the Placebo & the Nocebo effects?

1. The placebo effect is usually a desired change, such as healing and alleviating pain. The Nocebo is a usually an undesired change, such as worsening of symptoms. 
2. The Placebo is very common. The Nocebo isn’t.

    You could be Albus or Eliza. The effects are strong and they can manifest even if you are aware of them. These effects can form the basis of erroneous conclusions and commercial con-activities. Fake medicine, miracle cures, aphrodisiacs, etc. You don’t want to spend a months salary on medicine that is just a placebo and then it’s too late to manage the problems. You also don’t want to follow a routine that causes more harm than good, even though it came from an expert. Beware.

Quite often, a placebo effect can actually end up taking away monetary, psychological, and physical resources away from beneficial treatments. So it’s to consider all sides of what is happening around you so you spend your resources effectively.

The nocebo effect can often hamper student progress where a teacher’s solutions (useless) bring about lowered performance on tests. Bringing about positive effects with a placebo is still ok. The story gets dark when a harmless thing starts to harm you. These are the two twins that plagued Albus & Eliza –  The Placebo & the Nocebo Twins.

Placebo effect- something good happens because of having something that actually cannot bring about the desired change.

Nocebo effect- something bad happens because of having something that actually cannot bring about the undesired change. 

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