How great expectations can improve life outcomes

Ever envy someone’s luck or talent which made it no surprise they succeeded in their field? Well, research now shows it may not be entirely down to these factors, but more about attitude. In his new book, The Expectation Effect, science journalist and author David Robson reviews the cutting-edge science of how our mindset directs our lives, revealing how the mind and body are connected in powerful ways.

Along the way the author shows how scientific research has begun to uncover new techniques which we can all use to influence our lives — and the lives of those around us — by improving our fitness, productivity, health and happiness. Robson takes what might seem familiar about so-called “positive thinking” and shows just how much deeper the story goes. I had the opportunity to interview him via video call.

Q. How did you become interested in the expectation effect?

As a science writer specialising in psychology, neuroscience, and medicine, I’d spent quite a lot of time researching the placebo effect, which I suppose is the most obvious and well known example of the expectation effect. I then began researching how the placebo effect has this kind of evil twin, the nocebo effect, where our negative expectation, of an illness for example, can actually cause us to have symptoms of the illness. Many of the side effects of common drugs are largely caused by nocebo effects, rather than, say, the direct chemical action of the drugs.

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So the more I looked into it I found that expectations are actually having effects in all other areas of our lives. It’s not just medicine — it’s also in our relationship with exercise and diet, with effects as significant as our rate of ageing. So by collating the research over a number of years it really felt like the expectation effect was a story that needed to be told, especially because it has such a powerful impact on our overall well being.

Q. In your book you write that research in this area is growing. Is this really a research area in its own right?

Yes, I think we are seeing the emergence of an entire field researching the expectation effect. Now we are beginning to see conferences that are dedicated to this specific strand of research, and there are both emerging and already established research laboratories at different universities investigating the finer details. I think the most famous and the most active department is the Mind & Body Laboratory at Stanford University in California. That lab is pretty much entirely focussed on expectation effects.

Sure, the expectation effect hasn’t got a traditional base like, say, biology, medicine or neuroscience. But that’s what science does. Over time the depth of knowledge becomes so vast that new fields are spun out. Research into the expectation effect has only just begun to blossom.

Q. In a chapter entitled The Super Agers you talk about how our thoughts and expectations can accelerate or decelerate the ageing process. How does this work?

Yes, there is quite a lot of data on this now and the mechanism is fairly obvious when you think about it. It seems that if you are in some ways defeatist about ageing, you’re going to be less likely to look after your health as you get older, less likely to exercise, less likely to eat healthily. This of course takes its toll on your health.

There is also a more direct physiological component to the phenomenon, related to the feelings of vulnerability that are going to develop from a negative belief of ageing. Stresses can feel much more threatening than they really are, and have a negative physical effect on our bodies. For example, if one is worried, say, about getting lost going to the shop, as they get into their later years, because one assumes that ageing naturally brings poor memory, that increases the stress response, which will have a physiological effect.

Research shows us that people with negative views of ageing have a steady increase in cortisol over their lifespan from middle-aged into old age. That is also associated with increased inflammation, which we know leads to bodily wear, damaging our tissues and predisposing us to illness. We can even see these effects at the cellular level.

Q. What about the notion of managing expectations? Isn’t that the opposite of what you speak about?

Defensive pessimism I guess you might call that — the idea that if we keep our expectations low we can only ever be pleasantly surprised. But this approach is risky. You don’t want to anchor your thinking in that kind of way because, again, the data shows it does produce a negative expectation effect. I think we all know it doesn’t help to focus purely on the worst-case scenario all the time.

But equally, it really backfires if we do engage in unrealistic wishful thinking. A good example of that is when you have these good intentions to go to the gym and you expect yourself to quickly have the performance of an athlete. I think that’s going to bring disappointment.

So what is the right approach?

I would just say that, according to the research, we should focus on the small improvements that can be achieved and actively have faith in a process. The science is really solid that at any age we can actively improve our fitness, for example. Progress will be slow but your peak performance will only be achieved with the right frame of mind, connecting mind and body, in line with the expectation effect.

The science clearly shows that if we apply ourselves in this kind of way we can achieve our goals. It’s about belief. But it’s not simply the power of positive thinking — the expectation effect doesn’t cast aside natural negative thoughts or feelings, which are an important part of life. Just think of the expected pain which will be demanded in the gym.

This might seem overly obvious to some, or woo-woo to others, but the science is clearer every year. The expectation effect is real and definitely something you’re going to want to recognise in your life.

• Dr Conor Purcell writes about science, society and culture — twitter @ConorPPurcell — some of his articles are at cppurcell.tumblr.com