Editing Nocebo (section)

==Response==
In the narrowest sense, a nocebo response occurs when a drug-trial subject's symptoms are worsened by the administration of an inert, sham,{{sfn|Miller|2003}} or dummy ([[simulator]]) treatment, called a [[placebo]]. Placebos contain no chemicals (or any other agents) that could ''cause'' any of the observed worsening in the subject's symptoms, so any change for the worse must be due to some subjective factor. Adverse expectations can also cause [[anesthetic]] medications' [[analgesic]] effects to disappear.{{sfn|Bingel|Wanigasekera|Wiech|Ni Mhuircheartaigh|2011}}

The worsening of the subject's symptoms or reduction of beneficial effects is a direct consequence of their exposure to the placebo, but the placebo has not chemically generated those symptoms. Because this generation of symptoms entails a complex of "subject-internal" activities, we can never speak in the strictest sense in terms of simulator-centered "nocebo effects", but only in terms of subject-centered "nocebo responses". Some observers attribute nocebo responses (or placebo responses) to a subject's [[gullibility]], but there is no evidence that someone who manifests a nocebo/placebo response to one treatment will manifest a nocebo/placebo response to any other treatment; i.e., there is no fixed nocebo/placebo-responding trait or propensity.<ref>{{Cite journal|last1=Bishop|first1=Felicity L.|last2=Aizlewood|first2=Lizzi|last3=Adams|first3=Alison E. M.|date=2014-07-09|editor-last=Newman |editor-first=Christy Elizabeth|title=When and Why Placebo-Prescribing Is Acceptable and Unacceptable: A Focus Group Study of Patients' Views |journal=PLOS ONE|language=en|volume=9|issue=7 |pages=e101822|doi=10.1371/journal.pone.0101822|issn=1932-6203 |pmc=4089920|pmid=25006673 |bibcode=2014PLoSO...9j1822B |doi-access=free}}</ref>

Based on a [[Biosemiotics|biosemiotic]] model (2022), Goli explains how harm and/or healing expectations lead to a multimodal image and form transient allostatic or homeostatic interoceptive feelings, demonstrating how repetitive experiences of a potential body induce [[Epigenetics|epigenetic]] changes and form new attractors, such as nocebos and placeboes, in the actual body.<ref>{{Citation |last=Goli |first=Farzad |title=Body, Meaning, and Time: Healing Response as a Transtemporal and Multimodal Meaning-Making Process |date=2022 |url=https://link.springer.com/10.1007/978-3-031-17678-4_6 |work=Epigenetics and Anticipation |series=Cognitive Systems Monographs |volume=45 |pages=79–97 |editor-last=Nadin |editor-first=Mihai |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-031-17678-4_6 |isbn=978-3-031-17677-7|url-access=subscription }}</ref>