Understanding Placebo’s Opposite — The Nocebo Effect

What is the Placebo Response?

The Placebo Response is a positive healing effect evoked solely by the patient’s belief in the treatment or substance being employed to assist them to heal even when such treatment or substance is later revealed to be a worthless sham.

The patient’s positive expectancy is enhanced through:

  • positive verbal and non-verbal suggestion (body language) especially when delivered by a trusted authority figure
  • positive beliefs of others
  • ritual
  • happy or soothing music
  • relaxation
  • emotional support
  • spiritual support
  • power of prayer
  • and anything that calls up hope and powerful, positive emotions.

In the modern Western world, healing rituals usually mean surgery and allopathic medical treatment. However, historically healing rituals have included drumming, rattles, chanting, dancing around a fire, prayer meetings and healing ceremonies, taking herbs and drinking potions.

Such placebo response is made more effective when delivered or shared by a trusted authority figure, especially if such figure is considered to be an expert on the subject such as a physician or other health professional, shaman or minister. The nurturing care of others can also have a powerful placebo effect.

An example of the placebo effect is pain relief obtained even when a patient takes an inert sugar pill. If the patient thinks or is told that such pill is powerful pain medication, that belief alone will release the patient’s own natural pain relieving chemicals. According to Lissa Rankin, MD:

 “The placebo effect is real, it works about 18-80% of the time, and it’s not just in your head – it actually dilates bronchi, heals ulcers, makes warts disappear, drops your blood pressure, and even makes bald men who think they’re getting Rogaine grow hair!”

What is the Nocebo Response?

Negative expectations of the patient, or negative comments or suggestions including negative body language delivered by an authority figure or ‘expert’ can cause the opposite response, even unnecessary death. This is the Nocebo Effect sometimes called the ‘Voodoo Effect’ because the patient reacts much as if a witch doctor has cursed them by pointing the bone at them, or as if given the ‘black spot’ as in Robert Louis Stevenson’s novel, Treasure Island.

Unfortunately, it is caused all too often in our sophisticated western society by medical professionals because they do not understand the power of suggestion and how to say things in a way that does no harm. Hence, it has earned the term ‘medical hexing’ or ‘medical voodoo’.

As example of this, Rankin reports that

“patients believed to be terminal who are mistakenly informed [by their doctor] that they have only a few months to live have died within their given time frame, even when autopsy findings reveal no physiological explanation for the early death.” 

See The Nocebo Effect: How Negative Thoughts Can Harm Your Health

Rankin also says that women who believed they were prone to heart disease were four times more likely to die not because of poorer diets, higher blood pressure, higher cholesterol, or stronger family histories. “The only difference between the two groups was their beliefs.”

Fortunately, there are ways such a Neural Linguistic Programming (NLP) technique of anchoring/collapsing anchors to undo the nocebo effect and to re-establish the patient’s hope in successfully meeting any health challenge. Part of this is to explain the meaning behind the statistics given on recovery rates for any disease.

What I might say to someone who has been medically hexed

“Let me explain what the doctor was really saying when he gave you that negative diagnosis and prognosis. First of all, what the doctor gave you was his ‘opinion’. Because diseases can and have been misdiagnosed and that there might be other or even better treatment options, we understand the value of getting a second or third medical ‘opinion’.”

“Medical information is so vast and medical treatments are changing so fast that no one physician can keep up with it. And with international travel, many diseases not seen before are coming into the country. Medical opinion can, therefore, be faulty on multiple levels.”

“First, the diagnosis can be wrong. After all, many conditions have similar presenting symptoms. If the diagnosis is wrong, then the prescribed treatment will be wrong, and so will be the prognosis following that treatment.”

“Second, even if the diagnosis is correct, there may be multiple other options not known about or not presented to you by the doctor perhaps because it is outside of his expertise.” 

“For example, there can be a Chinese mushroom or herb used to combat cancer, but if the physician is not schooled in Chinese medicine, nor a herbalist experienced in using it, he is not going to recommend it even if he has heard about it which he may not have. Your doctor is only to prescribe those drugs or treatments with which he is familiar and has had experience.”

“Therefore, if the doctor’s prognosis is gloomy or if there strong negative side effects of any recommended treatment, you might want to investigate other options in order to make an informed decision. According to Bernie Siegel, M.D., people tend to respond better to a treatment when they feel it is going to help them, and not respond well if they don’t.”

“Third, the prognosis does not indicate how you personally will fare. The statistics are only based on what might happen to you if you follow the doctor’s treatment recommendations exclusively. Such prognosis is listed as a range of possibilities. This range is effected by so many variables in the person’s life, work and relationships that are not addressed by traditional medical treatment.”

“When the doctor said that ___ % ____(die/ end up in a wheel chair/ never walk again) what he was really saying was that the other  ____% ___(survive/ continue to walk) and some even do very well, perhaps even healing completely of the original condition.”

“There are many, many people who have healed even of so called incurable, end stage cancers and other fatal conditions. As a result, some doctors are now admitting that there are no incurable diseases. We now know so much about the mind/body connection because of those people who healed after the medical establishment gave up on them. If they could do it, why not you ? What do they know, or what did they do that helped them? Find out and do it yourself. The Institute of Noetic Science is a great resource.”

“Fourth, the doctor’s prognosis is based on doing what he tells you to do and only what he tells you to do, with what he knows and with only what he knows. But I know you are going to do more than just following the treatment outlined by your doctor. You are investigating other avenues of healing, and with each thing that you do extra, such as making changes in your diet, habits or sleep, engaging in prayer or meditation, getting bodywork or energy work such as Reiki, and especially reducing stress and resolving relationship issues—you completely improve your ability to heal.”

“That’s why I believe you are going to do better than expected, even much, much better!”

“Healing your body is about healing your life. And everything you do to bring balance into your life—taking time out for a vacation, a retreat, fun and recreation, dealing with both current upsets and old emotional wounds, reconnecting with friends and loving family, focusing your time on things that make life meaningful and worthwhile—all make a powerful difference in helping your body to heal.”

“There are many healing modalities that your doctor does not know either at all or not skillfully. Your doctor is probably not trained also as a nutritionist, herbalist, hypnotherapist, counselor or psychotherapist, acupuncturist, Reiki practitioner, or expert in any of the proliferation of additional modalities. As you investigate these modalities, checking into your options, becoming aware of the benefits and limitations of each, you can make informed decisions that you feel good about in designing your own well rounded healing package. Take into consideration the best medical advice that you can find with whatever else you find is helpful. Take responsibility for your treatment decisions. It is your life.”


Both the Placebo and Nocebo Response can be caused by the beliefs and perceptions of the patient himself as well as the beliefs, perceptions, verbalized and nonverbalized suggestions (e.g. body language) of those closest to the patient including those he considers to be the experts in such matters such as physicians. It can also be effected by the media. Because negative suggestion seems to have greater impact, the more negative these authority figures are, the more positive the patient needs as counterbalance to be to prove the prognosis wrong.

Whether created through traditional allopathic medical treatment or through the action of shamans, faith healers or witch doctors, both the Placebo or Nocebo Response are enhanced through ritual that increases the expectancy of a specific outcome. Such rituals can be to take this substance or undergo this action, procedure, ceremony.

If the ritual causes strong beliefs that healing is or will take place, and the emotions of hope, love and emotional support are strengthened, then the results will tend to cause a positive response, even if the patient was given ‘sham’ treatments or ineffective medicine.

Whereas, if the ritual calls up fear and hopelessness, it can sabotage any real healing power in true, beneficial drugs or treatment. It is, therefore, imperative that the patient feel good about those helping him and the course of treatment he is going to undergo. When the patient participates in the decisions for possible treatment options, it does, according to Dr. Bernie Siegal and my hypnosis mentor and former Director of Health, Education AIDS Liaison, Michael Ellner, increase the chances of a positive outcome. Dr. Siegal would have his patients draw a picture of the elected treatment. If the drawing indicated fear or gloom, he would discourage them from going through with it. 


  • If you are the patient and your medical team thinks that healing is hopeless, find another one.
  • If your medical team thinks that there is nothing they can do, understand that it really means that they are not the ones with the answers, not that there are no answers or remedies for you. Such remedies may simply lie outside of their experience, limited expertise or treatment modality. Go find those who either do have answers, a piece of it, or have some ideas to try out.
  • If you, as the physician, medical provider, healer or hypnotist  feel that the patient’s situation is hopeless, you must, in good conscience, refer them out to someone more hopeful or to modalities that can at least improve the situation if not the expected outcome. While doing so, please let them know that even while you may not be able to help them, that does not mean that there is no help, but that they need to continue their search elsewhere.

For more information, see article “When someone says there is ‘no cure’

Copyright by Roxanne Louise. However, this article may be shared in free online sources only if this copyright notice and link to http://www.roxannelouise.com and http://unlimitedpotentialhealingcenter.com  are included with the content.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: