The Stoics state that there are only three things we can control. They are our Perceptions, our Will, and our Actions. There is mounting evidence that our Perception will influence how effectively we embrace treatments and, as a result, how quickly we recover. Our Perception is within our control, but how do we influence our Perception to aid our recovery?

Most are familiar with the term placebo. It is derived from the Latin word placer, ‘to please’. A ‘sugar pill’ is given instead of the active ingredient; you then observe the effect of the sugar pill on healing. If the individual perceives the treatment will improve the symptoms. You will often see a beneficial effect with a sugar pill; This is the placebo effect.  

Contrast or opposites exist at all levels of existence, and the placebo has an opposite. The opposite of a placebo is nocebo. A word derived from the Latin word nocere ‘to harm’. Therefore, the nocebo effect creates adverse symptoms with the introduction of medication. The nocebo effect occurs when you perceive that you will experience adverse effects from the drug or treatments.   

There are many influences on Perception; culture, upbringing, social media influences, google searches, news outlets, friends, work colleagues and family members all affect your Perception. 

There is little to scant literature available to minimise the Nocebo effect. Currently, one enters into discussions with the individual, their family and the treatment provider. Answering concerns, detailing expectations and providing reassurance. The discussions tend to be intellectual. The challenge with these conversations is that transparency leads to increased anxieties rather than soothing them. 

If our Perception creates adverse effects, how can we shift our Perception? Firstly, moving Perception requires understanding the individual’s mindset. Then, collaboration with the individual, bringing them to an intellectual and embracing understanding. This process is a series of questions where the individual reflects on actual responses rather than imagined responses. 

I consulted with a client who embarked on the journey of chemotherapy to treat her breast cancer.  She had heard stories about previous patients’ sufferings from the side effects of chemotherapy; they were nausea, vomiting, tiredness, loss of appetite, and hair loss. She had heard comments such as “Oh my goodness, my Mum could not get out of bed.” “The mere thought of food made me want to throw up.” It conjured up the client imagery of negative perceptions of chemotherapy. Moreover, the likelihood of her experiencing a nocebo effect had just increased.  

Working with the Perception of impending adverse side effects such as nausea, vomiting, tiredness, loss of appetite. I asked the client, “When have you previously experienced these symptoms before?” she said;

“When I have had a tummy bug.” Great, when else?

“When I had a migraine.” Great, when else? 

“After I had my appendix out and when I had my tonsils removed.”

Then she started laughing and said, “Many times with a hangover!”  “I get motion sickness, and that wipes me out,” I said; what about pregnancy? Did you experience these side effects? “Oh my goodness, I had all of those same symptoms with my two pregnancies!” 

From her history, she has experienced these very same symptoms. Sometimes for less than 24 hours, sometimes more than 24hrs. Sometimes these side effects lasted for at least three months. 

She burst forth and said, “I have experienced this before, and I survived!”

That is the moment in a session when you sit in silence. As Whitehead said, “It takes an extraordinary intelligence to contemplate the obvious.” Her Perception had shifted because she had her own proof from her own experience, rather than being influenced by what other people had to say.

So, What happened when she received her chemotherapy treatment?   She did experience nausea and tiredness but no vomiting. The nausea was mild; the fatigue was not draining. She knew without any doubt that these symptoms would all pass, and they did. Her Perception of the side effects of chemotherapy had changed, and as such, she experienced fewer side effects than most. 

I started this blog by mentioning the Stoics, who declared we control our Perception. Your Perception is yours. You have the governance over your Perception. When we manage our Perception, we can turbocharge our recovery, our life goals and get more from our life. The opportunity to leverage and turbocharge your life depends on your Perception. Change the series of questions you ask yourself, and you will impact your recovery. 

Author – Adrienne Gulliver

Read more about Mind Over Matter: Patients’ Perceptions of Illness Make a Difference by the Association for Psychological Science.

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