A 26-year-old bursts into an American emergency room. “Help me! I’ve taken all my pills.” Then he collapses.
Next to him lies an empty vial. It’s from a clinical trial for a new antidepressant that he’s taking part in. 29 capsules, all gone.
The doctors take his readings: blood pressure 80 over 40. Pulse 110. He’s breathing fast, drowsy and barely responsive. They put in a line and give him fluids to stabilize his circulation. The drug screen is negative, no sign of acetaminophen or aspirin.
Then word reaches them from the study center. The young man had been in the control group. There was no active ingredient in the 29 capsules. It was filler.
Fifteen minutes after they told him, his blood pressure was 126 over 80 and his pulse was 80.
The case was published in 2007 in the journal General Hospital Psychiatry. No legend, no motivational seminar — a documented case report with measured values.
And it works in both directions: the conviction made him sick. The information made him well. Both without a single active ingredient.
To be fair: experts debate whether “nocebo” is the right label here — part of the reaction may simply have been panic. What isn’t disputed is what was measured. The body reacted to an assumption, not to a substance.
Why I Tell This Story and Not the Other One
There’s a better-known version of this. A man gets locked inside a refrigerated railcar, scratches parting words into the floor and is found frozen to death the next morning — even though the cooling wasn’t running and it was thirteen degrees inside the car.
I told it for years. It isn’t documented. Snopes has listed it as a legend since 2002, there’s no source, only motivational books copying from each other. The giveaway, by the way, is the farewell note: every version needs it, because otherwise we wouldn’t know what the man was thinking.
The case of the 29 capsules is less dramatic. But it’s true. I decided in favor of true.
Placebos Work Even When You Know
A placebo is a pill with no active ingredient. Usually glucose. Every new drug has to prove itself against one, and that goes wrong more often than you’d think: one medication helped 40 percent of patients — a success, they thought. Then it turned out the placebo helped 50 percent.
But that isn’t the most astonishing thing about the research. It’s the finding that placebos work even when the person knows they’re getting one.
You can even buy them. I checked — they’re out there online, advertised as an “Honest, Safe Placebo Pill,” thirty of them for thirty pounds. Quite a lot of money for a bit of glucose.
The Sentence Every Doctor Says
You get a medication, and the doctor says: “Take this. And if it doesn’t help, come back in two weeks.”
Medically, that’s sensible. Nobody wants someone to keep taking a drug they’re reacting badly to.
Psychologically, it’s unfortunate. Because you leave the office with a thought no one gave you and that’s there anyway: I’m probably the case where it won’t work again.
The other version would be: “Take this. My patients tell me they felt clearly better soon afterward. I’m sure it’ll help you too.”
Same active ingredient. Different course. I’m not saying doctors should talk this way — that’s their professional call. I’m saying: look at how much is packed into that one aside. And then look at your own asides.
How I Accidentally Got Myself a Higher Fee
I once ran a negotiation training at a bank in Zurich. One participant wanted to practice how to push through a higher commission with a client. A tenth of a percentage point, he said. I asked what that meant for the bank. His answer: 150,000 a year.
We practiced the conversation, and he actually got it later.
At lunch I went out to eat with the HR developer who had booked me. She asked how the workshop was going. I enthusiastically told her about the commission negotiation and the 150,000. She thought it was great.
On the way back it occurred to me that I’d been working for this bank for seven years — at the same daily rate. Despite inflation. I brought it up. Her answer came without hesitation: “Yes, go ahead, no problem at all.”
In hindsight I understood what had happened. I hadn’t talked her into anything. Half an hour earlier I’d handed her the idea that a higher fee is something perfectly normal. That wasn’t a strategy, it was an accident. But it was the moment I understood how reliably something like that works.
There are famous experiments for this effect. I deliberately don’t cite them: the best-known of them couldn’t later be cleanly replicated and are now considered contested. What I have is my own experience — and the observation over thirty years that the small talk before a conversation is rarely harmless.
What I Mean by Verbal Placebos
A verbal placebo is a sentence with no new factual information that still changes something. The state of the other person — or your own.
It’s not manipulation and not sugarcoating. It adds nothing false, it aims your attention differently. Used dishonestly, it’s noticed at once and costs more than it brings — especially in conversations where the real question is in the room anyway: can I trust this person?
I work with six techniques:
- Storytelling — a story instead of an argument. The conclusion stays with the other person, and no one contradicts their own conclusion.
- Mantra — deliberately swap out the sentences you say about yourself.
- Reframing — same facts, different frame. The difference lies in a single word: “and at the same time” instead of “but.”
- Suggestion — three undeniable facts, then the suggestion. It rides along on the agreement.
- Metaphors — offer an image and tie it back to the situation. Without that tie-back it stays decoration.
- Priming — what was said before changes what happens after.
The Most Important Person You Talk To
In workshops I like to ask: who’s the most important person you communicate with? The answers go to bosses, clients, partners, children. At some point someone says: myself. And that’s right.
When my son Tom was six, he absolutely wanted to go into the haunted house at the fair. I didn’t. Our friend Lucy, then 15, went in with him. Twelve minutes later the two came out: Lucy white as a sheet, Tom grinning from ear to ear.
Lucy talked about the darkness, about a hand on her shoulder and about the guy with the chainsaw. I asked Tom if he hadn’t been scared. He said: “No. I imagined they were all my friends. And when the one with the chainsaw came, I said: Hi friend, how was your weekend? He didn’t answer. His problem. I walked on.”
Years later I stood behind a curtain in Barcelona, about to speak in front of 120 executives from all over the world. I’d never done it before, and I felt uneasy. Then I thought of Tom.
I imagined they were all my friends — and walked out.
That was my first conscious verbal placebo. I gave it to myself. It changed nothing about the situation and everything about my state.
What You Can Start With Today
For the coming week, take on a single thing: replace “yes, but” with “yes, and.” Nothing more. “But” erases everything that came before it — including what the other person just said. “And” lets it stand and still attaches something.
Notice how often you say it. And notice what happens when you stop saying it.
I’m currently writing an e-book on verbal placebos — with all six techniques, examples and exercises. Anyone on the newsletter gets it first and for free.