Change your mindset, change the game | Dr. Alia Crum | TEDxTraverseCity
Transcriber: Queenie LeeReviewer: Peter van de VenSo today, I’m going to talkabout how our mindsets matterin virtually every facet of our lives. But I want to begin by telling a storyabout a group of researchers in Italy. Dr. Fabrizio Benedetti and his colleaguesstudied a group of patientsundergoing thoracic surgery. What you should knowabout thoracic surgeryis that it’s a very invasive procedure. Patients are put under anesthesiawhile the surgeons make major incisionsinto the muscles of the sides and the backin order to gain accessto their hearts and to their lungs. Now, about an hourafter the anesthesia fades away,the pain starts to set in. Fortunately, patients are givenstrong doses of morphine sulfate,a powerful painkiller. This is routine treatmentfor thoracic surgery,but Dr. Benedetti and his colleaguesmade a few subtle tweaks:half of the patientswere given the dose of morphineby a doctor at their bedside;the other half was giventhe exact same dose of morphine,but it was administered into their IVby a pre-programmed pump. You would think that bothof these groups of patientswould experience the same relief,but this was not the case. The group that receivedthe morphine by the doctorreported significant reductionsin their pain levels. The other group -the group who receivedthe same exact amount of morphinebut wasn’t aware of it -they didn’t seemto experience the same benefit. So Dr. Benedetti and his colleaguesdidn’t stop there. They used the same procedureto test the effectivenessof other treatments -treatments for anxiety,treatments for Parkinson’s disease,treatments for hypertension. What they foundwas remarkable and consistent. When the patientswere aware of the treatmentand expected to receive the benefit,the treatment was highly effective. But when they weren’t,that same drug, that same pill,and that same procedure was blunted,and in some casesnot even effective at all. So I read about these studieswhen I was a studentat Harvard University,and at the time, I was heavily immersedinto the literature on the placebo effect. And the more I read,the more I started thinkingabout the true nature of placebos. So what is the placebo effect really?Well, most peoplediscount the placebo effectas just some magical responseto some fake pill or some faux procedure,but that’s not what the placebo effect is. The placebo effectis not about the faux pill,or the sugar pill, or the fake procedure. What the placebo effect really is,is a powerful, robustand consistent demonstrationof the ability of our mindsets -in this case, the expectation to heal,to recruit healing properties in the body. So what is a mindset?A mindset is quite literallya setting of the mind,it’s a lens or a frame of mindthrough which we view the world,we simplify the infinite numberof potential interpretationsat any given moment. Now, the ability to simplifyour world through our mindsetsis a natural part of being human. But what I want to suggest to you todayis that these mindsetsare not inconsequential,and instead, they play a dramatic rolein determining our healthand our well-being. So while I was at Harvard,I had the opportunity to workwith Professor Ellen Langer. She is a professor of psychologyand when she heard that I was alsoa division one athlete, laughed at me. She said, “You know,exercise is just a placebo, right?” Now, I was kind of offendedbecause at the timeI had been spending up to four hours a daytraining my body to be in optimal shape. But she did get me thinking about mindsetsand how they might matteroutside of medical laws. Was I getting fitter and strongerbecause of the time and the energythat I was putting into my training?Or was I getting fitter and strongerbecause I believed that I would?What about the other extreme?What if people were gettingan extraordinary amount of exercisebut weren’t aware of it,would they not receive the same benefit?We decided to test this,and to test this we found a reallyunique group of women -a group of 84 hotel housekeepersworking in sevendifferent hotels across the US. These womenare on their feet all day long. They’re using a variety of muscles,and they’re burningan extraordinary amount of calories,just doing their job. But what’s interestingis that these women don’t seemto view their work in this light. We asked them; we said,“Do you exercise regularly?”And two-thirds said “No. ” So we said, “Okay. Well,so, on a scale of zero to ten,how much exercise you get?”And a third of them said,“Zero. I get no exercise at all. “So we wondered what would happenif we could change their mindset. So we took these women,we split them into two groups. We measured them on a variety of things,including their weight,their blood pressure, their body fat,their satisfaction with their job. And then we took half of themand we gave thema simple 15-minute presentation. We gave them this poster and we said,”Your work is good exercise. It satisfies the SurgeonGeneral’s requirements,which are quite simplyto accumulate about 30 minutesof moderate physical activity. You should expectto receive those benefits. 15 minutes. We came back four weeks laterand we measured them again. Not surprisingly,the groups that didn’t receivethis information didn’t change,but those that did looked different. They dropped weight,they had a significant reductionin systolic blood pressure,they dropped body fat,and they were reportedliking their job more. So what does this tell us?To me, it was fascinatingthat just as a resultof a simple 15-minute presentation,the whole game changed,producing a cascade of effectson both their health and their well-being. Presumably without even changing behavior. Now some of you might be thinking,”How do you know they didn’tchange their behavior,because that must have beenwhat produced the effects?We know they didn’t work any more,and the room attendantsthemselves assured usthat they didn’t jointhe sports club down the street. But of course, we can’t know for sureif they weren’t puttinga little more oomphinto making their beds. So this question really plagued me. Is there a direct, immediate connectionbetween our mindsets and our bodies?So to test this,I worked with my colleagues at Yale,Kelly Brownell, Will Corbinand Peter Salovey,and we did so by makinga big batch of milkshakes. So we made this big batch of milkshakes,and then we invited peopleto come to our lab to try the milkshakes,and in exchangewe would give them 75 dollars. Sounds great, right?The less appealing aspect of the agreementwas that while theywere drinking the shakes,we had them hooked up to an IVso we could get their blood samples. We are out to measure ghrelin. Ghrelin is a peptide secreted in the gut,the medical expertscall this the hunger hormone. So when we haven’t eaten in a while,our ghrelin levels start to rise,signaling to the brain,“It’s time to seek out food,”and slowing our metabolism,just in case we don’t find that food. Now say we go out,we find and we devour a milkshake,a hamburger, some french fries,our ghrelin levels drop,signaling to our brain,”Time to stop eating,”and revving up the metabolismso we can burn the foodthat was just consumed. So the participants came in,we hooked them up to an IV,and then we gave thema milkshake, Sensi-Shake. This is zero percent fat,140 calories, zero added sugar,this is guilt free satisfaction. So they drank their shake,and in responsetheir ghrelin levels droppedbut only very slightly,signaling to the brainthat some food had been consumedbut not a whole lot. So a week later,they came back to our lab,we hooked them up to an IV again,and we gave them this shake. 620 calories, 30 grams of fat,56 grams of sugar:now this, this is decadence you deserve. And in response to this shake,their ghrelin levels dropped again,but this timeat a significantly steeper rate,about three times morethan the shake they had before. Now, this would make good senseto any metabolic nutritionistwho understandsthat the drop in ghrelin is proportionalto the amounts of calories consumed. But there was a catch:in this study,even though the participants thoughtthey had consumed the sensible shake,and the indulgent shake,in reality, we gave themthe exact same shake at both time points. So what does this tell us?Just as in the casewhen the same amount of morphineproduced more or less of an effectdepending on our awareness,and just as in the casewhen the same amount of exerciseproduced more or less of a benefitdepending on how it was construed,here again our mindsets proved to matter. In this case suggesting it might not bejust calories in and calories out,or the precise makeup of fats,nutrients, but what we believe,what we expect, what we thinkabout the foods we eatthat determines our body’s response. So in light of this,it behooves us to consider our own lives:what are our mindsets?And how might we beginto shift them, to alter them,to have them be more beneficial?So take the stress, for example. What’s your mindset about stress?If you’re like most people,you have the mindsetthat stress is bad: bad stress. Now, this is not surprisingconsidering that everywhere we lookthere’s warnings, labelsyelling at us, reminding usabout the negative effects of stress. But the truth of stressis not so clear-cut,and in fact, there’s a robustand growing body of researchshowing that stresscan have positive effects,enhancing effects on our health,our well-being and our performance. Now I’m not here to try to persuade youthat the effects of stress are enhancing,but rather to pointout that the truth of stressis like most things in life,and that is, it is uncertain. And therefore to raise the question:do our mindsets about stressdetermine our response?So to test this question,I worked with Shawn Achorand Peter Salovey,and we workedwith a group of 300 employees. This was after 2008 financial collapse,and we decided – they were stressed,they had just heardthat ten percent of their workforcewas going to be laid off,and they were overworked. We decided to seeif we could change their mindset. And we did so by having themwatch simple video clips. So I’m going to show themto you here simultaneously,but half of the participantssaw the one on the left,half saw the one on the right. vs So you get the point, yes?So here we are . . . in the dark. So here we are -they’re watching facts,research, anecdotes,all true, but orientedtowards one view or the other. What we found was interesting:those who watchedthese simple three-minute video clipsbefore the bell rang,before their job began,over the course of the next few weeksreported fewer negative health symptoms,fewer backaches,less muscle tension, less insomnia. And they also reported a higher levelof engagement and performance at work. So at this pointI’ve presented four studies -four studies that demonstratethe power of mindsets in medicine,in exercise, in diet, and in stress. There are many othervery talented scholarstackling this phenomenon as we speak. Carol Dweck’s research demonstrates usthat if we can shift our mindsetabout intelligence and talentas something that’s fixedto something that’s changeable over time,it can dramatically alter our academicand professional success. Yale epidemiologistBecca Levy’s research shows usthat if we can changeour mindsets about aging,from viewing aging as an inevitableprocess of deteriorationto a process of gaining wisdom,gaining growth,not only shapes the courseof how we grow oldbut even extends longevity. Ted Kaptchuk and his groupat Harvard’s programfor placebo studiesis doing cutting-edge workunderstandinghow we can begin to harnessand ethically utilize the placebo effectin clinical practice. So though the context is different,the message is the same. Our mindsets matter. Don’t get me wrong,I’m not sayingthat medicine doesn’t work,or that there are no benefits of exercise,and that what we eatdoesn’t matter; it does. But the psychologicaland physiological effectof anything in our livescan and is influenced by our mindset. So is the power of mindset limitless?Probably not,but what I hope I’ve done for you todayis inspire you to reconsiderwhere those limits really are. Because the true task aheadis to begin reclaimingthis power for ourselves,to acknowledge the power of mindsetand know that just like this, in just the blink of an eye,we can change the gameof any facet of our lifequite simply by changing our mindset. Thank you.