The Nocebo Effect

There is an everyday  occurrence in modern clinical  psychiatry that is seldom discussed, poorly understood and constantly overlooked in daily practice.

It has a myriad of clinical, social and psychological consequences. It facilitates the bashing  of the pharmaceutical industry and modern psychiatry, it promotes the so prevalent negative stigma towards mental illness. The treatment for it is usually meaningful psychotherapy, but most therapists don’t know much about it, and many have never even heard of the concept. The phenomenon is present in just about every specialty in medicine, with the exception of maybe pathology or diagnostic radiology. Ironically it drives up the cost of health care, increases the practice of defensive, if not paranoid medicine, and sends us into a quandary when trying to help our patients. It leads us on quests and safaris to find a treatment, any treatment that will be beneficial, and somewhere along the lines we end up working a lot harder than the patient, to try to help and improve the patient’s well-being. Working and trying harder than the patient, is a political powder-keg and a taboo and unacceptable thing for doctors to admit on the internet or anywhere else. Yet at least in psychiatry it can be quite diagnostic of the phenomenon.

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