Installation 34: A Curious Case of Nosebo
What you put your attention on grows stronger. - anonymous
Our minds are literal judgement factories, we create hundreds of thousands of judgments a day including a host of “good, “bad”, “safe”, “dangerous”, “great ,“horrible”, all in the name of self-preservation. Some of us realize due to serious introspection that it is not terribly wise to believe and obey everything we think, and that in fact our thinking can sometimes cause deleterious effects on our bodies. Yes, our thoughts can give us a host of somatic issues including IBS, muscle tension, insomnia, headaches, weakness or shortness of breath.
Science is hip to the power of our trying-to-be-helpful brain, and for years have studied the power of our minds to work in concert with our bodies to create shifts in our perceptions for better or for worse. The placebo effect continues to haunt our logical mind, where we are told our minds may not cure anything, though it can most definitely have a lasting effect on psychological and physical symptoms. A placebo is defined as “a sham substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets, inert injections, sham surgery, and other procedures.”
The term “sham” could be a pseudonym for the carpet of marketing that surrounds scented products. We are asked by companies to consider their vegan, scented products as gateways to healing, possibly enlightenment, more intimacy, a better night out, and maybe more confidence. Tall orders for juice in a bottle, scent in a candle, fragrance in incense and lotions. That said, if our minds believe that by smelling a certain way we may feel more confident, if we could possibly measure that, it might in fact be true. This would be categorized as a placebo effect, since confidence is neither an ingredient in fragrance nor is there such an ingredient in any other material, it is simply a frame of mind or cognition.
"The placebo effect is more than positive thinking — believing a treatment or procedure will work. It's about creating a stronger connection between the brain and body and how they work together," - Professor Ted Kaptchuk of Harvard-affiliated Beth Israel Deaconess Medical Center, whose research focuses on the placebo effect.
The nocebo effect is the lesser-known brother of the placebo effect, the Cain to the omni-present cognition’s Abel. While the placebo effect produces positive physiological outcomes through a trick of the mind, the nocebo effect produces negative physiological outcomes. Each effect is a reminder of the power of our minds connecting to our bodies all in the effort to heal and protect.
Our minds and bodies are not separate, and through countless experiments over time we have learned the power of our cognitive expectations and negative bias. Doctors have even performed sham knee surgery to the same effect on patients as the actual surgery. While placebos are not “curing” existing conditions, they placate and relieve symptoms especially around pain. The nocebo has the opposite effect where if you present a negative bias to a patient’s expectation, they may report negative side effects, even if the pill or procedure was neutral.
Enter the nosebo effect, a term I am coining to echo the nocebo and label the effect caused by the belief that scents may cause harm to our health. In 2014 Monell Chemical Senses Center conducted an important study of cognitive expectations of odor safety, specifically related to airway inflammation. In other words, they studied the physiological and psychological reaction of people with mild asthma and a belief of being “odor sensitive”.
The people were presented with the odor phenylethyl alcohol (PEA) for 15 minutes, a rose-smelling material with no known irritant qualities. Eight of the participants were told that the scent was therapeutic and nine were told that the odor could potentially cause mild respiratory problems. As you might guess, there was a nocebo/nosebo effect, where participants who were told the possible negative side effects of the odor had airway inflammation after the exposure for up to 24 hours. Those that were told the scent was therapeutic reported no such intensity nor irritation, and their lung function and airway inflammation was unchanged.
The opposite of this nosebo effect, might be the plaseanose effect (please share your ideas for a better word if you are inspired to), where pleasant and positive physiological shifts may occur through the presence of an odor. Most people can relate to this, as we each have a scent that may make our heart race, or feel more calm. Many companies continue to try to capitalize on this, including IFF’s BrainEmotion – a database that supposedly tracks psychological effects of specific materials. The number of connections each person has to particular scents seems infinitely variable, so I’m not sure of the “neuroscience” behind linking say vanilla to happiness. As for companies and initiatives suggesting that scents have an effect on “wellbeing”: most of those claims suggest that pleasant smells can make for a happier, more calm you. In reality actual wellbeing is the incorporation and integration of a range of good and bad. In my opinion the commercial “wellness” model leaves a lot to be desired with respect to how humans are actually wired to navigate and find peace and connection in the world.
In sum, our brains are powerful, and if we believe the smell of baking bread consciously and unconsciously brings joy and contentment than yes that smell has the power of “wellness” for you. If you smell the same smell, though realize you cannot afford fresh bread, nor do you have the time to bake fresh bread, that smell may offer much more pain than comfort. Studies are also centered around a hedonic scale, measuring “pleasantness” with EmojiGrids. While a useful data gathering tool, the EmojiGrid does not reflect the complexity of human emotion instead it remains on the good/bad/pleasant/unpleasant scale. Remember this when you learn about “neuroscience” backing connections between scent molecules and our behavior and emotions. Also remember the petri pool for the studies. As of this writing there are over 350 million humans in the United States. Current olfactory perception studies I have reviewed use between 15-200 participants. Many authors of the research have cited that future studies should also include other factors that are known to influence odor appraisal, such as age, gender, personality, and culture (Liu et al, 2020). Most studies also point out that in fact while scientists agree that physiochemical features of molecules (e.g. size, structure, complexity) determine their perceived odor, the rules governing that relationship remain unknown.
Nosebo: (noun) The negative physiological and psychological effects of an odor material due to someone's negative bias of an odor material.
A nosebo effect may happen when one believes that a scent may have a negative or iriitating effect, even if there is no substantiating scientific evidence that the odor material may cause negative side effects.
Plaseanose: (noun) The positive physiological and psychological effects of an odor material due to someone's positive bias of an odor material. (Combination of pleasant/placebo.nose)
A plaseanose effect may happen when one believes that a scent may have a pleasant, blissful or calming effect, even if there is no substantiating scientific evidence that the odor material may cause positive side effects.