When I was an Emergency Room physician and teaching (and a non-believer in holistic medicine which I practice now), I knew the importance of the placebo effect. But now I can see how the mind can create what I call a negative placebo effect.
There were times in the ER that I would take sample capsules and empty them and give them to a patient with the admonition to “be careful since these capsules are very potent pain killers.” I never had a complaint that the medicine did not work (and it was free since the empty capsules originated from the drug representatives samples).
The title of this article could be the antithesis of the placebo affect because there are people out there that for different reasons do not want to get better and some even do not have any real pathology to cure. Maybe I should call this the “negative placebo affect.” I am not admonishing anyone in this article since there are different reasons for this; sometimes subconscious reasons that the person may not even realize why they stay feeling sick. For example, I had a backward patient that under hypnosis the reason for his constant complaints became overt. The reason was that as a child having his tonsils out he remembers the family paid him a lot of attention as did the nurses and he got plenty of ice cream. Therefore, being sick or believing so he sought the same bonding and love from his parents.
Sometimes a person has anger issues with another close person (family or lover,etc) and being sick can give them freedom to be demanding or even getting even by making that person a servant to them out of guilt. Yes, it happens! Maybe another person is just tired of being the caregiver and the way out of this is to be taken care of by having headaches or some other dis-ease.
I have tracked down the causative agent in a few people that were getting sick on and off too often. It was the only way they could get some rest without feeling guilty about taking time off from work or from caring for other(s). Sometimes when they have programmed their subconscious mental level that they are sick they really become sick (and also from any one of the reasons above which can cause stress that goes along with illnesses). It has happened to me as a child when I would lie about pretending to be sick to avoid school and then really getting a cold or sore-throat.
As an example, now that I am an Holistic MD I have noticed an alternative diagnostic test that may help uncover why a positive or negative placebo effect may be working on a client: the practice of kinesiology also called muscle testing. I certainly am not against this evaluation and have used it to some degree on clients and have had it used on me successfully and unsuccessfully. But I have found severalpossible flaws in this evaluation (as I have in blood testing also) that should be considered:
- It depends on the training of the person doing the kinesiology for several reasons:
- They have to be able to dissociate their own energies when testing. This is really important if they have their own negative problems. This energy whether it is chronic or even just an event (like an argument with someone that day) can interfere with their own energies and therefore with the kinesiology testing validity. They have to be trained well enough in this technique that they can test and discern whether the client themselves wishes to test sick or negate each attempt by the kinestheolgist. In my 25 years as an Holistic physician I have found only two people with this capability of discernment
- There exists some people that need to be sick on an subconscious level that will throw the testing in the direction that fills this need. Again, it takes a special healer kinestheolgist to recognize this and even bring it to the attention of the client.
- As you will see in the next paragraph, I do not believe that any one test is conclusive for diagnosing a person. There are too many dis-eases with similar signs and symptoms that have to be thought of and ruled out by the healer. This is called the differential diagnosis and is a list of diseases with similar signs and symptoms. The healer (kinestheolgist) needs to be aware of the pitfalls of believing that one type of testing is the “end-all” and panacea for a diagnosis.
- Unfortunately, I have found that healers that cannot write for labs and other licensed diagnostic techniques use muscle testing exclusively. Some have even just taken cursory courses in kinesiology and then believe they can diagnose their clients. I have also witnessed a physician that uses and relies on muscle testing as his primary source for putting people on supplements and even hormones. In fact, I have known him to take clients off their needed pharmaceuticals for serious chronic diseases with deleterious outcomes.
Now in my practice I do use blood and urine testing and sputum testing to help for a final diagnosis, but only as an adjunct to my 2–3 hours interview with the client. For example, if a thyroid blood test comes back within the normal limits; but the client tells me that they are losing their hair, always cold, gaining weight but exercising and not eating differently then before, fatigued constantly and that the outer 1/3 of their eyebrow has fallen out I strongly consider that they have a low thyroid condition (hypothyroid) in spite of the laboratory test. I may order other thyroid tests to rule out certain thyroid conditions that I did not originally test for like an autoimmune thyroid problem, but start treating the client on a low natural thyroid medicine. Not conventional I know but it has never failed me. The point is that I do not use just testing to come to a diagnosis but symptoms and signs, the interview and physical along with any tests I believe necessary.
Back to the title of this article and my beliefs! If a person intermittently but often gets sick, or gets chronically sick without respite no matter how long they have been treated by others and myself I need to do certain things and go through certain thoughts.
- Everything has been ruled out but the person is sick, fatigued may be no worse but certainly no better.
- It is not unusual for the person for some reason to have at first made themselves believe they are ill for one of the reasons stated or one of which I have not thought. But this stress probably has brought down their immune system so that they either have now created the problems for real that they stated or another dis-ease. It is of course, in my experience that with stress the client is going to have more then just one dis-ease. This can be treated still by many holistic techniques such as specific natural intravenous techniques, hypnosis, guided imagery, exercise, especially nutrition and I even often recommend and give a list of funny videos as a prescription.
- Go over their life style again: diet, exercise, stress
Permit me to go through a case study which may or may not apply to anybody else out there. It has to do with a client of mine that came in so fatigued that she could not function doing anything except bathroom obligations. She would be defined as a chronic fatigue patient since this had been going on for years and she saw many allopathic and integrative-complementary doctors and healers before being brought to me by her sister. All her laboratory results were normal including the complete blood count and no anemia was evident,etc. Her sister incidentally was an alternative practitioner . She not only took care of her older sister and also the mother who interestingly had similar symptoms of fatigue. In the family there is an older brother that did energy machine healing who was free of any similar problems. I treated the sister with IVs of colloidal silver, Mega Vitmins with extra B12 and folic acicd, and amino acid IVs since her nutrition regimen was poor and she stated she was too exhausted to eat even though her younger sister prepared the family meals. Treated her for weeks also with stress therapy. Finally I told her she needs someone that knew more then me and actually it would be helpful if the person was experienced in Chronic Fatigue Immune Disorder. She never got better. The sad part is her younger sister developed the same symptoms, again with a complete work-up and labs all normal. She became bed ridden and fatigued constantly and could not work neither.
I believe to this day that this case points to how a placebo-being the mind – can also be negative. I hope that it also points out that stress is the main culprit. if one takes allopathic or alternative treatments and does not search for the cause both treatments should be called alleviation and not cures.
Alan J. Sault MD, ABHM-Diplomat, Author: Emotional Vampires and Your Hormones: an holistic physician’s view on how stress affects your well-being and what you can do about it
Hi..I wanted to say I can relate to the lady that was”so fatigued” she couldn’t do anything but “bathroom” duties! That is me right now! I can barley brush my teeth. It’s terrible! This post is for sure not relatable to me in that I don’t want to get better though. At this point I can’t see any light but I MUST find away to get better. I was hospitalized a few weeks back because my thyroid was so “out of whack” as ER doc put it. I was admitted for observation. I was released with 4 prescriptions, 3 vitamins..multi vit-vit B-folic acid and a nausea med. I didn’t see Dr before I left and didn’t quite understand the reason for the vitamins. I saw my reg Dr in the next few days, he did his own blood work and said I didn’t need the vitamins. After finding you and reading your blog for couple days, I’ve started taking those vitamins. BTW, my TSH was 21 at hospital. I’m still waiting on my endo to call me back after I talked with her nurse about my hospital stay. I’m just having a really hard time right now and not getting much help from my Drs! It’s been nice to to have found you. What do you think of the vitamins I’m taking?
I really sympathize with all you have been through. I write the blogs to help people but hopefully they pick up that stress is the real cause. Meds be they supplements or pharmaceuticals are usually are alleviating a dis-ease and finding the cause. Do not forget that just being sick, even with one illness, causes stress and lead to a cascade of illnesses. That is why my book can really have a person understand stress and well-being and what to do about it. There are many options for you in the book. It is difficult to diagnose a person without taking a careful history and physical and I like to go over as much recent labs as possible (hopefully 2-3 yrs of them). I believe your first steps would be stress management and for you to learn to do this so you do not need someone all the time.
Isn’t it possible that the Nocebo effect occurs when someone doesn’t expect to recover, not necessarily not wanting to recover? There fore the kind of people susceptible to this would be pessimistic, depressed maybe..?
Still if the Nocebo happens to a person it may be that the person does not want to get better and creates a negative reaction to a placebo as one might to a real medication. Of course a placebo in some people might generate a real allergic reaction or possibly even a disease or autoimmune disease. A healer should not just put the person off as a “nut case” but rather investigate all possibilities.
That is a thought! But if they do not expect to get better there are reasons also for this. Maybe it is the physician’s fault for not giving the person more positive views. For ex. if a lady has breast cancer and the physician says 60% of people die with your type, he could be also saying that 40% do great. It could also be that the person is a negative person in many ways because of different “happenings” in their life. So many reasons that a person does not believe or expect to recover: hopefully they have positive and fun friends and also a healer. Maybe you are one of those since you are quite thoughtful in your question.