by Charles H. Booras, MD

Revised 7/27/97


Expectation is a powerful force in sickness and in health. Psychological factors do indeed influence the course of illness, though we're a long way from understanding how this works.

According to Dr. Herbert Benson, president of the Mind & Body Medical Institute at Harvard Medical School, the placebo (a dummy drug or treatment that has a positive effect simply because the patient believes in it) has its counterpart in the nocebo. In a clinical setting, this is the negative influence of a patient's fear, anxiety, and hopelessness, usually interacting with what is perceived as a physician's doubts or indifference. Negative expectations can work against you, however, even when no physician is involved at all.

Nocebo's can work in several ways. First, there's the more generalized form, in which a person who is depressed and pessimistic may be more susceptible to various illnesses and is less able to recover once ill. There is a large body of evidence showing that depression, hostility, anger, and pessimism can indeed have adverse health effects over the years. Second, there is the more specific kind of nocebo. It's been shown, for example, that women with breast cancer who have a fighting spirit may survive longer than those who feel hopeless. Other studies have found that chronic fear of heart attack can bring on chest pain even when no signs of heart disease can be detected. Recently a study in Circulation found that depression, as measured in almost 1,000 Danish subjects with coronary artery disease, predicted their death, especially among women.

In ancient times, physicians knew that lifting a patients spirits played an important role in relieving pain and curing illness.

Modern medicine, with it's army of specialists and it's reliance on testing, drugs, and technology, may need to pause and hearken back to those earlier times. A doctor's positive attitude is no substitute for knowledge, but "lifting the spirits" should always be included as a medical goal. The role of emotion in sickness and in health remains, to a large extent, a mystery. Optimistic, sweet-tempered people do fall ill and die; and the angry and pessimistic have been known to live long and healthy lives.

Nevertheless, keep these suggestions in mind.

Try to choose a doctor with a positive and open attitude. One who will take the time to talk with you, answer your questions, and respond sympathetically to your concerns. Form a partnership with your healthcare provider and make decisions together. A physician-patient rapport is therapeutic. If this healing connection is missing, then you are both better off by severing the relationship.

Try to learn better attitudes. Admittedly, it is difficult to turn pessimism into optimism. Personality traits are notoriously hard to alter. Consider some form of counseling or joining a support group. If you are depressed, remember that depression can usually be treated successfully. Get help. Chronic depression is not something you have to live with.

The connection between mind and body is very powerful. Our bodies have a miraculous array of systems available to keep us well. I feel we all have the ability to tap into this resource in order to heal ourselves. Making the most of this resource involves a healthy lifestyle, as well as a healthful attitude.

All pages Copyright
TGila Productions
(904) 739-2292

Disclaimer: The information above is provided as a convenience to you. Jacksonville Medical Park makes no endorsements as to the professional qualifications, licensing, or accuracy of any information provided. We assume no responsibility for any services provided by our participants. Information accessed through Jacksonville Medical Park is presented in summary form in order to impart general information relating to certain diseases, ailments, physical conditions and their treatments. Such information is not complete and should not be used as a substitute for a consultation or visit with your physician or other health care provider. Information accessed through Jacksonville Medical Park is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatments. Jacksonville Medical Park makes no warranty as to the information's completeness, reliability or accuracy. Should you have any health care related questions please see your physician or other health care provider promptly. Thank You.