A randomized trial published online March 12, 2026 in the European Journal of Pain found that telling volunteers outright that a device could not cause pain, and then pairing that disclosure with a procedure called counterconditioning, reduced an artificially induced nocebo effect on pain at least as well as concealing that information from them, according to researchers at Leiden University in the Netherlands. The study, led by Simone Meijer and colleagues, is among the first to directly compare an honest, "open-label" version of counterconditioning against a deceptive, "closed-label" version and against a third strategy, extinction, in which the false belief is simply left to fade with repeated exposure.
The researchers first conditioned 83 healthy women to associate a sham TENS device with worsened pressure pain, using open-label instructions that told them, accurately, the device was inert and the pain increase was suggestion-driven; this step confirmed the volunteers were susceptible to the nocebo effect. Sixty-six of them were then randomly assigned to one of three follow-up sessions: open-label counterconditioning, closed-label counterconditioning, or extinction. All three reduced the nocebo effect on pressure pain, but open-label counterconditioning produced the largest effect (d = 1.13), larger than closed-label counterconditioning (d = 0.69) and larger than extinction (d = 0.66); open-label counterconditioning also outperformed extinction directly and, in this sample, reversed the nocebo response into a placebo-like effect.
The finding matters because most nocebo research to date has documented that expectation and prior negative experience can worsen how people experience pain and side effects, without testing concrete ways to prevent or reverse that pattern once it has formed. This trial offers one candidate fix, and its authors frame the open-label result as encouraging because it does not require deceiving people about what they are receiving, an ethical advantage over strategies that rely on concealment.
The trial has real boundaries that matter for anyone reading it as a fix for real-world side effects. It was conducted in a single laboratory session with 66 healthy young women exposed to an experimentally induced pain response from a sham device, not people managing chronic illness, taking prescribed medication, or living with cognitive impairment. No one in the study had a dementia diagnosis, and the researchers did not test whether the technique works in older adults, in clinical settings, or against real medication side effects rather than a laboratory-induced one.