This review suggests that the power of positive thinking is real. In the review, author Donald Cole of the Institute for Work and Health in Toronto said "In each case the better a patient's expectations about how they would do after surgery or some health procedure, the better they did”. Across a wide range of clinical conditions, from lower back pain to heart surgery, patients who felt they would do well in recovery, did. Patients who were scared or pessimistic about their recovery did not recover as quickly as the optimists or as well.
A review in Psychosomatic medicine concluded that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations.
What is the effect of a negative outlook? A study in Science Translational Medicine was performed to find out. The researchers strapped a heat-beaming device onto the legs of 22 healthy volunteers, zapping it until people rated their pain at nearly 70 on a scale of 1 to 100.
The researchers then hooked up an IV to give them the powerful morphine-like painkiller, remifentanil. Typically used for surgery patients, it works rapidly but also is metabolized rapidly. It was able to be switched on and off as researchers alternated between giving the drug or plain fluid.
As expected, when the researchers told the volunteers they were about to inject the painkiller the pain levels dropped, even though they never injected it. They then told the volunteers that they were stopping the drug (they never did) and that the pain would probably get worse. Sure enough the reported pain levels increased back to almost pre-treated level as their expectations canceled out the effect of a proven and potent painkiller. This is the Nocebo effect.
How can negative thoughts or anxiety affect our health?
An article in the new scientist said it is well accepted that negative thoughts and anxiety can make us ill. The mechanism behind this is thought to be stress. Stress triggers physiological pathways such as the "fight-or-flight" response which is mediated by the sympathetic nervous system. These have evolved to protect us from danger, but if switched on long-term they increase the risk of conditions such as diabetes and dementia.
Optimism seems to reduce stress-induced inflammation and levels of stress hormones such as cortisol. It may also reduce susceptibility to disease by dampening sympathetic nervous system activity and stimulating the parasympathetic nervous system. The latter governs the so-called "rest and digest" response - the opposite of fight-or-flight.
What to take from this information and how to help
If you are starting a new treatment program, whether it be chiropractic care with me or something else, here a few simple tips to help get the best results and avoid the Nocebo effect:
- Enter in the process with an open mind. If you go into it with a pessimistic attitude, as the research shows above, you probably won’t get the results you are after.
- If you have any worries about the care or the process involved, talk to your provider about it, they will be able to answer your questions and ease your concerns.
- The healing process can take time. Results are not always immediate. Be patient. Focus on the positive outcomes not the negative ones.
- From a chiropractic point of view, if you are not comfortable with a certain technique there are other ones we can use which my suit you better. Just ask.
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Chida, Yoichi MD, PhD; Steptoe, Andrew DPhil Positive Psychological Well-Being and Mortality: A Quantitative Review of Prospective Observational Studies Psychosomatic Medicine: September 2008 - Volume 70 - Issue 7 - pp 741-756