Notes

How expectations shape your life


Irving Kirsch, contributor

In Mind Over Mind, Chris Berdik makes a compelling case that what we assume or expect from the world changes how we experience it

ONE purpose of your brain is to anticipate events. You decide how to behave largely on the basis of the outcomes you expect, and these expectations alter your experience of yourself and of the world.

The ability to predict the future has survival value. Experimental psychologists have found that even animals like mice form expectations that guide their behaviour. Animals need to know what will happen next in order to survive. As the philosopher Daniel Dennett quipped in his book Consciousness Explained, the brain is an expectancy machine.

As a book about expectations, Mind Over Mind is an unexpected find. Although journalist Chris Berdik covers most of the usual topics, such as the famous placebo effect, he also delves into areas neglected in other books on the subject. Relegating the placebo effect in medicine to the final two chapters, Berdik begins by exploring the effects of anticipation in sport, obesity, gambling, food and beverage tastes, and economics. In the process, he uncovers some truly surprising phenomena.

In one study, for example, simply telling women who clean hotel rooms that their work was a form of exercise led them to lose weight, lowered their blood pressure, and changed their waist-to-hip ratio. In another study, the performance of cricket batters was improved by having them wear goggles that blurred their vision. This possibly turned the batters' attention away from unnecessary detail, allowing them to focus on the motion of the ball and more accurately anticipate where it would be a split second later.

Even in the area of medicine, where the placebo effect has been so well covered, Berdik comes up with more surprises. Placebo surgery, for example, in which doctors cut patients open and sew them back up without performing any actual surgical intervention, can not only duplicate the effects of real surgery in some circumstances - at times it can even outperform it. In a landmark study of arthroscopic knee surgery, patients given fake surgery had less pain and showed more improvement that those given the real surgery - an effect that lasted for a year.

Perhaps the most surprising findings reported by Berdik relate to unconscious processes. Expectancy is generally assumed to be a conscious phenomenon. We know what we expect. But Berdik shows that unconscious expectations can also influence behaviour, especially in sports, where people have to react quickly and conscious deliberation can get in the way. As he notes: "There simply isn't enough time to track a professional fastball, tennis serve, or hockey slapshot in flight, process that visual information, decide the appropriate action, and end the motor commands to the muscles." In these situations, predicting the future has to be an automatic process. Conscious thought is too slow.

Mind Over Mind is a fascinating account of the power of conscious and unconscious expectations to alter our experience and our behaviour. If you think you might enjoy it, your expectations won't be shattered.

Irving Kirsch is associate director of the Program in Placebo Studies at Harvard Medical School. He wrote The Emperor's New Drugs (Bodley Head, 2009)