Michael Bernstein on Psychogenic Illness and the Nocebo Effect

The Michael Shermer Show Archives

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Can beliefs make you sick? Consider “The June Bug” incident from a U.S. textile factory in the early 1960s. Many employees began to feel dizzy, had an upset stomach, and vomited. Some were even hospitalized. The illness was attributed to a mysterious bug biting workers. However, when the CDC investigated this outbreak, no bugs or any other cause of the illnesses could be identified. Instead, it appears to be an illness caused by the mind — that is, sickness due to expectation.

The June Bug story is one of many striking examples of the nocebo effect, a phenomenon best summarized as the occurrence of a harmful event that stems from expecting it. The nocebo effect plays a role in side effects for some of the most commonly prescribed medications. It provides a lens for understanding how sensationalized media reports that sound alarm about public health might even become a self-fulfilling prophecy. It might even explain the mysterious symptoms associated with Havana Syndrome, during which dozens of US government employees fell ill after reportedly being exposed to an unidentified sound wave in Cuba.

We are just discovering the power behind this effect and how it can be ethically mitigated. Enlightening and startling, The Nocebo Effect is the first book dedicated to investigating this fascinating phenomenon by the foremost experts in the field.

Michael Bernstein, Ph.D., is an experimental psychologist and an Assistant Professor in The Department of Diagnostic Imaging at Brown University’s Warren Alpert Medical School. His work is focused on harnessing the placebo effect to reduce opioid use among pain patients. He is Director of the Medical Expectations Lab at Brown. He is the co-author of the new book The Nocebo Effect: When Words Make You Sick, with Charlotte Blease, Cosima Locher, and Walter Brown. https://MichaelHBernstein.com/ Twitter/X: @mh_bernstein

Shermer and Bernstein discuss:

• Placebo
• Nocebo
• Nocebo and brain imaging
• Voodoo deaths and hexes
• The psychology of placebo and nocebo effects
• The biology of placebo and nocebo effects
• The ethics of placebo and nocebo effects
• Nocebo and Covid-19
• Alternative and Complementary Medicine
• Pain, anxiety, depression and other subjective effects
• Anticipatory nausea and learning
• Risk assessment: expected dread associated + how much is known about the risk
• When Psychotherapy harms
• Cognitive Behavioral Therapy (CBT)
• Side effects
• Patient-clinician interactions
• Mesmerism and Benjamin Franklin’s test
• Psychogenic illness
• Havana Syndrome.

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