Nocebo Unmasked: How Negative Expectations Shape Illness

Carol Tavris reviews Helen Pilcher’s This Book May Cause Side Effects, examining how negative expectations can produce real symptoms and influence medical outcomes. She highlights compelling examples (like statin side effects mirroring placebo) but critiques the book for overgeneralizing the idea that all illness can be worsened by nocebo and for lacking precise data in places. Still, she notes useful implications and strategies—reframing supposed side effects, emphasizing the majority who don’t experience them, and pursuing personalized informed consent—to counter the nocebo effect in clinical care.