The Disease of the Mind

In the summer of 2010, an 80 m tall, 1.65 MW wind turbine was constructed in the small town of Falmouth in Massachusetts, by a private company called Notus Clean Energy. This wind turbine has the capacity to displace 5.2 tonnes of carbon dioxide on average every day, and to date, the turbine has generated over 16 GWh of electricity, enough to provide for 670 homes.

A few months later, local residents reported of symptoms including headaches, nausea and insomnia. Their first suspicion was that the newly built wind turbine may be affecting their health, as some noticed that the symptoms only appeared while residing at home. As a result many filed lawsuits, claiming that the wind turbine was detrimental to their well-being, despite being 500 m away from the nearest home.

In 2009, Dr Nina Pierpoint published a book titled Wind Turbine Syndrome, explaining how people living within 2 km of wind turbines often become ill to such an extent that they start abandoning their homes. Not only that, but the properties in close proximity to the turbine also start to decrease in value. In spite of scientific research leading to the conclusion that the wind turbine did not cause the symptoms, this has given the impression that wind turbines do result in adverse health effects.

This supposed ‘wind turbine syndrome’ is a classic example of the nocebo effect, the evil twin of the well-known placebo. The nocebo effect occurs when physical illness is caused by expectations of illness. It is completely psychogenic, relying on the belief that there will be an effect on your physical state even if no remotely harmful substances enter your body. Only when the resulting effect gives a negative response is it a nocebo response. This seems unreal, but there is scientific evidence that the nocebo effect exists and anyone could suffer from it.

For example, a study was conducted involving a patient who had an allergy to roses. The results showed that a reaction was induced by both natural and synthetic roses, illustrating that the effect of the rose did not stem (pardon the pun) entirely from its biological or chemical properties, but merely from the expectation that the rose would stimulate an immune response.

Examples of nocebo effects extend back to ancient times; the most striking and certainly most well-known is the voodoo culture, and in particular, voodoo death. For example, a nocebo response may explain the effect of the voodoo curse, in which a victim dies only because a belief in the power of a witch doctor has been so ingrained that, after the victim has been hexed, the target simply cannot believe that he will live.

Nocebo effects can be triggered by a number of causes; for instance the economic pressure to maintain work, vagueness from medical professionals, and a spontaneous outbreak of illness in a social or work group, to name a few. In the last case, it could eventually lead to a mass psychogenic illness, a particular category of illnesses that only flourish due to the fear it instils in the minds of its victims.

There are various methods to combat nocebo effects, and these vary depending on the situation. When prescribing medicines, doctors can utilise the concept of contextualised informed consent. The principle behind this is for doctors or other providers to take into account possible side effects, the susceptibility of the patient being treated to nocebo effects, and the type of disease or illness involved, so that they can provide the most information with the least potential harm. Doctors also need to construct a positive therapeutic alliance (doctor-patient relationship). In addition, industrial mass psychogenic illnesses can be controlled by using a combination of sanitary, medical and psychological measures that target and reassure the workers.

However, the most effective technique to avoid nocebo effects is to alter your way of thinking.  Surprisingly, traits such as obstinateness and scepticism are ones that can save you from the devastating consequences of the nocebo effect, because after all, it’s all in the mind…

Yanhao

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