What Does It Mean to Be Anal-Retentive?

If you’ve ever heard a meticulous, uptight person referred to as being ‘anal retentive,’ you’ve probably wondered exactly where that terms comes from. The term is rooted in Freudian psychoanalytic theory and suggests that characteristics like excessive orderliness, perfectionism, and control are the result of a fixation at an early point in child development. 

Also known as being anal-retentive, an anal personality is thought of as someone with an extreme need to control their environment or situations. A person with an anal personality will also have an obsessive attention to detail (even non-essential details) to the point that it might annoy others.

Their behavior goes beyond being helpful. For example, a person with an anal personality might research a product endlessly before buying it.

Origins of the Anal-Retentive Personality

The concept of the anal-retentive personality dates back to the time of Austrian neurologist Sigmund Freud, who was the first to propose the existence of this personality type as part of psychoanalytic theory.

Freud wrote about the anal-retentive personality in his early works on psychosexual development. He argued that there were three psychosexual stages during early childhood development:

  • Oral stage: From birth to one year
  • Anal stage: From age 1 to Age 3
  • Phallic stage: From age 3 to Age 6

It was during the anal stage and toilet training that Freud argued the anal-retentive personality would develop.

Freud believed that when a child grew to realize that they could manage and restrict their bowel movements that the stage would be set for them to potentially develop either an anal-retentive personality or anal expulsive personality.

Freud believed that toilet training that was too strict, began too early, or involved punishment for accidents could lead to the formation of an anal-retentive personality.

It might sound outlandish today, but certain aspects of the historical period in which Freud lived contributed to the development of his theories. In addition to the Victorian social mores of the time, historians believe that the state of indoor plumbing played a part.

Since there was no indoor plumbing, diapers, or washing machines, restricting one’s bowel movements would have been a *much* larger concern for children who lived when Freud was a young boy.

The Anal-Retentive Personality According to Freud

Freud depicted anal retentive people as being:

  • Overly orderly
  • Meticulous
  • Suspicious
  • Reserved

Further traits that were later described included being stubborn, rigid, stingy with money and/or time, and having an obsession with being neat or clean. Other adjectives used to describe this personality were perfectionistic, detail-oriented, overly self-reliant, and having a passion for organizing, classifying, or collecting objects.

What is an anal-expulsive personality?

A student of Freud’s, Karl Abraham, took the concept a step further and described the opposite of anal-retentive as being anal-expulsive (aka a person with a tendency to make a mess).

Obsessive-Compulsive Personality Disorder

While Freud described the anal personality, the closest mental disorder that is currently described today in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) is obsessive-compulsive personality disorder (OCPD).

OCPD

This psychiatric diagnosis refers to a person with a compulsive and inflexible need for mental and interpersonal control.

Similar to the anal personality, a person with OCPD will also show strong attention to detail, a need for orderliness in their environment, problems with perfectionism, and a tendency to make lists and rules to follow.

This person may also have trouble delegating tasks and will be obstinate and rigid in their interpersonal dealings. They may have trouble getting rid of old things or spending money.

Differences Between Anal-Retentiveness and OCPD

What are the differences between being anal retentive and having OCPD?

In common usage, a person who is said to have an anal personality would generally be considered to have a personality quirk. On the other hand, a person with OCPD would be considered to have a mental disorder that interferes with their daily life.

What Has Research Found About It?

In a classic 1966 study, researchers showed that those with an anal personality performed worse on a task that required them to place their hand into water that had an odor suggestive of fecal matter than people without an anal personality. The researchers speculated that this reflected ineffective defenses against “anal impulses.”

In general, research has revealed that anal retentive characteristics appear as a cluster of traits rather than a defined type that would be defined as a disorder.

Interestingly, researchers have found that people who experience constipation are more likely to exhibit anal-retentive characteristics, including a need for perfection, certainty, and control.

In general, the term is rarely used in current psychological research and has much more been adopted colloquially to describe a certain personality “style.”

Signs You Might Be Anal-Retentive

So, how can you tell if you might have what some might call an anal-retentive personality? Some of questions you might ask yourself include:

  • Do you buy 10 of everything at the grocery store so that you won’t run out?
  • Do you organize the bills in your wallet by color?
  • Do you look up words before you type them on social media to see whether you need to add a hyphen for proper grammar?
  • Do you categorize your grocery list so that it is in the exact order of the items that you will be buying at the store?
  • When you set clocks in your house, do you need to make sure that they are all set to the same minute and second?
  • Does it bother you greatly if you see small errors or details?
  • Have other people referred to you as overly neurotic about having things perfect around you?
  • Do you find it hard to relax on the weekend or vacation when you know that it should be a time to unwind and recharge?
  • Are you stingy in how you consume things, such as using only one square of toilet paper or not spending any of your money?

While these are just some examples of what it might be like if you are anal retentive, they show a common theme of needing to control your environment or behave in a way that involves withholding or being very careful about what you do.

How to Cope

What should you do if you think you have an anal personality? That all depends on whether it bothers you or the people around you.

If you have trouble making decisions or feel anxious if you don’t control your environment, it might be worthwhile speaking to a mental health professional to determine whether you might be living with something more than just a personality quirk.

Do you feel as though your anal retentive behavior is excessive or out of your control? Those are other signs that you might need to seek help. If you have trouble delegating tasks or can’t handle it when things don’t work out perfectly, this could interfere with your daily life or your ability to function at work.

All of these are signs that it may be helpful to speak to a professional.

On the other hand, if you are functioning well, aren’t bothered by your quirks, and the people around you are accepting of your personality, then it may simply be something that you learn to live with.

Takeaways

It’s important to remember that there is a strong distinction between being anal retentive and having a diagnosable mental health disorder. If you are living with someone who is showing signs of needing to control their environment to an extreme, it may be hard to know if this is just a personality quirk or something deeper.

If that person’s behavior appears to interfere with their daily life, causes them distress or causes distress to you or other people in their life, or they are unable to control their impulses or feel great anxiety when unable to carry out compulsions, these are all signs of something deeper than an anal personality.

On the other hand, if someone you know appears to happily clean and organize and manage their money in a way that seems odd to you but that they enjoy or brings them joy, it could be that they simply are showing signs of what Freud identified so long ago. The translation of some unmet need or conflict during childhood into an adult manifestation that is less likely to cause trouble and appears more socially acceptable.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Haslam N. Anal expulsive/anal retentive personality. In: Zeigler-Hill V, Shackelford TK, eds. Encyclopedia of Personality and Individual Differences. Springer International Publishing; 2016:1-2. doi:10.1007/978-3-319-28099-8_1357-1

  2. Silverman DK. Psychosexual stages of development(Freud). In: Zeigler-Hill V, Shackelford TK, eds. Encyclopedia of Personality and Individual Differences. Springer International Publishing; 2017:1-5. doi:10.1007/978-3-319-28099-8_1417-1

  3. Guido G, Belk RW, Rizzo C, Pino G. Consumer behaviour and the toilet: Research on expulsive and retentive personalities. J of Consumer Behaviour. 2018;17(3):280-289. doi:10.1002/cb.1709

  4. Yılmaz TU, Taş Hİ, Uçar E, et al. Relationship between functional constipation and anal-retentive behavior features. Turk J Surg. 2018;35(3):165-170. doi:10.5578/turkjsurg.4035

Arlin Cuncic

By Arlin Cuncic, MA

Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master’s degree in clinical psychology.


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Signs, Types, and How to Cope

Infidelity—also referred to as cheating or adultery—describes the act of engaging in emotional or sexual intimacy with someone outside the agreed-upon boundaries of your marriage or relationship. Infidelity may or may not involve sexual encounters, and can happen in person or online.

It’s also one of the most painful breaches of trust that can happen in a relationship. Unfortunately, it’s also common. Rates of infidelity in relationships vary from about 20% to 50%. Infidelity can have a strong impact on the relationship and can lead to depression, guilt, blame, and anger.

What Are the Signs of Infidelity?

It can be difficult to know if your partner is cheating on you without concrete evidence. However, there are some warning signs that your spouse may be engaging in infidelity. When it comes to infidelity, there will usually be multiple red flags that clue you into what is going on.

Some potential signs of infidelity include:

  • You may notice significant changes in your sex life, that your partner is less interested in sex than usual and has trouble becoming sexually aroused with you, or that your partner is much more interested in sex with you than they usually are.
  • Your partner may want to engage in sexual activities that seem foreign or off-putting to you.
  • Your partner may be paying more attention to their appearance than usual.
  • Your partner may not be sleeping well.
  • Your partner may seem unusually distracted and stressed.
  • Your partner may be more private than usual and may demand more privacy.
  • Your partner may be spending more time away from home or going on longer and more frequent trips for work or with friends.
  • You may find it more challenging to connect with your partner, and they may be more reactive, more hostile, or colder than usual.
  • You may also experience sleeplessness, stress, and distraction as a result of your suspicions about your partner’s behavior.

Why Do People Do It?

Many of us have the idea that infidelity only happens in unhappy relationships, but even people in happy relationships cheat. Infidelity often occurs because of dissatisfaction within a relationship, but it can also happen because of low self-esteem, or an addiction to sex or romance.

At other times, it happens because of personality traits, a permissive attitude about sex, and cultural and societal norms about sex and relationships that support infidelity.

Some studies show that men are more likely to cheat than women, but others show that men are more likely to engage in sexual infidelity. In contrast, women are more likely to engage in emotional infidelity. People with higher sexual urges are more likely to engage in infidelity, as are people with higher levels of insecurity, who may be seeking validation through an affair.

What Is Considered Infidelity?

Infidelity doesn’t just look like someone going out to a motel and having a secret sexual affair. Cheating can take many forms and doesn’t always involve in-person encounters. It’s also important to note that what may constitute infidelity for one person may not ring true for another.

For example, while some people consider viewing pornography “cheating,” others may view this as normal and acceptable. The point is that each couple should clearly define what is and isn’t allowed in their relationship and which activities would constitute a boundary violation.

The main types of infidelity that most couples recognize are:

Sexual Infidelity

This involves engaging in sexual relations of any kind outside of the relationship. There may or may not be an emotional component here.

Emotional Infidelity

The difference between a platonic relationship and a case of emotional infidelity is that the relationship involves flirting, sexual chemistry, and a level of emotional intimacy similar to romantic relationships. Additionally, there is secrecy involved: information about the relationship is often purposefully hidden.

Online Infidelity

Online, or cyber infidelity, involves engaging in sexual or emotional affairs online, via chat rooms, messages, texts, and exchanging of photos and sexual fantasies. Some people consider viewing pornography without engaging with others a type of cheating, while others do not.

Impacts

The fallout from infidelity can be devastating for relationships and the individuals involved, including the person who was betrayed and those who do the cheating. When infidelity impacts a relationship, it can leave the people in it feeling highly distressed, depressed, and out of sorts.

It can cause heightened anxiety, suicidal ideation, and even signs of a form of post-traumatic stress disorder (PTSD). Post-infidelity stress disorder is a proposed type of anxiety disorder that can occur following infidelity. It is characterized by symptoms such as rumination, avoidance, anxiety, depression, trauma recall, insomnia, and social withdrawal.

The person who was cheated on may feel deeply betrayed and suspicious of their spouse’s activities going forward. They may experience nightmares, flashbacks, and may have images of the affair playing in their head as if on a movie reel. Trust may be severed, and difficult to repair.

The damage is often irreparable. Infidelity can strain or break apart relationships or marriages. Infidelity is one of the top reasons that couples go to relationship counseling, and it’s one of the most common reasons for divorce.

How to Cope

Although the impacts of infidelity can’t be minimized, and it is not recommended to remain in a relationship with someone who betrays trust repeatedly without remorse and avoids taking responsibility, there is some hope. Relationship counseling with a licensed therapist can be effective at helping couples heal, move on from affairs, and establish firm boundaries so that infidelity does not become a chronic problem.

Therapy for infidelity usually begins with the therapist creating a safe and supportive space for each partner to share their feelings, needs, and relationship goals. Reasons for the affair may be explored to gain greater awareness about the root causes and the couple may decide whether to mend or end the relationship.

If saving the relationship is desired, a skilled couples therapist can support the couple with tools to help improve communication and facilitate repair. What is needed to restore trust and safety in the relationship can be explored and practiced in the healing process.

A therapist can also work with the couple to help address what is not working in the relationship, including unhealthy patterns such as codependency and self-blame. A therapist can help the couple improve and change ineffective ways of communicating, such as stonewalling, criticism, defensiveness, and contempt.

Couples therapy can look very different depending on the therapist’s therapeutic orientation, personality, and practice style, and the couple’s unique dynamic and presenting issues. It’s essential to find a therapist that each person feels comfortable working with. Interviewing multiple therapists is highly recommended.

Takeaways

If you suspect your spouse is cheating, but aren’t sure what to do, it can be helpful to speak to a therapist or counselor to help sort your feelings out and to make a plan for how to confront this problem. If cheating is confirmed, it’s important to take your mental health seriously, as dealing with the aftermath of an affair can be stressful and traumatic. Be gentle with yourself, and honor your emotional boundaries.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Vowels L, Vowels M, Mark K. Is infidelity predictable? Using explainable machine learning to identify the most important predictors of infidelity. Journal of Sex Research. 2022;59(2):224-237. doi:10.1080/00224499.2021.1967846

  2. American Association for Marriage and Family Therapy. Online infidelity.

  3. American Association for Marriage and Family Therapy. Infidelity.

  4. Knopp K, Scott S, Ritchie L, Rhoades GK, Markman HJ, Stanley SM. Once a cheater, always a cheater? Serial infidelity across subsequent relationships. Archives of Sexual Behavior. 2017;46(8):2301-2311. doi:10.1007/s10508-017-1018-1

  5. Fye M, Mims G. Preventing infidelity: A theory of protective factors. Family Journal. 2019;27(1):22-30. doi:10.1177/1066480718809428

  6. Lonergan M, Brunet A, Rivest-Beauregard M, Groleau D. Is romantic partner betrayal a form of traumatic experience? A qualitative study. Stress Health. 2021;37(1):19-31. doi:10.1002/smi.2968

Additional Reading

Wendy Wisner

By Wendy Wisner

Wendy Wisner is a health and parenting writer, lactation consultant (IBCLC), and mom to two awesome sons.


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The Benefits of Deep Breathing

Take a deep breath—a good, deep breath—and let it out. If you’re feeling a little lighter, you’re not imagining it. Mental health professionals and yogis alike will recommend deep breathing because of all the amazing ways it can benefit your mental health, not just your respiratory system.

We take more than eight million breaths per year, so why is it so hard to get a deep one? And just what is a deep breath? Below, learn more about why you should try deep breathing and how to do it effectively.

Types of Breath

You take breaths every moment of the day, but you may not know that there are different types of breathing. In fact, there are four!

The four types of breathing are:

  1. Eupnea: Eupnea is probably the type of breathing you are doing right now as you are reading this. This is the breathing that occurs when you are not thinking about breathing. Also known as “quiet breathing, both the diaphragm and external intercostal muscles must contract.
  2. Diaphragmatic breathing: Also known as deep breathing, this type of respiration requires the diaphragm muscle to contract. As the muscle contracts, breath passively leaves the lungs.
  3. Costal breathing: This type of breathing, also known as “shallow breathing” uses your intercostal muscles, the muscles between your ribs. As these muscles relax, the air leaves your lungs. If you are stressed, you may be doing this type of breathing right now (or even unconsciously holding your breath).
  4. Hyperpnea: Also known as forced breathing, hyperpnea occurs when muscle contractions cause both inhalation and exhalation to be active rather than passive. 

What Are the Benefits of Deep Breathing?

Every type of breathing serves its purposes, but there are various reasons why deep breathing is such a heavy hitter when it comes to boosting your health.

What Deep Breathing Can Help

  • Anxiety
  • Depression
  • Managing stress 
  • Improving focus 
  • Better sleep
  • Faster recovery from exercise or exertion

Why Deep Breathing Helps

You may wonder why “just” breathing can be so powerful. Slow breathing activates the parasympathetic nervous system (PNS), also called the “rest and digest” system. Its job is to conserve energy for bodily processes such as digestion and urination.

Deep breathing also activates the vagus nerve, which is like the boss of the PNS, influencing mood, digestion, and heart rate. It will also send more oxygen to your brain and other organs.

Take a minute and check in with yourself before you start a deep breathing exercise to see how you feel, and then compare it with how you feel afterward.

If you find yourself feeling lightheaded after deep breathing, you may want to stop. The feeling should pass quickly after you stop. (If you continue to feel lightheaded, call your doctor.) Also, if you are dealing with anxiety, it may, sometimes, make it worse. 

How to Do Deep Breathing

There are many different ways or exercises, but here are a few. An added benefit is that they are all repetitive in nature, which will also help you reach a meditative state. 

If you already have asthma or any other issues with breathing, be sure to check with your doctor before beginning any deep breathing exercises.

Diaphragmatic Breathing

If you’re not familiar with the diaphragm, it’s a small muscle right below your lungs. If you’re breathing “correctly,” it will contract and move downward so that your lungs can expand to take in fresh air. Upon exhalation, the opposite happens; it relaxes and slides further up your chest cavity.

To engage in diaphragmatic breathing:

  1. Begin with one hand over your heart and one hand over your belly.
  2. Breathe in through your nose and let the air fill your belly. Keep your hands on your heart and belly, and observe how the one on your belly moves while the one on your heart should stay the same.
  3. Draw your navel towards your spine as you exhale, as if you were blowing out birthday candles. 
  4. Feel the hand on your belly slide down to its original position. 
  5. Repeat this three to five times to start, noting how you feel after each time. 

4-7-8 Breathing

With 4-7-8 breathing, you will breathe in for four seconds, hold your breath for seven, and exhale for eight:

  1. Start with one hand on your heart and one hand on your belly as in the diaphragmatic breathing exercise.
  2. Take one, deep slow breath from your belly as you feel your diaphragm slide down. Count to four as you breathe in.
  3. At the top, hold your breath as you count to seven.
  4. For eight counts, exhale through your mouth, emptying your lungs completely. 
  5. Repeat three to five times, or until you feel calmer.

Deep Breathing Tips and Tricks

Below are some tips and tricks to try as you practice deep breathing techniques.

Make Time for Deep Breathing

It may sound silly to you to set an alarm or timer to breathe, but it can help you ensure that you are getting these great deep breathing benefits regularly.

Instead of rolling over and grabbing your phone when your alarm goes off, try for a few rounds of these breathing exercises.

Do It Prior to and During High-Stress Situations

Practice deep breathing exercises when you don’t necessarily need them at first, so that when you are feeling stressed and could benefit from it in the moment, you are already an expert at the type of deep breathing you want to utilize. You don’t want to try deep breathing for the first time when you are in a high-stress state.

The best part about breathing for relaxation is that nobody needs to know you’re doing it, so you can do it any time, anywhere.

You probably have places or situations that you know are likely to stress you out—like standing in line at the grocery store or getting stuck in traffic. Once you’ve mastered deep breathing, take a minute to treat your brain to that sweet, sweet oxygen before the situation escalates.

Apps for Deep Breathing

If you’d prefer to be guided through some deep breathing activities, don’t worry, there’s an app for that. The following are just a few meditation apps you might want to consider:

iBreathe

As you might guess, the app iBreathe is all about breathing. It offers you several pre-programmed exercises, an option to customize your own and the ability to send you reminders.

Breathe+ Simple Breath Trainer

If you are a person who has trouble focusing when deep breathing, you will enjoy Breathe+ Simple Breath Trainer. It syncs with your breathing so you can see beautiful visualizations that correspond with your breath.

Apple Watch Breathe

If you have an Apple Watch, you already have access to a built-in breathing app, literally called Breathe. The app will check in with you and prompt you to take a one-minute breathing break, guiding you when to inhale and when to exhale.

Takeaways

Deep breathing can benefit many people, but it is only one tool in your mental health toolbox. If you’re not getting the deep breathing benefits you’d hoped for, don’t be discouraged. Keep practicing as with anything new, it may take some time. Consider other tools that you have in your mental health toolbox. If your anxiety remains severe or gets worse, consider talking to a mental health professional.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Whited L, Graham DD. Abnormal respirations. In: StatPearls. StatPearls Publishing.

  2. Magnon V, Dutheil F, Vallet GT. Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Sci Rep. 2021;11(1):19267. https://doi.org/10.1038/s41598-021-98736-9

  3. Bentley TGK, D’Andrea-Penna G, Rakic M, et al. Breathing practices for stress and anxiety reduction: Conceptual framework of implementation guidelines based on a systematic review of the published literature. Brain Sci. 2023;13(12):1612. doi:10.3390/brainsci13121612

  4. Jerath R, Beveridge C, Barnes VA. Self-regulation of breathing as an adjunctive treatment of insomnia. Front Psychiatry. 2019;9:780. doi:10.3389/fpsyt.2018.00780

  5. Myerholtz L. Take a deep breath. Fam Med. 2023;55(4):284-285. doi:10.22454/FamMed.2023.731271

  6. Breit S, Kupferberg A, Rogler G, Hasler G. Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Front Psychiatry. 2018;0. doi: 10.3389/fpsyt.2018.00044

  7. The American Institute of Stress. Take a Deep Breath.

Theodora Blanchfield AMFT

By Theodora Blanchfield, AMFT

Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer using her experiences to help others. She holds a master’s degree in clinical psychology from Antioch University and is a board member of Still I Run, a non-profit for runners raising mental health awareness. Theodora has been published on sites including Women’s Health, Bustle, Healthline, and more and quoted in sites including the New York Times, Shape, and Marie Claire.


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A Fake Treatment With a Real Response


The mind can trick you into believing that a fake treatment has real therapeutic results, a phenomenon known as the placebo effect. In some cases, placebos can exert an influence powerful enough to mimic the effects of *real* medical treatments.

When this happens, some people experience real benefits after the administration of an inactive lookalike substance or treatment. This substance, or placebo, has no known medical effect and can be in the form of a pill (sugar pill), injection (saline solution), or consumable liquid.

In most cases, the person does not know that the treatment they’re receiving is actually a placebo. Instead, they believe they’ve received the real treatment. The placebo is designed to seem exactly like the real treatment, yet the substance has no actual effect on the condition it purports to treat.

However, the placebo effect is much more than just positive thinking. Most people have no idea they are responding to what is essentially a sugar pill. Placebos are often used in medical research to help doctors and scientists discover and understand the physiological and psychological effects of new medications.

Placebo vs. Placebo Effect

It is important to note that a “placebo” and the “placebo effect” are different things. The term placebo refers to the inactive substance itself, while the term placebo effect refers to any effects of taking a medicine that cannot be attributed to the treatment itself.

What Causes the Placebo Effect?

Although researchers know that the placebo effect is real, exactly why it happens is a bit of a mystery. Various factors probably play a role in this phenomenon.

Hormonal Response

One possible explanation is that taking the placebo triggers a release of endorphins. Endorphins have a structure similar to that of morphine and other opiate painkillers and act as the brain’s own natural painkillers.

Researchers have demonstrated the placebo effect in action using brain scans, showing that areas with many opiate receptors were activated in both the placebo and treatment groups.

For example, studies have shown that believing that pain relief will work activates the brain’s pain relief systems in the same way that real painkillers work. This phenomenon is known as pain analgesia.

Conditioning

Other possible explanations include classical conditioning, or when you form an association between two stimuli resulting in a learned response. In some cases, a placebo can be paired with an actual treatment until it evokes the desired effect.

For example, if you’re regularly given the same arthritis pill to relieve stiff, sore joints, you may begin to associate that pill with pain relief. If you’re given a placebo that looks similar to your arthritis pill, you may still believe it provides pain relief because you’ve been conditioned to do so.

Expectation

Expectations, or what we believe we will experience, have been found to play a significant role in the placebo effect. People who are highly motivated and expect the treatment to work may be more likely to experience a placebo effect.

A prescribing physician’s enthusiasm for treatment can even impact how a patient responds. If a doctor seems very positive that a treatment will have a desirable effect, a patient may be more likely to see benefits from taking the drug. This demonstrates that the placebo effect can even take place when a patient is taking real medications to treat an illness.

Verbal, behavioral, and social cues can contribute to a person’s expectations of whether the medication will have an effect.

  • Behavioral: The act of taking a pill or receiving an injection to improve your condition
  • Social: Reassuring body language, eye contact, and speech from a doctor or nurse
  • Verbal: Listing to a health care provider talk positively about treatment

Genetics

Genes may also influence how people respond to placebo treatments. Some people are genetically predisposed to respond more to placebos.

Research has found that people with a gene variant that codes for higher levels of the brain chemical dopamine are more prone to the placebo effect than those with the low-dopamine version. People with the high-dopamine version of this gene also tend to have higher levels of pain perception and reward-seeking.

The Nocebo Effect

Conversely, individuals can experience more symptoms or side effects as a response to a placebo, a response that is sometimes referred to as the “nocebo effect.” For example, a patient might report having headaches, nausea, or dizziness in response to a placebo.

These responses are defined as any negative outcomes to a treatment that the treatment’s pharmacological effects cannot explain. Such effects can be influenced by past negative experiences, verbal suggestions, environmental cues, and seeing others having negative reactions.

Examples of the Placebo Effect

The placebo effect can be used in a variety of ways, including in medical research and psychology research to learn more about the physiological and psychological effects of new medications.

In Medical Research

In medical research, some people in a study may be given a placebo, while others get the new treatment being tested. The purpose of doing this is to determine the effectiveness of the new treatment. If participants taking the actual drug demonstrate a significant improvement over those taking the placebo, the study can help support the claim for the drug’s effectiveness.

When testing new medications or therapies, scientists want to know if the new treatment works and if it’s better than what’s already available. Through their research, they learn the sort of side effects the new treatment might produce, which patients may benefit the most, and if the potential benefits outweigh the risks.

By comparing the effects of a treatment to a placebo, researchers hope to be able to determine if the effects of the medicine are due to the treatment itself or caused by some other variable.

In Psychology Experiments

In a psychology experiment, a placebo is an inert treatment or substance that has no known effects. Researchers might utilize a placebo control group, which is a group of participants who are exposed to the placebo or fake independent variable. The impact of this placebo treatment is then compared to the results of the experimental group.

Even though placebos contain no real treatment, researchers have found they can have a variety of both physical and psychological effects. Participants in placebo groups have displayed changes in heart rate, blood pressure, anxiety levels, pain perception, fatigue, and even brain activity.

These effects point to the brain’s role in health and well-being.

Benefits of Using a Placebo

The major advantage of using a placebo when evaluating a new drug is that it weakens or eliminates the effect that expectations can have on the outcome. If researchers expect a certain result, they may unknowingly give clues to participants about how they should behave. This can affect the results of the study.

To minimize this, researchers sometimes conduct what is known as a double-blind study. In this type of study, neither the study participants nor the researchers know who is getting the placebo and who is getting the real treatment. By minimizing the risk of these subtle biases influencing the study, researchers are better able to look at the effects of the drug and the placebo.

One of the most studied and strongest placebo effects is in the reduction of pain. According to some estimates, approximately 30% to 60% of people will feel that their pain has diminished after taking a placebo pill.

For example, imagine that a participant has volunteered for a study to determine the effectiveness of a new headache drug. After taking the drug, she finds that her headache quickly dissipates, and she feels much better. However, she later learns that she was in the placebo group and that the drug she was given was just a sugar pill.

Outcomes

While placebos can affect how a person feels, studies suggest that they do not have a significant impact on underlying illnesses. One older review of more than 150 clinical trials involving placebos found that placebos had no major clinical effects on illnesses. Instead, the placebo effect had a small influence on patient-reported outcomes, particularly of perceptions of nausea and pain.

However, another review conducted nearly 10 years later found that in similar populations, both placebos and treatments had similar effects. The authors concluded that placebos, when used appropriately, could potentially benefit patients as part of a therapeutic plan.

Depression

The placebo effect has been found to impact people with major depressive disorder. In one study, participants who weren’t currently taking any other medication were given placebo pills labeled as either fast-acting antidepressants or placebo for one week. After the week, the researchers took PET scans and told the participants they were receiving an injection to improve mood.

Participants who took the placebo labeled as an antidepressant, as well as the injection, reported decreased depression symptoms and increased brain activity in areas of the brain linked to emotion and stress regulation.

Pain Management

A 2021 systematic review found that placebo effects accounted for clinically significant reductions in pain. There were also some improvements in overall disability. Such findings suggest that placebos may have a place in the management of pain.

Symptom Relief

The placebo effect has also been studied on cancer survivors who experience cancer-related fatigue. Participants received three weeks of treatment, either their regular treatment or a pill labeled as a placebo. The study found that the placebo (despite being labeled as such) was reported to improve symptoms while taking the medication and three weeks after discontinuation.

Takeaways

The placebo effect can have a powerful influence on how people feel, but it is important to remember that they are not a cure for an underlying condition.

Healthcare providers aren’t allowed to use placebos in actual practice without informing patients (this would be considered unethical care), which reduces or eliminates the desired placebo effect.

However, by using placebos in research, during which they don’t have to inform the participant, scientists are able to get a better idea of how treatments impact patients and whether new medications and treatment approaches are safe and effective.


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How Internal Rewards Drive Behavior

Why do some people devote themselves to learning a new language, training for a marathon, or perfecting a new skill just for fun? They have something known as intrinsic motivation, an internal drive to engage in a behavior because of the inherent satisfaction of the activity rather than the desire for a reward or specific outcome.

Intrinsic motivation happens when we act without being compelled by obvious external rewards. In other words, the activity itself is its own reward. Intrinsic motivation can be contrasted with extrinsic motivation, which involves engaging in a behavior to earn external rewards or avoid punishment.

The three main elements of intrinsic motivation are autonomy, purpose, and mastery. People are intrinsically motivated when they can act independently, feel that their efforts matter, and gain satisfaction from becoming more skilled.

Is It Extrinsic and Intrinsic Motivation?

What Are Examples of Intrinsic and Extrinsic Motivation?

Consider for a moment your motivation for reading this article. If you are reading it because you have an interest in psychology and simply want to know more about the topic of motivation, then you are acting based upon intrinsic motivation.

If you are reading this article because you have to learn the information for a class and want to avoid getting a bad grade, then you are acting based on extrinsic motivation.

How Intrinsic Motivation Works

When was the last time you did something simply for the enjoyment of the activity itself? You can probably think of many activities that fall into this category. For instance, you might plant a garden, paint a picture, play a game, write a story, take a walk, or read a book.

Some of these activities might be productive or result in some reward, but that’s not really your goal. Instead, you do them because you like to. They make you happy.

When you pursue an activity for the pure enjoyment of it, you are doing so because you are intrinsically motivated. Your motivations for engaging in the behavior arise entirely from within rather than out of a desire to gain some external reward, such as prizes, money, or acclaim.

Of course, that isn’t to say that intrinsically motivated behaviors do not come with their own rewards. These rewards often involve creating positive emotions within the individual.

Activities can generate such feelings when they give you a sense of meaning, like participating in volunteer or church events. They may also give you a sense of progress when you see that your work is accomplishing something positive, or competence when you learn something new or become more skilled at a task.

How Extrinsic Reinforcement Affects Intrinsic Motivation

Sometimes, extrinsic rewards can have a detrimental effect on our existing internal drive to engage in a behavior. Researchers have discovered that offering external rewards or reinforcements for an already internally rewarding activity can actually make the activity *less* intrinsically rewarding. This phenomenon is known as the overjustification effect.

Essentially, intrinsic motivation means that a person already feels that the internal rewards they experience provide sufficient justification for engaging in the behavior. However, adding an external reward to the mix can create confusion. In order to understand their true motivation, people will sometimes mistakenly attribute their motivation to the external reward.

People tend to be more creative when they are intrinsically motivated.

In work settings, for instance, productivity can be increased by using extrinsic rewards such as a bonus. However, the actual quality of the work performed is influenced by intrinsic factors. If you are doing something that you find rewarding, interesting, and challenging, you are more likely to come up with novel ideas and creative solutions.

How It Impacts Your Behavior

Intrinsic motivation can drive behavior in all aspects of life, particularly in education, sports, careers, and personal pursuits.

In Education

Intrinsic motivation is an important topic in education. Teachers and instructional designers strive to develop intrinsically rewarding learning environments. Unfortunately, many traditional paradigms suggest that most students find learning boring, so they must be extrinsically goaded into educational activities.

Some researchers suggest that this does not need to be the case. They identify several different ways to create intrinsically rewarding learning environments.

An activity is intrinsically motivating if people do it for the sake of the activity and not to get a reward or avoid a punishment. The words fun, interesting, captivating, enjoyable, and intrinsically motivating are used interchangeably to describe such activities.

In Personal Pursuits

Examples of intrinsic motivation in daily life abound. If you participate in a sport because you enjoy it rather than to win awards or competitions, you’re responding to intrinsic motivation.

Another example: You try to do your best at work because your tasks and mission provide fulfillment and satisfaction, regardless of extrinsic factors such as pay and benefits.

Perhaps you maintain a beautiful garden because you enjoy planting it and watching it grow, not because the neighbors would complain if your yard were messy. Or, maybe you dress stylishly to express yourself and your interest in fashion, rather than to garner attention. Whenever you do something “just for you,” you’re responding to intrinsic motivation.

Factors That Influence It

While intrinsic motivation arises from within an individual, it doesn’t exist in a vacuum. There are a variety of environmental and psychological factors that can either help or hurt a person’s internal drive. Understanding these factors can help us create conditions that foster greater intrinsic motivation.

  • Challenge: People are more motivated when they pursue goals with personal meaning and when attaining the goal is possible but not necessarily certain. When performance feedback is available, these goals may also affect self-esteem.
  • Control: People want control over themselves and their environments and want to determine what they pursue. They feel more intrinsically motivated when they have this sense of control.
  • Cooperation and competition: Intrinsic motivation also strengthens when people gain satisfaction from helping others. It also applies to cases where they can compare their performance favorably to that of others.
  • Curiosity: Internal motivation is increased when something in the physical environment grabs the individual’s attention (sensory curiosity). It also occurs when something about the activity stimulates the person to want to learn more (cognitive curiosity).
  • Recognition: People enjoy having their accomplishments recognized by others, which can increase internal motivation.

Potential Pitfalls

Experts have noted that offering unnecessary rewards can have unexpected costs. While we like to think that offering a reward will improve a person’s motivation, interest, and performance, this isn’t always the case.

When children are rewarded for playing with toys that they already enjoy playing with, their enjoyment of those toys, and their motivation to continue playing with them, actually decreases.

It is important to note, however, that a number of factors can influence whether intrinsic motivation is increased or decreased by external rewards. Salience or the significance of the event itself often plays a critical role.

An athlete competing in a sporting event might view the winner’s prize as confirmation of competence and exceptionalism. On the other hand, some athletes might view the same prize as a sort of bribe or coercion.

The individual’s view of the importance of different characteristics of the event impacts whether the reward will affect their intrinsic motivation for participating in that activity.

Takeaways

In your own life, there are probably many things you do which are prompted by intrinsic motivation. These are important elements for a well-balanced life. If we spend all of our time working to make money, we may miss out on the simple pleasures of life. Realizing your own intrinsic and extrinsic motivations and balancing them can be quite rewarding.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Levy A, DeLeon IG, Martinez CK, et al. A quantitative review of overjustification effects in persons with intellectual and developmental disabilities. J Appl Behav Anal. 2017;50(2):206–221. doi:10.1002/jaba.359

  2. Malone TW, Lepper MR. Making learning fun: A taxonomy of intrinsic motivations for learning. In: Snow RE, Farr MJ, ed. Aptitude, Learning, and Instruction: Iii. Conative and Affective Process Analysis. Erlbaum.

  3. Morris LS, Grehl MM, Rutter SB, Mehta M, Westwater ML. On what motivates us: a detailed review of intrinsic v. extrinsic motivation. Psychol Med. 2022;52(10):1801-1816. doi:10.1017/S0033291722001611

  4. Liu Y, Yang Y, Bai X, Chen Y, Mo L. Do immediate external rewards really enhance intrinsic motivation? Front Psychol. 2022;13:853879. doi:10.3389/fpsyg.2022.853879

Kendra Cherry

By Kendra Cherry, MSEd

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the “Everything Psychology Book.”


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All-or-None Law for Nerves and Muscles

Neurons (aka nerve cells) are responsible for communication in the brain and body. They receive stimuli, communicate it to the brain, and transmit signals from the brain to the rest of the body. When a neuron “fires,” it transmits a signal down the length of the axon to trigger the release of chemicals at the end of the neuron that then trigger a reaction in the connecting cell. Whether this process happens (or not) hinges on the all-or-none law.

The all-or-none law states that the strength of a nerve cell or muscle fiber’s response is not dependent upon the strength of the stimulus. A nerve or muscle fiber will fire if a stimulus is above a certain threshold.

According to the all-or-none law, an individual neuron or muscle fiber will either respond fully or not at all.

How Does the All-or-None Law Work?

If a stimulus is strong enough, an action potential occurs and a neuron sends information down an axon away from the cell body and toward the synapse. Changes in cell polarization result in the signal being propagated down the length of the axon.

The action potential is always a full response. There is no such thing as a “strong” or “weak” action potential. Instead, it is an all-or-nothing process. Why? By always triggering a full response, it minimizes the possibility of information being lost along the way.

This process is similar to the action of pressing the trigger of a gun. A very slight pressure on the trigger will not be sufficient and the gun will not fire. When adequate pressure is applied to the trigger, however, it will fire.

The speed and force of the bullet are not affected by how hard you pull the trigger. The gun either fires or it does not. In this analogy, the stimulus represents the force applied to the trigger while the firing of the gun represents the action potential.

How the Signal Triggers an Action Potential

In its normal resting state, the inside of a neuron is around -70 millivolts. When activated by the stimulus, the membrane depolarizes, causing ion channels to open. As a result, sodium ions enter the action and change the polarization of the axon.

Once the cell depolarizes to the required threshold, the action potential will fire. As the all-or-nothing law states, this action is not graded—it either happens, or it doesn’t.

A stimulus might cause sodium to enter the cell, but too few ions might enter the cell. This means that the cell won’t reach the required threshold and it will not fire.

Determining Stimulus Strength

The body still needs to determine the strength or intensity of a stimulus. For example, it’s important to know how hot a cup of coffee is as you take an initial sip or how firmly someone is shaking your hand.

To gauge stimulus intensity, the nervous system relies on two sources of information:

  • The rate at which a neuron fires: A neuron firing at a faster rate indicates a stronger intensity stimulus.
  • How many neurons fire at any given time: Numerous neurons firing simultaneously or in rapid succession would also indicate a stronger stimulus.

If you take a sip of your coffee and it is very hot, the sensory neurons in your mouth will respond rapidly. A very firm handshake from a co-worker might result in both rapid neural firing and a response from many sensory neurons in your hand. In both cases, the rate and number of neurons firing provide valuable information about the intensity of the original stimulus.

According to the rate law, the more intense a stimulus is, the faster the neuron will fire. In other words, a strong stimulus will cause the neuron to fire much faster than a weak one.

The rate at which a neuron can fire is determined by its absolute refractory period, which is the period of time after a cell fires, during which it cannot generate another action potential regardless of the stimulus’s intensity.

Examples of the All-or-None Response

Some examples of the all-or-none response can be seen in different sensory and perceptual situations. For example:

  • Touching a hot pan
  • Smelling a delicious scent
  • Feeling the coldness of a glass of water
  • Detecting the sweetness piece of candy

In each case, sensory information is transmitted via the action potentials that carry the signal to the brain. Once the threshold has been reached to trigger an electrical impulse, the nerve fires and transmits the sensory information. That is an example of the all-or-nothing law in action.

It is the speed and frequency that the nerve fires that provide information to the brain about the intensity of the stimulus.

So touching a hot pan, for example, would result in the rapid firing of a nerve impulse that would result in an immediate response.

Discovery of the All-or-None Law

The all-or-none law was first described in 1871 by physiologist Henry Pickering Bowditch. In his descriptions of the contraction of the heart muscle, he explained, “An induction shock produces a contraction or fails to do so according to its strength; if it does so at all, it produces the greatest contraction that can be produced by any strength of stimulus in the condition of the muscle at the time.”

While the all-or-none law was initially applied to the muscles of the heart, it was later found that neurons and other muscles also respond to stimuli according to this principle.

Takeaways

The all-or-nothing law is an important principle that describes how nerve cells either fire at full strength or do not. Because of this, important information does not lose strength as it is carried to the brain, ensuring that people are able to respond to environmental stimuli.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychological Association. All-or-none law.

  2. Prieto N, Wrobleski J. Action potentials. In: Vonk J, Shackelford T, eds. Encyclopedia of Animal Cognition and Behavior. Springer International Publishing; 2017:1-5. doi:10.1007/978-3-319-47829-6_1268-1

  3. Shao S, Meister M, Gjorgjieva J. Efficient population coding of sensory stimuli. Phys Rev Research. 2023;5(4):043205. doi:10.1103/PhysRevResearch.5.043205

  4. American Psychological Association. Refractory period.

  5. Leivaditis V, Mulita F, Dahm M, et al. History of the development of isolated heart perfusion experimental model and its pioneering role in understanding heart physiology. Arch Med Sci Atheroscler Dis. 2024;9:e109-e121. doi:10.5114/amsad/188270

  6. Chakravarthy VS. Demystifying the Brain: A Computational Approach. 1st ed. 2019. Springer Singapore : Imprint: Springer; 2019.

Kendra Cherry

By Kendra Cherry, MSEd

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the “Everything Psychology Book.”


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