Placebo and Nocebo Effects as Bayesian-Brain Phenomena: The Overlooked Role of Likelihood and Attention

The Bayesian-brain framework applied to placebo responses and other mind-body interactions suggests that the effects on the body result from the interaction between priors, such as expectations and learning, and likelihood, such as somatosensorial information. Significant research in this area focuses on the role of the priors, but the relevance of the likelihood has been surprisingly overlooked. One way of manipulating the relevance of the likelihood is by paying attention to sensorial information. We suggest that attention can influence both precision and position (i.e., the relative distance from the priors) of the likelihood by focusing on specific components of the somatosensorial information. Two forms of attention seem particularly relevant in this framework: mindful attention and selective attention. Attention has the potential to be considered a major player in placebo/nocebo research, together with expectations and learning. In terms of application, relying on attentional strategies as amplifiers or silencers of sensorial information could lead to an active involvement of individuals in shaping their care process and health. In this contribution, we discuss the theoretical implications of these intuitions with the aim to provide a comprehensive framework that includes Bayesian brain, placebo/nocebo effects, and the role of attention in mind-body interactions.

Automated summary

The Bayesian-brain framework suggests that the effects on the body are the result of the interaction between priors and likelihood. While the role of priors has been extensively studied, the relevance of likelihood has been overlooked. Attention is proposed as a way to manipulate the relevance of likelihood by focusing on specific components of somatosensorial information. Mindful attention and selective attention are particularly relevant in this framework, and attention has the potential to be a major player in placebo/nocebo research. Attentional strategies could actively involve individuals in shaping their care process and health.