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