It is possible to catch leprosy from an armadillo if you are a human or an armadillo. Were you to handle an infected armadillo and contract the disease unwittingly you might never notice, around 95% of humans are immune to leprosy. Even if you did contract leprosy it could easily be stopped early on. That is for real leprosy, what about imaginary leprosy? What happens if I told you that you had leprosy – and you believed me?
If you believed that you had leprosy from your excessive armadillo handling sessions, something curious would happen. You would look up the symptoms, then they would manifest. Your skin might become rough, your muscles would feel much weaker and you might notice that the nerves in your hands and skin aren’t working, it is harder to feel things. The problem is this; nothing at all is hurting you, you should be healthy. Then medicine enters.
Medicine would have little physical effect on you, after all there is nothing to fight. You would suffer the side effects, but if you believed the medicine would work, your symptoms would disappear.
In The Mind
It all felt real, in fact those effects were real, though there was only one external factor. The idea of leprosy. A person believing they had a disease, as long as they know the symptoms, will develop the symptoms. This is the extreme case of mind over matter and it is most definitely a real problem. This is the nocebo effect. Nocebo comes from the Latin for I will harm. It is the evil twin of the more famous Placebo effect.
Placebo, meaning I will please, has come more into common knowledge, and while useful it is still a pain. It most obviously emerges in drug trials. For pharmaceutical companies to best show the effectiveness of the drug they set up two groups of people: the test group which is given the drug, and the control group which is given a similar looking drug that does nothing. This is often referred to as a ‘sugar pill’.
Over time progress is measured, for example they might measure the amount of joint pain the groups feel. Both groups can feel an improvement though, in fact it is far from uncommon that the control group with no actual drugs feels just as good as the group with drugs. This is not because the drugs are ineffective, although that can be the case. It is because of the control group is healing itself without drugs, using the power of the placebo effect.
The placebo effect is powerful but it is no replacement for good medicine, but medical uses abound. In the imaginary leprosy case above the doctor would likely have check the patient’s skin for the presence of the bacteria. Finding no bacteria there the doctor could have realised the effects were imaginary, a harmful nocebo effect that didn’t need drugs. At that point, to spare expensive drugs and side effects the doctor would have been free to provide the patient with a sugar pill. Letting the placebo effect counter the nocebo effect.
Based on its effects, cheap manufacturing costs, why not directly sell placebos? Mainly because you need to believe them, and anything that forms a good placebo will have no effect, and advertise it. An option is to sell a variety of harmless substances and claim it will help you with specific ailments, despite the lack of any chemicals proven to help. This is two things: a lie, and homoeopathy.
Death Without Disease
The placebo effect cannot single-handedly cure diseases, but the nocebo effect can create them. Multiple cases have been reported where a doctor has given a faulty diagnosis, something like thinking a benign tumour is cancerous. Based on that assumption they tell their patient that they have cancer, and that tumour will cause them to die in a matter of months.
The patient goes away, convinced and probably depressed. Their health deteriorates and bang on time, they are dead. Later examination of the body looks into the cause of death, but none is found. The body is healthy and the tumour was benign, harmless, at worst a bit ugly. The doctor is not to blame, they made the best diagnosis the could with available data. The cause of the death is the patient’s belief, the patient’s brain, and the nocebo effect.
What do you do?
Belief is a powerful thing, it can change how one views the world, people, and arbitrary events that affect them. Perhaps the most pertinent effect is that upon the body, the power over life and death. Placebo, nocebo, they are unavoidable quirks of the human condition. Their mechanisms are unknown at the moment to science. There is not much you can do, I imagine. Still I shall try, here is my advice to avoid the nocebo effect, and improve your life and health.
Do not believe everything you are told. Do not believe everything you feel. Be rational; and laugh, it’s good for you.
Image source: Brain Blogger on Flickr
This article was written for, and first published on The Manic Thought Society, a blog about science philosophy and much more.