Negative Expectancy Lowers Symptoms

H. Bernard Wechsler

Tell me the worst and I can handle the pain better, is scientific research not bravado. Who follows it?

When a child or an adult is in pain, it is intuitive for us to sooth their fears with false information and phony promises. We say stuff like; My Aunt Tilly lived another 25 years after they chopped off her legs, so be cool. It is meant with the best of intentions of course.

You heard of Placebos, positive effects allegedly caused by the power of suggestion from an authority figure. It is usually a sugar pill or liquid of no medical potency.
Derived from Latin, it means I shall be pleasing to you; its sister is Nocebo, meaning
harmful and unpleasant.

Bob And The Medics

My pal Bob Handler took weekly shots at King County Hospital for asthma and allergies for two-years and was completely symptom-free. He told the doctor he was leaving to start MIT for nuclear physics when his physician informed him he was being injected with a sterile saline (salt) solution in water.

Bob freaked out to me about damn lying doctors, but he went to Cambridge, graduated, and never suffered asthma symptoms again; without the water injections.
The truth will set you free?

The Effects of Manipulating Expectations

Dr. Max E. Levine and his team at Wake Forest University School of Medicine has
their research published in Psychosomatic Medicine 68:478-486, 2006.

It is all about the role of human expectation in the experience of nausea from motion
sickness. The results: symptoms of motion sickness were drastically reduced by group participants with negative-expectancy. Half the experiment had participants
receive Placebos causing positive expectations, and they lost their cookies.

The other half of folks who were told to expect the worst because that was exactly
what was coming, (Nocebos, displeasing knowledge), handled the experience exceedingly well and frequently giggled at the discomfort of their compatriots.
Not you, only immoral people would laugh at their fellow scholars.

Scientific Conclusion

Patients preparing for difficult medical procedures benefit from a bad truth,
rather than a good lie. Give them the Nocebo not the Placebo language and
the patient handles it better. Makes your 3-pound coconut kind of hurt with
Cognitive-Dissonance?

Thinking of Pain Freaks Out Your Brain

Placebos are not, (nynet, non, no-way) caused by the Power of Suggestion exclusively. The use of a phony-baloney salve (cream) to reduce pain from a jolting electric shock or stressful doses of heat registers on the brain of participants hooked
up to a fMRI. It may be in your head, but it is also physiological not merely mental.

Dummy (Placebo) treatments are as real as a heart attack. Those who had the cream rubbed on their wrist and then rocked with electric or heat, reported
significantly less pain than the untreated volunteers at Harvard.

The fMRI indicated major physiological changes in both the PreFrontal Cortex,
and the Mu Opioid Receptors. The useless cream activated the brain to release
pain masking Endorphins.

Dr. Stephen Kosslyn, Harvard, together with his research team from the universities
of Michigan, Princeton, Wisconsin and Texas, has their results published in Science
magazine, 2.20.04 and is cited to date.

fMRI

The scans used on the participants powerfully indicate the Placebo Effect is real
and reproducible under scientific conditions. It presents proof the pain processing
structures of the brain are inhibited. The areas of the brain involving anticipating
both rewards and punishment (pain) are stopped in their tracks by a Placebo.

Later research following up on Kosslyn, deals with the brain structures of reward
(pleasure) and punishment including the Nucleus Accumbens, Ventral Tegmental Area and the release of the neurotransmitter, Dopamine.

Dr. Kosslyn suggests the Frontal Lobes (executive top-down function) wire synapses
to not release pain into the neural networks. He worries about the Nocebo Effect caused by physicians telling patients there is no hope.

The comments of doctors could be responsible for a patient forgoing their will to live, and increasing a patient expectation of their early demise. Words are things,
and the suggestion from an authority registers in the brain of the listener as an
order.

Federal Government

The U.S. Federal Drug Administration accepts the evidence of Placebos as a given
in all applications to permit the sales of new drugs. The applicant for licensing
must produce evidence their new drug is more effective than a Placebo.
Placebos prove as potent as the new drug between 30 to 50% of time. It is called
spontaneous remission when the body heals itself.

Discovery of the Pain Sites

Dr. Ulrike Bingel et al. at the University Medical Center Hamburg-Eppendorf
had published in the journal Neuron, 8.13.07, his new proof Pain in not all in
the mind. They discovered the regions of the brain registering pain and impairing
our cognitive processes.

The participants were asked to distinguish images while being koched on the hands
with small doses of laser beams.

Using fMRIs Dr. Bingel identified a brain area called LOC, Lateral Occipital Complex, an area for both working memory and pain receptors. Then he found
what causes the LOC to function (excite or inhibit pain).

ACC Anterior Cingulate Cortex

The rostral (front) of the ACC is the site of pain processing. When they figure out
how to activate or deactivate the LOC, located in the back of the brain producing mental images, drug companies will coin money with new products.

N.B. The ACC has executive brain functions, particularly on our Attention Span.
Recent research points at a tiny brain structure called the Insula as having
a role in the experience of pain. It is not just one area, but many while one
may be dominant in the excitement or inhibition of pain.

Endwords
Placebo and Nocebo are in your mind, and definitely in your brain.
The new research is Nobel Prize level and may revolutionize the pain products
produced by the U.S. Drug industry.

We suggest you lubricate the sulci and gyri of the convolutions of your brain;
your gifts are cells that fire together (synapses), wire together. Evidence is
clear the elasticity of neural networks remain flexible with active use.

For great longevity and a firewall against Alzheimer and Parkinson, we
suggest life-long-learning and reading.

You might want to investigate the skill to 3x your learning skills, and 2x your
long-term memory. Ask us how.

See ya,

copyright 2007 H. Bernard Wechsler
www.speedlearning.org
hbw@speedlearning.org

Published August 29, 2007

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August 28th, 2007

H. Bernard

Wechsler

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