New Year’s expectations

Today, New Year's Resolutions are as popular as ever – and according to various surveys, the majority end in disappointment. Is this inevitable?

In my new book The Expectation Effect, I've explored the many ways that our beliefs can powerfully influence our capacity to make positive changes to our lives. Whether we are trying to get fit, sleep better, or maintain the willpower to stick to a diet, our expectations will shape our experience in surprising and fascinating ways. And by shifting our assumptions, we may find it much easier to turn our good intentions into reality.

This should not be confused with the vague commands to 'think positively' that are common in the self-help literature. The expectation effects that I describe concern our specific beliefs about particular abilities or challenges – whether you think you are particularly prone to gain weight, for example – rather than an undefined optimism about life in general. And rather than relying on some mystical 'law of attraction', they are the product of known psychological and physiological mechanisms that profoundly alter our chances of success. 

Pill-less placebos?

If this seems far-fetched, you might consider expectation effects to be an extension of the famous placebo response in medicine. Since the 1950s, doctors have increasingly come to recognise that our expectation of a drug's effects can bring about objective changes in the body, even if we are only receiving a sugar pill. It is now known that the brain can release endogenous opioids when we believe that we are receiving a sugar pill – providing natural relief from pain (Colloca & Barsky, 2020). 

The moral implications of lying to patients has limited the practical application of these findings. In recent years, however, scientists have started to find exciting new strategies that can harness placebo-like responses without any deception. Health psychologists in Marburg, for instance, recently helped patients undergoing heart surgery to set up more positive expectations of recovery. In a series of conversations, they described the likely benefits of the procedure, and set out a likely trajectory for the patients' recuperation. They also discussed any discomfort the patient might feel and helped them to frame it as a normal part of the healing process – rather than a cause for distress or doom-laden thoughts. 

Follow-ups revealed that these patients were discharged from hospital around five days earlier than patients who had experienced the 'treatment as usual', and they continued to show greater improvements in their physical functioning over the following six months (Auer et al., 2018; Rief et al., 2017). It's likely that this was partly the result of behaviour and motivation, but blood tests revealed that they also had lower levels of important pro-inflammatory markers such as interleukin-6, which suggests that the positive expectations and reduced anxiety had brought about some important physiological changes too.

Primed for exercise

Alongside these pioneering studies, it is becoming increasingly clear that placebo-like responses can stretch far beyond clinical medicine into everyday health and wellbeing.

Imagine that you want to get fit in the New Year. Perhaps you have great faith in your body and you just know that you are going to feel great after each workout. If so, lucky you! Many people, however, will have the impression that they simply aren't cut out for exercise – and this belief could make the whole experience a lot more painful. 

Consider a study from the Stanford University's Mind and Body Lab (Turnwald et al., 2019). The participants were first given a genetic test that identified different versions of the gene CREB1. The gene is known to influence someone's aerobic capacity and body temperature during exercise – and if you have the 'high risk' version, you are probably going to find your workouts a bit less comfortable.

The test was genuine, but the researchers didn't reveal the true results immediately. Instead, the participants received completely random feedback, which created the belief that they were or were not 'naturally' good at exercise.

The effects of these expectations were striking. Participants who had been told they had the 'negative' version of the gene found a subsequent workout more uncomfortable, and showed lower stamina, than those who had been told they had the 'good' gene. Indeed, when it came to measurements of the transfer of carbon dioxide and oxygen in their lungs, the expectations proved to be more influential than the gene itself in shaping the participants' physiological responses.

The researchers noted a markedly similar effect when they looked at expectations of appetite. Half the participants were told that they carried a beneficial variant of the FTO gene, which results in increased satiety after eating, while the other half were told they had a variant that would leave them feeling hungrier. Once again, the expectations shaped both their subjective feelings and physiological responses to a meal, such as the levels of Glucagon-like Peptide 1, which controls appetite by regulating the movements of the digestive system and by binding to brain receptors associated with energy balance.

We may not have taken a genetic test, but many other factors could create similar expectation effects. Our assumptions may be shaped, for example, by #fitspiration posts on social media depicting (practically) unobtainable body types. An Australian study found that, far from being motivating, viewing those images before exercise put participants in a worse mood, and made the workouts feel physically more fatiguing (Prichard et al., 2020; see also Robinson et al., 2017).

Where there's a will…

We can see similar expectation effects in many other domains, including sleep. Multiple studies show that our estimations of how much sleep we get, relative to what we need, are often highly inaccurate. Many people achieve the necessary seven to eight hours a night, for example, but they believe that they are constantly lacking – developing an 'insomnia identity'. And they are much more likely to suffer from symptoms such as poor concentration, fatigue, depression and anxiety than people who sleep less, but have a more positive opinion of their night's rest (Lichstein, 2017). As the author of one recent meta-analysis told me: 'worry about sleep is a stronger pathogen than poor sleep'. 

It is our beliefs about willpower that may be most pertinent for our New Year's Resolutions, however. Self-control was once thought to be governed by 'ego depletion'. According to this theory, attempts to remain focused on our goals, and to resist temptation, depletes a limited resource – often assumed to be glucose – in the brain. Unless we allow ourselves time to rest and those resources recharge, our willpower will weaken and then break, leading us to give in to our urges. We gorge on chocolate treats, procrastinate on social media rather than focusing on our work, and skip the gym to slob out in front of reality TV. Yet recent research suggests that our self-control and mental focus can be swayed by our expectations, depending on whether we have a limited or non-limited mindset. 

As the name suggests, those with the limited mindset tended to assume that self-control and concentration can easily wear down. They are more likely to agree with a statement such as 'when situations accumulate that challenge you with temptations, it becomes harder and harder to resist those temptations'. Those with the non-limited view believe that their willpower can fuel itself. They are more likely to agree with the statement 'If you have just resisted a strong temptation, you feel strengthened and you can withstand any new temptation'.

In a wide range of studies, Veronika Job at the University of Vienna has shown that these willpower mindsets can influence behaviours in a range of situations – from laboratory tests of mental focus to real-life academic studies and health regimes (Job et al., 2015; Savani & Job, 2017). To a certain extent, you have as much willpower as you think you have.

While some people may tend to gravitate to one mindset or the other in all domains, it's worth noting that our beliefs will also vary with context and the particular activity you're doing. For example, some people may have a non-limited mindset about their capacity to control their emotions or avoid procrastination, but they may believe that their capacity to resist delicious foods is severely limited (Bernecker & Job, 2017). 

New narratives

This research – and many other findings like it – shows that we really are the product of the stories that we tell ourselves, and by changing that narrative, we may find it far easier to make positive changes to our lives.

As the heart surgery patients in Marburg had shown, this does not need to involve any form of deception. Indeed, there is some evidence simply learning about these expectation effects, and the scientific basis for them, can shift your mindset, at least in the short term (i.e. Savani & Job, 2017). Knowledge really is power. 

We can also use techniques, such as reappraisal, that are borrowed from cognitive behavioural therapy. Try to take the attitude of a scientist who is constantly testing their pre-conceptions, or a well-meaning friend who is offering honest encouragement.

Suppose that you are trying to get fit, and you have a generally dim view of your body and its capacity for exercise. The first step may be to question whether there is a strong factual basis for the underlying assumptions. Perhaps you absorbed the negative opinions from unpleasant experiences in PE that are no longer valid. 

Next, you might try to spot when negative thoughts and feelings come into your mind during your workout – and, where possible, reframe them. When you start to feel fatigued, for example, you might notice yourself thinking 'I'm so unfit; I'm simply not cut out for this' or 'there must be something wrong with me to be feeling this way'. In place of those harsh words, you might reassure yourself that the sensations are a natural consequence of exercise and a sign that you're building strength and stamina. This kind of approach, in which you try to be more objective and less negative about the feelings during exercise, can reduce people's perceived exertion over the course of the workout (Giles et al., 2018).

Finally, you can keep a focus on your overall trajectory. Remember that even small improvements deserve to be celebrated, and that step by step, you are getting closer to your goal. That's far healthier than constantly comparing yourself to other people – and always finding yourself wanting.

Similar acts of reappraisal could help you to cope more effectively with your perceived sleep loss. Indeed, cognitive behavioural therapy for insomnia may work through the correction of people's dysfunctional beliefs about sleep (Thakral et al., 2020). If you feel like you have had a broken night, for instance, you might try to question whether you have exaggerated how long you were actually awake; often, a brief period of restlessness can seem like it lasts much longer than it really does. And you might try to notice catastrophic thinking (such as 'I just can't cope') and instead remind yourself that the brain and body are more resilient to moderate sleep loss than you might think.

To change your willpower mindset, meanwhile, you might try to cultivate a sense of autonomy. When we have chosen to do a task – rather than being forced – we tend to feel more energised (Muraven, 2008). And it seems that simply recalling times that you have willingly exerted self-control can help to prime the non-limited beliefs, which may then help you to exert more willpower in the future (Sieber et al., 2019).

Question your 2022 stories

These are just a few suggestions that come from our burgeoning understanding of expectation effects. They cannot work miracles by themselves, but they should make it far easier to adopt healthier behaviours and they should maximise the benefits from that hard work. In my own life, I try to test my pre-existing beliefs with small challenges that slowly take me outside of my comfort zone. If I succeed, I can use that as 'proof' that my pre-existing assumptions have been wrong. 

While writing The Expectation Effect, I couldn't help wondering whether there is some kind of 'meta-mindset' that determines how easily someone can change their beliefs. We see something similar in clinical psychology: a client's 'outcome expectancy' of CBT – whether they think it is going to be useful or not – seems to predict the effect of the therapy (see 'Placebo psychotherapy'). 

If you have a strong sense that your current narratives are set in stone, then you might find it hard to question your beliefs and shift your mental habits. But if you are willing to keep an open mind, and to question at least a few of the stories that you have told yourself, you may be pleasantly surprised by what 2022 brings.

Box: Placebos in psychotherapy

Treatments such as cognitive behavioural therapy are designed to help participants challenge unhealthy thoughts and attitudes that might be contributing to their anxiety or depression. And it seems that the patients' beliefs about CBT itself can determine its success. 

Someone with a more positive 'outcome expectancy' of the treatment is much more likely to benefit than those who feel that CBT is useless – in much the same way that positive expectations of anti-depressant drugs could increase their efficacy through a placebo response. This has led some to argue that patients should be presented with a more detailed description of the rationale of the therapy's methods at the start of their treatment to maximise their expectations of success and – as a consequence – its actual effects on their lives (Thiruchselvam et al., 2019).

- David Robson is an award-winning science writer based in London. His book The Expectation Effect: How Your Mindset Can Transform Your Life (Canongate) will be published on 6 January 2022.

Key sources 

Auer, C.J., Laferton, J.A., Shedden-Mora, M.C. et al. (2017). Optimizing preoperative expectations leads to a shorter length of hospital stay in CABG patients. Journal of Psychosomatic Research, 97, 82–9.

Bernecker, K. & Job, V. (2017). Implicit theories about willpower in resisting temptations and emotion control. Zeitschrift für Psychologie, 225, 157-166.

Colloca, L. & Barsky, A.J. (2020). Placebo and nocebo effects. New England Journal of Medicine, 382(6), 554–61

Giles, G.E., Cantelon, J.A., Eddy, M.D. et al. (2018). Cognitive reappraisal reduces perceived exertion during endurance exercise. Motivation and Emotion, 42(4), 482-496.

Job, V., Walton, G.M., Bernecker, K. & Dweck, C.S. (2015). Implicit theories about willpower predict self-regulation and grades in everyday life. Journal of Personality and Social Psychology, 108(4), 637.

Lichstein, K.L. (2017). Insomnia identity. Behaviour Research and Therapy, 97, 230-241.

Muraven, M. (2008). Autonomous self-control is less depleting. Journal of Research in Personality, 42(3), 763-770.

Prichard, I., Kavanagh, E., Mulgrew, K.E. et al. (2020). The effect of Instagram #fitspiration images on young women's mood, body image, and exercise behaviour. Body Image, 33, 1–6.

Price, M. & Anderson, P. L. (2012). Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder. Psychotherapy, 49(2), 173–179.

Rief, W., Shedden-Mora, M.C., Laferton, J.A. et al. (2017). Preoperative optimization of patient expectations improves long-term outcome in heart surgery patients. BMC Medicine, 15(1), 1–13.

Robinson, L., Prichard, I., Nikolaidis, A. et al. (2017). Idealised media images: The effect of fitspiration imagery on body satisfaction and exercise behaviour. Body Image, 22, 65-71.

Savani, K. & Job, V. (2017). Reverse ego-depletion. Journal of Personality and Social Psychology, 113(4), 589-607.

Sieber, V., Flückiger, L., Mata, J. et al. (2019). Autonomous goal striving promotes a nonlimited theory about willpower. Personality and Social Psychology Bulletin, 45(8), 1295-1307.

Thakral, M., Von Korff, M., McCurry, S.M. et al. (2020). Changes in dysfunctional beliefs about sleep after cognitive behavioral therapy for insomnia. Sleep Medicine Reviews, 49, 101230.

Thiruchselvam, T., Dozois, D.J., Bagby, R.M. et al. (2019). The role of outcome expectancy in therapeutic change across psychotherapy versus pharmacotherapy for depression. Journal of affective disorders, 251, 121-129.

Turnwald, B.P., Goyer, J.P., Boles, D.Z. et al. (2019). Learning one's genetic risk changes physiology independent of actual genetic risk. Nature Human Behaviour, 3(1), 48–56.