Nocebo, Fear, and Symptoms

I talked about nocebo in this weeks group class. A lot of the chronic pain and chronic symptoms I see are productions of the brain not the body. I found part of this article enlightening as many people ask about emotions and nocebo. Fear is the usually the culprit emotion behind a nocebo effect as mentioned below in a quote from article.
‘One part of the nocebo effect that is a result of neurobiology is nocebo hyperalgesia where the expectation of pain increases the pain experienced. When a person anticipates pain, they release cholecystokinin, which allows pain transmission. If that anticipation and anxiety can be reduced, the pain will also be reduced.
Dr. Merrill explained how this happens: “Sensations can be amplified by our brain in feedback loops triggered by fear, which results in amplification of pain and other symptoms. This does not mean the pain is not real, but rather that the pain is primarily signaling fear rather than damage.”’