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Book Review of the Expectation Effect

Book Review

This book review was originally published at New York Journal of Books on 2/14/22. 

In The Expectation Effect, award-winning science writer David Robson answers these questions: “What are the beliefs and expectations that rule our physical and mental well-being? How do the body, brain, and culture interact so potently to produce these self-fulfilling prophecies? And how can we use these fascinating findings to our own benefit?”

He explains how beliefs “shape your health and well-being in profound ways, and that learning to reset our expectations . . . can have truly remarkable effects on our health, happiness and productivity.” He also shares how he reset his own expectations regarding his anxiety and depression and how much better he feels and is faring since changing his assumptions about them and himself.

The book is replete with studies and stories from around the world about how expectations affect us physically, mentally, and emotionally. When speaking of expectations, Robson stresses that he’s not referring to general optimism or pessimism, but to the meanings we assign events and, based on them, our specific beliefs about what will happen to us. He explains that being unaware of the power of expectations doesn’t prevent them from driving our destinies for better or worse. His goal is to help us become cognizant of our expectations in order to take charge of them to make ourselves smarter, fitter, less stressed, happier and healthier.

The first chapter explains the placebo (meaning “I shall please”) and nocebo (meaning “I shall harm”) effects that Robson refers to throughout the book. The placebo effect is the expectation that we will be healed or served well by something (or someone), which actually produces “physiological changes to blood circulation, hormone balance, and immunological response.” The nocebo effect is the expectation that something will harm or hurt us. It, too, generates “measurable physiological changes, including significant shifts in our hormones and neurotransmitters.” In brief, beliefs or expectations are the catalysts that generate biological changes that cause us to flee or fight, sink or swim, and succeed or fail.

Robson describes the brain as a “prediction machine that constructs an elaborate simulation of the world, based as much on its expectations and previous experiences as on the raw data hitting the senses.” Because predicting affects what we think we see, taste and hear, what we perceive and experience is often a product of sensory expectation. Unfortunately, due to our brains’ biases, what we think and feel may warp our perceptions of reality without our knowledge.

Prediction works for or against us. Positive expectations about illness and disease or the drugs we’re given to cure or comfort us may promote physiological changes that actually make us feel better. The same is true for nocebo expectations which may make us feel worse. This process explains why some people appear to self-heal and others take unexpected turns for the worse with similar conditions.

Studies show that placebos work even when people are told they’re being given them in treatment, that simply thinking about having symptoms of a disease can cause us to suffer from it, and that people may experience “death by expectation” based on a reverse mirroring effect where negative beliefs appear to disrupt the body’s vital functions and cause them to collapse. Says Robson, “Worst-case thinking doesn’t prepare you—it promotes the worst case.”

He describes mass hysteria as a contagion that starts when mirror neurons automatically recognize what someone else is feeling or doing, an unconscious process that jump starts physiological changes in our bodies. His antidote to succumbing to mass hysteria is recognizing “just how much our well-being depends on the concentric rings of our social circle” and understanding the three laws of contagion that foment outbreaks in our communities and worldwide.

The author also tackles how to start and stick to a work-out routine and excel at fitness, describing the significant part expectations play in achieving success. As world-class athletes know, to succeed, we must train our minds along with our bodies. One of the major reasons we fail to sustain exercise or reach peak fitness is that we don’t believe we can. Robson presents numerous tricks of the mind to move us forward, including visualization and reframing our beliefs about progress.

He points out that a diet mentality or (food) deprivation mindset “may make it much harder for us to lose weight on a seemingly spartan diet than when we are eating meals packed with our favorite comfort food.” This happens because we are expecting not to be satisfied with “diet” or “healthful” fare. Studies also show that we must pay attention to what we’re eating, or the body won’t register calories ingested and will feel hungry again sooner after eating. The author stresses that we must remember the food we eat to feel sated and offers other valuable suggestions for managing our relationship with food.

Robson explains anxiety as being caused by a cascade of chemicals in the body that produce stress along with our expectation of a threat causing a fight, flight, or freeze response. He encourages readers to reframe stress as a performance enhancer and challenge and to see the positive ways anxiety keeps us on our toes. The reader may be surprised at the counter-intuitive, science-based ideas Robson has for managing insomnia, depression, anxiety, and illness.

The concept Robson uses to unleash willpower is that “self-control and mental focus can become stronger with practice, like working a muscle” and that whether we regard our brain’s resources as finite or infinite can change our experiences “and capacity to remain self-controlled and focused under pressure.” In lay terms, he’s saying it’s all in how you think about doing difficult things, for example, as strengthening resolve and elevating energy.

“Our intellectual performance can be influenced by our beliefs,” as well, often by the expectations of people around us. Robson provides research showing how we can “think ourselves smart,” and maintains that we can raise IQ, increase memory, and boost creativity by how we think about these qualities. He also points out the damage of institutional barriers and stereotyping that make us feel we’re less than based on gender, race, poverty, etc. To bolster confidence, he recommends visualizations and affirmations.

Robson also focuses on how “beliefs about the aging process may be as important for your long-term well-being as your actual age” because of how expectations affect your cells’ biological clock by turning on and off genes. His strategies for avoiding chronic inflammation and other aging conditions include believing that you’re not really old yet, ridding yourself of aging stereotypes, learning new skills, and holding on to feeling young.

Robson does an excellent job of balancing change theory with practical ways readers can improve their lives by reframing experiences and generating positive expectations. Each chapter ends with a summary of major points and take-away messages that will shift your expectations on the spot. Whether you’re looking to make major or minor changes in your life, this book will help you leave the starting gate with positive expectations of success.

 

Best,

Karen