The Expectation Effect

David Robson (2022).?The expectation effect: How your mindset can change your world.?Henry Holt and Company: New York

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1-2?study from Harvard University.?The participants were hotel cleaners, whose work is often physically intense yet feels very different from the exercise you might perform at the gym … the shift in their beliefs about their bodies, and their new expectations of their work, had brought about real, physiological benefits – without any change in lifestyle

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2?the power of expectation is so strong that it can even determine how long you live

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4?(scientific research continues to show that simply denying the difficulties of a situation will only lead to worse outcomes.)

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4-5?you can learn to reframe and reappraise your thinking without any self-deception

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5-6 ?the placebo effect (from the Latin, “I shall please”) … nocebo effects (from the Latin, “I will harm”) … the placebo and nocebo responses to drugs are just two examples of the ways that beliefs can become self-fulfilling prophecies … these phenomena are variously called “expectation effects,” “expectancy effects,” “Oedipus effect” … and “meaning responses.”

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6-7?“complaining good sleepers” … “non-complaining bad sleepers” … we slept as well as we think we did

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7?Beliefs about the consequences of anxiety, meanwhile, can change someone’s physiological responses to stress

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7?People with a more positive attitude to their later years are less likely to develop hearing loss, frailty, and illness – and even Alzheimer’s

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7?Alia Crum “… our minds actually change reality …”

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12?the brain is a “prediction machine”

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12-13?Hermann von Helmholtz … the brain draws on past experiences to tidy up the visual mess … “unconscious inference.”

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13?Moshe Bar … “We see what we predict, rather than what’s out there.”

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14?the use of predictions to guide vision helps the brain to cut down the amount of sensory information it processes, so that it can focus on the most important details

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15?(… we can’t tickle ourselves.)

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18?Clearly, seeing isn’t believing – believing is seeing.

????Believing is also hearing … auditory hallucinations … are more common when we feel stressed and have consumed caffeine, which is thought to be a mildly hallucinogenic substance and may lead the brain to place more confidence in its predictions

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18?Strange visions are apparently common among polar explorers

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20?there may be no such thing as a fully objective observer … Anil Seth … “We don’t just passively perceive the world, we actively generate it …”

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20-22?almost completely blind … Ophthalmologists could find nothing wrong … “functional neurological disorder” (FND) … deafness … FNDs are in fact the second most common reason for someone to be referred to a neurologist (after migraines and headaches) … full recovery

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22?there are many subtle ways that our perceptions are biased by less than healthy expectations … micro-illusions – small deviations in perception that will confirm and amplify what we are already feeling

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23?enduring anxieties and phobias are accompanied … by permanently distorted perceptions of potential dangers in the environment

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23?Warped perceptions … can also contribute to our social anxieties

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24?exposure therapy … may work by recalibrating people’s perceptions

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24-25?“cognitive bias modification.” … look for actual unambiguous acts of friendliness

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27?an expensive bottle of wine; thanks to altered expectations of quality, knowledge of a higher price tag can result in a marked improvement in flavor

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27?Sometimes the exact same substance can evoke intense pleasure or outright disgust, depending on someone’s expectations … A mixture of isovaleric and butyric acid … can be found in two familiar substances: Parmesan cheese and vomit … it’s little wonder that people’s tastes in food vary so much

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27-28?trying a new food … reading up on the meal beforehand … host a dinner party … the way you describe your food will strongly influence the ways you and your guests appreciate it

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31?we are often poor judges of our own abilities, and it is possible to push the limits of what we can achieve through a simple change of mindset

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31?In her autobiographical novel Seduction of the Minotaur, Ana?s Nin … protagonist, Lillian … “We do not see things as they are, we see them as we are,” … what we feel and think will determine what we experience, which will in turn influence what we feel and what we think, in a never-ending cycle?

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35?There is in fact increasing evidence that people can respond to a placebo even when they know they are taking a sham treatment – a finding that seems to defy reason

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38?Parkinson’s disease … is caused by a deficit of dopamine in the brain

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40?it certainly seems likely that much of the stent’s benefits for angina arise from the patients’ expectations of improvement, rather than from the physical change to the heart’s plumbing

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43?the relationship between you and the health-care provider.?The placebo effect will be far more potent if they seem caring and competent

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43?It may sound paradoxical, but … knowledge of the placebo effect can itself provoke a healing response – equipping patients with the mental tools to treat themselves

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44?the strange inflation of placebo power seemed to be concentrated in the United States, while trials in Europe were largely unaffected

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46-47?Cláudia Carvalho … 2020 … participants in experiments often find knowledge of expectation effects to be highly empowering, with long-lasting benefits

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48-49?The power of the word “placebo” may be the bane of pharmaceutical companies hoping to invent new drugs, but it could be an enormous boon for many patients looking to avoid the risk of addictions or to overcome its iron grip

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49-51?Johannes Laferton … PSY-HEART … patients who had been encouraged to develop positive expectations tended to show the quickest recovery … they also reported a greater capacity to return to work … The patients’ improvements were probably a combination of behavioral and psychosomatic changes

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52?Sometimes a single sentence may make all the difference … the doctor can … accelerate the healing process with the words they say … Kari Leibowitz

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53?none of these exciting new treatments involves instilling a sense of false hope.?Each project simply used the facts at hand to help the patient understand the process and their prognosis and to frame their progress in the most positive way possible

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56?“bone-pointing” … “voodoo death” … “culture-bound syndrome,”

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57?G.W. Milton … “self-willed deaths”

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61?“this may hurt” … In reality the short statement will make that pain more likely … positive expectations can trigger the natural release of dopamine and opioids … negative expectations of pain can trigger the release of chemicals … such as the hormone cholecystokinin (CCK), which boosts the transmission of pain signals

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64-65?The stark truth is that nocebo responses are an inevitable consequence of the human brain’s predictive processing.?Anytime we feel unwell, our thoughts will be shaping our symptoms – and we ignore that fact at our own peril

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74?process known as “reappraisal,” in which we look for positive interpretations of negative events … we can apply this technique ourselves whenever we are injured or ill

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76?Like any skill, reappraisal takes practice

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79-80?“mass psychogenic illness.”

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81-82?In the early 1990s Giacomo Rizzolatti’s team … uncovered a neural basis for empathy

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83?imagine that you became friends with someone with an astonishingly positive attitude, who is incredibly satisfied with her life … Because of your regular interactions with her, you would be 15 percent more likely to achieve a high score … of life satisfaction … social contagion

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87-89?the precise conditions that make a mass psychogenic illness more likely … The first was the amount of stress they had been experiencing recently … The second was their connection to the other victim … The third – and last – concerns the environment: whether there is a feasible threat that would raise overall expectations of illness

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92?mass psychogenic illness … a natural consequence of our socially sensitive minds and the … capacity to pre-empt threats

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96?the accessibility of negative coverage online is directly proportional to the percentage of patients experiencing side effects

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100?Be aware that personal stories, while compelling, do not provide strong evidence of a real danger

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100?we are all susceptible to expectation effects that can bring about real physical discomfort

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103?You can train your body day in, and day out for years on end – but ultimately it is your mindset that will decide your physical limits

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104?By adopting the right mindset, even the most devoted couch potato can enjoy more gain, and less pain, from their workouts

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110?Carefully controlled studies show that a large proportion of all commercial sports supplements may aid performance by enhancing someone’s perceptions of their abilities, independently of any direct physiological effects

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112?Jeff Montes and Gabriele Wulf … how fit someone appeared … changed according to how fit they thought they were

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113?feel free to use any aids that work well for you.?Whether it’s a favorite drink, fancy sportswear, or motivational music, the change in mindset will bring the benefits

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114?Rather than dwelling on the feelings of failure, however, you can remind yourself that any exercise at all is better than nothing; your body is still benefiting

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114-115?Research shows that recognizing that your physical fitness is within your control, and can be improved over time, will ensure that you maintain your enthusiasm and energy, rather than descending into self-defeating rumination

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115?“invisible exercise”

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118?roughly a third of all English people using public transport already meet the governmental guidelines for physical activity from their commutes to and from work – by waiting for buses, walking to or from the station, or changing trains

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118?Alia Crum and Ellen Langer … By thinking of everyday activities as exercise, rather than work, it seems, we can become healthier

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119?Crum and [Octavia] Zahrt found that the “perceived physical activity” … could predict their risk of mortality

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121?Zahrt and Crum’s studies suggest that we should avoid “upward comparisons,” constantly judging ourselves against the people who are fitter than we are

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122?Scientific experiments have confirmed that the effects of visualization can be profound for professional sportspeople and casual exercisers alike

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124?various studies … have shown that regularly practicing mental imagery of exercise for a few minutes each week can increase people’s motivation and enjoyment of their exercise regimes, as well as their performance … try not to be overambitious in your visualizations … You don’t want to set yourself up for disappointment … or … injury

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125?The phenomenon of ordinary people showing incredible abilities in times of crisis is known as “hysterical strength,”

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130-131?“deprivation mindset,” … Whatever particular diet plan we are following, this expectation effect has the potential to make our weight loss far harder than it needs to be … recognize that a sense of indulgence should be an essential ingredient in every meal

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134-135?food … consumed … participants … Their sense of fullness and satisfaction was almost completely the result of their “expected satiety”: that is, it was based on their visual memory of what they believed they had eaten, rather than the food they had actually consumed

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135?The unhealthy habit of working, watching TV, or surfing the internet while eating can act as a distraction that impairs memory formation of the foods we have consumed, reducing our expectation of feeling sated

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137?our beliefs about what we have eaten can also influence our digestion and metabolism

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137?Ghrelin is often called the “hunger hormone” because it stimulates our appetite

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141?meal … food processor … absorption was far higher when the food was served as a recognizable meal, compared with the puree

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143?obesity … currently affects 13 percent of adults worldwide

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144?On a scale of 1 (strongly disagree) to 5 (strongly agree), do you think that

·???????There is usually a trade-off between healthiness and tastiness of food?

·???????There is no way to make food healthier without sacrificing taste?

·???????Things that are good for me rarely taste good?

The researchers found … the higher someone scores … the greater their body mass index

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145?food marketing … continues to reinforce the belief that healthy foods are inherently less satisfying

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145?Researchers … have found that simply adding the words “fuller for longer” to a yogurt container significantly increased people’s satiety up to three hours later

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147?among … social animals: those at the lower end of a group’s pecking order tend to eat more when the opportunity arises, and then burn energy less quickly

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147-148?avoid liquid calories in sweetened drinks … Be especially wary of high-sugar sports recovery drinks

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148?maximize your pleasure in the food you eat … make the most of intensely umami ingredients such as anchovies or Parmesan cheese.?The small number of calories that you add to that meal are more than compensated for by the greater satiety that you experience later on

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148-149?Cultivating a sense of indulgence is especially important for times when you enjoy an inevitable treat … participants who associated treats such as cake with “guilt” tended to gain weight … while participants who associated cake with “celebration” made progress toward their goals

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149-150?In a Canadian and French study from 2016, researchers first encouraged participants to vividly imagine the taste, smell, and texture of various sweet treats … most of the participants … [opted] for a smaller portion than those who had not been primed to think about the sensory qualities … With a bit of anticipation about what you are eating, it seems that you can make each bite more potent

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150?avoid distraction while you eat, and be sure to savor each mouthful … And afterwards try to make a point of remembering what you have eaten

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150?see each meal as an indulgence and something to be celebrated.?This will benefit both your physical and mental health

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151?studies have shown that labeling a food as “healthy” in France does not reduce satisfaction and pleasure as it does in other Western countries … French people also tend to have few negative connotations around treats and desserts

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152?Thanks to their more positive food culture … French people seem less susceptible to [the] nocebo response.?They know that – in moderation – they can have their cake and eat it, too.?We would all be healthier for experiencing that same joie de vivre

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159-162?Jeremy Jamieson .. noticed that some teammates would often get pumped up and excited before a game, whereas they would feel nervous and “freak out” before an exam.?These were both high-stakes situations – so why was the potential stress of the situations so helpful in one context and detrimental in another??…?Graduate Record Examinations … “People think that feeling anxious while taking a standardized test will make them do poorly on the test.?However, recent research suggests that arousal doesn’t hurt performance on these tests and can even help performance – people who feel anxious during a test might actually do better.?This means that you shouldn’t feel concerned if you do feel anxious while taking today’s GRE test.?If you find yourself feeling anxious, simply remind yourself that your arousal could be helping you do well.” … this small piece of guidance … helped these participants to perform better on the real test … Distraction didn’t work, but reframing did … When people are taught that stress can enhance their performance and contribute to personal growth, they tend to show more muted fluctuations in cortisol – just enough to keep them more alert without putting them in a long-lasting state of fear.?They also experience a sharper increase in beneficial “anabolic” hormones, such as dehydroepiandrosterone sulfate (DHEAS) and testosterone

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162-164?attitudes to stress can also transform behavior and perception in quite profound ways … our attitudes to stress can have a meaningful impact on all kinds of situations … People who were under high pressure but who believed it to have little effect on their health were actually less likely to die than those who experienced very little stress at all

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164?Jamieson … the aim is to change your interpretation of anxiety rather than suppressing the feeling itself … you don’t need to worry if you still feel breathless and your heart is still racing: the simple point to remember is that those responses are not a sign of weakness and should actually help you to perform at your best and to grow in the future ?

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167?Billie Jean King … pressure is privilege … “… something I got to do instead of something I had to do.”

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168-171?Iris Mauss … found that the people who valued happiness the most, and strove the hardest to achieve it, were unhappier on every measure that she considered … The harder we try to be happy, the less happy we are … On a scale of 1 (never / very rarely true) to 7 (very often / always true), how would you rate the following statements?

·???????I tell myself I shouldn’t be feeling the way that I’m feeling.

·???????I criticize myself for having irrational or inappropriate emotions.

·???????When I have distressing thoughts or images, I judge myself as good or bad depending on what the thought or image is about.

·???????I think some of my emotions are bad or inappropriate and I shouldn’t feel them.

·???????I believe some of my thoughts are abnormal or bad, and I shouldn’t think that way.

… the higher people scored on this questionnaire, the more likely they were to report symptoms of depression and anxiety, and the worse they scored on general measures of life satisfaction and psychological well-being.?People who reported accepting their thoughts and feelings … tended to have better psychological health

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171?people who see meaning in unpleasant feelings tend to be far happier

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173?[Maya Tamir] angry participants were about three times better than the calmer participants – provided they knew about the benefits of that emotion and its potential use as a source of energy

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173-174?negative emotions … may be a product of our expectations.?We don’t need to enjoy such feelings – but recognizing their potential value will allow us to channel them more effectively, and to recover more quickly once they have served their purpose.?By accepting the bad with the good we begin to resolve the paradox of happiness

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175-176?“worry about poor sleep is a stronger pathogen than poor sleep.”

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176?people who are asked to passively monitor their thoughts and feelings, without actively fighting them, take significantly less time to fall asleep

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177?we are actually much more resilient to moderate sleep loss than people assume … The trick is to take it slowly rather than hoping for immediate, total relief, and you don’t need to tackle every issue at once

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178?Hans Selye … “eustress,” … Stress … “is not what happens to you, but the way you take it.”

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180?Barack Obama … Arianna Huffington, Steve Jobs, Richard Branson, and Mark Zuckerberg are all said to have simplified their wardrobes as a way of preserving their brains for loftier tasks

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181-182?The idea that our mental resources are limited and can become exhausted over time certainly chimes with many of our own experiences at home and at work … What we once assumed to be a biological limit is really a cultural artifact, and by learning to change our expectation we can make better use of the brain’s enormous reserves.?This understanding can even help us to recognize the true power of superstition and prayer – for believers and atheists alike

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182?“willpower” … Sigmund Freud … saw our psyche as having three components: the id, the ego, and the superego

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183?1990s … [Roy] Baumeister saw our willpower as a mental muscle that tires with time

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185?Baumeister argued that the surest way to boost overall self-control is to change your environment, avoiding small, everyday ordeals that slowly sap your energy so you can spend it on things that really matter

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186?Yet some recent studies have questioned whether ego depletion is really as inevitable as we once thought.?Baumeister’s theory, is seems, was missing something essential: the power of belief to control the brain’s resources

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186?Dutch researchers have shown that simply being told that we may find an exercise to be energizing, rather than fatiguing, can reduce the sense of depletion, so that participants are more persistent and focused … Even more powerful … are our expectations about our own capabilities and our reactions to hard mental work in general … Veronika Job … our beliefs about the brain’s resources – whether we see them as finite or non-limited

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188?Job’s results seemed to show that the consequences of ego depletion are real – but only if you believe in it

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189-190?The effects of these mindsets are especially salient during the most stressful times, such as the run-up to exams?Those with the limited mindset report greater fatigue throughout the period … Those with the non-limited view, in contrast, find it much easier to maintain their studies and achieve good grades without procrastinating or neglecting their health

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190?Working with Krishna Savani … Job has shown that the non-limited view of the human mind is much more common among Indian students than among people in the United States or Switzerland – and their mental stamina is much greater as a result … the greater prevalence of the non-limited belief in India may arise from various religious traditions, including Buddhism, Hinduism, and Jainism

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192?willpower grows with practice

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193?the brain-boosting effects of caffeine were found to arise primarily from our beliefs about its benefits

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194?Fortunately, extreme workaholism does not seem to be a common problem for people with the non-limited beliefs … Indeed, the research shows that they tend to be happier and healthier … they … plan their work effectively, without wasting time on distractions

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194?simply learning about your vast mental reserves can have immediate benefits for your focus and self-control

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196?Parents and teachers may want to take particular note of these findings

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197?Look into the biography of any elite performer in sports or entertainment and there is a good chance they’ll have some kind of superstition or ritual

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198?One study … found that people who spend time in spiritual contemplation sustain greater focus on tests of concentration than those who do not

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199?The adoption of secular rituals can also improve our resolve in some classic tests of willpower

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202?beliefs of the people around us can change our intellectual abilities … some people bring out the best or worse in you

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202?Spruce Elementary School in San Francisco … 1964

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204?Our intellectual performance can be influenced by our beliefs, and we often absorb assumptions from the people around us … the implications of this research are political – since there is strong evidence that expectation effects can increase social equity

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209?Expectation effects are especially important when we confront new difficulties that challenge our existing abilities.?Abundant research shows that moderate frustration … is actually a sign of learning … “desirable difficulties” … Once again it’s a self-fulfilling prophecy: if you expect frustration to help you learn, it will

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210?You must beware the trap of overconfidence … be realistic … question your assumptions and keep an open mind

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211?many … studies have confirmed that a teacher’s expectations can have either positive or negative influence on a child’s academic performance

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212?organizational psychologists … a leader’s expectations boosted or limited their employees’ performance

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213-214?“confirmation bias”: we are always looking for reasons to support our existing opinions … contradicting evidence … we will choose to dismiss it rather than updating our beliefs

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214?Stephen Hawking … “Behind every exceptional person, there is an exceptional teacher,”

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216?Gina Rippon … argues that adults’ expectations about gender roles start to shape their brains from the moment they are born … prejudices

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217?There is now strong evidence that teachers consistently underestimate the abilities of poorer children … particularly … ethnic minorities

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219?many people still have to contend with overt sexism, racism, and classism

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220?[Christine] Rubie-Davies … teachers … it is possible to change the way someone communicates their expectations of others, and to teach them how to empower others with greater self-belief – and that can have a significant impact on their (or our) lives

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221-223?“self-affirmation” … researchers found that the benefits of self-affirmation were greatest for the women who had previously bought into the sexist stereotype … self-affirmation was acting as an antidote to the negative beliefs transmitted by society

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223-224?self-affirmation can also remedy the negative expectations that are often associated with poorer economic circumstances … [and] … the academic achievement of Black students in the US

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225?Self-affirmation is now one of the most reliably tried-and-tested interventions to combat the effects of negative stereotypes.?If we are looking for new ways to reduce academic inequality, its widespread use is really a no-brainer

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229?your beliefs could add or subtract years from your life

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232?[Becca] Levy … the average person with a more positive attitude to aging lived on for … a difference of around 7.5 years?… 2002

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233?positive attitudes to aging even seems to protect us from certain kinds of dementia

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236?“stereotype embodiment.”

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239?If someone considers themselves to be weaker, dimmer, and more vulnerable as a result of their age, they are more likely to see a difficulty as a negative threat rather than a positive challenge – resulting in more damaging stress responses that could wreak havoc on the body over time

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241?we can at least slow our decline by living a healthier lifestyle and by changing our expectations of what it means to be old

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242?Beat Knechtle … ultramarathon runners … there’s around an 8 percent drop in performance for each decade lived

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244?The way we age is very much within our power

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245?Doctors today often talk about the health span … as opposed to the life span

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248?a study from 2018 found that just 7 percent of the differences in longevity can be attributed to our genes

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249?on a personal level we might try to build bridges between generations, befriending people who are older and younger than us.?But as a society, we need to go much further and tackle ageism just as we do racism, homophobia, and other kinds of prejudice

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251-252?“… Healing isn’t just about medicine, it’s about people.”

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252?we are all shaped by our beliefs

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254?Carol Dweck … In general, people with the “growth mindset” tend to progress more quickly than people with a “fixed mindset.”

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255?“Everyone’s brain is a work in progress!”

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256?“self-distancing” … Ethan Kross … take an outside perspective of the situation

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258?an attitude of “self-compassion” is crucial for any personal transformation … Whatever you hope to achieve with the expectation effect, try to keep an open mind when testing different techniques, forgive any failures, and celebrate any successes

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258?Shakespeare … Hamlet … “there is nothing either good or bad, but thinking makes it so.”?