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Fear of pain can trigger the nocebo effect

The nocebo effect refers to experiencing pain or side effects because one is convinced that something is harmful, as opposed to the placebo effect.

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Key facts

  • With the nocebo effect, the fear of being in pain is enough, on its own, to produce side effects. Nausea or headaches can thus appear.
  • The nocebo effect refers to feeling unwell, or being in pain, because one is convinced that something is harmful. The term comes from the Latin…
  • It is the opposite of the placebo effect. One then feels better because one is convinced of being treated, even if that is not the case.

With the nocebo effect, the fear of being in pain is enough, on its own, to produce side effects. Nausea or headaches can thus appear.

The nocebo effect refers to feeling unwell, or being in pain, because one is convinced that something is harmful. The term comes from the Latin nocere, which means to harm.

It is the opposite of the placebo effect. One then feels better because one is convinced of being treated, even if that is not the case.

The placebo effect is widely known. A tablet that contains absolutely nothing, presented as a medicine, sometimes eases symptoms.

The phenomenon is also akin to a negative Pavlovian reflex: the expectation of harm triggers the reaction.

It does not manifest in the same way in every situation. The nocebo effect would be very different depending on the context.

Finally, it can be automatically reduced when it risks exposing someone to a greater danger. This is the case, for example, if the pain felt prevents the person from fleeing.

Dig deeper

What is a Pavlovian reflex?

Ivan Pavlov, a Russian physiologist, showed that a signal linked to an experience can by itself trigger the same reaction: here, the expectation of harm plays that role.

Where do the words nocebo and placebo come from?

Nocebo comes from the Latin nocere, "to harm," and placebo from "I shall please": one describes expected harm, the other the sense of well-being linked to the belief that one is being treated.

Why does the nocebo effect matter in care?

The mere fear of adverse effects can make them appear, even without an active substance, and make it harder to distinguish a real symptom from a reaction to expectation.

Does the nocebo effect always act in the same way?

No: it varies according to the context and can lessen if it exposes one to a greater danger, for example when pain would prevent flight.

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