The Scientist July 1, 2013
“Nocebo” (meaning “I shall harm”) is the dastardly sibling of placebo (“I shall please”). In a placebo response, a sham medication or procedure has a beneficial health effect as a result of a patient’s expectation. Sugar pills, for example, can powerfully improve depression when the patient believes them to be antidepressants. But, researchers are learning, the reverse phenomenon is also common: negative expectations can actually cause harm. “For many years, I dismissed the value of the term ‘nocebo,’” says UTMB’s Dr. Howard Brody, who first began studying the placebo effect in the 1970s. He and others had long assumed that nocebo and placebo were two sides of one coin, that the same process in the brain supported both illusory effects — one was just manifested as a positive outcome, while the other caused harm. But after reading [Fabrizio] Benedetti’s work, Brody changed his tune: “I received my comeuppance,” he laughs.