Nature & Nurture #151: Dr. Michael Bernstein - The Placebo & Nocebo Effects

Dr. Michael Bernstein is an experimental psychologist, Assistant Professor at Brown University Medical School, and the author of The Nocebo Effect: When Words Make You Sick. Dr. Bernstein’s research is focused on the overlap between cognitive science and medicine, studying the role of expectation in healthcare and leveraging the placebo effect to improve patient outcomes.  In this episode, we explore the mechanisms, implications, and ethical dilemmas of the placebo and nocebo effects in healthcare. Dr. Bernstein explains that the nocebo effect is essentially the opposite of the placebo effect, where negative expectations can lead to worsening symptoms. He shares examples from randomized trials and addresses ethical challenges in medical disclosure. We also discuss the impact of patient expectancy, anxiety, and media influence on symptom manifestation, along with considerations for future research and practical applications in medicine. 00:27 Understanding the Nocebo Effect 02:11 Ethical Dilemmas in Medical Disclosure 04:38 The WebMD Effect and Media Influence 08:20 Psychological Mechanisms of Nocebo and Placebo 17:28 Conditioning and Expectation in Healthcare 18:34 Evolutionary Perspectives on Placebo 23:16 Trust, Authority, and the Placebo Effect 29:04 Understanding Negativity Bias in Behavioral Economics 29:46 Environmental Factors and Nocebo Effects 31:54 Recency Bias in Medical Procedures 33:47 The Role of Cognitive Biases in Healthcare 35:46 The Placebo Effect in Surgeries 43:24 AI in Medicine: Ethical Considerations and Future Directions 51:52 Open Label Placebos and Pain Management 53:44 The Importance of Ritual in Healing 55:30 Exploring Placebo Effects in Animals