An Anti-dote to the Nocebo Effect

Turning Anti-Aging and Nocebo Upside Down: Menopause, Midlife, and the Power of a New Narrative.

The way menopause is depicted in our culture as a time when your body is “failing” and falling apart is a setup for the nocebo effect. You’ve probably heard of the placebo effect. The nocebo effect is its lesser-known but powerful counterpart:

The nocebo effect is the opposite of the placebo effect.

Here is what it is:

NOCEBO EFFECT: a worsening of symptoms or onset of adverse effects due to an expectation or perception of a negative experience.

Usually, the nocebo effect is used to describe a medicine or treatment but in this case, I’m relating it to our culture’s framing of menopause and the aging woman’s body and experience.

The dominant conversation around menopause often centers on how unbearable the physical symptoms are—belly fat, weight gain, hot flashes—framed as problems to fix or silence. So much of the messaging starts with a checklist of 30+ symptoms, setting the stage for fear, frustration and sense of pathology from the outset- the idea that something is going terribly wrong!

Instead of looking under the hood to understand what's happening on a systemic level (physically, emotionally, and neurologically), we're handed alarm bells—and told to fight our bodies.

But what if this transitional phase is actually an upgrade? I’d like to hear more conversations about how this can also usher in a time of expansion, empowerment that makes us stronger and whole whole with an even better brain!

Brains, Bears and Biology

Here’s the twist: neuroscience experts have told us that the nocebo effect may have a larger impact on clinical outcomes than the placebo effect. Why? People form negative perceptions much faster than positive ones. Of course, evolutionarily this makes sense. It’s advantageous for one to pay attention to life-or-death events. It helps our future selves if we lay down a deep track in our nervous system for the later instantaneous recall of alarming fight-or-flight reactions that save our bacon.

Take this personal example, the payoff you can gain from somaticizing the experience of encountering a grizzly bear in the woods is big:  getting to live another day.  

If I somaticize the fight vs flight adrenaline experience of encountering a grizzly bear, my brain remembers it instantly and forever—because survival depends on it. (And yes, I know this firsthand—over 20 years ago, I was literally treed by a grizzly sow and two cubs in the Rockies. I can still feel that cortisol surge viscerally like it happened yesterday.)

In contrast, the delight and joy of discovering a ripe patch of berries in the woods? Sweet, but only useful if I already feel safe enough to enjoy it. It’s such a lovely scene, but only feels like a benefit to be in “rest and digest” mode if I have the luxury of feeling secure that I will live another day.

Our nervous system lays down deep tracks for fear because it's evolutionarily advantageous. But in menopause, those alarm bells—about our bodies, our worth, our changes—can trap us in a spiral that isn’t actually necessary or helpful.

So How Do We Lay New Tracks?

Let’s look at, talk about, and do menopause and midlife aging differently. Here are four starting points:

Here are at least 4 ways I can think of- and love to hear from you about more! 

1. Understand that this is not a system failure.  

Your ovaries are not failing- they were built with this “taking leave” in mind, just like they kicked into active hormone production initially when you were ready to leave childhood and ushered in puberty—they have a had retirement plan this whole time. 

As Emily and Amelia Nagoski put it, the bikini industrial complex doesn’t want you to feel good about that- it’s bad for their fiscal health.

2. See this for the natural transition that it is, just like puberty, but in reverse.

You wouldn’t tell a young girl, to suppress the process of puberty and go back to childhood, but she does need support for the process as it also isn’t without its challenges or bumps on the road. Do you remember acne, mood changes, irritability need for more sleep? Yes, transitions all around can be disruptive. Passages into a new life stage involve change, but it doesn’t mean they are bad, and we are falling apart. We all know that we can grow as we grow up. Why not offer ourselves the same compassion and perspective as we’d give to that young girl.

3. Let’s stop using dinosaur language

Louann Brizandine wrote a book called The Upgrade and calls out the outdated terms that fuel fear and contempt of maturing “dinosaur language”.

These terms I hear spoken often about menopause or midlife women’s health that need a serious update:

·      Ovarian failure

·      Zone of chaos (the most prolific Instagrammer about menopause uses this, ugh!)

·      Dysfunctional Uterine Bleeding

·      Geriatric pregnancy (if you are pregnant at or after 35 years!)

These words don’t serve women. They can give us a sense that our body is betraying us as it goes through a natural life cycle.  This makes us feel unsafe in our very human vessel. This serves industries (ie. bikini industrial complex) that promise to fix us by providing never-ending instantaneous “solutions” to our pain and insecurity, but never solve for our core need to feel at home and at ease in our own body.

4. Be for it vs against it.

I recommend being Pro-Aging vs Anti-Aging.

The anti-aging message that is prevalent in health/wellness + beauty makes you think there is something optional about going through this transition and that you should or could find a way to turn this process (aging and menopause ?! ) around.

You can’t take a pass on menopause, no matter your interest in longevity hacks or “age-less” skin.  And that is not a bad thing.  Again, you wouldn’t want to tell a young girl, (or your daughter) to stop the process of puberty and go back to childhood when she is 12 or 13! But she does need support for the process as itisn’t without its challenges or bumps on the road.  I hope you would wish to help her feel positive about becoming a woman. Your own mindset and guidance impact her experience. Let’s similarly steer ourselves in a more supportive direction with our own self-talk - Let’s cut off the oxygen supply to toxic anti-aging messaging by NOT disparaging our own natural process and linking every single negative experience we might encounter (as of course we will experience some!) to “getting older”.  

A Call from the Pink Zones.

Let’s redefine what it means to grow older.

Let’s find and foster what I call The Pink Zones—and places where women are celebrated as they age in nourishing and sustaining ways and empowered to contribute a wealth of gifts that come from having rich life in their years!

I’d love to hear from you: What are your ways of turning the nocebo effect upside down?