After months of drought, it finally rained last night in Middle Georgia. A wild, heavy rain with bouts of loud thunder and lightning that had the dogs running scared. I woke up happy, even mildly euphoric; the rain had arrived, our trees might survive.
Soon enough that turned sour. Why? Maybe the dogs? Maybe not.
I’m a fairly happy guy. Still, sometimes in the night I have odd terrors. Scared remembrances. In the morning I report that my demons had visited in the night. In the midst of last night’s emergent terrors I remembered a September piece from The Atlantic, The Dark Side of the Placebo Effect: When Intense Belief Kills:
Across cultures, night-mare visits play out in very similar ways. Victims experience the strange feeling of being “awake.” While they have a realistic perception of their environment, they can’t move. Worse, they feel an “overwhelming fear and dread” accompanied by chest pressure and difficulty breathing. Scientists have a pretty good grasp of how all of this happens. The paralysis, the feeling of pressure on the chest, all that is explained quite nicely within the scientific models of sleep. During sleep paralysis, a person experiences an “out of sequence” REM state. In REM sleep, we dream and our minds shut off the physical control of the body; we’re supposed to be temporarily paralyzed. But we are not supposed to be conscious in REM sleep. Yet that is precisely what happens during sleep paralysis: it is a mix of brain states that are normally held separate.
And then there is the weird stuff… the night-mare. People who have an experience of sleep paralysis tend to feel some horrible, evil being is near them. “I just knew this presence was there. An ominous presence … not only could I not see it, but I couldn’t defend myself, I couldn’t do anything,” one victim told Adler. This feeling is consistent across cultures, even if it goes by different names and presents through the culture one knows.
The Atlantic piece is a look at the work of Shelley Adler, and her book, Sleep Paralysis: Night-mares, Nocebos, and the Mind Body Connection. A nocebo effect?
Her argument amounts to a stirring and chilling case for the power of the nocebo, the flipside to the placebo effect. While placebo studies have grown in importance, the nocebo effect has not been studied well in scientific literature, in part because of the ethical issues involved in deliberately doing something that might harm people. Limited studies suggest that it is real and it is powerful. For example, doctors have found that patients made to feel anxious need larger amounts of opiates after surgery than other people. They’ve found that pretending to expose people who say they are sensitive to electromagnetic radiation to cell phone signals can give them debilitating headaches. Even patients’ level of side effects from arthritis medication seem determined by those patients’ beliefs about those medicines. Logically speaking, if the evidence shows the upside of belief, why wouldn’t we believe in the downside, too? And why wouldn’t we believe that the intensity of the downside would vary with the intensity of the belief, even if those beliefs were about something unscientific, like spirits or astrology?
So now I want to learn more about the nocebo effect. How about you?
From 2002 in the WaPo, The Placebo’s Evil Twin.