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The Nocebo Effect : Be Careful What You Believe

“Nocebo – (Latin for “I shall harm”) is an inert substance or form of therapy that creates harmful effects in a patient. The nocebo effect is the adverse reaction experienced by a patient who receives such a therapy. Conversely, a placebo is an inert substance or form of therapy that creates a beneficial response in a patient. The phenomenon by which a placebo creates a beneficial response is called the placebo effect. In contrast to the placebo effect, the nocebo effect is relatively obscure.” – Wikepedia

Virtually everyone is aware of what is sometimes called the power of suggestion. If you’veIllness ever been to a magic show, thought you had scabies, or got freaked out by some show about snakes on Animal Planet, you know how it works. You are exposed to, or told something, that you begin to believe relates to you. That scratching that you see somebody else engage in triggers something in you and you respond in kind, literally feeling their pain, at least until you realize that it’s not really happening to you. Anyone who has ever taken Psychology 101 is aware of the placebo effect and the positive benefit that comes from the power of belief. (See also: http://mindbodycoach.org/really-power-placebo/ ) What most people are not aware of is the nocebo effect, the negative impact from negative beliefs, expectations, and previous negative experiences. Unfortunately, the nocebo effect is even more powerful and prevalent than the placebo.

As a practicing psychotherapist and coach for the past 20 years, I am acutely aware of the power that the nocebo has on people’s lives. People carry negative beliefs and expectations well into their senior years that impact their lives in negative ways, impose limitations on quality of life, and even lead to early or possibly sudden death. Consider the following : Eighteenth Century Viennese neurologist and university teacher, Erich Menninger von Lerchenthal, described how students at his medical school picked on a much-disliked assistant. Planning to teach him a lesson, they sprung upon him before announcing that he was about to be decapitated. Blindfolding him, they bowed his head onto the chopping block. One student swung and ax into a chunk of wood, while another dropped a wet cloth on his neck. Convinced it was the kiss of a steel blade, the poor man “died on the spot”.

The power of the nocebo as a cause of sudden death is well documented. In many cultures, the curse of a witch doctor or shaman has led to the demise of believers. In the modern era, people frequently get sick from the flu, viruses, and exposure to elements that are both real and imagined. In fact, with many minor illnesses it is really difficult for science to know what the actual cause is – an exposure to a germ or virus, the power of the nocebo, or some combination of the two. Research on the power of the nocebo is very hard to quantify-how it happens, who is more susceptible, or how frequently such events occur, but most of us have been exposed to this either through our own beliefs or those of people that we know. In this day and age the Internet is full of warnings, anecdotal tales of medical catastrophes, strange occurrences, and a host of ideas that can wreak havoc on the imagination of someone prone to the power of the nocebo.

We’ve all heard stories of someone who at an advanced age literally chose the way that they would die. My paternal grandmother, a 5 foot tall bundle of Italian energy, passed away in her sleep at age 84, exactly as she had predicted for the previous 10 years. As her mind began to deteriorate, she would occasionally experience brief waves of depression and wish that she would go to bed that night and not wake up. She passed away peacefully in her sleep early one Sunday morning, literally choosing the way that she wanted to exit this life. Coincidence or choice? Really doesn’t matter because my grandmother had the luxury of choosing the way that she wanted to depart this earth. If your family is similar to mine, I’m sure there is some similar story in your family tree as well.

The power of the nocebo also influences beliefs about our capabilities, likability, skills, and ability to learn new tasks. For whatever reason some people are impacted more by negative messages in childhood than others. These messages come from parents, teachers, clergy, friends, and classmates where, for whatever reason, something that is said to us or happens to us sticks with us for a lifetime. I had a counseling client years ago who was in his early 40s and never had a meaningful relationship as an adult because of a traumatic breakup when he was in the eighth grade. A girl broke up with him rather publicly at an eighth grade dance. His behavior through his high school years and beyond reinforced this belief-that he was undesirable, ugly, and incapable of having a meaningful relationship. One of the great things about life is that age is a great equalizer. The “beautiful people” of our high school years eventually look like those who were labeled as physically ugly or undesirable. Any high school reunion beyond the 30 year mark proves this. People still carry these negative beliefs about themselves that are formed in adolescent and early teen years, one of the more interesting and detrimental aspects of the nocebo.

“The man who thinks he can, and the man who thinks he can’t, are both right.”-Henry Ford

As a former athletic coach and official I’ve seen this hundreds of times. Athletics tends to Sumobe a great laboratory for beliefs and the power of both the placebo and nocebo. Athletics are filled with thousands upon thousands of examples of athletes who either exceeded their physical ability through hard work combined with a powerful belief system or athletes who squandered a lot of God-given talent because they were “head cases,” unable to harness their ability. Those that succeed are able to put setbacks in perspective and assess their situations realistically, those who can’t fall back upon their negative belief systems. If you’re a sports fan, I’m sure you can think of hundreds of examples that illustrate this. For every Larry Bird and Carl Yastremski there is a Todd Marinovich and a Johnny Manziel.

We tend to believe our own thoughts. We are not always fully aware of where these thoughts come from. It’s not important to know where the thoughts are coming from as much as it is to be aware of the impact that our thoughts, self talk, and beliefs about ourselves have upon our current behaviors. We tend to believe our thinking and it becomes our “truth” even if it is not literally true. In therapy and coaching you can often see how people’s behavior reinforces their beliefs and how a person’s actions, or lack of, really make the faulty beliefs come true. Clients frequently respond to failure with logic such as, “See, I told you I couldn’t do it!”

Take a careful look at how you are influenced by the power of the placebo, but more importantly, the nocebo. Before you fall victim to the latest medical scare, before you fail at some task, or hesitate to take some chance, ask yourself: what am I thinking right now, where is this thought coming from, and is there some action that I could take that would give me a better outcome? You may be surprised at the answer. We all just may lead richer lives if we become aware of the role that negative belief systems and the nocebo affect play in shaping our reality.

“I discovered that everything you do is in response to a request or a suggestion made to rockyyou by some other party either inside you or outside. Some of these suggestions are good and praiseworthy and some of them are undoubtedly delightful. But the majority of them are definitely bad and are pretty considerable sins as sins go.” – Flann O’Brien, The Third Policeman


P. S. If you found this article helpful, you may benefit from some personalized mindbody coaching. Contact me at http://mindbodycoach.org/contact-us/ if interested in online mindbody coaching. Please check out my Products page through the link at the top of this post.. Follow me on Facebook, Twitter, YouTube, and social media. Email me with questions at john@mindbodycoach.org

Sleep: Life’s Secret Sauce

“Sleep is the single most important thing that you can do for your health.” – Shawn Stevenson, author of Sleep Smarter

Sleep is one of the most mysterious, misunderstood, complicated, maligned, yet simple things that a human being does. Most of us reluctantly spend about one third of our life asleep. We often drag ourselves to bed feeling that we are missing out on somethingSleep more important, more exciting, and more beneficial to our lives. It is complicated, somewhat mystical, and even feared by some people. It is the easiest, simplest, and most important thing that anyone can do for their physical, mental, spiritual, and emotional health. Why do so many of us find it to be a nuisance, a waste of time, and an obstacle to how we want to live our lives? How can we optimize it and make use of the incredible benefits of this very misunderstood third of our lives?

Studies indicate that the average person needs at least seven the half hours of sound sleep per night. The majority of people fall short of this number and it may be that many of those getting the required amount do not sleep soundly. If you follow this blog on a regular basis, you probably try to take care of all aspects of your wellness and health, exercising regularly, trying to eat healthy, and trying to de-clutter your mind and think positively. You do the best you can, keep up with the latest research and try to implement it in your life. Sleep is more than likely the forgotten ingredient in your wellness program, the secret sauce, the difference that makes the difference, that you probably have been overlooking. Ironic isn’t it? How can something so simple and biologically basic be something that you don’t pay enough attention to?

Much of the reason that the health and wellness benefits of sleep are under appreciated have to do with the kind of personality that develops a well thought out wellness program. Study after study indicates that people who have some sort of a wellness program lead more successful, happy, and fulfilled lives. They usually are the kind of people who try to cram as much living into those 24 hours as they possibly can. They want to maximize the time that they have available to them, and quite frequently have to make compromises with how those 24 hours are spent. Sleep, being the most taken for granted eight hours of their day, frequently gets shortchanged as people shave off an hour or two here or there in order to carve out a little more time for something deemed to be more important. Big mistake.

A solid and sound eight hours of sleep is a force multiplier in all aspects of your life. When people get adequate sleep on a regular basis, everything in their life gets better. Physical, mental, and emotional health benefit almost immediately and are the first improvements that people recognize. Less recognizable, but definite, are a person’s relationships and spiritual wellness. Intuitively, we all know this. Think about how bad you feel if you have something that impedes on your sleep two or three nights in a row. You feel absolutely horrible, you’re miserable, you hate the world, your life, and most of the people in it. You instantly recognize the reason – you haven’t been sleeping well. Conversely, it is very difficult to recognize the relationship between good sleep and our wellness. High achieving people tend to focus too much on those waking hours and try to squeeze out more than they should out of their waking existence.

The need for restful and solid sleep is built-in to our DNA. It is only in the last 130 years or so, since the development of artificial lighting, that people have not slept with the Cockrhythms of nature. People of the 19th century and before usually rose with the sun, slept shortly after sunset, and were only stressed out by things that related to their survival. The going to bed at 11 PM mentality makes no sense from the standpoint of human evolution or development. The mere act of going to bed an hour so after sunset would yield almost immediate gains. Instead, most of us make the big mistake that when we need more time, sleep is the first thing to be compromised. While you can “get by” with less sleep, should you? More importantly, what’s the trade-off and the cost to your health and wellness?

Here’s some things that we do know about the benefits of productive sleep:

  1. Sleep optimizes human growth hormone, or HGH. Human growth hormone is the anabolic hormone responsible for the growth of muscle, and tissue. Natural development of HGH ironically peaks around age 18, a time when most young people begin to skimp on their sleep requirements. As adults, sleep is the best time for us to optimize our production of HGH. HGH is better known as the hormone that is artificially given to athletes to improve their performance and to actresses and celebrities to make them appear more youthful. The greatest anabolic sleep will occur between 10 PM and 2 AM. If you are not sleeping soundly during those hours, you’re missing out on some pretty serious health benefits. One hours worth of sleep before midnight has approximately twice the value of an hour in the early morning. Get to sleep early to maximize your sleep quality and natural production of HGH.
    2. Sound sleep aids in the production of leptin, a hormone that is associated with weight control and energy. See also http://mindbodycoach.org/leptin-the-free-energy-boosting-weight-loss-miracle/ . It also reduces cortisol levels, a hormone associated with collection of health problems as metabolic syndrome. See also http://mindbodycoach.org/syndrome-x-the-not-so-silent-killer/ . Waking earlier enables a person to utilize this hormonal benefit more effectively.
    3. Sleep impacts our lives in ways that are not immediately apparent. When we feel rested and refreshed, we are less prone to moodiness and anger, more tolerant of others and life’s ambiguities, and generally more happy. Sleep deprived people frequently have poor relationships simply because of the inconsistent moods and attitudes that they bring to those relationships. Improve sleep = more tolerance of your fellow man. Obviously a good thing for all the relationships that one has.
    4. Sleep deprivation impairs thinking and learning motor skills. The National Highway Safety Administration has conducted studies that showed sleep deprivation to be as much of a problem on our national highways as driving while intoxicated. Some researchers think it is even a greater problem, because people don’t recognize it as such and it is harder to prosecute in a court of law. Sleep deprivation ranks highly in surveys that assess causes of poor productivity and accidents among workers.
    5. Adequate levels of sleep can prevent disease and illness, but also decrease the amount of time needed for recovery. There may be a link between sleep deprivation and the development of cancers. Some preliminary studies have been conducted that indicate that nurses working regularly on overnight shifts have a two 2/3 higher chance of developing breast cancer, but at this point further research needs to be done.
    6. Sleep is one of the most readily available and underutilized sources of emotional wellness. There is no mental health problem that sleep deprivation will not imitate. Many low levels mental health issues that people suffer with will improve almost instantly with an increase in the amount of and quality of sleep that one gets.
    7. Adequate sleep can effectively help people who have anger management problems cope almost instantly. Most people who are prone to problems with anger and affect regulation are significantly sleep deprived. This is not a coincidence.
    8. Sleep is when the benefits of your exercise program occur. Your workouts, even those light routines, break your body down. Growth occurs while resting and growth on all levels accelerate while sleeping. It is not enough to rest in a recliner and watch television. You must be sleeping soundly, preferably before midnight, in order to get the full anabolic effects of your exercise routine.
    9. Sound sleep is necessary to clear thinking during your waking hours. Recent studies indicate that one of the reasons that human sleep is to clear the mind of clutter and unnecessary information that we take in during the day. An average human is exposed to more sensory inputs in two weeks than our ancient ancestors were exposed to in a lifetime of 60 years. Sleep enables us to sort through and delete information that we do not need for survival. As a result of all this sensory stimulation, sound sleep is more necessary now than at any other time in human history. Sound sleep leads to clarity in decision-making. “I’ll sleep on it and give you an answer in the morning,” is more than a tagline in a pop song, it is an effective way to make important decisions.


Sleep has developed a bad rap in this highly velocitized and technological age in which we live. It is not a sign of laziness, in fact it takes self-discipline to get to bed at a reasonable hour. It is something that we shouldn’t fight, but we should accept and learn sunriserunto look forward to. It’s kind of ironic that something that is so beneficial and necessary to a high quality of life is something that most of us resist and fight.

Get to bed early. All aspects of your life will thank you.

Check the search box to the right of this post more more articles on how to improve the quality of your sleep.

“A good laugh and a long sleep are the best cures in the doctor’s book.” – Irish Proverb


P. S. If you found this article helpful, you may benefit from some personalized mindbody coaching. Contact me at http://mindbodycoach.org/contact-us/ if interested in online mindbody coaching. Please check out my Products page through the link at the top of this post.. Follow me on Facebook, Twitter, YouTube, and social media. Email me with questions at john@mindbodycoach.org

The Five Minute Procrastination Cure

“The impediment to action advances action. What stands in the way becomes the way” – Marcus Aurelius

The world of self-help, coaching, and counseling is fraught with nonsense, gibberish, Confusedand analysis paralysis. Many on both sides of the couch assume that if one only knows why something is the way it is, then he will be miraculously resolved, worked through, and disappear. Problem solved due to insight. While sometimes insight and analysis can lead to change, it may just be a little bit more simple than. Sometimes action is required before one figures out why. Asking how is sometimes better than asking why.

Everyone, whether they engage in counseling or coaching or not, has feelings and behaviors that they wish to change. Each of us has something in our human experience that we wish was different. Sometimes they are major things, sometimes minor. Regardless of the size of the problem, the initial reaction tends to be stagnation, procrastination, and a feeling of stuckness. We all know that feeling, it’s as normal for a human being as breathing. The feeling is often accompanied by internal dialogue that says things like if only, I’m going to, I will soon, and some day. Often time passes, nothing changes, and someday never comes. This action can lead a person to feel incompetent, powerless, and stuck.

The answer is obvious: “Just Do It!” We all know this and have known well before Nike made it an ad campaign slogan in 1988. Duh! Why is it that so many of us don’t take the initiative and act upon this simple advice?

The reason is simple, you are waiting to feel inspired, and then you will act. Most humans believe that feelings are facts. We live in a world of parallel experiences, the outside, external world that we live in, and our own internal world of subjective feelings and emotions. We believe that our feelings and emotions are reality, after all they are the way that we interpret and negotiate with the outside world. Sometimes, however, we get caught up in our internal experience and allow that to dictate how we negotiate our environment. Procrastination often comes because of something internal, a feeling state, where we are waiting for inspiration to take action.

Behavioral scientists have an answer to this root cause of procrastination and inaction. Feelings often follow behavior. In other words, if you do something your feelings about that thing will begin to change. Your behavior creates the inspiration required to get a task done, to make a change, and to be productive. Your internal reality changes because you’ve done something, tangible proof that you can accomplish a task.

Not exactly rocket science here. Your entire life you’ve done this without noticing it. For example, as a child, you learned literally thousands of extremely complicated things because you took action, just did them, and didn’t think about it. We forget about how difficult it was to tie your shoes, learn to read a clock, write your name, (remember cursive writing?) read a book, throw a ball, etc. As a result, we also forget the intense pride, joy, and feeling of competence from accomplishing something that once appeared impossible.

The answer is simple, Just Do It! Before you say, “Yeah, right,” here’s a way to break it down using what is called the Five Minute Solution:

Pick that task that you have been putting off doing. You know the one, it’s been nagging you for weeks. On one level you know it’s simple, but you just can’t bring yourself to do it. Yeah, that’s the one.
Set aside five minutes. Five minutes, no more and no less. In fact, set an alarm on your watch or phone to make sure that you dedicate exactly five minutes to the task.
past dueStart. You can do any aspect of the task as long as it is toward the ultimate goal that you know you need to accomplish. For example, if you’ve been putting off your tax returns then spend five minutes gathering your W-2’s. If that takes less than five minutes then continue on to the next task, calling an accountant, tax preparer, or choose an online software program. If it’s paying bills, then gather the bills, lay out the statements on a table, get your checkbook ready, and begin. You get the idea.
Stop when the alarm goes off. This is where it gets interesting. Because you are only allowed five minutes, you’ll notice how frustrated you are when the alarm goes off because the rule is you have to stop at five minutes. That frustration is a feeling. Stop anyway. This has a paradoxical impact on your emotions. You find yourself frustrated that you can’t continue with a task that you dreaded starting in the first place.
Don’t hesitate or overthink during that five minutes. All thoughts, efforts, and behaviors during that five minutes should be dedicated toward accomplishing the tasks at hand. Stay focused on what you need to do next, then next, and then next, until that alarm goes off.

“Bodies in motion tend to stay in motion. Bodies at rest tend to stay at rest.”-Isaac Newton

Action creates momentum and trumps affirmations, self talk, willpower, and want to. leapStudies have shown consistently that actions can change brain chemistry and that the new neural connections create positive thinking and new belief systems. We are all more likely to continue toward attaining our goals if we believe that we can accomplish them. Give yourself five minutes to lean into some task that you have been putting off and just do it. You’ll be surprised how it feels.

“You may delay, but time will not.” – Benjamin Franklin


P. S. If you found this article helpful, you may benefit from some personalized mindbody coaching. Contact me at http://mindbodycoach.org/contact-us/ if interested in online mindbody coaching. Please check out my Products page through the link at the top of this post.. Follow me on Facebook, Twitter, YouTube, and social media. Email me with questions at john@mindbodycoach.org

Analysis Paralysis, Decision Fatigue, And Diseases Of Choice

“A good plan, violently executed right now, is far better than a perfect plan executed next week.” – George Patton

To live in the 21st century, almost by definition, is to have a multitude of choices about Explode headvirtually everything. We start our day with hundreds of choices about the most basic of human needs. What kind of toothbrush and toothpaste to use, thousands of breakfast choices, clothing choices, ways to get to our jobs, and on, and on, and on. We grow up having to make so many decisions and choices that many people inadvertently learn to overthink things. We often overanalyze, overthink, and overcomplicate our lives as a result of this expectation that there is a perfect choice to be made. The result is a life that is overcomplicated, indecisive, and often disillusioned.

While choice is good, giving life variety and excitement, do we really need that many choices? The simple act of going to a supermarket to purchase food can be paralyzing at times. Walk into any modern food store and observe the number of choices you have for the most basic of items. For example, something as simple as a loaf of bread could be Decisionscomplicated by the 50+ choices you have on the shelves in front of you. A simple bar soap leads to a similar amount of choices. While most people don’t agonize too much over which ones to buy, being creatures of habit we tend to gravitate towards those that we have already tried, this illustrates the possible confusion and overanalyzing that has become a part of modern life. Think about it. How many channels do you have on your television? How many sources of information do you have at your fingertips? How many food choices, coffee choices, entertainment choices, and choices of jobs, partners, and living situations do you have? It can get overwhelming at times.

The result of all these choices becomes what is frequently referred to as analysis paralysis, a pattern of over analyzing and overthinking a situation so that an action or decision is not acted upon, in effect paralyzing the outcome. The decision becomes overcomplicated because the person gets bogged down in the details, other options and choices, and what has become known as “what if” thinking. What if it doesn’t work? What if it’s different than it’s supposed to be? What if I have made the wrong choice? What if I’m choosing this over a better option? In many cases this hesitation leads to an opportunity lost due to an option not being chosen at the appropriate time. Doubt, fear, and hesitation allows what may have been a golden opportunity to slip away.

Living in the information age gives us literally millions of choices for things that were far more simple as recently as a decade ago. Browse for an item on any of the online marketplaces for something simple, but don’t buy it immediately. For the next few weeks you will be inundated with pop-ups for that item from hundreds of other online marketplaces trying to entice you to buy that product from them at a better price, with better quality, and free shipping. You are literally stalked by a marketing strategy that capitalizes on the human tendency towards over analyzing. Many who browse the Internet for goods, services, or relationships are frozen, waiting for the perfect item, perfect price, or perfect partner, afraid to make a choice now because of fear of missing out on a perfect situation that may materialize later.

Behavioral scientists have studied variations of analysis paralysis and come up with a number of ways that this phenomenon occurs. Here are some of them:

⦁ Hick’s Law. This describes the situation where the number of choices a person has available to them correlates to the time that it takes a person to make a decision. Put simply, too many choices leads to slower decision-making and thinking, resulting in an opportunity lost due to the passage of too much time.
⦁ Decision Fatigue. This describes the deterioration in the quality of decisions made over a period of time where numerous decisions have been made. For example, studies show that judges in court rooms make less favorable decisions as the day goes on. They are more lenient and considerate in the morning and more abrupt and make less favorable decisions later in the day. As an individual mentally or physically fatigues, they make ill thought out decisions simply to be done with it.
⦁ Impulse Buying. Supermarkets know that people in checkout lines will frequently make quick decisions at the last minute about items that they don’t need or even want. Marketing strategists take advantage of their customer’s mental state, low blood sugar, and boredom while waiting in checkout lines by the candy rack and those crazy headlines on newspapers such as the National Inquirer or the Globe. How many times have you grabbed something on the way out of the store, thrown it on the counter and impulsively bought it at the last minute?

How a person makes decisions is a complicated matter, influenced by personality, upbringing, previous experiences, and opportunity. Making choices is a basic human freedom that we all enjoy as a result of being thinking mammals. Unlike other mammals, we can’t merely go with our basic instincts and genetic determinism. However, unlike other mammals, we may be spending and inordinate amount of time worrying about if we will make or have made the right decision. We all have the ability to adjust, adapt, and modify most decisions that we make. To be flexible in our thinking, we need to be willing to take risks and be less than perfect. Sometimes “good enough” can turn out to be far better than you ever expected.

“Of all the words of mice and men, the saddest are, “It might have been.” – Kurt Vonnegut

To delay a decision is to make a decision. Sometimes you have to make a choice, breakrearview off that rearview mirror, and drive.


P. S. If you found this article helpful, you may benefit from some personalized mindbody coaching. Contact me at http://mindbodycoach.org/contact-us/ if interested in online mindbody coaching. Please check out my Products page through the link at the top of this post.. Follow me on Facebook, Twitter, YouTube, and social media. Email me with questions at john@mindbodycoach.org

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