The Expectation Effect

Transcript

Rachel Salaman: Hello, I'm Rachel Salaman. How much can our expectations of something affect how that thing turns out?

Well, think about the placebo effect – when inert tablets deliver some of the same effects as pharmaceutical drugs. That’s the very definition of mind over matter. Does this happen elsewhere in our lives too? And if so, can we use it to our advantage?

The science writer, David Robson, has brought together a wealth of research into this topic in a new book, called, "The Expectation Effect: How Your Mindset Can Transform Your Life." And he joins me now to discuss what he found out and its implications. Hello, David.

David Robson: Hey. I'm really excited to be here.

Rachel Salaman: Thanks so much for joining us today. Well I mentioned the placebo effect just now, and in many ways, that's a good place to start, isn't it? Because the idea that expectations can change outcomes began in the world of medicine. Can you fill in a bit of that background?

David Robson: Yes, sure. I mean, absolutely it's the best place to start because it really provides such a strong experimental foundation for all of the other research that I discuss.

Doctors had kind of understood the benefits of positive expectations of recovery before the advent of modern medicine. But then, as medicine became more scientific and they started to understand the chemical action of drugs, for example, the use of dummy treatments, sham treatments, just fell out of fashion and was considered to be ethnically dubious. But around the 1950s researchers really started to look at that again and take it more seriously.

Henry Beecher, who had been an anesthesiologist during World War II, really kick-started that research when he found that, actually, when you compare people taking placebo painkillers to kind of regular analgesics – like morphine, for example – that actually the dummy treatments proved to be almost as effective as the real drugs. That observation really kick-started the use of the placebo-controlled clinical trial.

What this did was allowed doctors to amass a huge amount of evidence, you know, all of this data was recorded, that showed that placebos are actually quite effective in many different areas of medicine.

And they're not just kind of producing a subjective change, it's not just that the patient feels a bit happier or reassured, but that often it actually results in real physiological change. If you take a placebo painkiller, your brain actually starts to produce its own endogenous opioids, so its own natural painkillers.

These scientists kind of say that the brain has its own inner pharmacy. It can't perform miracles, but, actually, it can do things like produce opioids, it can reduce inflammation, it can change the kind of balance of hormones within the body, it can reduce blood pressure – you know, all of these things that are, actually, very medically important.

Sometimes the changes are even visible. So expectations can actually help to heal a rash that's on the skin. So, you know, it's really... The understanding has really started to show that actually the placebo effect itself can be quite important and something that shouldn't be ignored anymore.

Rachel Salaman: So if we go back to that question from the introduction, does this happen elsewhere in our lives too? The answer is yes, isn't it?

David Robson: Yes, absolutely. And this is a much more recent realization. Scientists have just kind of assumed that the placebo effect simply happened within medicine, you know, in hospitals and doctors' surgeries. But of course, there's no reason why that would be the case, and what we see is that we experience similar expectation effects in every area of our life. So when we're doing exercise, when we're dieting, it can affect our sleep and how we deal with sleep loss, how we respond to stress, all of these things can be shaped by our expectations with really profound results.

Rachel Salaman: You mentioned stress there, and you have a chapter on stress – or de-stressing stress, to be precise. Tackling anxiety and overwhelm, which is often the source of stress, it feels like a very modern issue to us, doesn't it – but, in fact, it dates back more than 100 years! Can you tell us about the start of this idea and how it developed?

David Robson: Yes. I mean, even if you look kind of further back than the 19th century you'll probably find like discussions of anxiety. But I think then it really started to take hold, this idea that the modern world, with all of our kind of new technology... You know, at that time it was like electricity, the telephone, trains, now it's kind of smartphones and this question of whether our notifications are causing us undue stress. But throughout all of this modern period, there's been this big discussion of whether, actually, our lives are becoming too hectic, that's causing us to become too stressed and anxious, and then that's damaging our health.

Now, back in the early 20th century, late 19th century, you even had these kinds of abstinence groups called "Don't Worry Clubs" that were trying to change people's mindset, to stop them worrying and just kind of accept life's challenges and to kind of just generate this feeling of happiness, which they thought was absolutely essential for good health.

There was always this idea that stress and anxiety, however we experience them, are inherently bad for us, that they're going to contribute to things like heart attacks and they're going to damage our performance in the workplace. And what the recent research says is virtually that's not necessarily true, and it actually depends on your attitudes and beliefs about stress and anxiety for whether they harm you or whether they might actually sometimes be quite useful sources of energy.

Rachel Salaman: Yes, and I think in the book you mention that you yourself used to struggle with anxiety, but the more you looked into this research the more convinced you were that we can de-stress stress, reframe it, put anxious feelings to good use. Could you share a little bit of that story?

David Robson: Sure. I mean, so what this research that I discovered told us is that actually we just have to think about the potential adaptive value of the anxious feelings. There are plenty of potential advantages of sometimes feeling anxiety – it's the reason that it evolved.

So one of these advantages [is] that when your heart is beating really quickly, it's pumping lots of blood to your brain – it's carrying oxygen and glucose to your brain cells, which will sharpen your thinking. Similarly, even the stress hormones, like cortisol, can actually help to improve your mental acuity.

The problem seems to be that when we have the overly negative views of anxiety, when we assume that it's debilitating. That just ramps up our anxiety even more: it's like adding another layer of anxiety, it's almost like a meta-anxiety, you're anxious about being anxious. And what that does then is it pushes you more towards the "fight or flight" response, where your heart is perhaps racing too hard. So it's putting stress on the heart, and that actually your thinking starts to be focused solely on the kind of threats around you, which then stops you from concentrating on the challenge at hand and thinking creatively.

And what the scientists showed was, when you help to shift that mindset and tell people about those adaptive benefits of anxiety, that that actually just prevents that from occurring. So what happens is that people do actually start to use the anxiety as a source of energy, and that can be seen in things like their performance on exams, their performance at public speaking. Also in physiological measures, so you see that the heart and the cardiovascular system reach this kind of optimum level of activity, rather than going too far, and that the people recover more quickly afterwards, so they're not facing the kind of strain on their bodies for too long, for hours after the stressful event itself.

That research is now really convincing, and to me it also feels very practical. I've used it myself, loads of times. And it's just so much easier for me to kind of reconfigure my thoughts in that way, to just feel the feelings and to acknowledge them, and to kind of not try to deny them, but to also just recognize that they could be useful to me. That's just so much more easy for me to achieve than trying to kind of suppress them and just act as if they're not there.

Rachel Salaman: Yes, and in the book, you also reframe happiness, which is another emotion that's given rise to a movement, or you could even say an industry. What's a useful way to apply expectations to being happy?

David Robson: So, I think obviously we'll enjoy being happy – that goes without saying. But I think one of the movements that's gone alongside this kind of anti-anxiety movement, this kind of idea that anxiety is dangerous, is this idea that we should try to be happy all the time. And that if we're not feeling happy it's some kind of failure, and that the negative feelings are kind of inherently bad for us.

So, things like anxiety, obviously, but also frustration, disappointment, anger. You know, it kind of stigmatizes the bad feelings because we're so focused on the good feelings.

In my book, I try to actually explain that that, essentially, is actually just creating a negative expectation effect. Whenever we feel that any of those bad feelings, we're amplifying the unhappiness that we're feeling because we also start to feel this kind of shame around them. Very similarly to how I described how we should think about anxiety, actually we can start to just try to look at the meaning of those negative feelings when they do arise, and the fact is that they might be uncomfortable but often they are kind of telling us something important.

So disappointment is really horrible to experience, but, actually, it's helping to tell you that the goal that you were trying to achieve really mattered. And that maybe you can learn something from your failure. And that maybe you need to kind of sit in that feeling for a bit to reassess your performance, and to try to avoid the same thing happening in the future.

So rather than just trying to distract ourselves from feeling bad or to beat ourselves up for feeling bad, actually we can just kind of lean into that mood a little bit. And what the research shows actually is that people who do that, who have a more accepting attitude to negative feelings and who see meaning in their negative feelings, they actually show a lot better kind of mental health and physical health. So much like the research on stress, dealing with your emotions appropriately in this way is actually just good for the mind and the body.

Rachel Salaman: So people worry about being happy enough – they also worry about getting enough sleep. And you share some really interesting research about sleep in your book. Could you sketch out the main points for us now?

David Robson: Absolutely. So sleep, again, kind of sleep loss, has been seen a bit like anxiety. I think especially in the last few years there's this idea that any kind of disturbance in your sleep is going to be bad for you: bad for your health, that you're going to struggle to function the next day. You know, we value sleep so much, and it's absolutely true that sleep is essential, that we can't kind of burn the candle at both ends over long periods of time and maintain a high level of health. But I think maybe we've taken that message a bit too far, and lots of people now are overly anxious about the amount of sleep that they're getting and any tiny disturbance.

What the research has shown is that, actually, those worries and those expectations – that if you suffer sleep loss then you're going to suffer all of these negative consequences – that's actually then producing those negative consequences.

This has been shown in observational experiments. So the researchers would ask people to come into the lab and they would actually measure, using brain scans, how much sleep people were actually getting, and then ask them whether they felt happy with the amount of sleep they were getting or whether they considered themselves to be a bad sleeper.

What they found was that a sizeable number of people, about 20 percent of people, are these "complaining good sleepers." So, objectively, they're getting enough sleep, but they really think that they're suffering from bad sleep loss. And what you find is that they are much more likely to suffer from fatigue the next day, concentration problems, they're kind of extra crabby and moody – you know, all of these things that we associate with sleep loss, and that's coming just from their expectations.

There have also been some interventional studies, where the scientists gave the participants sham feedback about their research. So, if someone was sleeping well, they kind of just temporarily told them, "Actually, you had a really bad night last night." And they found that actually priming people to think that way produced all of those negative consequences, so the fatigue and the poor concentration and poor cognition.

So it's very robust research now showing that our expectations can be really quite profound in explaining some of the symptoms of sleep loss. You know, one scientist told me that actually the anxiety is about sleep are now a greater pathogen than sleep loss itself, which is a very strong statement to come from a scientist.

Rachel Salaman: Yes, interesting. Your chapter about limitless willpower has a lot of surprises, like the idea that strenuous mental activity can actually energize you rather than deplete you, with the right expectations. So how can we make that happen?

David Robson: I mean, what I find fascinating about this is that, actually, the mindset kind of varies by culture. So in the U.K. and U.S. and in lots of European countries, we do have this assumption that mental activity is inherently depleting. Whereas the researchers found that in India it's the opposite and that people do more naturally tend to this view that, if you concentrate, that can actually be energizing in itself, and you gain momentum by performing difficult tasks.

So it's almost like starting up a car: it's a bit harder to start with, but then you keep going the longer you concentrate. And then what the research has shown is actually that becomes a self-fulfilling prophecy, these kinds of beliefs. So if you think hard mental work is going to be depleting it does become depleting – you feel tired, you feel distracted. If you think it's going to be energizing, then it's actually a lot easier to concentrate for a lot longer.

The research shows that actually just understanding the science behind this – you know, reading kind of short texts about the different mindsets – can actually help to produce the necessary change in itself. So, you know, as with a lot of the expectation effects, actually knowledge is power. You don't have to deceive yourself; you just have to understand how your beliefs might be affecting you. But there are some other ways as well that we can try to achieve this.

One that I find especially useful for me is to try to remember a time in the past where I've actually showed a lot of concentration for a long time, and often it's just doing an activity that I really enjoyed, so like reading a novel into the early hours of the morning, you know, because I was enjoying it so much I kind of forgot that that's hard mental work, but actually it is taking a lot of concentration to do that.

What the research shows is that, once you kind of remember those instances where you had shown a lot of willpower and a lot of concentration, once you remember that, that just puts you into the necessary mindset, so that you'll find it easier to do the same in whatever task you're facing.

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Rachel Salaman: There's an intriguing passage on rituals in your book. I wondered if you could talk about the Harvard University experiment by Alison Wood Brooks that involved a karaoke song and a seemingly meaningless ritual?

David Robson: Sure, yes. I mean, this is one of my favorite studies. So I think the idea with rituals is that we associate them with superstitions and we kind of think that it's irrational to perform a ritual.

So when we see athletes, like Rafael Nadal, for example, he has lots of rituals that he performs before a tennis match: everything from whether he can step on the lines of the court or not to how often he bounces the ball, you know, what order he eats his sports supplements. We kind of assume that that's just an irrational behavior that isn't really going to change performance – but the research shows that actually it really can be quite profound.

And the important thing here is that, actually, you don't have to believe in magic for it to be important. There seems to be something about performing a kind of rigid set of movements or activities in a particular order that just creates this kind of sense that you're in control. It reduces your anxiety and it just helps you to maintain focus.

So this study put that to the test at Harvard University, and what the researchers did was they just invited these students in for karaoke, they had to sing "Don't Stop Believin'" by Journey, and, obviously, a lot of these students were quite nervous about singing in public, but the researchers just asked them to form like a really meaningless ritual, but it did feel like a ritual because it was so rigid and regimented.

So they had to draw a picture of themselves, sprinkle some salt on it, scrunch up the paper and then throw it in the bin, and that actually improved their performance by a huge amount. So their singing was rated by the karaoke software for how accurate it was, and I think they performed about 13 percentile points better than the participants who didn't perform that ritual, who just kind of sat and tried to gather themselves alone, by themselves.

Rachel Salaman: So one message to take away from that I suppose is that if we do have private little rituals that we do we should stop feeling silly about them because they could actually be helping us?

David Robson: Yes, that's exactly it. You know, like we might want to listen to a certain song that we find empowering before going to an interview, or we might perform a series of stretches in exactly the same order each time before an important meeting. You know, these are the kinds of rituals that we can incorporate into our daily lives.

I kind of use one that was inspired by Beethoven, who apparently counted out 60 coffee beans for each cup of espresso that he made, and so I just try to do that each morning. It's kind of ludicrous in a way; there's no reason why 60 beans should be better than 61 or 59. But I think the point of these rituals is that they have to feel specific and exact, so it's actually that process of counting out the beans one by one that I think makes it so powerful.

Rachel Salaman: And in your book, you share some research about how our own expectations of achievement can determine what we achieve, in all aspects of life, including at work. And this reminded me of the work of Carol Dweck on Mindsets. I wonder if you could just talk a little bit about that?

David Robson: Sure. So I'm a big fan of Carol Dweck's work on mindset. Just very briefly, she has kind of looked at two different mindsets that we might have about our own abilities. One of those mindsets is the fixed mindset, that just involves assuming that your abilities are innate and inherent, they reflect something important about you, yourself. People with the growth mindset, they concentrate more on their capacity to produce incremental improvements. So someone with a growth mindset might think that they're not very good at maths now, but they might assume that they could get better in the future if they practice.

Carol's not saying that anyone can be a genius just with a change of mindset, but what she has shown is that, actually, people with the growth mindset do tend to perform better in various settings, in academia and in the workplace. The reason for that is just that when they face challenges, they're more likely to persevere. Whereas people with the fixed mindset, if they face a failure, they just kind of shy away from it and they don't want to take the same challenge again.

Rachel Salaman: It's interesting, yes. And the expectations of others about us are also very influential, aren't they? How does that work in a positive way in the workplace?

David Robson: Well this is the famous Pygmalion effect. The research on that began in the 60s, [then] it kind of fell out of fashion, but now there's lots of research showing that it is a robust phenomenon.

Put simply, it's just that if a teacher has high expectations of a student, then the student is more likely to perform better in all of their exams, than if the teacher has low expectations of them – and that's independent of the child's actual ability at the beginning of the year. So, you know, you can control their actual test scores that they'd performed just before they met this new teacher. So, that research has now been replicated and also shown in the workplace, it seems quite robust.

I think what the interest today really is focusing on [is] the way this interacts with certain societal prejudices, so things like sexism or racism. You know, even if these are implicit biases, a teacher or manager will be communicating low expectations, which could then affect the student or employee's performance. And they're often doing so just through small differences in body language, and the tone of voice, and the way they interact with this person – it doesn't have to be overt racism or sexism at all, it's just very much being communicated below their conscious awareness.

Rachel Salaman: Yes, and you talk about this quite a bit in your book, including suggesting some solutions of how we can... I think the phrase you use is "buffer ourselves," against other people's expectations. What are some ways to do that?

David Robson: So one of the best ways that's been found so far, to buffer ourselves against other people's expectations, is this process called self-affirmation. Self-affirmation is just listing say 10 qualities or values that you have, and then elaborating on one of them.

So, it could be your sense of humor, it could be your ability to play music or appreciate music, it could be how good a friend you are – it bolsters your own sense of efficacy, your sense of purpose, it kind of helps to reduce those anxieties you might be feeling as a result of those other people's expectations.

Rachel Salaman: I wanted to ask you about a slightly different expectation effect that I've noticed, which is when high expectations lead to greater disappointment. For example, if we think we're joining a fantastic company in a brilliant new role, we're more likely to be disappointed by the reality than if we'd had no expectations or lower ones. How does that kind of expectation effect fit into this discussion?

David Robson: Yes. I mean, that's definitely true. And I also think it's true that even if you're talking about yourself and you give yourself over-inflated expectations of what you're going to achieve in the workplace, or if you're starting out a new fitness regime and you tell yourself that you're going to be an Olympic athlete within a year and then you're not, then you're going to face disappointment and feel demotivated.

So that was something that I was always conscious of. But I think all of this research on the expectation effect is very much about just recalibrating your expectations realistically. It's not about living in this kind of deluded self-confidence or just denying the realities of a situation, and I think that will backfire – actually, I think once you've been disappointed because you had over-inflated expectations, it's going to be much harder to maintain even realistic expectations: you're going to feel so down, you're going to feel so disappointed that you may be even more negative than if you just had entered it with kind of neutral expectations.

So I would say, with all of the expectation effects that I've described, it's much better really to take that kind of approach that Carol Dweck has spoken about, and just to look incrementally at what you can achieve, and kind of push yourself out of your comfort zone. And what you find is that when you take that incremental approach, actually, over a period of weeks or months, you really can achieve great things. It's just not expecting for it all to come straight away after just one exercise.

Rachel Salaman: Absolutely. You include a chapter on expectations around aging in your book, what are your key takeaways here, particularly in the context of an aging workforce?

David Robson: I mean, this is astonishing research. And it's now two decades' research that has shown this fact: that our age beliefs can affect how we age – you know, actually, biologically how we age.

So people who associate aging with some positive attributes – so greater wisdom, better decision making, they see old age almost as an opportunity – they tend to live a lot longer than people who associate aging with disability and dependence and decline. A really seminal study from 2002 showed that the difference in lifespan was about 7.5 years. And that's been followed up with a huge amount of research showing that our age beliefs can affect all kinds of things, like risk of Cardiovascular Disease, our risk of Alzheimer's Disease, you know, all of these things that we associate with old age.

There's also some really plausible mechanisms by which this could occur. One is obviously behavior: if you have a positive view of aging, you're more likely to be motivated to stay physically active, which is going to protect you against various illnesses. That's really important.

There's also a direct physiological mechanism as well, and that's that if you feel vulnerable, as you get older, and you assume you're going to be more vulnerable, then that's going to make all of the challenges around you feel more threatening, more scary – so you actually have a higher stress response. The researcher has shown that this is indeed the case amongst people once they reach a milestone age, like 60, that people with the positive views of aging actually show a decline in the stress hormone, cortisol, while people who have the negative views of aging, who feel more vulnerable, they show a steady increase in cortisol.

And we know that stress can change things, can cause damage to cells. And so actually the research shows that this is reflected even in things like the length of the telomeres, those tiny protective caps at the end of chromosomes – the people with the negative views of aging, those protective caps get shorter and shorter as they get older, so they're much shorter than the telomeres of the people who have the positive views of aging. That's important because once these protective caps start shrinking, the cell is more likely to malfunction and die, putting you at greater risk of illness.

So there's a really strong biological mechanism that can explain how this occurs. One of the obvious implications of this research is that we actually have to be especially conscious of the kind of ageism around us.

So that could be in the media, but I think it's also prevalent in the workplace, you know, just the way you talk to older colleagues or about older colleagues, you might accidentally be reinforcing these negative age beliefs, and that's going to be damaging to the older people that you see today. You're actually then internalizing those beliefs yourself so that you're going to age worse as you get older too, so it's in everyone's interest to battle ageism.

Rachel Salaman: So if we're trying to manage the expectation effect better, and we're finding it hard, in the book you recommend that we try "self-distancing." What is that? And what are some ways to do it?

David Robson: So, I think one of the problems that can stop you from changing your mindset and from benefitting from the expectation effect, is that you're too harsh on yourself.

Any time you face a kind of failure you just assume that it's not working and it's not going to go anywhere. But actually, when we're trying to apply the expectation effect, we have to accept that, like any kind of skill, it takes a bit of practice. What self-distancing does, it just helps you to be a bit kinder to yourself and to see things in a more neutral light.

So self-distancing just involves trying to put yourselves in the shoes of a friend who might be advising you, rather than talking to yourself. So if you were considering your age beliefs, for example, and you have really negative views of yourself as you get older, and you're finding that really difficult to shift, it might just be helpful to think, "Well, what would my best friend tell me about these things?"

And I hope it would be unlikely that your best friend would say, "Well, you know, you're getting to the end of middle age now, your life's pretty much downhill from here, so you might as well just give up." You'd hope that your friend would tell you, "There's lots more opportunities," that you have control over your life, that you can do all of these positive things to actually improve your health and well-being.

So that's just the idea there, is that, with self-distancing, you're much likely to be kinder to someone else than you are to yourself, and just practicing that with a little bit of imagination can be quite powerful.

Rachel Salaman: Absolutely. Well, we've covered a lot of ground in this conversation, David. What for you are the most useful takeaways?

David Robson: So, I think we haven't spoken yet about fitness and dieting, which I realize maybe aren't so relevant in the workplace. But, actually, I think it could be really useful for listeners still to just understand that, you know, when you're trying to get healthy, that actually your expectations have a really big role to play there.

So, there's been lots of research showing that when people are doing difficult workouts, that if you lead them to believe that they're genetically indisposed to working out, that they have a high-risk gene that makes exercise harder, that reduces their endurance, that that actually becomes a physiological reality. So even things like the gas exchange within the lungs becomes less efficient when you have that negative expectation. And your movements start to be a bit more clumsy, a bit less efficient, which makes it harder to maintain the exercise. Conversely, if people believe that they are genetically predisposed to exercise, that can be beneficial: it kind of improves the efficiency of the cardiovascular system and helps them to perform at their peak.

So, here, the takeaway for me is just that we should really question our assumptions about those abilities. You know, throughout your early years you might have absorbed all kinds of negative assumptions about your ability to do exercise. You know, if you had bad experiences at gym class or PE that make you just assume that exercise is going to be a horrible experience and really difficult for you, just questioning whether that has any factual basis. Or perhaps you could just shift your expectations and think that, you know, at the gym, like just open your mind to the possibility that it could be fun, and that actually you might perform better than you think.

That could be really powerful, in just making it easier to stick to the fitness regime, because it will actually be preparing your body for the workout and it will just help you to feel a bit more comfortable, a bit more motivated, you know, with these physiological changes it could even change your performance.

Rachel Salaman: That's a great point to finish on. David Robson, thanks very much for joining us today.

David Robson: Thanks, it's my pleasure.

The name of David's book again is, "The Expectation Effect: How Your Mindset Can Transform Your Life." I'll be back in a few weeks with another Expert Interview. Until then, goodbye.