Leisure, Lifestyle & Wellness
The Nocebo Effect

The anticipation of disaster is often worse than the disaster itself


Ellen Langer is probably the longest serving psychologist at Harvard, at 67 years. No one, to date, has done as much research as she has on the connection between the human mind and disease.


Her research has brought to light the vital role that mind plays in causing as well as curing disease. She is the one who gave respectability to the placebo effect—the good that a positive mindset can do for the body. She showed that the fear of disease and negative prognoses, especially in cancer and heart disease, are among the most important factors that interfere with the body’s healing capacity, also termed the ‘Nocebo’ effect.

One case report is very significant. There was a middle-aged man who came for a check-up; his routine chest X-ray showed a coin lesion—a small rounded shadow whose details were not clear.
The doctors told him, in no uncertain terms, that the ‘coin lesion’ was due to cancer and needed further probing. The man got admitted and, to cut a long story short, he was dead in six months due to fast spreading lung cancer. These should not be called cancers. They have a new name—incidentalomas.
One of his relatives was a doctor who happened to look at his miniature chest X-ray taken 30 years earlier when he joined his government job. The coin lesion was there at the same place.
The moral of the story is that if that coin were malignant, he would have died long ago. The minute his mind was given the Nocebo signal, the cancer started growing very fast, to kill him in six months. That shows the power of the mind over the body. Both have now been shown to be two faces of the same coin.
Langer’s recent study tried to quantify the Nocebo effect. “In that study her staff will encourage the women to think anew about their circumstances in an attempt to purge any negative messages they have absorbed during their passage through the medical system.” This is crucial, Langer says, because just as the mind can make things better, it can also make things worse. The Nocebo effect is the flip side of the more positive placebo effect; she says that one of the most pernicious Nocebo effects can occur when a patient is informed by her doctor that she is ill. The diagnosis itself, Langer says, primes the symptoms the patient expects to feel. “You change a word here or there, and you get vastly different results,” Langer says. She told scientists about a yet-to-be-published study she did in 2010, that found breast-cancer survivors who described themselves as ‘in remission’ were less functional and showed poorer general health and more pain than subjects who considered themselves ‘cured’.
Another patient of mine comes to mind. The septuagenarian former governor of Karnataka had his routine check-up with an illustrious Delhi cardiologist, who saw his ECG (electro-cardiogram). He pronounced that the old man had serious heart disease and needed an urgent angiogram and may be either an angioplasty or a bypass after that. Someone told him to see me.
I found that the anomaly was seen even in his ECG report taken 35 years ago.
When I told him that he needs no treatment, as this must have been a condition that he was born with, his doubt remained because his other cardiologist was an illustrious one and could not have been so wrong! I took the two readings and explained the changes in great detail to him, showing him that whatever ‘serious disease’ he was supposed to have had was there 35 years ago also. If he could be active and working for 35 years with the block, he could go on for another 35 years.
His face brightened and he is still alive, kicking and active! Removing his Nocebo effect did the trick.
May I earnestly appeal to our colleagues not to frighten patients with Nocebo thoughts in the first place?
‘You have cancer and only six months to live’; 'if you do not get angioplasty right now you might die on your way home’. Some cancerologists argue that they have to tell the patient the truth.
Where is the truth in their statement? Science does not know what cancer is? How do we so confidently give the patient a death warrant? Even if one has to tell a small lie to avoid a Nocebo situation that might save a life, it might be worth weighing our words, before we speak as doctors.
“The art of medicine consists in amusing the patient while nature cures the disease.”Voltaire
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)


Nifty, Sensex will try to head higher –Weekly closing report

As long as Nifty does not close below 8,320, the index may head higher


The S&P BSE Sensex closed the week that ended on 14th November at 28,047 (up 178 points or 0.64%), while the NSE's CNX Nifty ended at 8,390 (up 53 points or 0.63%).


Previous week, we had mentioned that the Indian benchmarks may move sideways.
Although the week began with the Nifty reaching its new all time high, it was unable to sustain at that level and closed Monday at 8,344 (up only 7 points or 0.09%). The cabinet reshuffle brought in four ministers into the Narendra Modi government, while three took charge as Ministers of State (independent charge). The Prime Minister also included 13 ministers of state in his cabinet on Sunday.

On Tuesday, Nifty closed at 8,363 (up 18 points or 0.22%). The market move was influenced by the news of Ministry of Civil Aviation releasing the Draft Civil Aviation Policy, which mentions that airports are to be designed as integrated multi-modal hubs to provide the best possible service levels, as well as potential for growth. Along with this, the Ministry of Road Transport & Highways and the Ministry of Railways signed a memorandum of understanding (MoU) on policy related to constructions of Road Over/Under Bridges (ROBs/RUBs) on National Highway corridors. Meanwhile, the Reserve Bank of India (RBI) issued a revised Regulatory Framework for Non-banking Finance Companies (NBFCs), with a view to streamlining the regulations for the sector.

On Wednesday, Nifty broke the high it hit on Monday but the move was supported by lower volume. Nifty closed at 8,383 (up 21 points or 0.25%). After market hours the government released the IIP data for September 2014, which was at 2.5%, compared to 0.4% recorded in the month of August and the CPI (consumer price index) inflation stood at 5.52% in the month of October as compared to 6.46% reported in the month of September.

Nifty closed Thursday in the negative for the first time during the week. India and the US claimed to have resolved their differences on public stockholding of food and this opened the way for implementation of the WTO trade facilitation deal, which India refused to sign earlier.

On Friday, Nifty closed at all-time high after India's wholesale price inflation (WPI) dropped to a five-year low of 1.77% in October over continuing decline in food prices, including vegetables.

Out of the 27 main sectors tracked by Moneylife, top five and the bottom five sectors for this week were:


ML Top sector


ML Worst sector




Oil & Gas


Auto Components




Consumer Products




Lifestyle & Leisure


Non-Ferrous Metals


Consumer Durables








3 years ago

Is there any regulation regarding maximum distance between two ATMs of a bank. A customer should not be compelled to use other bank's ATM due to cartelization.

IPL Spot Fixing: N Srinivasan, Meiyappan, Kundra named in Mudgal Committee report

The list released by the Supreme Court consists seven names out of the 13 people who were named in the Mudgal Committee report


The Supreme Court on Friday disclosed names of people probed by the Justice Mudgal Committee for their alleged links to the Indian Premier League (IPL) spot-fixing scam.


It includes N Srinivasan, the president of Board of Control for Cricket in India (BCCI), BCCI's chief operating officer (COO) Sunder Raman, Rajasthan Royals co-owner Raj Kundra and Chennai Super Kings team principal Gurunath Meiyappan.


The court further directed the findings of the Mudgal report on non-cricketers to be disclosed.


According to reports, Stuart Binny and former England batsman Owais Shah are allegedly also under scrutiny. One player from the Chennai Super Kings team is also under scrutiny.


According to Aditya Verma, the secretary of Cricket Association of Bihar (CAB), who was the petitioner in the case, the apex court has not revealed the names of the big players.


"The Supreme Court released the seven names of the 13 people who were named in the Mudgal report. Three of the names are of players, while the others are of officials. The court requested that the names of the players not be disclosed," he said.


"The names that have not been released are all of players, but the court has kept the revealing of the said names on hold as of now," he added.


Verma also questioned the motives behind the BCCI's proposal to postpone its annual general meeting (AGM).


"Even after top officials of the BCCI have been named by the Mudgal report, why is the organisation not willing to go ahead with its AGM and name new officials? I request all state associations to not stand by this," he said.


On 25th March, the court had told Srinivasan to step down from his position as BCCI president in order to ensure a fair investigation into the betting and spot-fixing charges levied against his Meiyappan, the team principal of Chennai Super Kings.


The BCCI does not recognize the CAB and Verma, who had filed the public interest litigation (PIL) against the cricketing body last year, accusing it of corruption.



Joji Achangadon

3 years ago

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