Psychogenic Illness and the Nocebo Effect

The Michael Shermer Show

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The nocebo effect demonstrates how the mind can cause illness through negative expectations, as highlighted by a famous incident in a U.S. textile factory in the 1960s. Workers believed a bug was causing dizziness, nausea, and other symptoms, yet no physical cause was found. This mysterious outbreak underscores the potent influence of beliefs on health, a phenomenon that’s becoming increasingly relevant in understanding modern psychosomatic conditions like the controversial Havana Syndrome.

In this episode, Michael H. Bernstein, an expert on placebo and nocebo effects, explains how psychological factors can result in perceived physical harm. As co-author of The Nocebo Effect: When Words Make You Sick, Bernstein shares insights into the intersection of psychology, medicine, and public health. His research focuses on reducing opioid dependence by leveraging the placebo effect, while also exploring the ethical concerns surrounding nocebo-related side effects.

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.

Shermer and Bernstein discuss: the placebo and nocebo effects, brain imaging, and the ethics of using these phenomena in medicine. Bernstein discusses the biology and psychology behind these effects, touching on notable cases such as Voodoo deaths and Havana Syndrome. Other subjects include psychogenic illnesses, patient-clinician interactions, alternative medicine, and how expectations can amplify or mitigate pain, anxiety, and depression. The conversation also delves into anticipatory nausea, psychotherapy, and the impact of cognitive behavioral therapy (CBT).