May 22, 2024 – When it comes to your health, mindset matters – whether you’re coping with yet another migraine or a serious cancer diagnosis.
That’s the consensus from an increasing number of research studies that find our mindset – core assumptions we make that lead to expectations and behaviors – affects outcomes.
In one of the most recent studies, researchers told some patients with have migraine that they were enrolled in a migraine headache study. Others with migraine were told they would be the “healthy controls” to help research vertigo. After watching roller coaster videos, those assigned to the first group reported more dizziness (a complaint of many migraine patients) and said they had more headache days a month than did those assigned to the “healthy control” group.
In other words, patients who have migraine headaches reported fewer headaches a month after watching a video that might have triggered their migraines.
The take-home here, said study leader Hauke Basedau, MD, of the University Medical Center Hamburg-Eppendorf, Germany, is not to minimize the very real pain of migraine, but for both researchers and health care providers to be aware of the effects of suggestion, as well as the impact of expected roles, both on research and health outcomes. The findings, he said, provide insight “that is not only crucial for academic purposes but also has practical implications in clinical settings.”
Mindset has been studied for its effects on migraine, cancer, exercise activity, carpal tunnel surgery, chronic kidney disease, and many other conditions.
So strong is the link between a healthy mindset and better outcomes that Stanford University researchers have developed a training program, called Medicine Plus Mindset, to teach health care providers how to evaluate and help improve patient mindsets. And if your doctor isn’t aware of the importance of mindset, you can learn to improve your mindset on your own.
Mindset Matters: Research Roundup
Among the host of studies linking mindset and health outcomes:
- Recently diagnosed cancer patients who completed an online interactive program called the Cancer Mindset Intervention had better overall health-related quality of life, coped better, and had less distress from physical symptoms than those in the usual care group, Stanford researchers found. The program included videos of cancer survivors talking about their challenges and how their mindset shifted.
- In another study of 273 survivors of breast or gynecologic cancers, those who saw their cancer diagnosis as a catastrophe had a lower health-related quality of life 4 years after the diagnosis than did those who viewed it either as manageable or an opportunity (such as a time to take on a new challenge or path in life).
- Patients getting a wrist procedure known as carpal tunnel release who had high expectations about the treatment and knowledge about the condition had better outcomes 6 months later than those who did not. Depression and extreme anxiety about the pain were already known to predict poor outcomes.
- Mindset predicts whether people with knee arthritis will develop an exercise habit, as recommended. In one study, people with knee osteoarthritis who looked at exercise as fun, pleasurable, social, or indulgent were more likely to report exercising when they retook the survey 3 weeks later. Mindset was related to higher levels of activity even after taking health, osteoarthritis symptoms, and demographics into account.
- Mindset is crucial for losing weight and keeping it off, according to a survey of more than 6,100 members of a national weight loss program who lost an average of 54 pounds and kept it off for 3.4 years. They cited perseverance in their weight loss efforts in the face of setbacks and, once the weight was off, reflecting on their reduced pain, better body image and health, and more self-confidence to stay the course.
Stanford’s Medicine Plus Mindset Program
Stanford researchers, who have long studied the impact of mindset, trained 186 health care providers and staff at five primary care clinics in the San Francisco area with the university's Medicine Plus Mindset program, then shared the health care providers’ reaction in a recent report. While many training programs focus on helping health care providers empathize and communicate with patients, “I don’t know of any other physician training programs that are focused on helping physicians use patient mindsets as part of their clinical practice,” said Kari Leibowitz, PhD, a health psychologist in Amsterdam who did the research with colleagues while at Stanford.
The aim, she said, is training health care teams to “drill down” on some of the specific mindsets that help patients, such as understanding the diagnosis, as well as what they can do to improve their health outcome. Health care providers and their staff attended a 2-hour session to learn about the effect of mindsets on health outcomes and strategies for shaping patient mindsets in their office. They reported back at a 1-hour follow-up session.
The key areas, Leibowitz said, include a patient’s mindset about the diagnosis and illness, the treatment, the patient’s body and how they feel about it, and how they feel about the care team. Health care providers can impact all these areas, she said, and sometimes with very simple gestures or conversation. For instance: “When a physician is handing off a patient for a blood draw, [saying about that team member], ‘You are in great hands. She’s the best.’ ”
Training includes the entire office staff, she said, and it had a big impact on health care providers who were not doctors. She recalled one medical assistant who told the researchers: “It made me see how I am also part of the patient’s healing process.”
In Real Life: Patients Talk Mindset Shifts
In 2010, Jenn Powell, of Orange County, CA, woke up unable to speak or move. “I thought it was a stroke,” she said. An emergency exam and testing by a neurologist produced the sobering diagnosis: multiple sclerosis. First it was what’s called relapsing-remitting, with periods of relapse then recovery, and then it became secondary progressive, with the condition steadily worsening.
The pain and loss of mobility were big challenges, Powell said. And life couldn’t be the same, she knew. One mindset shift she made early on: “I am not going to Machu Picchu (a lifelong ‘bucket list’ dream). But I’m not getting rid of the bucket.” She also adopts what she calls a mantra for the day, when needed, such as: “My legs hurt. But I have them.”
When she got nervous about the need to start yet another medication, she decided to look on the extra medication as a gateway. “I didn’t know what that gateway was, but it was better than the roadblock [of the medications she was on not working well enough.]” Likewise, she used to frown on the need for any assistive device. “Now I see it as a tool to freedom.”
She’s also got new purpose: As a feature writer for Multiple Sclerosis News Today, part of BioNews, a resource for patients with rare conditions, she provides insight to others who share her diagnosis. “I was far more unhappy as a healthy, robust individual at 20 than I am now, at 55, with MS.”
The right attitude and mindset also help Steve, a Southern California resident who is 60-plus, deal with several diagnoses, including type 2 diabetes, arthritis, weight issues, and polycystic kidney disease. He asked that only his first name be used to protect his privacy. One major challenge is having multiple kidney cysts that must be treated.
On seven occasions, he said, “I’ve had long needles stuck into my side to drain multiple cysts in my kidney.” Under ultrasound guidance, the cysts are aspirated, and then injected with alcohol to make it less likely for them to return. His mindset: “I am beating the odds. I’m alive.” He also focuses on how lucky he is to have his health care provider, who he describes as a “top doctor.”
Change Your Mindset, Change Your Health?
One of the simplest strategies to improving our mindset, said Leibowitz, “is just to say out loud the mindset you are trying to adopt.” For instance: “This [diagnosis, treatment] is manageable. I feel bad now, but I will feel better later.”