Did you know that buying branded headache tablets are more likely to work than own-brand ones, even when the ingredients are exactly the same? Did you know that capsules work better than tablets, even when the ingredients are the same? Did you know that certain colours such as red and yellow are better for pain relief pills than white ones, even when the ingredients are the same?
All in the mind?
What we’re talking about here is the ‘placebo effect’. Essentially, how our expectations have a significant impact on how well/or not a health intervention works.
There’s also an opposite, but less well-known effect called the ‘Nocebo effect’. Nocebo effects are adverse reactions produced by negative expectations. This is the reason why research had to be done to explore the most effective way for doctors to explain potential medication side effects to patients. It was found that if you tell patients about possible side effects you increase the likelihood they will experience them. But obviously doctors can’t not tell somebody if they’re asked.
Let’s not be rash
In Japan in 1962 there was a famous experiment, now known as the Japanese poison ivy experiment. 13 boys all allergic to a leaf similar to poison ivy were told they were to have the leaf rubbed on one arm, and their allergic response measured, then a normal leaf on the other arm and the response measured. As expected, all 13 had a reaction to the poison ivy, and only 2 to the normal leaf. But the experimenters had actually lied to the boys, the arm where all 13 had a reaction was just a normal leaf, and the arm where just 2 of the boys had a reaction was the actual poison ivy. And on top of this, the 13 reactions to the fake harmless leaf were actually more intense than the 2 to the real poison ivy. This is the nocebo effect in action.
More tea vicar?
In another experiment, two groups of 15 people were all given de-caffeinated coffee. But one group was told it was de-caff, the other told it was regular coffee. Then both groups were given a leaflet to read on the effects of caffeine on the mind and body. The group who were told they were drinking regular coffee reported greater alertness scores than the group who were told they were drinking de-caff, even though all received de-caff.
Be careful what you wish for
So, it appears that our expectations play a huge role in health outcomes. If we expect something to happen, it can increase the likelihood it will. We are highly suggestive beings, and our expectations are powerful. Especially when it comes to subjective outcomes such as pain and mood.
Are you planting seeds in your employee’s minds?
The word stress gets thrown around in so many workplaces. And whilst that has its own set of issues, there’s a more problematic one, that is of setting people’s expectations to feel stressed. Imagine the impact of telling new recruits that “This is a great place to work, but it’s really stressful”, or telling them about the inherently stressful nature of this department”, or regular talk amongst colleagues about “what a stressful job we do”.
These seemingly benign statements are essentially planting seeds of expectation for negative health outcomes. Many well-intentioned businesses constantly talk about stress in their comms, but their efforts might actually be contributing to the problem they’re trying to resolve.
What’s the alternative?
Whilst it’s not easy to change our language, it’s important that we don’t place too much emphasis on medicalising our speech. Although stress isn’t actually a medical term like Schizophrenia, it comes with all sorts of baggage and expectations in the same way that anxiety and depression do. So, whilst we don’t need to avoid talking about how challenging work life can be, we might be well advised to avoid sticking a medical sounding label on those challenges.
How can your business avoid the nocebo effect?
Have a think about the terms you regularly hear in conversations in your organisation, the language used in your wellbeing comms, the newsletter, the online portal, and consider whether they might be planting seeds of negative health expectations. The news media already does enough of this, it’d be great if workplaces weren’t adding to it.