my spleen really doesn't like this

I can’t go to the grocery store, Reader.

I mean yes, physically I’m capable of going into a crowded Publix on a holiday weekend but it is a disaster waiting to happen.

No, I don’t love wonky lines of pushy people at the deli counter but that's not it.

And no, I don’t have a past trauma that keeps me from trying to find the best parking spot (which is actually the one with even the tiniest bit of shade).

It’s my inability to be discerning. At all.

I’m incredibly susceptible to ANY kind of marketing and ESPECIALLY prone to the displays at the ends of the grocery aisles.

Even the lamest marketing schemes will draw me (and my Visa) to put things into my cart I would never normally consider as reasonable purchases.

But they stack up all those seasonably festive cases of red, white, and blue and I have to wonder: why don’t we have Bud Light at home? This seems like a must have right now! I’ll take 2.

So weak. No streamers or samples or anything and yet I’m $24 poorer with a light beer I’ll probably struggle through one can of.

Weirdly, I’m great at lists but my best laid plans fail with the beautiful, fluffy piles of King’s Hawaiian Hamburger buns and festive (impressive!) houses built of Oreos and Chips Ahoy! cookies.

Glorious! Mesmerizing! Get in my cart!

And then the reality. How did all this cheap beer and highly processed shelf stable food-stuff get here? What about my list??

And in a panic I rush to the checkout without finishing my shopping and hide everything in the pantry so I can pretend I didn’t get into trouble buying groceries. Again.

But I know this about myself so I can manage it a little better. Mostly I just buy groceries online 100% of the time now. It's what works for me.

What about with medications though?

If someone tells me something about my magical Tylenol will I believe it?

Gel coated so it’s easier on my stomach? I think I can tell!

Potentially toxic to my liver? I think that’s exactly where it hurts right now! Uh oh.

Which brings me to the placebo and nocebo effects!

Most people know that the placebo effect is when someone feels better when taking a fake pill (like it’s just a tic tac) although this can also apply to real meds that haven’t had time to kick in yet.

But what about the nocebo effect? Do you know what that is, Reader?

This is when people eat the Tic Tac they think is a real medicine and then have ACTUAL side effects from it! And doctors cause that all the time when they consent their patients and discuss all the bad things that can happen when their patient takes a medication.

It’s sucks because we want to tell people all the stuff so they can make a good choice but we also CAUSE some of the problems (we’re GIVING them side effects) just by talking about them! Ugh. Harder than deciding between apple pie or fudgey brownies.

The video is just under 15 minutes and it’s full of really interesting stuff that you can share immediately! Like when you’re finished with your leftover chips. Or kale salad. Or sparklers.

Things you need to know about making this stuff work for your clients:

Fostering the placebo effect:

  • Use your supportive therapeutic relationship to build trust and confidence
  • Share positive expectations that the treatment will help
  • Explain the treatment process and give details, more non-negative info can be helpful here
  • Engage the client to take an active part and take ownership of making choices

Minimizing the nocebo response:

  • Use positives when sharing treatment benefits and show confidence in treatment
  • Strong empathic rapport builds trust and reduces anxiety
  • Explain what the nocebo phenomenon is and find out how much info they may want to know about potential side effects and where to get detailed info if they want it i.e. the FDA drug insert info
  • Encourage positive expectations and high engagement with treatment
  • Dig into emotional or psychosocial concerns that may be contributing to negative responses or expectations

The video has some cases too! Because sometimes examples are better.

It's like the awesome display at the grocery store! Without the edible samples. Or expenses.

Here’s to a happy weekend! Online shopping only, for me, thanks!

Cheers to healthy brains,

Dr. B

Jessica Beachkofsky, MD

Your friendly online psychiatrist!

P.S. Here’s the video!

Welcome to Brain Bites with Dr. B!

Brain Bites is all about broadening your reach with easy-to-digest psych knowledge! Join me for quick, interesting medication and brain science tidbits! Elevate your therapy practice with insight and data from your friendly online psychiatrist!

Read more from Welcome to Brain Bites with Dr. B!

I’m short. Or maybe not really, but compared to my family and friends, I’m a short 5’4”-ish. I don’t HAVE to wear petites but they sure fit better than “regular”. Or I can buy the SHORT version. That’s nice too. (Eye roll. Can't it be a cuter designation? Short is so obvious and boring!) It’s something I’ll probably never really get over (a little punny, maybe? over? no? ok.) but I do have workable solutions! Other than consistently buying pants that don’t fit because they’re too dang long:...

“But how does it actually help? How does it work? What’s going on in my brain right now?” This series of rapid fire questions came from an intake with a woman whom I’d just slapped a PTSD label onto. Label? Slapped? Really? I know. It has been a long journey to get where I am. And I recognize that labels don’t usually help people as much as they do with insurance reimbursement. But I’ve learned a lot. “Well your brain experienced a lot of trauma and now it’s extra sensitive. Zoloft can be...

I love seeing patients. And I know this is true because as I was working on this video, I kept saying "This is my favorite case" or "my favorite patient said..." Can they all be my favorites? I mean, probably not, but what a great way to feel about work! Which is strange because 2 years ago I was pretty unhappy in my contract position and I didn't have a private practice at all! I had spent months dancing around the idea of my own virtual private practice and set the whole thing up as if I...