Beware That Nocebo Strapped to Your Wrist

Most people are familiar with the concept of a placebo, but the opposite of it, a nocebo also exists

Beware That Nocebo Strapped to Your Wrist
A smart store. (Photographer: Chris Goodney/Bloomberg)

Most people are familiar with the concept of a placebo, where merely providing positive information can improve perception of well-being. Yet the opposite also occurs, with negative data making people feel worse about their own health.

That’s a nocebo — Latin for “I shall harm” as opposed to “I shall please” for placebo. And there’s a good chance you have a nocebo strapped to your wrist.

A wave of health-tech gadgets — from fitness trackers to Apple Inc.’s Watch — means hundreds of millions of people are hooked up to real-time feedback devices. They’re designed to measure your steps, encourage you to exercise more, and give daily updates on your mental and physical health. Apple wants you to “close your rings” — the three colorful circles the Watch uses to monitor your progress — and Garmin Ltd. helpfully tells you when your health is “excellent.”

They make for popular gifts and are bound to be stocking-stuffers this year. Various models of the Apple Watch occupied four of the top 10 most popular items in November’s Black Friday sales, according to Business Insider.

But there’s also good reason to think twice about whether you, or a loved one, will truly benefit from 24-7 monitoring, arbitrary goals served up by an algorithm, and regular notifications telling you that you’re stressed, tired, fit, or simply “unproductive.”

In fact, research on the nocebo effect — first conceptualized in 1961 — has shown that perceptions of pain can increase with shifts in information and detail. Patients with suspected concussions have shown poorer neurocognitive performance when their history of traumatic injury is called to attention. Concentration falters when unpleasant data is provided. Sometimes, even a change in the color of a specific signal associated with health can trigger discomfort.

With more devices strapped to people’s bodies, noceboes are now creeping into every day life as people put more faith in data to guide their habits. “It’s about sleep for me, because I will wake up and feel pretty darn good and then I'll look at my score and sometimes it's not pretty darn good, " fitness podcaster and Youtuber Ali Spagnola says. “And I can tell that I will actually feel worse after that.”

While a constant flow of data can help people optimize their health, she says she is starting to understand that the opposite can also be true. Spagnola, who produces videos on music, comedy and fitness for more than 2 million social media followers, says sometimes all we really need is positive reinforcement.

“There's an exact moment where I speak to the camera and say: I should just make an app that says ‘you are great, and you feel awesome today,’ every day,” she says. That moment led to her producing the O Band. It’s a real product but it literally does nothing but hang around your wrist. It’s a joke with a very serious message.

The nocebo effect has become inherent in social media. Rather than logging on to feel inspired and connected, Instagram and Facebook have made users feel anxious and depressed. The constant feedback of hits, likes and retweets has undermined what should be appreciations of creativity. According to its own research, Instagram makes teenage girls feel worse about their bodies, the Wall Street Journal reported in September.

It wasn’t supposed to be this way. Well-meaning executives who churn out gadgets and apps place a high degree of faith in their products’ ability to improve life. They rarely stop to think about the downsides. “I believe that technology can make our lives better,” Facebook Chief Executive Officer Mark Zuckerberg said in October when he announced his company’s name change. “The basic story of technology in our lifetimes is how it's given us the power to express ourselves, experience the world with ever greater richness.”

Apple has a similar view of its own devices. Its Watch, “encourages you to be active and get more out of your workouts,” CEO Tim Cook said in September when he announced the latest iteration of the gadget. “And it monitors your health, helping you live a better day.”

It’s a world where we’ve been blindsided by the unexpected. And so we want to believe that technology can forewarn us of dangers and risks. We’ve come to depend on the devices on our wrists to constantly flag us about our physical and mental health. This is more than a little naive. Sometimes all we really need is to be told we’re awesome.

More From Other Writers at Bloomberg Opinion:

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Garmin's Connect app helpfully informs you if it's proprietary algorithm thinks you're peaking, recovering, detraining or even unproductive.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Tim Culpan is a Bloomberg Opinion columnist covering technology. He previously covered technology for Bloomberg News.

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