Understanding the Power of Perception

“WHETHER YOU THINK YOU CAN, OR YOU THINK YOU CAN’T — YOU’RE RIGHT.” — Henry Ford

Living a fuller life begins with your perceptions.

You may think you’re doing well as long as you’re practicing yoga; doing self-care and morning routines; and eating well. But while performing these activities, do you view them as a chore or as a therapy? If we bring worry, comparison, guilt, and shame with us to these practices, then simply going through the motions aren’t going to help. And certain mindsets can even be harmful. If you bring a restrictive mindset to your eating habits, for instance, it can lead to eating disorders.

Beyond wellness practices, what is the mind’s contribution in all the choices, actions, goals, and dreams you make? Does your mind help you get success, or does it sabotage you at every step along the way?

Does the idea of your mind affecting well-being more than wellness practices themselves seem hard to believe? Let’s explore the science.

Mind Over Matter?

The placebo effect — where a “fake” treatment like a sugar pill helps a patient, will be used to illustrate how powerful the mind can be. The placebo effect usually has a negative association. Those responding well to them are labelled gullible or are written off as not really suffering from an illness to begin with. But there is more to the story. Taking placebos gives these people an action to take that they belief will improve their health.

Placebo effects come about by external factors in the environment that affects peoples’ perceptions and emotions. “The placebo response may be driven by many different environmental factors involved in the context of a patient, factors that influence patients’ expectations, desires, and emotions.” [1] These factors can be in hospitals, in the spaces we clean, in the news we consume, in the food we eat, or even in our own heads!

Placebo Effect in Hospitals

Many studies show that when a patient is told about pain relief, the pain reduces more than when they are not told. “Adding an overt suggestion for pain relief can increase placebo analgesia to a magnitude that matches that of an active agent.” [2] What’s more is that when these suggestions are given in an open and professional way, the placebo effect is amplified. “Positive expectations, when delivered by a warm and competent provider, diminished participants’ allergic responses. However, when delivered by a provider that was less warm and less competent, neither positive nor negative expectations had influence.” [3]

But the placebo effect works even without doctors telling you these things. Just by using a smartphone app that self-records and monitors depression, patients’ symptoms can be reduced! One “study involved a smartphone app designed to help patients self-monitor and record their symptoms of depression. Even without any direct therapeutic intervention, smartphone self-monitoring significantly reduced symptoms.” [4] The app takes the place of an administer, signaling that the patient is taking the right steps.

Placebo Effect in Cleaning

In one seminal study, room cleaners who believed they were getting exercise while cleaning increased health more than those who did not believe cleaning was a form of exercise. “4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index.” [5] During the month of study, there was no indication that the house cleaners had altered their routines in any way.

What the hospital and cleaning cases show is that if you expect a positive outcome, then you’re likely to have a positive experience. Not surprisingly, the opposite also holds true: if negative expectations or experiences are involved, the likeliness of the placebo not working, or even having harmful effects, are observed! In this case, the placebo effect is called the nocebo effect. “The nocebo effect, the evil twin sibling of the healing placebo effect, has been documented in a vast research literature… When some people are exposed to frightening information about agents or exposures, expectancy effects just as powerful as placebo effects can operate to make people feel sick with worry or anxiety.” [6] The nocebo effect is why some people get queasy at the sight of blood or a needle.

Placebo Effect and the News

Just by consuming news about the side effects of drugs, some people develop greater aversions, and sometimes even intolerances, to drugs. Countries where patients using Google are more likely to find websites about statin side effects have greater levels of statin intolerance. The nocebo effect driven by online information may be contributing to statin intolerance.” [7] During COVID-19, news consumption alone could also be leading people to feel more sick! Although substantial research hasn’t been conducted yet, it’s even suspected that “scary health stories about COVID-19 pour out of the media floodgates every minute. These might be causing ‘nocebo effects’ — where we become more ill because we expect to.” [8] Heightened worry, fear, and anxiety compromise immune function, which could increase the chances of getting the virus, or lead to a slew of other health issues.

Placebo Effect and Food

Eating is not just a biological act. It’s social, cultural, and mental. “The tastes, colours, shapes, names and labels of foods elicit emotions, expectations, associations and conditioned responses rooted within both public consciousness and individual experience.” [9] We see a salad and believe it’s good for us. Vice versa, we see the word gluten, and even if you’re not suffering from gluten sensitivity, intolerance, or celiac disease, you’ve likely gained an expectation that eating gluten is unhealthy. This explains why despite there being no “proven health or nutritional benefits of a GFD [Gluten-Free Diet]… those who purchase gluten-free foods outside of a GFD and apart from treatment of disease comprise the bulk of gluten-free product consumers.” [10]

In certain cases, foods that have been scientifically proven to not be good for us can nonetheless promote health! “Comfort and ceremonial foods are defined by specific cultural and religious contexts. Although their chemical composition is often nutritionally or pharmacologically unfavourable, these foods offer a sense of comfort, contentment, tradition and connectedness that nonetheless contribute to mental health and well-being.” [11] Eating highly processed, sugary foods such as cake is bad, but doing so with friends for special occasions or as an occasional indulgence can still contribute to your happiness and wellbeing.

Conclusion

If your mind has such power over pain relief, depression, news, cleaning, and food, what does this mean to other areas of your life? “Desire and expectation also interact and underlie common human emotions, such as sadness, anxiety, and relief.” [12] We all hold certain views, beliefs, and perceptions based on our own experiences that shape our world, some for the better, some for the worse.

If you fail at something, what internal news stream are you exposing yourself to? Do you ever catch yourself saying “I have the worst luck,” “I shouldn’t have made that mistake, I’m so stupid!,” or “See, I knew that the world was against me!”? Or, rather, do you see failure as an opportunity to learn and grow? In either case, you’re right, and mindset plays a role in self-fulfilling your future endeavors.

Happiness is a decision we all make at every moment of every day. Some experiences you have no control over, whether a natural disaster, or COVID-19. But you do control how you respond to them. Mental well being is choosing to find and focus more on opportunities, benefits, and what’s the most healing in any situation, not on challenges, drawbacks, or fears.

Will you choose to use a personal placebo or nocebo more in your life? The choice is yours.

REFERENCES

[1] Price, Donald & Finniss, Damien & Benedetti, Fabrizio. (2008). A Comprehensive Review of the Placebo Effect: Recent Advances and Current Thought. Annual review of psychology. 59. 565–90. P. 2.3.

[2] Ibid., P. 2.7

[3] Howe, L. C., Goyer, J. P., & Crum, A. J. (2017, March 9). Harnessing the Placebo Effect: Exploring the Influence of Physician Characteristics on Placebo Response. Health Psychology. P. 7.

[4] Torous J, Firth J. The digital placebo effect: mobile mental health meets clinical psychiatry. Lancet Psychiatry 2016;3:100–2. P. 101.

[5] Crum, Alia J., and Ellen J. Langer. 2007. Mind-set matters: Exercise and the placebo effect. Psychological Science 18, no. 2: 165–171. P. 165.

[6] Khan, Sarah & Holbrook, Anne & Shah, Baiju. (2018). Does Googling lead to statin intolerance?. International Journal of Cardiology. 262. 25–27. P. 41.

[7] Ibid., P. 25.

[8] Howick, Jeremy, Giulio Ongaro, and Oxford Empathy Programme. “Coronavirus: Could Reading about the Pandemic Cause Harm?” The Conversation, May 7, 2020. https://theconversation.com/coronavirus-could-reading-about-the-pandemic-cause-harm-135585. Accessed 18 May, 2020.

[9] Harris CS, Johns T (2011) The total food effect: Exploring placebo analogies in food and culture. The Journal of Mind-Body Regulation 1, 143–160. P. 143.

[10] Reilly, N.R. The Gluten-Free Diet: Recognizing Fact, Fiction, and Fad. J. Pediatr. 2016, 175, 206–210. P. 209.

[11] Harris CS, Johns T (2011) The total food effect: Exploring placebo analogies in food and culture. The Journal of Mind-Body Regulation 1, 143–160. P. 147. P. 144.

[12] Price, Donald & Finniss, Damien & Benedetti, Fabrizio. (2008). A Comprehensive Review of the Placebo Effect: Recent Advances and Current Thought. Annual review of psychology. 59. 565–90. P. 2.4. P. 2.7.