This episode of Hub Dialogues features host Sean Speer in conversation with David Robson, an award-winning science writer, about his fascinating book, The Expectation Effect: How Your Mindset Can Change Your World.
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SEAN SPEER: Welcome to Hub Dialogues, I’m your host, Sean Speer, editor-at-large at The Hub. I’m honoured to be joined today by David Robson, an award-winning science writer who’s published in major newspapers and magazines around the world on the brain, the body, and our behaviour. His 2022 book, The Expectation Effect: How Your Mindset Can Change Your World, has earned wide acclaim, including winning the British Psychological Society Book Award.
It’s now out in paperback and is a must-read for those who want to understand the interplay between our expectations and experiences. I’m grateful to speak with him about the book’s findings, including how our expectations shape our health, happiness, and overall lives. David, thanks for joining us at Hub Dialogues, and congratulations on the book.
DAVID ROBSON: Thanks so much, Sean. It’s a real pleasure to be chatting with you about this.
SEAN SPEER: Let’s start with a basic question. Why did you write this book? What were you looking to discover? What societal perceptions were you aiming to challenge?
DAVID ROBSON: It was a mixture of my intellectual curiosity and the scientific research, but also a personal experience, and the two actually collided. As a science writer, I’d often written about the placebo effect, and I’d always found that research fascinating; how our expectations of a sham treatment could actually shape not only our subjective perceptions of feeling better, but you could also see some physiological changes. An example I kept on coming across was with pain relief.
When you believe you’re taking a drug, like morphine, your brain actually starts producing its own endogenous opioids. That was always fascinating to me, that there was this mind-body connection. Then I was at the BBC, I was researching a piece about the opposite of the placebo effect, which is the nocebo effect. That’s where your expectations of illness can actually cause you to become sick through many of the same biological pathways.
That’s quite common in people who are taking different medications, and they can start to experience the side effects, even if they’re taking a sugar pill, a dummy pill. I was writing this piece, researching how placebo effects can pass from person to person, what causes patients to develop these nocebo symptoms. It just happened that I was actually put on a course of pills by my own doctor, who warned me that they might cause headaches as a side effect.
Then I started experiencing these really quite severe headaches that lasted all day, were a huge distraction from my work, but just by coincidence, the fact that I was researching that piece at roughly the same time, I looked into the science to see if, actually, nocebo effects were common with this kind of pill. I found that in the clinical trials, people taking the dummy pills had headaches almost as commonly as the people who were taking the real, active pill.
The chances were that I was experiencing a nocebo effect and that my pain was caused by this expectation. That realization actually provided an enormous amount of pain relief for me. It took about a day, I guess, for my mind to process that information, but very quickly, I was totally free from that side effect. Well, firstly, it helped me to realize that when we talk about these expectation effects, they’re very difficult to distinguish from the real, direct biological cause.
Actually, it’s completely impossible for me to tell the difference between the nocebo headache and any other headache, and when you look into the research, the physiological changes are the same, in that you can measure changes in the neurochemistry and the vasculature within the brain, that might be causing the pain. There’s such a big overlap between the purely physical and the mental, that we can’t really distinguish the two very, very easily.
That just got me thinking, “Well, where else do expectation effects have a role in our lives?” It turned out, the more I looked, that actually it’s not just in medicine, it’s not restricted to our responses to medications, but it’s shaping how we respond to exercise, how we respond to a new diet, how we respond to sleep loss, and even how we age. Your longevity can be shaped by your beliefs about aging.
That seems like such a profound new understanding of ourselves and the human body. I really wanted to tell that story, and also to look at the ways that we could use the expectation effect to our advantage.
SEAN SPEER: As you say, David, your personal experience is reflective of this broader research that you outline in the book. As you explain expectations, “shape your health and well-being in profound ways. Learning to reset our expectations can have truly remarkable effects on health, happiness, and productivity.” Before we get into the outcomes, I want to talk a bit about expectations themselves. Let me ask you a two-part question.
First, what are our expectations? How would you describe them? Second, how much control do we have over our expectations? To what extent are they operating at an unthinking, almost subconscious, level?
DAVID ROBSON: Yes. That is something that I do try to tackle in the book. First of all, I would say our expectations are malleable, whether or not they are initially conscious or subconscious, the research is very clear, but actually learning about the expectation effect, does give you the power to shape your expectations. Broadly, I would say expectations are these kinds of underlying beliefs and assumptions that we have about the way the world is working, or about ourselves, our own body, and what’s happening within our bodies.
I think sometimes we’re very conscious of those expectations as being a particular expectation, we know that it might be subjective. I think often, we’re not really aware that we take it as a fact. We think that is just the way things are, and that it’s totally objective. That, I think, is where the expectation effect has really become quite powerful, especially with these negative expectation effects.
If you just assume that you don’t have the physical ability to do and enjoy exercise, you just carry that belief without really questioning it, or interrogating it. That’s going to have an effect, say, on your performance in the gym, how much you enjoy working out, and what improvements you see in the long term. Now, when I say that our expectations and beliefs are malleable, I’m not asking people to go around with this Pollyanna-ish view, where everything is rose-tinted, and we’re always just trying to be unrealistically optimistic.
I actually think just questioning those assumptions and recognizing them for what they are, just having that open mind can itself be very powerful. That was what I experienced when I was dealing with my placebo effect with those headaches. It wasn’t like I was repeating a mantra to myself telling myself that I wasn’t feeling the pain. I just opened my mind up to the possibility that it might not be inevitable, that the pills themselves are causing that.
In that particular case, and in many other cases, it seems that that is enough in itself to cause some benefit and relief from what we’re suffering.
SEAN SPEER: You mentioned optimism, David. I want to take up that subject if that’s okay. Why are some people more or less prone to optimistic expectations than others? What’s the role of body and mind in explaining our more pessimistic friends and family members? Is it a learned behaviour or does it have some physiological origin?
DAVID ROBSON: Like lots of things about the human mind, it is a combination of both. You do see that there are some genes that could change the balance of neurotransmitters in your brain that might predispose you to being a bit more cheerful, or a bit more pessimistic. Also, obviously, I think we learn it, and I think we learn it from a young age, from conversations with our parents, they coach us in the ways to see the world, how to interpret and frame different events, and we carry that with us later in life.
We also have the power to change that, and through these techniques, many of which are borrowed from cognitive behavioral therapy, which is used to treat conditions like depression, but which also seems to be very relevant in dealing with these negative expectation effects. I’d also say, even if you’re generally a pessimistic or optimistic person, that doesn’t mean you’re going to be pessimistic or optimistic in every single area of your life.
That’s what we really see with these expectation places, that you might have positive expectations about your fitness, more negative expectations about how you’re going to age, the effects of sleep loss, all of these things are quite independent of each other. That’s one of the things that I’ve tried to teach in the book, is that we need to interrogate each expectation that we’re holding, rather than just try to adopt a generally positive or generally negative attitude. It’s all about the specific details.
SEAN SPEER: What’s the interrelationship between one’s own expectations and the transmission effect from society? How do the people around us, the norms and values of our community and society, influence our outlooks?
DAVID ROBSON: Cultural norms are a huge source of expectation for us. We’re social creatures, we absorb these beliefs, and actually, that often is why we don’t question them, because we’re so used to hearing other people have the same beliefs. I would say the classic example of this is the idea that stress is inherently debilitating. We hear that so often. You can trace it back to articles in the British Medical Journal from the 19th century, they were saying that the stress of this steam train was causing people to have excess heart attacks.
We just have so much, and all of the media telling us, “Stress is bad for you, you need to suppress your stress, we need to just eliminate stress from our lives.” Actually, the scientific research tells a different story, and that is that stress is uncomfortable but it can also serve a purpose, and that was the reason that we evolved the stress response. It’s not always the case of being super relaxed, or you’re in the fight or flight mode, but we have different stress responses that are adapted for different situations.
What the research shows is that when you teach people that different way of looking at stress, and recognizing that sometimes it can bring you energy—when your heart is racing, it’s pumping oxygenated blood around your body, and that’s a source of energy, to give just one example. When you teach people about this more nuanced view of stress, actually, they then respond to stressful events in a different way, they have a more productive stress response that’s healthy for the body and also promotes things like creativity, more productivity, and that problem-solving.
The fact is, it’s our culture that had led us down this one path. It’s only recently, with this scientific research, that we’re learning how to question that assumption, that cultural assumption, and to look at it in a more nuanced way. So yes, culture is very important.
SEAN SPEER: One final conceptual question, before we dig into some of the specific examples in the book. If there’s this interrelationship, David, between the individual and the society or culture, when it comes to expectations, is it possible that societies would be collectively more or less optimistic than others? Could you say, for instance, that on balance, the United States is collectively more or less optimistic than, say, the United Kingdom or Canada? Or is that not the right way to think about it?
DAVID ROBSON: I’m sure that could be true. I would say actually, again, it’s all about the specific beliefs and whether they’re more or less common. For example, in the U.K. and the U.S., we very much have this belief that willpower is limited and easily depleted. It’s like a resource that runs out very quickly, which is why we believe that if you’re on a diet, the more you resist snacking during the day, the harder it’s going to be at night to not go to McDonald’s for fast food. Actually, we don’t see that that belief is universal at all.
Actually, in countries like India, there seems to be a different prevailing belief, and that is that the more you practice willpower, the easier it becomes. Then that is manifested in their behaviour, and how they experience different challenges. Even at the level of specific beliefs, we do see that different cultures transmit different ways of viewing ourselves and our abilities and that then has an effect on the way we behave, and even these physiological measures I mentioned.
SEAN SPEER: I mentioned I wanted to ask some questions about specific examples in the book. You outline, for instance, how “our intellectual performance can be influenced by our beliefs.” In effect, we can raise our IQ, enhance our memory, and even boost creativity by how we think about these qualities. Do you want to unpack this insight a bit, David? Can we really will ourselves to be smarter?
DAVID ROBSON: Yes, that’s what the research seems to show. This comes from all of those studies, those brain training apps, that maybe aren’t so fashionable now, but I think 10 years ago, they were advertised a lot on TV with people like Nicole Kidman playing these cognitive games that were meant to keep your brain sharp, and some even claimed could increase your IQ. Now, some of the research seemed to show that they were indeed increasing people’s intelligence.
The researchers wondered, well, how much of that was just due to the hype that was creating these expectations? They looked at the previous studies, and how they’d been advertised to the participants. They noticed that lots of these, when they were recruiting people to take part in this study, they often gave a hint that “You’re going to test whether you can make your brain smarter.” It was only in those studies that had done that, that you saw the big cognitive gains.
From that alone, it seemed that people’s beliefs were shaping how they responded to this cognitive training. Then they tried to do their own experiment, where they specifically manipulated people’s beliefs beforehand. They specifically told some people, “This might make you smarter.” Other people were told it was—I can’t remember, but they were given a very neutral message about what was happening, without anything specific about intelligence.
What they found was that with the manipulation, with that positive reinforcing message beforehand, those people gained about five IQ points, compared to before they played the game, whereas the others didn’t really see any improvement. That’s just one example. There have been similar studies looking at if you prime people to feel that they’re going to be more creative, do they become better at problem-solving, and they do.
Just in general, the way we frame the emotions that we’re feeling when we’re learning, that can shape how well we learn. If you see frustration as a sign of intellectual growth, as a necessary step that you have to go through to build a better brain, you’re more likely to make these kind of cognitive leaps compared to people who see frustration as a sign of their own failings. Yes, it’s very powerful, and I find it very compelling, all of these results.
SEAN SPEER: How do you think we ought to account for the expectation effect in educational curriculum, particularly for low-performing students? How can a reconceptualization of expectations actually improve learning outcomes for children?
DAVID ROBSON: This is a huge issue because we know that teachers’ expectations can spread to children, and it’s often not through them explicitly telling them that they don’t believe in their abilities, but just the nonverbal cues that they’re giving off. It could just be something as simple as asking a student a question and then cutting them off before they have a chance to finish what they’re going to say, and not letting them develop their ideas.
Children are very sensitive, and they understand when an adult doesn’t have a lot of belief in them. What we know is that that does then seem to shape their academic performance during that academic year, but there seems to be a knock-on effect later on. This is very much shaped by implicit biases. A teacher might be biased by someone’s socioeconomic background, their ethnicity, their gender. Like in science and mathematics where people have these implicit preconceptions about who’s going to be good and who isn’t.
Something that, very much, our educational institutions need to be aware of, there’s some promising research showing that you can educate teachers about this possibility, and eventually, it really helps if you film them in the classroom, and they’ll notice the way that they’re manifesting those beliefs in ways that they might not have been conscious of before. That seems to help. I think we can also help the students themselves.
One of the big problems is that if your teacher is showing that they don’t have faith in your abilities, that produces this lack of confidence, or lack of self-efficacy, which is bad for motivation. It also creates a lot of anxiety in the exam hall itself. Actually teaching people ways to reframe stress can be very useful. Telling them that, when they feel anxious, that might actually be powering them to do better, to achieve more in the exam. That can be helpful.
Practicing an exercise called self-affirmation, which sounds a bit kind of pseudo-scientific, but it’s not. Self-affirmation is just getting children to realize that they’re bigger than the individual problem they’re facing. It’s telling them to list, say, 10 qualities about themselves that they’re proud of, or 10 values that they have. It could be anything, from their musicality to their sense of humor, their friendships, what a good family member they are.
What that does is, it builds up this sense that they are strong, effective individuals, and that can be a kind of antidote to the anxiety that they’re feeling in the particular exam. There are lots of different ways that this can be approached, and I think it is very promising that a lot of these interventions don’t have to be very expensive, and they can make a difference.
SEAN SPEER: That’s really powerful David. Just in parentheses, I’ve seen some public policy research, that shifting post-secondary grants from when a student enters university or college to much earlier, giving them an amount, earmarked for them in a personalized account, beginning, say, in elementary school, changes their expectations about the possibility of attending university or college in the future.
In effect, it expands the horizons of students who, for socioeconomic reasons, family reasons, or whatever, may not envision a future in which they can attend university or college. There, as you say, are different ways in which relatively small changes to public policy can account for the power of the expectations effect in quite positive ways. If I can shift the conversation to your discussion of expectations and aging, you write that “beliefs about the aging process may be as important for your long-term wellbeing as your actual age.”
How do our beliefs and expectations influence the aging process?
DAVID ROBSON: It sounds incredible. I would say of all the expectation effects I examined, that’s the one that really caught my attention the most. Also, I went into it the most skeptical because I felt like you really had to join the dots there, make sure the claims stood up, and they did. There was a big study in 2002, 21 years ago, that launched this. It showed that if you ask people about their beliefs about aging and midlife, whether they think their life is going to get better, worse, or stay the same, that predicted their longevity decades later.
The difference between having the positive or negative beliefs was about seven and a half years. Very big effect. If we knew there was some lifestyle difference that was going to cause that change in longevity, we would be taking action against it. Even something like the levels of cholesterol in your blood, it’s comparable to those, so it really is something that we should be taking seriously.
Since that 2002 paper, there’s been a lot of research replicating this, looking specifically at the risks of different diseases, like Alzheimer’s disease, and cardiovascular disease. In each case, age beliefs made a difference. Then the researchers also looked at the mechanisms, and behaviour is a big one. Obviously, if you have positive beliefs about aging, you’re more likely to look after your health, it just seems worth it, and you are less scared of doing exercise.
Equally importantly is changing the way you appraise the different challenges that you might face. You can imagine, if you feel very negative about aging, you’re expecting it to involve this inevitable decline, disability, and forgetfulness, all of the challenges you face in your life, like going to the post office, meeting new people, driving to a new location, they’re going to feel more stressful. That produces this chronic stress response. Day after day, you’re having heightened cortisol, but it’s never really changing that much.
You’re not really having a rest period between the different challenges. It’s raising things like inflammation, which the body increases inflammation when it feels under threat because inflammation can be an effective way to deal with injuries. It’s preempting injuries. In the long term, that stress response, the increased inflammation, they cause bodily wear and tear, they’re damaging to tissues. We can see the effects of this at the level of the individual cell.
In people with the positive beliefs, they show fewer signs of aging in the epigenetic changes that occur within a cell naturally. Their biological clock seems to be ticking a little bit more slowly than the people with those negative beliefs, who are experiencing the greater stress and the greater inflammation. That is why I find it so compelling, is that they’ve not only replicated the results but then also looked at the mechanism, and they’ve been able to trace it step by step.
SEAN SPEER: It’s intuitive, but it’s still extraordinary. As a follow-up question, David, does the research identify any characteristics or traits that tend to correlate with positive views about aging? I’m thinking, for instance, marriage status, grandchildren, or even, say, religious views, are any of those types of traits more or less likely to be found in those with positive views about the aging process and getting older?
DAVID ROBSON: Interesting. There’s definitely research showing that being married or just having stronger social relationships in general, having a close group of friends, and lots of support, that can reduce aging or reduce the effects of aging. Similarly, going to church is a social activity. Religious experiences can also fill us with hope, it gives us meaning in our life. All of these are positive things that can actually help us to deal with stress, and that’s going to help you through that transition as you get older.
I would imagine they’re correlated with the positive views of aging, but they’re not necessarily tightly interconnected. You could be religious but have a negative view of aging still, and vice versa. We know all of those activities are good for us. They’re also things that we should be pursuing because they actually work through the same mind-body connection.
SEAN SPEER: In terms of resetting our expectations, you argue that “Self-control and mental focus can become stronger with practice, like working a muscle.” What can people do to take control of their expectations and direct them in more positive ways?
DAVID ROBSON: I think it depends on the situation, to a certain extent. I’ll give a few examples, and I think there are common patterns. I mentioned how aging with stress, we might have this view that whenever we feel anxious, that that’s inevitably a bad thing, that it’s going to cause failure, and that, over time, it’s going to cause bodily damage. But actually, a more muted stress response, that happens on the acute level but isn’t chronic.
The stress dissipates after a certain time and you can go back into a relaxed and digesting state. We know that can be very beneficial. Just learning about those benefits, but then also learning how to reappraise what you are experiencing. When your heart’s racing, rather than catastrophizing that and going through this negative cycle of thinking—If I was giving a talk and I would be a bit nervous about the talk, my heart would be racing, then I’d think, “Well, if my heart’s racing, I must be really anxious. If I’m anxious, I’m going to perform badly. If I perform badly, then I’m going to embarrass myself.”
Going through that worst-case thinking. We can nip that in the bud by just reappraising the initial sensation, so we can just tell ourselves that the heart racing is not necessarily a bad thing, and that, actually, it can have the benefits. Then that prevents all of the worst-case thinking, that catastrophic thinking. That’s the process I’m talking about.
Learning about the science can be useful for doing that, but I think just having this awareness of when you’re going down this catastrophic spiral is really important, and trying to question your assumptions as soon as you notice that you might be doing that. With stress, just questioning, “Is it inevitable that if I feel anxious, I’m going to fail?” The answer is no, it’s not. If you’re on the treadmill and you start to feel a bit uncomfortable, you feel breathless, your muscles are aching. Again, you might start telling yourself that it’s a sign of your lack of fitness, that you should be ashamed of yourself, that you’re never going to get fit. Your mind can similarly go through this negative spiral, but actually just asking yourself whether those symptoms are inherently bad, or are they actually desirable? Are they just a sign that while you’re on the treadmill, that you’re pushing your body to its current limit? Then that in itself is leading to growth, later on.
The research is, if you do that, it not only makes the whole experience more pleasant, it actually helps to improve your performance. I think that’s the fundamental role, is looking to just question your assumptions and to stop yourself going down the catastrophic route. Again, it’s having an open mind. Without telling yourself in the gym, “I’m going to be an Olympic athlete.” You don’t have to tell yourself something unrealistic like that to get the benefits.
It’s actually just learning to put things in perspective and to not be overly negative. What you find is that over time, you’ll find an improvement that day, and then if you focus on your trajectory and just focus on the fact that step by step, you’re getting better, then you might be really surprised by what you achieve, and you might be surprised that your trajectory is much more positive and much quicker than you had ever thought it could have been.
SEAN SPEER: That’s a great segue, David, into my penultimate question. What are the limits of this type of thinking? Presumably, our beliefs alone can’t make us NBA basketball players, or exceedingly rich. How should we think about the opportunities and limits of having greater intentionality with respect to our beliefs and expectations?
DAVID ROBSON: Right. I’d say expectations are an important ingredient in reaching our goals. They’re an important element of our ability to reach our goals, but they’re not the one and only element. I think that’s important to acknowledge. In different situations, there might be systemic barriers within our culture that are going to make it harder for you to achieve what you want to. There might be internal limitations that you have.
Expectations can’t make you a basketball player if you have totally the wrong physique to be a good basketball player. I see them more, our expectations, as a brake on your progress. If you have negative expectations, they’re constantly dragging you back. If you shift and reframe the way you’re looking at the situations, then you’re taking those brakes off of your progress and you’ll find that you can progress much more quickly.
If you set your goals to be realistic, you’ll get to them much more quickly. It’s not, by no means, the only thing affecting our success, but it certainly is a way of limiting our success, and making all of the effort that we’re putting in, whether it’s doing those workouts, changing our diet, studying hard. If we have negative expectations, it’s limiting how effective that is, and just by changing your expectations, you can actually make sure that you achieve the most that you could, with the work that you have put in.
SEAN SPEER: Yes, I just say in parentheses that I use the word intentionality with some intentionality because a major takeaway from me in the book is that a lot of these negative expectations are too infrequently scrutinized by people. That we’re constrained by our expectations without even fully being cognizant of it. So, for me, a major lesson is just to be a bit more discerning about my expectations and how they’re influencing the way I think about different challenges in my life.
Final question. You’ve been writing about the body and mind for a long time. What’s the one thing you discovered in researching this book that surprised you the most?
DAVID ROBSON: I’d say the research on the aging mindset. I found it very surprising, shocking, even, to start with, and that completely transformed the way I look at my own life and how I hope to age as I get older. Besides looking at the science, I also spoke to some really amazing people, like Paddy Jones, who’s the world’s oldest acrobatic salsa dancer. She only started dancing professionally in her 60s after her husband passed away.
Now, she’s performed all over the world. She was at the San Remo Music Festival. She’s appeared in reality shows like Dancing With The Stars in Argentina, in Britain, in Germany. She’s really made this amazing career for her. It’s like a second lease of life. Looking to people like that has been really important for me, to recognize that you can question your assumptions about the course your life is taking, that you can try to take on your opportunities, and to push yourself out of your comfort zone.
You can do that slowly. I don’t think that we should all be taking on insurmountable challenges straight away, but you can do that. With the right expectations, with the right mindset, you can be really surprised by what you can achieve just by slowly pushing against your boundaries.
SEAN SPEER: That’s a great message to wrap up our conversation. The book is The Expectation Effect: How Your Mindset Can Change the World. David Robson, thank you so much for joining us at Hub Dialogues.
DAVID ROBSON: Thanks for the great questions.
